Wednesday, March 12, 2008

Deb's Medical Journal

Part III

Part I of this medical journal details the symptoms of uterine fibroids and how I finally went to a doctor only to find out that I had several fibroids, one of which was very large.

Part II details the symptoms of uterine fibroids and the options my doctor gave me for dealing with them which were Hysterectomy, Myomectomy or, since we wanted to have a baby, get pregnant anyway and deal with the fibroids later.

However, as you see, none of those options included the procedure I eventually had which was uterine artery embolization or to be exact in my case, uterine fibroid embolization or UFE.

This post is going to detail my issues with the female reproductive system. If you are in any way squeamish about this sort of things, I promise, you will NOT want to read this. You have been warned.

I have never asked and will probably never know if the doctor simply did not know about UFE or if, like many gynecologists, refuses to inform patients about it. It seems many gynecologists will insist that the only way for women to deal with their fibroids is through hysterectomy or myomectomy. And their reasons for withholding this information seem ridiculously self serving and selfish.

Some gynecologists say they are simply seeing things from a doctors point of view. What will give the best outcome medically, which is to remove the fibroids and ensure they never return. The only way to absolutely to ensure this is hysterectomy. And myomectomy, they consider is only the next best thing.

But both of these procedures are major surgery. Not only do they require a large incision and at least six weeks of recovery time, they are expensive - the procedure, hospital stay, time off work, prescriptions - these costs mount up and you best believe the gynecologist has his hand out for his fees.

There also seems to be a bit of pissing contest taking place between the gynecologists and the interventional radiologists, with the gynecologists being the decided antagonists. Even though thousands of women have successfully undergone UFE since it was first done in the 1970's, gynecologists still tend to regard it as a new procedure and not a "good option" for women.

But it's not just about getting rid of the fibroids and for some women, it's not even about future fertility options. They simply want to stop the symptoms that are keeping them housebound or severely limiting their quality of life.

But we did want to have a baby and so we chose to try to get pregnant with the fibroids.

It was the worst advice I was ever given, that I have ever followed and that caused me to lose more than I ever thought possible.

I'd been cranky and listless all summer but hadn't figured on pregnancy. My father had died that spring and I'd lost my job that June. I was still working part time at a second job I'd picked up, but finances were tight. If anyone had reason to be depressed it was definitely me.

One night, I woke up in hellish pain and vomiting. Somehow, I knew that this wasn't a normal illness. I woke up Ye Olde Matey and he woke up Little Arabella and we all went to the nearest emergency room.

Unbeknowst to me, I was given a pregnancy test. It was positive. We were so very happy for such a little while. But the pain, the vomiting. The nurses already knew but took to me to ultrasound to be sure.

As it turned out, one of the larger fibroids was blocking my left fallopian tube. Sperm was small enough to get through, but the fibroid would not allow the larger baby to move down to the uterus.

When they did the ultrasound, I could hear the baby's heartbeat. I thought that meant everything would be all right.

But I was wrong. I would have to have surgery. They would have to remove the fallopian tube and the baby. If not, it would rupture and I would bleed to death.

I wailed. Ye Old Matey and I cried. The surgeon came and had prayer with us. Ye Olde Matey called my mother who called a family friend to come and get Little Arabella.

There wasn't much time then to mourn. Before I knew it, I was prepped for surgery. I woke up later in recovery it was all over.

My baby was gone.

But the hole in my heart remained.

Part IV

Friday, March 07, 2008

Debs Medical Journal

Part II

Last week, Wednesday, February 27, I had a procedure called Uterine Fibroid Embolization (UFE). I am hoping that this will be the beginning of the end of what has been an 8 year journey of life with uterine fibroids.

This post is going to detail my issues with the female reproductive system. If you are in any way squeamish about this sort of things, I promise, you will NOT want to read this. You have been warned.

Part I of this medical journal details the symptoms of uterine fibroids and how I finally went to a doctor only to find out that I had several fibroids, one of which was very large.

Uterine Fibroids are tumors. They are benign (not cancerous) and many women live with them without problems. However they can cause several life-interfering symptoms such as:

Extremely heavy bleeding - Some women report having to stay in bed or near a bathroom for several days to deal with this. In the end, I resorted to using
Depends because I was too stubborn to stay home and stay in bed. A lot of women are diagnosed as anemic due to the bleeding.

Constipation - Fibroids, as they grow, can press against the intestines

Frequent urination or constant pressure - Women with fibroids all tend to have one thing in common. Fibroids pressing on the bladder making it feel as if you constantly have to go to the bathroom. And if the don't outright cause incontinence then the feeling of pressure results in what I call a case of the NoGo's. You always feel like you have to go but you don't. Plus, since there's so little room already, all it takes is a sneeze or hard cough and incontinence can be the result anyway.

Pain/ Pressure - One thing I have learned from this experience - there is only so much room inside the human body. When a woman has a baby, her organs are smooshed to make room. It seems there is some biological accounting for this, but not much. Being pregnant can be decidedly uncomfortable.

Having a large uterine fibroid is like constantly being pregnant. All the pain, pressure and hormonal fluctuations and even weight gain. Your body has to change to support the darn things and any woman will tell you, her body has no end of ways to gain weight. Fibroids help you pack on pounds and also keep you from exercising with all the other symptoms, especially the bleeding. Naturally a lot of overweight women have fibroids, but I think this is more like a chicken and egg conundrum. Impossible to tell which came first especially as women can have fibroids long before they feel the effects of them.

I presented all of these symptoms to my doctor. After an exam and an ultrasound, he confirmed that I had uterine fibroids. At the time, Ye Old Matey and I had decided we wanted to try for a baby. The doctor told me that my options for dealing with the fibroids were as follows:

1. Hysterectomy - without a uterus, you can't have uterine fibroids. Problem solved. Of course, you also can't have a baby without a uterus.

2. Myomectomy - they simply burn off or cut the fibroids out of the uterus. This is successful for many women however too much loss of tissue or blood and they would possibly have to do an emergency hysterectomy anyway, which I would have to agree too before the surgery.

3. Get pregnant anyway - the fibroids should not interfere with pregnancy. There would be additional weight and pressure, but that would be all. I should be able to have a normal pregnancy and could deal with the fibroid issue afterward.

Considering the permance of Option 1 and the scariness of Option 2, Ye Olde Matey and I decided to go with Option 3. Even then we dithered over whether we really wanted to add to our family or not but by the following spring our minds were made up. We'd long since stopped using any sort of birth control and we didn't talk about if, but when we would have a little one running around.

And then my father died. And the world came crashing down around us again, as it had when Ye Old Matey's grandmother and mother had passed away a few years before. Our world of grief only seemed to emphasize the fact that we wanted to create a new life.

Part III