Re: concerned husband

[Guest guest]

Hello Hal,

It is so good of you to help your wife by investigating all you can about

fibroids for her. Here are some things you will need to know before her

next doctor apt.

There are three types of fiborids. It is important to know which types she

has.

1.Subserosal fibroids= grow on the outside of the uterus wall and may press

on surrounding organs such as the bladder, bowel, and nerve bundles.

2. Intramural fibroids= grow in the uterine muscle wall. They can push

themselves toward the outside of the uterus or toward the inside of the

uterus's endometrial cavity.

3. Submucosal fibroids= grow within the uterine endometrial cavity. These

are usually the cause of heavy bleeding and clotting.

All fibroids can cause pain. But not all fibroids will alter a woman's

menstrual flow. It is important to ask about which type your wife has as

well as which tests she needs to have to find their location.

Tests:

Abdominal Ultrasound= This is the basic test that many gynocologists perform

first before any other tests are ordered. It can be done together with an

intravaginal ultrasound during the same appointment. Jelly is applied to

the woman's abdomen and a scanning instrument is moved across her uterine

region. This can give the doctor some idea of how large a fibroid may be as

well as its location.

Intravaginal Ultrasound= This is a vaginal instrument that is inserted up to

the cervix. It can get a better look at the endometrial wall of the uterus

as well as the tubes and cervix than the abdominal ultrasound.

Saline Sonohysterogram= This is an in-office test. Saline solution is

injected through the cervix into the uterus. An intravaginal ultrasound is

performed. The doctor can see in the uterus and can tell if there are any

unusual growths.

Hysteroscopy Exam= This is an in-office test where the doctor inserts saline

into the uterus again, but this time a small 3mm scope is also inserted into

the uterus. This test gives the doctor a much better look at the

endometraial wall. If your wife has heavy bleeding and clots this test

should be one to ask about with her doctor.

MRI= This test can give a doctor a good look at the entire uterus's

structure. It can give a gynocologist an idea of where a woman's fiborids

reside as well as the arteries and veins.

There are many different choices of treatment available today depending on

where the fibroids reside in the uterus.

Treatments and surgeries:

Medications:

Birth control pills are prescribed for those women who aren't surgery

candidates or have small fibroids that have minimal symptoms.

Lupron Depo= This is a shot that is prescribed to shrink the size of

fiborids. It is a once a month shot that puts a woman into a false state of

menopause. With such low levels of estrogen, the fibroids often shrink. It

is not recommended for long term use (over 6 months at a time) and will not

stop the fibroids from continueing to grow after the shot therapy is

stopped. This drug is used primarily to shrink fiborids before a surgery so

that they are more operable and will lose less blood during the procedure.

There are many more drug therapies available, each treatment is specific to

the individual woman's case.

Surgeries:

HYSTEROSCOPIC RESECTION= A day procedure with minimal pain and discomfort.

The surgeon removes submucosal fibroids with electric impulses in a vaginal

procedure. This is done with either an epidural or general anesthetic.

Sometimes this procedure has to be performed more than once if the woman has

very large fibroids.

D & C= This is the scraping of the endometrail wall. It is usually performed

to smooth out the endometrail lining so that the woman's chance of getting

pregnant increases.

LAPAROSCOPY= Several small incisions are made in the belly button or the

bikini region. A small instrument is inserted and small fibroids

(subserosal) can be removed. This is not commonly used for fibroid removal,

it is more comonly seen with women who have endometriosis.

ABDOMINAL MYOMECTOMY= This is a major surgery that is used for intramural

and subserosal fibroids. It is recommended when fibroids are symptomatic

and too large to be removed via laparoscopy. Fibroids are removed through

a larger bikini incision in the abdomen.

UTERINE ARTERY EMBOLIZATION= Small clots are inserted into the main artery

that supplies the large fibroids to block their blood supply. This surgery

is not recommended for women who want to conceive and carry a full term baby

in the future. Most fibroids that have embolized arteries will shrink or

die away.

HYSTERECTOMY= Depending on the doctor, this surgery is becoming less and

less popular. Preservation of the uterus has become the challenge these

days. But some women have such large fibroids that are inoperable they must

have a hyst to improve their health. Some large fiborids can be hazardous

to remove by myomectomy because they lose too much blood during surgery. A

risk of hemorrhaging is very high. Also those women with multiple uterine

problems may have to have a hysterectomy to resolve their issues. But hysts

come with their own side effects too due to the loss of the uterus and

sometimes the ovaries as well.

This is simply a sum-up of what we discuss in this forum group. There are

more options available to women, but not all are available in every

location. You said your wife down plays her condition. That is very

dangerous, although many of us here do the same thing. Unfortunately,

ignoring fibroids can lead to anemia and complications of the surrounding

organs of the uterus. Your wife really needs to take the time to get

serious about her health. The longer a woman waits to seek treatment, the

larger the fibroids can grow and become symptomatic.

We are glad you found this group, we hope it will help you and your wife

learn about her choices for treatment. Please don't feel like you have to

take one doctor's opinion to heart. There are many differing opinions out

there, so seeking a 2nd and 3rd, or even more opinions is important. Many

women here see Reproductive Endocrinologists, even those who are past their

years of pregnancy. This might be the type of doctor your wife needs if she

wants to avoid hysterectomy, however there are many wonderful gynocologists

who are highly skilled in performing myomectomies and UAEs.

Good luck to you. Please let us know how you and your wife are doing.

Best wishes,

Sonja

[Guest guest]

Sonja,

How kind of you to put together such a thorough post to help out.

I'm sure lots of ladies will find that post a great resource.

I do want to challenge one thing you mentioned, though. You said:

> HYSTERECTOMY= Depending on the doctor, this surgery is becoming

less and less popular. Preservation of the uterus has become the

challenge these days. But some women have such large fibroids that

are inoperable they must have a hyst to improve their health. Some

large fiborids can be hazardous to remove by myomectomy because they

lose too much blood during surgery. A risk of hemorrhaging is very

high. Also those women with multiple uterine problems may have to

have a hysterectomy to resolve their issues. But hysts come with

their own side effects too due to the loss of the uterus and

sometimes the ovaries as well.

Dr. Stanley West mentions in his book The Hysterectomy Hoax, that no

fibroid is too large to remove via abdominal myomectomy and fibroids

alone are not cause for a hysterectomy. He uses a drug called

Pretissin (forgive me if I've spelled that incorrectly) that reduces

the bleeding during a myomectomy to the point that very few women

lose much blood. If the doctor that a woman is seeing is saying

that she'll lose too much blood during the procedure Dr. West

recommends that she find a new doctor that is more skilled at

perforimg the operation.

Thanks again for taking the time to help out so many.

Giselle