Re: Please help, need advice

[Guest guest]

Hi Nikhil

All the best for your friend's operation.

Fibroids can come in all sizes and it's not that uncommon for

doctors to find patients with very large fibroids or numerous

fibroids. Sometimes a sizeable fibroid can be hardly

symptomatic, while a small fibroid can cause all sorts of bad

symptoms: it depends on type and location. Surgery is a very

common treatment approach. It sounds as if she'll be having a

myomectomy, where the uterus is retained to preserve fertility.

She should tell the surgeon that she wants to have children in

the future, so that they take that into account in the treatment

approach (Even if she is single now).

She should have had an ultrasound test of one sort or another.

This gives a lot of useful information on the fibroids and any

other potential problems, such as ovarian cysts, polyps and

endometriosis that can sometimes occur in combination with

fibroids. Sometimes a cyst may just be a normal menstrual cycle

cyst showing up on a scan.

In my case, (In addition to an external ultrasound) I had a

physical examination and was asked questions by both the GP

and gynaecologist. Some kind of smear/swab test was taken

and blood was also tested.

Some surgeons are happier with the myomectomy operation

that others. A doctor who is confident about the operation, has

performed many successfully and who rarely has to transform

myomectomies into hysterectomies is a good bet. They are duty

bound to warn patients of the potential risks of surgery that in

practice may rarely happen. In the case of the myomectomy,

some of the risks include post operation infections, the need for

a transfusion, the possibility of adhesions with a lot of surgeries,

and a myo turning into a hysterectomy.

You could ask the surgeon how many myos he has

performed/typically performs, how often they require transfusions

in his cases, how to avoid post op nausea occurring, would it be

possible to contact them with questions the GP couldn't answer

when out of hospital? How often are their myos converted into

hysterctomies and how high a probability is it that this will

happen here?

There are also different types of hysterctomy.

The ones to avoid are those who are very negative about all

options other than the hysterectomy and who seem to be using

scare tactics that don't ring true (It happens sometimes when

surgeons are practiced at hysterectomies and not

myomectomies, or uninformed about treatments). If anyone talks

of cancer, she should ask them if they are talking about general

national statistics or specifics of test results because fibroids

are NOT cancerous and very very common, compared to cancers

of the womb, which are statistically very unlikely here.

A good way to work out whether the advice given is sound is to

ask lots of questions, to establish what the doctor's reasoning is

when they discuss treatment options and risks. As patients we

can then compare that against what fibroid books and websites

say.

It's important to note that there are occasions when hysterectomy

IS the right course of action. Patients therefore need a doctor

they can trust.

Shrinking drugs have their pros and cons and some women

aren't given these. I wasn't prescribed any for my 8cm fibroid

mass. Apparently sometimes the shrinking drugs can have

unpleasant side effects and small fibroids may shrink so they

are not spotted, only to return to their previous size after surgery.

It may be that your friend's doctor considered they wouldn't be so

helpful in her particular case.

Your friend can discuss the ground rules with the surgeon about

trying to retain her fertility, and safeguarding her health before

her operation when signing the permission forms.

Uterine Artery Embolisation (UAE) is sometimes performed

before a later myomectomy surgery, when appropriate.

< is there some website where I can

get information about prognosis for patients with this type of a

fibroid (need for a hysterectomy).>

There are various excellent websites on fibroids, but ultimately

the experience of your surgeon in performing myomectomies is

the real indicator. Check out the internet bookellers (and

sisterhood network's site) for the best selection of fibroid books.

Try web surfing the sites of Dr Indman, Dr. , Dr. Toaff and

Dr. West for more information on these operations and fibroids

generally. A lot of great sites will come up from web surfing the

links and basic keyword searches. The fibroid and fibroid related

forums usually have archives. (Keep paging back as they may be

grouped by month.)

With the myomectomy, there is a possibiity that the patient will

get fibroids again at some time. They may also need a Cesarian

Section if they have kids. It's possible to have ore than one

myomectomy or other fibroid treatment approach in your life.

I hope that helps

Aztek

[Guest guest]

You or she needs to take the situation into your own hands!!!!!!

How could she just be so passive about this situation?????

Questions need to be answered. The facts need to be straight.

What kind of fibroid does she have? Where is it located but more

importantly, what are her symtoms? How big is the fibroid??????

These questions will help to determine the kind of treatment she

should get. You can't just let it be up to the doctors!!!!!!!!!!

Most gyno's will route you towards a hysto!!!!!!!!! This should be

the very LAST RESORT!!!! Find these answeres and start researching

your obtions.

Jen

> A very close friend of mine has been diagnosed with a very large

> uterine fibroid(fundal origin). She is going to undergo surgery at

> the end of this month. The surgeon says that depending on what

they

> discover during surgery they will have to decide whether a

> hysterectomy will be neccessary or not.

[Guest guest]

she needs to tell the doctor of her wishes to have

children and refusal of a hysterectomy...if he cannot

do what she wants then she needs to see someone who

can

--- Nikhil Parelkar niksjoint@...> wrote:

> A very close friend of mine has been diagnosed with

> a very large

> uterine fibroid(fundal origin). She is going to

> undergo surgery at

> the end of this month. The surgeon says that

> depending on what they

> discover during surgery they will have to decide

> whether a

> hysterectomy will be neccessary or not. However no

> medication has

> been prescribed in order to cause any kind of

> shrinkage prior to

> surgery. My friend is extremely stressed cause she

> has no kids and

> has always talked about having kids. I know that it

> is not possible

> to get any definitive answers but is there some

> website where I can

> get information about prognosis for patients with

> this type of a

> fibroid (need for a hysterectomy).

>

> THANKS

> Nik