The Gory Details (aka The End of a Career)
So, you really want the gory details? OK! After a 30-year, mostly unproductive career, my uterus will be taking permanent retirement via hysterectomy next Wednesday.
I say "mostly unproductive," because rather than doing nothing, like I intended for it to do, it's been brewing fibroids. More on that later.
Here's the e-mail I sent to my support squad (family & friends):
[If you got that e-mail and want newer, more fun information, here are some sites I found helpful:
Referential measurements for fibroids
http://www.geocities.com/tiggernut24/Fibroids/MeasureFibroids.html
A hospital site with VERY graphic pictures
http://www.jeffersonhospital.org/obgyn/article9361.html
A support site with good articles. Requires membership to post, but not browse.
http://hystersisters.com
There are tons more, but I've got to get after other things!]
... after a prolonged, but not necessarily hateful battle with my uterine fibroids, my Dr and I have decided that a hysterectomy is the best option. After seeing to 3 doctors and talking to/reading from others "in the know," I will be having a laparoscpic procedure on Wednesday 6/4 at noon (by Dr. Carl Giesler), unless it gets bumped up earlier in the day. The surgery is at St. Luke's Episcopal Hospital in the Medical Center and I will be staying overnight.
That's the short version. As for more info, requests, etc:
- This is clearly not a secret, so if it comes up or anyone asks feel free to share. There is actually a limit to how many addressees can go in one e-mail!
- If you are in town and can spare some time in the next few weeks, I will be needing some assistance with driving and meals and such, and would love to press you into service if you are willing. The lovely and phenomenal Amy Winstead is coordinating that effort. If you are able to assist, please contact her at [info deleted]. None of us has food allergies, but we are lactose intolerant, so easy on the cream & cheese, please ;-} !
- Who is "we," you ask? Of course, my Mom is coming down on Sunday. My middle sister, Janessa will help her out from Tuesday through Sunday, and then my baby sister, Alexa will come over the weekend and stay for a week or so, by which time Mom and I ought to be ok on our own. I don't think any of them will be doing any driving-- they've been here before and their families want them back in one piece.
- Can I visit? Likely not in the hospital, as I don't plan to be there very long. We'll see how I do at home. Call the house and "my people" will let you know the 411. [info deleted]
If you have more than enough information, STOP READING NOW!!! I mean it. Here's where it gets gross and/or TMI. But I know some of you will or have asked these questions, so better to answer them in one place. Really, if you are tender of stomach or easily embarrassed, stop reading. If I left something out, feel free to ask. I am a veritable font of gynecological information by now.
****
******
**********
OK you were warned.
Why hysterectomy?
- It is the only permanent cure for fibroids, short of menopause, to which I am not sufficiently near enough to be useful. There are other procedures (embolism, laser, hormones, surgery to take out the fibroids only); either I am not a candidate for them for one reason or another and/or they are not permanent.
What are fibroids?
- Benign tumors of muscle and connective tissue that are present in most women. They can be so small as to be unnoticeable, or very, very large. There have been reports of single fibroids upwards of 10 inches across. The stats say that 25-40% of all women have symptomatic fibroids of some sort (pain, pressure, excessive bleeding, bladder and rectal issues, nerve impingement), and at autopsy, nearly 77% of women were found to have fibroids. They feed on estrogen, and sometimes they grow fast and sometimes slow. They are hardly ever cancerous.
Why do fibroids happen?
- Why not? I guess it's what happens when nature gets bored. Uteri were meant to produce humans, so maybe this is weird uterine wish fulfillment.
Why YOU for hysterectomy?
- I have several large fibroids, ranging in size from a tangerine to a softball. One is even attached to the top of my uterus by a stalk (pedunculated). All told, they have occupied my uterus to the point that it is the size of a 16-18 week pregnancy (now you know what I'd look like 4-5 mos. pregnant-- just the same. But I can feel them. Not so much fun).
How is it being done?
- There are basically three ways. Old fashioned "open" abdominal, kind of like a C-section, Vaginal (remember the old joke about the OB/GYN who goes to auto repair school for fun and repairs the entire engine through the tailpipe?), or laparoscopic, where the surgeon uses instruments inserted into holes or "ports" in the abdomen. I'll take #3, Alex, for the win.
How do you take it out through small holes?
- It gets cut up (de-bulked) with a morcellator, and the rest is done through the uh, tailpipe.
How long is the surgery?
- He says around 2 hours if there are no problems.
Problems? What kind of problems?
- The usual and very rare ones that could happen anytime one goes in for abdominal surgery; organ injury, bleeding, etc. Panic not.
What about your ovaries?
- Staying as long as they look good once the Dr. gets in there.
Will you go into early menopause?
