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Possible Hysterectomy In My Future
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09-09-2002, 06:53 AM
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Guest
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Possible Hysterectomy In My Future
Hi everyone. I'm not really jumping the gun here. I'm just curious and searching for information.
I'm 60 yo. Post menopausal 10 years. Just quit the monthly bother one month with nothing different in the previous months of periods. Occasionally a possible hot flash the last 10 years, not even quite sure about them. All has been a breeze.
I also have Crohn's disease. A mild case. One small bowel resection 20+ years ago. Do have a partial obstruction at the resection site but the bacterial overgrowth that occurs is handled very nicely with alternating antibiotics as needed. We did find a new area of Crohn's activity nearer to the ileocecal valve but that has been in remission with Pentasa.
Had some symptoms of the bacterial overgrowth at the partial obstruction in late June except the nausea that is always my first symptom didn't materialize. So my gastro ordered an abdominal CT scan. The bowel appeared normal but the scan did reveal what appears to be a simple cyst on the left ovary.
Two abdominal and transvaginal ultrasounds later with a third scheduled in October we've found a possible very tiny cyst on the right ovary as well and a small amount of fluid in the endometrial canal. All 4 of my kids were delivered by my GP so this is my first experience with a gyn and so far, after two visits, I like him quite well. He seems more concerned with the small amount of fluid in the endometrial cavity (uterus) than the apparent simple cysts. All my Pap smears have always been normal. The endometrial stripe has measured 4 cm on the first set of ultrasounds but weren't measure on the second set. I guess 4 cm is about the maxium thickness for a postmenopausal stripe (lining). At least as near as I've been able to determine in searching around the net.
This second office visit the gyn broached the subject of an office procedure (I'm sure it is an endometrial biopsy) and a procedure requiring "sedation" I'm pretty sure hysteroscopy). My GP and I both forewarned him about my strong aversion to sedation and anesthesia. He also asked if I had given any thought to if I needed surgery whether I would want to go to Mayo Clinic or consider having it done locally. In addition he asked if gyn surgery were indicated if I had any ideas about what I would want to do about the Crohn's, if anything, at the same time.
My guess is he is "softening me up" in anticipation that a hysterectomy might be indicated.
I found an excellent description of the endometrial biopsy procedure at
http://www.aafp.org/afp/20010315/1131.html
for anyone who is interested who hasn't undergone one already.
Anyhow, I am just exploring just what a hysterectomy really is, what types of "hysterectomy" are done, how much to part with and why, etc. I found reference to hystersisters at obgyn.net and here I am.
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09-09-2002, 08:45 AM
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Guest
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Posts: 268
Hysterectomy: August 27th, 2002
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Welcom Crohnie
Welcome to a wonderful site
Glad you found us. I recently had abdominal hyst with left ovary removal, kept cervix and right ovary. This site has been great for me. You may also want to try the chat room to talk to some girls who may be able to answer any questions you have.
Take care and good luck. s Wendy
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09-09-2002, 10:50 AM
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Guest
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Possible Hysterectomy In My Future
Hi Wendy,
Thanks for your reply. I'm curious, do you mind my asking why you had the abdominal hysterectomy rather than laparoscopic?
I've already decided that if surgery should be necessary I'm opting for open abdomen. I already have an incision path for them to follow so they don't get lost and take out my tonsils instead. Grin. Mostly I just prefer that they have a plenty good visual field to see what they are doing and to avoid the minimal risk to the intestines via the "scope" as well as not being at all impressed w/the gas pains after the scope procedures. I prefer my familiar "hug the pillow" routine.
Don't want the pubic "smiley" either. Like I say, I want them to have the best visual field possible. Don't want them mistaking some small intestine for an enlarged fallopian tube or something. Wicked grin. Besides, have a "smiley" already from a tubal ligation, bladder & uterine suspension & appendectomy. The surgeon took a lot of pride in his work and l'd like to preserve his artistry w/the outer incision. You really have to look for it to find it.
Can't say the same for the resection incision. Had it done at Mayo. WONDERFUL PLACE FOR SURGERY! It was easier on me than the tubal ligation! But - they let some newbie close and it must have been his first "stitching" job. Sheesh! I'm thinking if I have the hysterectomy done locally the gyn might take a lot of pride in his work and he can improve the looks of my abdominal scar when he closes. I'll certainly challenge him to do as good a job as the guy who did the "smiley"!
I am curious: if they take the uterus what do they do about the "empty hole" at the top of the vagina and cervix? I mean you sure don't what your husband pumping sperm into your abdominal cavity during play time!
