Friday, June 13, 2008

I Still Am Not Sure About My Options

I had my doctor's visit this morning. The visit was with a GYN Nurse Practioner (NP). This does not bother me; I do not have a need to see the actual GYN. They are normally very busy people who are never on time, always running around birthing babies. I liked the NP. She was pleasant, almost on time and had plenty of time to talk to me about what is going on and what my possible options are. Unfortunately, I am not crazy about those options.

Apparently my uterus is significantly enlarged (should I be a little annoyed with my regular family doctor here? The damn thing is NOT where it is supposed to be, shouldn't he have noticed?), but that is all she could tell without an ultrasound. That is scheduled for next Wednesday. I had one about 7 years ago, which is when I was diagnosed with the fibroids, but that does not do me any good at this point.

The only options she really offered me, though was
#1. Endometrial ablation :
Endometrial ablation is a procedure that uses a lighted viewing instrument and other instruments to destroy (ablate) the uterine lining, or endometrium. Endometrial ablation can be done by:
Laser beam (laser thermal ablation).
Heat (thermal ablation), using:
A balloon filled with saline solution that has been heated to 85C (thermal balloon ablation). This is the one available to me.
Normal saline (heated free fluid).
Electricity, using a resectoscope with a loop or rolling ball electrode.
The endometrium heals by scarring, which usually reduces or prevents uterine bleeding.
What To Expect After Surgery

Endometrial ablation is usually done in an outpatient facility or hospital. The procedure may be done using a local or spinal anesthesia, although general anesthesia is sometimes used.
It takes a few days to 2 weeks to recover. (WebMd)

#2. Hysterectomy
The surgical removal of the uterus. It is done to treat certain gynecological conditions, including childbirth complications; cancer; and fibroids, endometriosis, or uterine bleeding that hasn't responded to other treatments. (WebMd)

But until the ultrasound is done, there is no way to know if the ablation will work for MY fibroids. And the thought of a hysterectomy does not sound even vaguely pleasant. Not to mention the fact that recovery time is normally 4-6 weeks and I only have about 3 weeks vacation time saved up. I have savings, of course, and so does DSD, so the bills will be paid, but what if I am out for 6 weeks and they don't miss me? What if they realize they can get along without me? I can't afford to lose my job and there have been issues lately with some of my co-workers.

After everything I have read in the last week, I was leaning more toward
Uterine Fibroid Embolization (also called uterine artery embolization):
shrinks or destroys uterine fibroids by blocking the artery that supplies blood to them. During a UFE procedure, a radiologist places a thin, flexible tube called a catheter into the upper thigh and guides it into the uterine artery that supplies blood to the fibroids. A solution is then injected into the uterine artery through the catheter. (WebMd)

I like non-surgical! Of course, this isn't offered at the GYN, but it is something that I could possibly pursue on my own if hysterectomy is my only other option (I have already found 2 radiologists who perform this locally. One at the radiology place that does my mammograms and that will be performing my ultrasound). IF, of course, my insurance will pay for it. Sadly, from everything I have read, it is NOT cheaper than a hysterectomy and
in one study, about 1 in 5 women who had uterine fibroid embolization (UFE) needed another UFE or a hysterectomy within 3½ years. (WebMd) (Edwards RD, et al. (2007). Uterine-artery embolization versus surgery for symptomatic uterine fibroids. New England Journal of Medicine, 356(4): 360–370.)

So, I have been left with more questions than answers. My mom is a little pissed about it, but there is not a lot that can be done at this point. Just wait and see.

Enjoy your weekend.


Pete Bogs said...

I don't know nothin' 'bout birthin' no babies, but I do know someone who had the balloon thingy done... it was quick and caused minimal discomfort... hope things turn out all right, LLL!

Shel said... easy choices here. Hopefully you will get more answers than questions this week. Hang in there. I'm sending good thoughts your way!

LeftLeaningLady said...

Thank you to both of you!

Pete, we need another post from you!