- Not if my ovaries remain unmolested. It is possible that I will go into it earlier than I would have otherwise, but not significantly.
Sooooo, does this mean no babies? You ok with that?
- Yes, this means no babies of my own flesh (other than my amazing nieces and nephews). Yes, I'm quite ok with that. No periods either. BONUS!
What about your vocal cords?
- My surgeon has specifically requested an anesthesiologist with good experience in this area, it is written all over my orders, I will tell everyone I encounter in Pre-OP and I may even tattoo it on my forehead with a Sharpie. I'll likely have a size 6 or smaller cannula and extreme care will be taken in intubation and extubation. On top of that, I will prophylactically go on vocal rest for 3 days following extubation. So don't call before Friday unless you want to talk to one of the fam, who I imagine will be willing to give reports.
I think that does it. Your prayers and good wishes are coveted.
I say "mostly unproductive," because rather than doing nothing, like I intended for it to do, it's been brewing fibroids. More on that later.
Here's the e-mail I sent to my support squad (family & friends):
[If you got that e-mail and want newer, more fun information, here are some sites I found helpful:
Referential measurements for fibroids
http://www.geocities.com/tiggernut24/Fibroids/MeasureFibroids.html
A hospital site with VERY graphic pictures
http://www.jeffersonhospital.org/obgyn/article9361.html
A support site with good articles. Requires membership to post, but not browse.
http://hystersisters.com
There are tons more, but I've got to get after other things!]
... after a prolonged, but not necessarily hateful battle with my uterine fibroids, my Dr and I have decided that a hysterectomy is the best option. After seeing to 3 doctors and talking to/reading from others "in the know," I will be having a laparoscpic procedure on Wednesday 6/4 at noon (by Dr. Carl Giesler), unless it gets bumped up earlier in the day. The surgery is at St. Luke's Episcopal Hospital in the Medical Center and I will be staying overnight.
That's the short version. As for more info, requests, etc:
- This is clearly not a secret, so if it comes up or anyone asks feel free to share. There is actually a limit to how many addressees can go in one e-mail!
- If you are in town and can spare some time in the next few weeks, I will be needing some assistance with driving and meals and such, and would love to press you into service if you are willing. The lovely and phenomenal Amy Winstead is coordinating that effort. If you are able to assist, please contact her at [info deleted]. None of us has food allergies, but we are lactose intolerant, so easy on the cream & cheese, please ;-} !
- Who is "we," you ask? Of course, my Mom is coming down on Sunday. My middle sister, Janessa will help her out from Tuesday through Sunday, and then my baby sister, Alexa will come over the weekend and stay for a week or so, by which time Mom and I ought to be ok on our own. I don't think any of them will be doing any driving-- they've been here before and their families want them back in one piece.
- Can I visit? Likely not in the hospital, as I don't plan to be there very long. We'll see how I do at home. Call the house and "my people" will let you know the 411. [info deleted]
If you have more than enough information, STOP READING NOW!!! I mean it. Here's where it gets gross and/or TMI. But I know some of you will or have asked these questions, so better to answer them in one place. Really, if you are tender of stomach or easily embarrassed, stop reading. If I left something out, feel free to ask. I am a veritable font of gynecological information by now.
****
******
**********
OK you were warned.
Why hysterectomy?
- It is the only permanent cure for fibroids, short of menopause, to which I am not sufficiently near enough to be useful. There are other procedures (embolism, laser, hormones, surgery to take out the fibroids only); either I am not a candidate for them for one reason or another and/or they are not permanent.
What are fibroids?
- Benign tumors of muscle and connective tissue that are present in most women. They can be so small as to be unnoticeable, or very, very large. There have been reports of single fibroids upwards of 10 inches across. The stats say that 25-40% of all women have symptomatic fibroids of some sort (pain, pressure, excessive bleeding, bladder and rectal issues, nerve impingement), and at autopsy, nearly 77% of women were found to have fibroids. They feed on estrogen, and sometimes they grow fast and sometimes slow. They are hardly ever cancerous.
Why do fibroids happen?
- Why not? I guess it's what happens when nature gets bored. Uteri were meant to produce humans, so maybe this is weird uterine wish fulfillment.
Why YOU for hysterectomy?
- I have several large fibroids, ranging in size from a tangerine to a softball. One is even attached to the top of my uterus by a stalk (pedunculated). All told, they have occupied my uterus to the point that it is the size of a 16-18 week pregnancy (now you know what I'd look like 4-5 mos. pregnant-- just the same. But I can feel them. Not so much fun).
How is it being done?
