Dr. Goldstein in NYC; cons and pros

[Guest guest]

I just went to the nuff website doctor-mention list to see if anybody other than

me had ever reported any experiences with Dr. Goldstein in NYC and I see

that he is NOT on the list, and I cannot find any post in which I mentioned his

name. I was sure I had, but perhaps not, so I'll tell some back history.

I'm a 49 year old NYC-ex-fibroidian (had 2 myos, one in 1985, one in 2003).

When I went to see Dr. Goldstein for my first visit, in 1985, I had no symptoms

of having fibroids and my previous gyno had not ever mentioned anything about me

having them. Dr. Goldstein told me that he felt something on my uterus, that he

would have thought was fibroids, but if my checkup a year earlier did NOT find

them, it was unlikely to be fibroids, due to the size. (Unfortunately, the

doctor who had 'missed' seeing, or mentioning the fibroids, was the

teacher/mentor of Dr. Goldstein, and even though I suggested that I had switched

doctors because I thought the previous guy was losing his competence and I

didn't trust him, Dr. G. had total respect for previous doc, so based his

diagnosis on the fact that these must have grown in the past year.) He thought

it might be a cyst, or something else (I forget what and don't have good records

from those visits).

As it turned out, it didn't matter. He recommended a laparoscopy, under

anaesthesia, to check out what was growing inside. He said he might be able to

remove whatever needed removing by laparoscopy, but might need to convert to

laparotomy (bikini-line incision), which is what happened. He removed about a

dozen fibroids, and a handful of polyps too. He was very careful to reassure me

in advance (without my needing to ask) that whatever it was, it was extremely

unlikely to be cancer. And neither of us ever mentioned hysterectomy as an

option. And, naive and uneducated about all this as I was, it didn't occur to

me that that might be an outcome.

I was 30 years old at the time, single and childless, and I presume that he felt

it was important to protect my fertility. In fact, after the surgery, he told

me that he saw no reason I couldn't have successful pregnancies, and deliver

vaginally. I never met the man to have kids with, and while I considered it,

decided not to attempt single parenthood. So we'll never know if I could have

conceived/carried a pregnancy/had a vaginal birth. He did encourage me to try

to have any children I wanted soon, because the fibroids were likely to grow

back, as they did.

At the time, he accepted the insurance I had (Blue Cross, I think) so my costs

were minimal.

Jump ahead 18 years to 2003. I am on different insurance, so I have not gone

back to Dr. G. in years, and he no longer accepts any insurance. But I realize

that the fibroids have regrown to the point that I need surgery again, so I go

back to Dr. G., asking for another myo. He recommends hysterectomy. I

politely state that I understand that is the usual treatment for somebody of my

age, but it's not what I want. I have done much reading and am concerned about

various possible consequences of H. and I want a myo. He agrees to a myo, with

the warning that " I might need to convert to a hysterectomy if the bleeding

becomes too much " . I ask him how likely this is; he agrees it is very unlikely.

I ask him how often this has happened, and he says it's been over 20 years since

he has had to convert to a myo. (But I also believe that with the pressure he

exerts for a hysterectomy, unless somebody is as educated as we become through

this list and extremely assertive, most women will

succumb to his pressure and agree to allow him to perform the H. So I wonder

how many times he has attempted a myo on women with fibroids as massive and

numerous as mine.)

He says he wants me to take Lupron. I tell him all the reasons I don't want to;

he insists that none of his ladies have had problems with Lupron. (He also

insists that NONE of the many women he has performed a hysterectomy on has ever

had any negative sexual side effects. And he DOES ask them 6 months later.)

Side point here; to the women discussing Lupron. Many of us who are afraid of

Lupron are more concerned about the possibility of long-term side effects,

especially the bone-density loss, than we are about the short-term menopause

effects during the actual period the Lupron is in our systems.

So I give in, and agree to the Lupron and schedule a date for surgery with Dr.

G. He tells me he'll try to give me just one shot. I figure one shot is better

than 3. I come back in about a month later for my Lupron shot. He CONTINUES

to tell me why he thinks I should have a hysterectomy. I firmly tell him that

my mind is made up. I also tell him that since he does not accept any insurance

now, and I need to spend quite a bit of money out-of-pocket, I am only coming to

him because he is a specialist in myomectomies. I tell him that IF I were going

to have a much simpler hysterectomy, I would go to somebody who does accept my

insurance, and trust them to handle it successfully.

He continues to recommend H, but agrees to a myomectomy. But by the time I

leave his office, I'm too worried that his 'better judgement' will convince him

to convert to a hysterectomy during the procedure. And, in retrospect, what

appeared to be 3-5 fibroids turned out to be OVER 40 fibroids. I'm very

skeptical that he would have given me the myomectomy that I wanted.

I know I've just said lots of negative things about him, yet..........when I did

have my 2nd myo, performed by Dr. Stanley West, he told me after the fact that

he was impressed by the lack of adhesions from the first surgery; that my

previous surgeon was obviously very skilled.