And if they leave the ovaries, do they also leave the fallopian tubes, and how the devil do they do that? They don't just leave them floating free, I wouldn't think. Yet if the uterus is gone what are they anchored to? The cervix?
But what if they take the cervix too? The top of the vagina? What is this I've heard that sometimes they shorten the vagina? WHY on earth would they do that? Seems if anything you would want it lengthened a little bit. Wicked grin.
Anyone know where there is a website that goes into good detail on describing the hysterectomy procedure? Especially an open abdominal hysterectomy?
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09-09-2002, 01:43 PM
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HysterSister
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Posts: 4,768
Hysterectomy: May 29th, 2002
Surgery Type: LAVH
Ovaries: Removed both
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Possible Hysterectomy In My Future
Hi Crohnietoo
I had LAVH a little over 3 months ago. I chose LAVH because my physician is an expert in that procedure and is the one he recommends and prefers (if at all possible, depending on size of uterus, etc). I had never had surgery before and wanted to avoid an abdominal incision if possible.....this was the best choice for me and it all went very well.
When the uterus and cervix are removed the top of the vagina is sewn shut...kind of like tying one end of a sock closed. I too had heard the "rumors" of the surgery possibly shortening the vagina?
When I asked my physican about it he said "Absolutely not." And he was right, there is no difference now after my surgery.
There is a website you can go to that explains hysterectomy (with pictures so it's pretty graphic), but explains the procedure very well. The site is www.pelvicfloor.com
Best wishes to you!
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09-09-2002, 04:18 PM
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Guest
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Posts: 268
Hysterectomy: August 27th, 2002
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Possible Hysterectomy In My Future
Hi Crohnie,
Here's a little bit about my story, had myomectomy for very large fibroid 6 yrs ago, 5 yrs ago had abdominal to remove adhesions, left ovary was stuck to uterus and bowels. This time going in, was to have a lap done first to seperate adheions if possible, but not possible, of course Dr and I had discussed proceedure at length b4 went in and decided if lap could not be done, then he could take adhered ovary and uterus if necessary, but not my cervix. I am 32 and feel I need cervix to support bladder. So, that is why the abdominal. Ended up with left ovary adhered to uterus and bowels again, and uterus adhered to bladder. Turns out, uterus was also hiding a fibroid inside of it. So glad to have had hyst. Do you close by Mayos? I am in Illinois. The pelvic floor is a great site, as Shelley mentioned. As for vaginal hyst, you can do a search on this site to find out about women who have had this. I have talked to many of these women and they say no difference in love making, if anything it is better and that orgasm is also better. Healing is much less time with a vaginal also. I was in castle 2 days, my neighbor in castle who had vaginal was out in 24 hours. It will be less recovery with vaginal, but for me abdominal was the way to go. I also knew what to expect from previous surgeries and that helped. Good luck, lemme know if you have more questions. s and s, Wendy
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09-11-2002, 02:02 AM
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Guest
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Possible Hysterectomy In My Future
Gads, Wendy,
It just dawned on me! You were only in the hospital for TWO days after having open abdominal surgery???? That sounds barbaric! Especially w/so much adhered to so many other organs!
I'm 12 hours from Mayo but MUCH prefer it to U of MI or Cleveland Clinic which are 2 and 5 hours from me. Cheaper, friendlier, more efficient and excellent care.
Was disgusted at CC to have to wade thru a concourse FULL of fast food joints to try to find the cafeteria. I mean like Burger King, Mickey Ds, etc., etc., etc. They are all there. Talk about selling your soul for the almighty buck! Not much better at U of MI, stay at the "oncampus motel" and after 6-7PM the only food is fast food delivery, pizzas, etc. from town. Everything is too far away. Appt scheduling at CC and U of MI was terrible too. Last appt at CC was 3 in afternoon to go over xrays and discuss options, it was after 5 and secretaries all gone when doctor finally saw me as last patient of day and he wasn't about to spend any time discussing the xrays to any degree. The very reason for my making and keeping that appt. It was obvious he wanted me gone and he wanted to be outta there. U of MI physician set me up for some tests, put an emergency rating on them and sent me to the appt desk where they couldn't set me up for testing for 6 weeks!!
Mayo once you have initial appt you start testing same day and next day and zap you are thru and back to your physician w/his recommendations and if surgery indicated you usually have it done w/in 3-4 days after initial appt if you are willing. If you need time they give it to you and you're scheduled as soon as you decide. As I said earlier the bowel resection at Mayo was an easier surgery than the tubal ligation done locally!!! Even an upper GI series w/small bowel follow thru is easier and faster at Mayo! They add Reglan to the barium which then moves things thru faster and helps to avoid the barium setting up in guts that tend to have trouble eliminating it before it sets up like mine does.
