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Hi. I'm new to this group. My name is Meg and I'm 47. I found out I

had fibroids at a " well woman " exam 1/30/04; also dx'd with iron-

deficiency anemia same day. Ultrasound 2/3/04 showed 16-wk-size

uterus, one 6 cm fibroid, smaller fibroids. Started on iron therapy

1/30/04 and technically not anemic 2/27, still improving on iron

therapy. Although menstrual flow had been heavier a year ago (on days

2 & 3 of 5 days) and I passed that off to being perimenopausal, it

was now slowing down to more normal for my age. Symptoms of

fibroids? Enlarged abdomen (thought it was due to 30-lb. weight gain

from migraine preventives), urinary frequency at nighttime, heavier

flow day 2 (change super pad every 3 hours) of 5 days but also days

of spotting only during those 5 days, very mild cramping w/period, no

symptoms rest of month.

I've had three gyn consults since early Feb. Two have been at the

prominent hospital where I work; the third was highly recommended at

an outside facility. All three recommended vaginal hysterectomy and

are quite skilled at performing vag hysts on women with a larger

uterus (particularly at my hospital from personal knowledge). Even

though I'm past child-bearing years, I am adamant about not wanting

to lose my uterus and do not believe in hyst unless absolute last

resort or cancer.

The first consult was in early Feb. at my hospital with male gyn

surgeon. We did not click. It was...uterus out, ovaries recommended

out " because you're over 45, " HRT, very easy recovery, on your way,

sex 'basically' the same, bye. " Didn't like him. Asked him indication

for surgery. Answer: size of uterus and anemia; still had anemia at

that time.

Second consult outside of my hopsital with great female gyn surg. I

was told by my family doctor that she would NOT recommend surgery if

it was not indicated and this is why he was sending me to her. She

recommended vag hyst, insisted I keep ovaries, said indication for

surgery was " size of uterus and anemia " (the anemia had resolved at

this point; perhaps she thought it would come back). She said

watchful waiting was okay, but conceded that many women find their

symptoms only progress, but hoped for the best in my case.

Third consult was three weeks ago with female gyn surg at hospital

where I work who comes highly recommended by all my colleagues (would

have gone to her first had I known). She went through checklist of

all my options with me, unlike other two gyns. However, she said she

believed myo was too risky (heavy bleeding) in my particular case,

even though she seemed open-minded to the idea for others; uterine

artery embolization (didn't feel this was well indicated for me and

also stated she did not feel it had enough of a track record " just

for now " in her opinion). She also discussed other non-surgical

options with me that she did not feel were appropriate (Lupron, etc.)

and agreed with watchful waiting now if that was what I wanted to do.

Advised me not to have surgery until I felt it was necessary.

I could tell they all truly wanted me to have the vag hyst,

especially the first gyn. The female gyns particularly encouraged me

to be certain that I WANTED surgery and it was the last resort before

I proceeded.

In the meantime, my family doc and neuro put me on Mircette low-dose

BCP to hopefully assist with literally disabling, severe, very

frequent hormonal (ovulation & perimenstrual) migraines. In five

years, prominent headache specialist/neuro has tried *everything*,

including Botox, acupuncture, all migraine preventives, estrogen

patch, nothing works to prevent. After five years of failed

treatments, classified disabled by neuro and family doc due to

migraines; off work for several months and very discouraged not

working. Feel life is literally on hold.

Called third gyn female consult, my favorite, about the Mircette

family doc had prescribed, as she and I had discussed at consult the

role of BCPs to reduce blood flow, stabilize estrogen level, ?help

with migraines. She said it would either work or make things worse,

depending if my migraines were solely hormonal. Within several days

on Mircette, I was in extreme, unrelenting migraine pain during a

time when I normally don't have hormonal migraines (week after

period). Called female gyn above and she said stop. Period came as a

result of stopping BCP just several days after last period. Spotted

first few days, then BANG last night went through a super tampon,

heavy flooded a very big pad at same time, and have to stay close to

home this morning. First time this has happened. Very discouraged,

fairly certain heavy bleeding last night and this a.m. was caused by

Mircette, not coincidence. I hope it stops soon, as things had been

going well on watchful waiting. I'm very scared this has set

something off.

Most disabling diagnosis is extremely frequent hormonal migraines,

started age 42, never before. Developed into chronic daily headaches.

When I started iron, three years of daily headaches went away (found

out frequent headaches symptom of anemia). Migraines are literally

disabling; disabilitiy would never have been recommended or okayed by

employer if this was not the case. I do not want disability, but

cannot work. Migraines are *ruining* my life, my DH's life, teen's

life, marriage, family life (no one handling my not being a

physically active or entertaining " Martha " very well), life

on hold. Trying to stay strong but this is so hard. I take pain

extremely well, rarely complain, but am wearing quite thin after 5+

years with no help, outside opinions, etc.

None of the gyns or neuro say hyst will " cure " migraines. Can go

either way, stay same, even worsen. I didn't think it could worsen

until experience this month with Mircette low-dose BCP. It took away

my *only* no-migraine week of the month.

I resolved long ago to find a cure for my hormonal migraines that

waste away 2/3 of my month, (daily headaches " cured " with iron), that

my cure might come with menopause. No signs of menopause yet. Still

hoping I can do watchful waiting if little symptomatology returns

after this bad BCP experience this week.

I am not oppposed to myo or UAE, but do not want to have these

procedures. Don't want to have hyst as I adamantly believe a uterus

(not to mention ovaries) should only be removed as a literal last

resort with no other options. Hoping HIFUS may help if/when it

becomes available. Also hope medical therapies (raloxifene,

asoprisnil) may help, but fear FDA approval too far off.

Basic force " driving " me to have vag hyst are (1) knowing three gyns

said it was the best thing *and* family doc keeps reminding

me " you'll feel so much better " ; (2) DH thinks hyst is " worth the

gamble you'll at least possibly get rid of the migraines " (!); (3)

just generally feel pressure knowing I am disabled from working and

feeling that I'm not moving forward.

So sorry this is long. Felt I had to introduce myself and

circumstances. So glad I found this group. If any of you have

opionions, I'm very accepting of even very frank remarks, so are open-

minded to all. Thanks so much.

Meg

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