your scheduled myomectomy

[Guest guest]

Candace,

I've forwarded your last post to a gyn at UCLA. I may not get a

response until Monday, however, and am extremely concerned about you in

the meanwhile. I think the level of detail on surgical technique and

materials you are asking about contains highly individualized

preferences among gyn surgeons and is going to be terribly difficult for

you to discern appropriately on your own or with the advice of any of

the women on this list group. Any one person's commentary to you about

their own myomectomy surgery would be purely " anecdotal " and probably

not completely relevant to your own situation. (Any gyns on the list

group care to speak up here????)

I would say that you posted many things about your discussion with your

gyn that would give me reason to think that she is truly interested in a

positive outcome that is suitable to your desires to retain your

uterus. The 1% statements are wonderful. This is the minimum

requirement for informed consent -- she can't very well guarantee you of

retaining your uterus -- there are always unknown risk factors that

could occur. But just by saying this tells me that she has no intention

of performing a hysterectomy. I am a little concerned about the consent

form you signed, however. Does it contain a statement indicating that

hysterectomy will only be performed in the case of life-threatening

emergency? If not, it should. Even if you have to hand write it in.

I am also concerned about the fact that your gyn has only done 2 supra

cervical hysts and that she balked over this type of hyst. Verbal

agreements mean nothing, BTW. (Sorry, I prescribe to the " trust no one "

side of medicine.) Signature on a document means a lot. Words spoken

aloud and not documented are soon forgotten and mean nothing during

surgery -- or a court of law. You have a right to specify retention of

your cervix. If she doesn't want to do it, that's her problem and

something that, I would think, might give her a reason to refer you to

another gyn who will do as you wish in this regard and do so competently

with confidence. Provided that it's even necessary, that is. Hopefully

it won't be. Even so, you should place your cards with the player who's

going to follow your desires from square A to square Z. Not with one

who is going to Rambo through the surgery with what is best for THEM and

not YOU.

Did you ask your gyn specifically how many myos she has performed in the

last year? The last month? vs. how many hysterectomies? Did you ask

how many myos she's performed that have turned into hysterectomies?

Critical questions that can give you strength and confidence going into

this surgery -- or make you cancel and start looking for another gyn

immediately. You might want to call on Monday and ask. When you do,

you might also want to ask about how to void the previous consent form

you signed and how to go about signing a new one with any items you want

to add or change. Just a thought.

A conservative approach to the ovaries is reasonable. You should ask

her about any potential change in her game plan should she find

something unusual with the ovaries. I think by leaving the ovaries

alone, they do often " bounce back. " However, dealing with them can

sometimes present a new host of problems. It's a catch-22 on the risk

factors here and much depends on what the doc sees when she does the

surgery.

The tummy tuck is unusual. But not unheard of. It also happens to be

another line item that your gyn can bill separately for when they submit

your insurance claim -- and since it's cosmetic it can be rejected by

your insurance. You should check on this. If you don't want it, say so

to your doctor and write it in on the consent form.

BTW, in cases of emergency bleeding, an interventional radiologist can

use gelfoam to stop the bleeding through embolization. This is uterine

artery embolization -- but with a temporary embolic agent that is

absorbed by the body after several weeks. It's been used for over 20

years for uncontrollable post-partum bleeding. I know you already

donated your blood for possible transfusion, but it still doesn't hurt

to ask your gyn if she knows about embolotherapy and if there will be an

IR on call in the hospital the day of your procedure. At least open the

door of discussion regarding extensive bleeding and how it will be

managed.

Hang in there. As for other people telling you what to do or not do....

it's so hard on us when the people who are near and dear to us don't

understand the dilemma of our decision-making with surgery. Just

remember one thing -- THEY don't have to live in your body after the

surgery, YOU do. Ask them what they will do should this surgery turn

out bad and you end up without your uterus and with a whole host of new

problems. It happens. Ask them how they will support you and help you

if it happens to you. Confidence in your surgeon and the choice you are

making is critical. Would they want any less for themselves if they

were looking at surgery?

Go with your gut instincts Candace. If you feel you have all the

information you need to make a decision and are still uncomfortable with

the decision you are making, then I would be highly concerned about

going forward and doing something that you are not ready for just yet.

But only you know your body and what you can and cannot handle

physically, mentally, and emotionally with your uterine fibroids.

Uterine fibroids aren't generally life threatening and any surgery is

considered elective. It's hard when fibroids are destroying us a little

bit each day and consuming so much of our lives, but sometimes taking

the necessary time to get additional surgical opinions can be a source

of confidence building in making a decision.

Best wishes to you,

Carla Dionne

mailto:cdionne@...

http://www.uterinefibroids.com

/list/uterinefibroids

" Never doubt that a small group of thoughtful committed citizens can

change the world. Indeed it's the only thing that ever has. " Margaret

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