Myo on October 7 - long post

[Guest guest]

Dear all, I am so grateful for this group and all the information

shared here. I feel very ready for my upcoming myo and well-informed

from all that is here in the posts. Thanks Carla for starting this

group and for your book!!!

I have 5 fibroids, sizes 2 to 3 cms and one is 5 cms,plus too many

little ones to count, most of them intramural. My uterus is 4 times

normal size. I had excessive problems with bleeding in July to the

point in 3 weeks my hemotocrit went from 35 to 19 and I then had to

have a transfusion (2 units). Since then I have been on prometrium

to stop me from having any period and it is working well, except for

after I had my pre-op exam with my gynecologist and started bleeding

profusely. I have upped my prometrium and that has seemed to slow

it down. I have had no other effects from the prometrium. My

history is ongoing heavy bleeding problems for the last three years,

managed through chinese medicine and acupuncture, which really seemed

to be working, until this July. I had a previous myomectomy in

September of 1992, removing 9 fibroids, (on the outside of my uterus).

Reading through the questions others have posted here has been really

helpful. I printed out 's questions from December and used them

as a baseline for my pre-op with my gyn.

I am scheduled for a laparotomy myomectomy with horizontal bikini

incision.

My gynecological surgeon comes highly recommended and is rated in the

top doctors in Seattle by her peers. Her name is Mihalov at

Virgina Mason. I was very impressed with my first meeting with her,

she laid out all the options, including UAE and long term

progesterone therapy (one I hadn't heard of such as Prometrium). She

never pushed me to have a hysterectomy and has really heard me when I

said I did not want to have a hysterectomy. We talked about possible

complications that could lead to hysterectomy and other ways to deal

with them without hysterectomy. Such as adenomyosis (take out as

much as she could and leave the rest), excessive bleeding (using a

Interventional Radiologist). We discussed the possibility of cancer

and what she would do. I told her I did not want a hysterectomy if

there was cancer, that I wanted her to close up and make sure first.

I did ask her to remove an ovarian cyst and if it was cancerous I

wanted her to take out the one ovary. (this is due to the fact that

my best friend has been diagnosed with stage IV ovarian cancer --

which is very hard to detect until it is very far along.) I would

recommend to all woman to research the symptoms of ovarian cancer and

to be tested immediately if you suspect it.

I was able to amend consent forms with no problem from my doctor.

There are only 2 consent forms I had to sign.

Where I started to get into roadblocks in my pre-op appointments was

after I talked to my doctor (who I had a great visit with), when I

was dealing with assistants and a resident anesthesiologist.

First I had a woman tell me there was no way I could see a fibroid

after surgery as they all had to go to pathology! Next I was told

by a resident anesthesiologist that there was no such thing as saving

your blood during surgery (cell saver) as well as that my husband

could not come up to the pre-op/induction area before I went into

surgery. This along with the fact that I could not have acupuncuture

during surgery and in the recovery room made me extremely angry.

I decided that I would go straight to my doctor to work things out.

I called an assistant of hers, who I had been working with, and left

my message about the above. She assured me that I could see a

fibroid, that Dr. Mihalov had done this for other patients before.

She told me I had the right to have one person go up to pre-

op/induction with me. She also told me I could have my husband stay

overnight at the hospital with me, even if it was a double room, they

might hassle me, but could not kick him out. She is sending me a

copy of the federal patients bill of rights (which is more

comprehensive than my hospital's bill of rights). Also I am getting

a copy of my doctor's notes about what we agreed upon.

I can not do anything about the acupuncture during surgery as doctors

have to be on staff to be in those areas. I did arrange with my

naturopath/acupuncturist to put in small needles before I went into

the hospital and he is also going to come to my hospital room after

surgery. I have had such success with acupuncture for many problems

and I know the power of it and hope that it will help with the pain

and to clear the anesthetic out faster.

I was leaning towards an epidural as it sounded like less nausea than

with general (I have always had pretty intense nausea with general

anesthesia). Now I am having second thoughts about epidural as I have

heard some horror stories about the intense headaches you can get for

2 to 3 days if they hit the spinal fluid by mistake. Anyone have

this complication? (I have been reading through the archives and

have not found info on the headache with epidural). I know they do

have much better medicines for nausea now than they used to. (My

friend with ovarian cancer has had very little nausea from the chemo

due to the drugs she is taking).

My actual anesthesiologist will not be known till the day before

surgery so I am going to call to talk to him/her ahead of time and

confirm as much as possible what she/he will do. Talking to the

resident was helpful to a point, but she was only giving me general

information.

This is a teaching hospital, so I did confirm that my surgeon will do

most of the surgery though she will have a resident helping. I trust

her to keep a good eye on the resident!

With either an epidural or general my surgeon will give a nerve block

at the incision area before opening me up (with Marcane - sp?).

Bikini incision, separate the muscles, pull uterus out on top to work

on it.

I will let you all know how it goes. Any

comments/suggestions/questions are welcome.

Robyn A.