- There are basically three ways. Old fashioned "open" abdominal, kind of like a C-section, Vaginal (remember the old joke about the OB/GYN who goes to auto repair school for fun and repairs the entire engine through the tailpipe?), or laparoscopic, where the surgeon uses instruments inserted into holes or "ports" in the abdomen. I'll take #3, Alex, for the win.
How do you take it out through small holes?
- It gets cut up (de-bulked) with a morcellator, and the rest is done through the uh, tailpipe.
How long is the surgery?
- He says around 2 hours if there are no problems.
Problems? What kind of problems?
- The usual and very rare ones that could happen anytime one goes in for abdominal surgery; organ injury, bleeding, etc. Panic not.
What about your ovaries?
- Staying as long as they look good once the Dr. gets in there.
Will you go into early menopause?
- Not if my ovaries remain unmolested. It is possible that I will go into it earlier than I would have otherwise, but not significantly.
Sooooo, does this mean no babies? You ok with that?
- Yes, this means no babies of my own flesh (other than my amazing nieces and nephews). Yes, I'm quite ok with that. No periods either. BONUS!
What about your vocal cords?
- My surgeon has specifically requested an anesthesiologist with good experience in this area, it is written all over my orders, I will tell everyone I encounter in Pre-OP and I may even tattoo it on my forehead with a Sharpie. I'll likely have a size 6 or smaller cannula and extreme care will be taken in intubation and extubation. On top of that, I will prophylactically go on vocal rest for 3 days following extubation. So don't call before Friday unless you want to talk to one of the fam, who I imagine will be willing to give reports.
I think that does it. Your prayers and good wishes are coveted.
posted by YankeeHobbit | 7:37 PM
2 Comments:
I'm the president of a non-profit women's health education. More than half of the women who contact HERS (www.hersfoundation.org) have fibroids. Many were told hysterectomy was either their only option or the best alternative. I respond with my brief fibroid "lecture":
Fibroids are benign growths of muscle and connective tissue that grow until you reach menopause. Then they slowly and gradually shrink to a negligible size, at which time they will be small and calcified.
The average size of the uterus including fibroids in the late thirties to early forties is a ten to twelve week pregnancy size (about 13cm in the largest dimension), in the middle forties fourteen to sixteen weeks is average (about 17cm in the largest dimension), and in the late forties to early fifties eighteen to twenty weeks is average (about 21cm in the largest dimension).
Fibroids have two rapid growth spurts that are natural, predictable, and not a cause for alarm. The first rapid growth spurt is in the late thirties to early forties. Then you have a few years of slower growth. Right before you go through menopause, when you have the hormone changes associated with the beginning of menopause, you have the second and last rapid growth spurt. Then the fibroids slowly and gradually shrink to a negligible size.
You develop all of the new fibroids you are going to have in your 30's you do not develop new fibroids in your 40's.
Both estrogens and progesterone stimulate fibroid growth. Many women use the so called "natural" progesterone yam cream that promoters claim shrinks fibroids, but in fact it makes them grow.
Fibroids are not a disease, they are your genetic blueprint. If you can live with the symptoms it would probably be better than unnecessary intervention of any kind. If you cannot live with the symptoms a myomectomy is a reasonable option.
You never need a hysterectomy for fibroids unless you have the wrong doctor. If you would like information about doctors who have consistently good outcomes removing any number and size fibroids please contact the HERS Foundation. You may also find it helpful to watch the video "Female Anatomy: the Functions of the Female Organs" at www.hersfoundation.org/anatomy and to read HERS blog at http://hysterectomyinformation.blogspot.com
With all due respect, Ms. Coffey,
Knowing Melissa as I do, I would never suggest that she is the sort of person who would undertake any sort of surgery without careful consideration and understanding of all her options.
Myomectomy would certainly be another option, but, unlike the laparoscopic procedure that Meg will be getting, it requires opening her abdomen. Now, presumably you haven't read the rest of Meg's blog, so you may not know that she uses her abdominal muscles a whole heckuva lot more than she uses her uterus.
To insinuate that she's being victimized by a bad doctor is almost laughable.
When I had uterine prolapse, my doctor informed me that, given my age, my job, and other factors that are unique to ME, I had a choice between hysterectomy or repair of the situation. Both procedures required the same amount of time in surgery and the same amount of time to recover from. I considered MY options and MY emotions, and decided, for a number of reasons, that I would have the hysterectomy. I haven't regretted it for a minute since.
Please understand that I agree - many women are pushed into a procedure that might not be their best option. In Meg's case, and in my own, our decisions are (were) based on considerations of our particular needs, bodies, histories, etc.
To suggest that we are not sufficiently intelligent or educated to make a decision about our bodies almost reads like something a "pro-lifer" would say!
Just because my decision or Meg's aren't what you would wish does not mean that made those decisions from a position of ignorance or victimhood.
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