Dr. West charged $12,000; Dr. Goldstein quoted $7,500.

Do I think Dr. West is the best? Yes.

But if you have to go out of pocket, AND you're young enough that you can

convince him you want to preserve your fertility (even if you have to lie about

that), I would still recommend that somebody consider Dr. Goldstein. It seems

that he is great at myos, IF he thinks a woman deserves one. Is this my ideal?

No. But we see that many doctors are willing to do myos on younger women, but

only want to perform hysterectomies once we pass 40, or whatever they consider

the end of childbearing age.

Have any other women here been patients of Dr. Goldstein? I'm curious to hear

other people's experiences.

Also, thanks for the links to the 1st MeetUp photos.

R.

[Guest guest]

Dear : Thank you for posting your experience. Although I don't have exp.

with Dr. Goldstein, I do have a similar situation with NYC doctors. I am

also being told that at my age, 48, I should have a hysterectomy because I'm

basically " not using my uterus anymore " , a somewhat insulting way of viewing our

anatomy, don't you think? I still get my period, granted I will probably go into

menopause in 1 to 3 years, I'm not fond of " tossing my uterus " like a piece of

unwanted garbage! Some history: I have been diagnosed through MRI/CAT scan, a

large fibroid & possibly a few smaller ones as well. They have retroverted

(tipped) my uterus a good deal more than my normal angle and are putting

pressure on the rectal and surrounding areas causing constipation,etc. I have no

unusually heavy bleeding (my periods have always been heavy), nothing unusual in

that way at all. What complicates the issue is that I have a congenital

Mullerian uterine anomaly which basically creates 2 uterus divided by a septum,

2 cervix fused as one into a figure 8, and had an obstructed/double vaginal area

as well (surgery for the vaginal thing was performed in 1976 so I could live a

" normal " life, but the rest was left intact. Told I would never give birth due

to this anomaly, I defied the odds and actually delivered via C-section in 1991,

a wonderful daughter. In 1994, I had a bilateral mastectomy due to breast cancer

and am thankful that I am cancer free to this day. Timing is Everything!!!

OK that's the history: Now, I've got this fibroid situation and I just don't

want to do a hysterectomy! I've seen 2 doctors at NYU Medical Center in NYC (I

live in a nearby suburb) and like your experience, our age seems to dictate this

automatic Hysterectomy. In addition, like you, I am arguing for a myomectomy but

so far, they say it's pointless. To Who? Certainly not to me. , was it

difficult to get Dr. West to agree to the myo? Did he argue the hysterectomy

point with as much conviction as Goldstein? I have spoken with Dr. Porges from

NYU, a very experienced older gentleman, who just won't view me as a myo

candidate due to my age! He actually referred to my feelings about losing my

uterus as " sentimental " . According to the research I've done to date, it's a bit

more than sentimental issues I'm talking about! By the way, I agree with your

feelings about the Lupron as well and would have made the exact same choice that

you did. Would it be as difficult for a man to argue about keeping his

reproductive parts (provided there is no cancer involved), if he is " beyond his

child-fathering years " ? Suffice to say, I'm ready to confer with a few other

doctors who may be more sensitive to my feelings regarding hysterectomy.

Anyway, are you happy with your ultimate decision? What is your prognosis, etc?

Had you considered UAE as an option? I'm concerned about the risk of infection

from unexpelled fibroid tissue and of the possibility of one of those PVC

pellets traveling to an ovary or lodging in & blocking enough blood flow to make

me go into full blown menopause anyway or at the worst, emergency hysterectomy

due to infection! My anomaly also plays a major role in any procedure as the

doctor would have to be very skilled to work around it. I believe that's why

they just want to remove the whole thing, because it's easier. , I pride

myself on being a well informed woman and am quite used to being my own

advocate, but I'm so upset, confused, & frustrated by this insistence upon

hysterectomy when there are other viable options! I was so encouraged by reading

your e-mail. As someone who shares this " age " thing with me, it certainly makes

a difference with the treatment options being offered to us! I really need a

doctor who understands the true implications of hysterectomy and why there are

women who may not want that as their preferred method of treatment. , thank

you so much for sharing your story and if I should hear anything about Dr.

Goldstein, I will be sure to pass it on to you. Please feel free to

contact me through my e-mail or the uterinefibroids web site. Sincerely, Janet

Pike

Dr. Goldstein in NYC; cons and pros

I'm a 49 year old NYC-ex-fibroidian (had 2 myos, one in 1985, one in 2003).

But if you have to go out of pocket, AND you're young enough that you can

convince him you want to preserve your fertility (even if you have to lie about

that), I would still recommend that somebody consider Dr. Goldstein. It seems

that he is great at myos, IF he thinks a woman deserves one. Is this my ideal?

No. But we see that many doctors are willing to do myos on younger women, but

only want to perform hysterectomies once we pass 40, or whatever they consider

the end of childbearing age.