In case you haven't guessed I am a passionate fan of Mayo! I swore up and down that I would NEVER have surgery again any place but Mayo so you can guess how much I like this gyn so far that I have even CONSIDERED possibly having a hysterectomy done here if one is indicated as I suspect.
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09-11-2002, 03:58 AM
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Guest
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Posts: 268
Hysterectomy: August 27th, 2002
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Possible Hysterectomy In My Future
Crohnie,
It sounds like you know what you are doing as far as Mayos goes. That is sooooo good. Cannot believe dr wouldn't go over results of xray or anything at end of day. I know that feeling, my post op visit w/my was good, but had to wait hour and a half amd then they forgot to give me some estrogen dr said i was to take home. Went back to office to get it like 2 minutes after we left - Closed For Lunch. Oh well, I probably wouldn't have taken it anyway. Hot flashes are ove already as ovary has started working again. Thank goodness for that.
As for me being out in 2 days, that was due to ins co saying I didn't to be in another day....imagine Dr was in shock when he found out his assistant had checked my incision and given ok for me to go. He was planning on seeing me on Friday, which I knew this, but didn't realize insurance was involved in me leaving. No one told us a thing. Hope all goes good for you and you are able to find out what needs to be done soon. Keep me posted. Hugs, Wendy
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09-11-2002, 05:57 AM
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Guest
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Possible Hysterectomy In My Future
We ran into that once too, locally, with my husband's back. Dr scripted he be put in traction a couple of times a day to stretch out the spine for a few hours each day. My husband has stenosis at his old surgery. Anyone w/a ounce of brains knows that stretching the spine narrows the spinal canal and stenosis IS a narrowing of the spinal canal. Duh. So my husband refused traction.
They would send him down to physical therapy and he'd be moving pretty good, then they'd put him in traction and he stiffened up and could barely move again. Duh. THAT in itself should have told them something too.
Then he began refusing the pain medication. His theory being how could he tell what was and what wasn't helping if he was doped up and not feeling any pain. Me? I'm not that much of a masochist but he's the patient and only he knows how much pain he is enduring or willing to endure.
The doctor called me complaining that the hospital was going to insist on his being released because of insurance if he kept refusing traction. Then she called me again when he began refusing most of the pain medication saying the hospital was pushing her to release him because insurance wasn't going to pay if he kept refusing "treatment".
Well, now, he wasn't refusing treatment! He was refusing what made his symptoms worse or what was masking what symptoms were left. So he was released.
When he had more trouble again and we went to Mayo they were flabbergasted that a doctor would order tractions for someone with the stenosis he clearly had at and near the site of his prior surgery!
In your case it is a real sad state of affairs when the insurance company can override a doctor's treatment suggestions and in my hubby's case it is even worse when a hospital's fear of an insurance company pushes a doctor to release a patient before the doctor believes they are ready for release.
In fact, it is the fault of the insurance companies that my husband had to have a second and third surgery and is now walking around with steel bars in his back. They wouldn't pay for the treatment that works, they'd rather pay for surgery and hopefully be done with it. STUPID. False economies. Two weeks of complete bedrest, knocked out w/sedatives and physical therapy 3 x daily gave him 12 years of a decent back 8 years after the first surgery. Because insurance would no longer pay for the 2 weeks of hospitalized bed rest when he had trouble again he had to have a second surgery which only bought him 4 years before he was in trouble again. And that only bought him 3 years before they had to do the major third surgery with the stainless steel bars and all lumbar vertebrae fused. Even Mayo told him insurance would not allow them to do what was BEST for him which was the two weeks hospitalized bed rest virtually knocked out w/muscle relaxers and passive physical therapy daily. They virtually apologized for having nothing to offer him but the third surgery due to insurance.
The greatest country in the world and our medical care reduced to this. Snort.
Anyway, back to a possible hysterectomy. Still haven't heard from the gyn about having had the two previous ultrasound films re-read. It seems he's more worried about why the minimal fluid can't get out of the uterus and he's thinking of an endometrial biopsy to detect or rule out cancer in the uterus. He is probably also going to wait for that 3rd set of ultrasounds in early October to see if the endometrial lining is any thicker - and then my 15 Oct appt to recommend the biopsy. What the hey, if the second set of ultrasound indicates the lining is any thicker than it was at the time of the first set I fail to see the logic of waiting 3-4 more weeks and then the scheduling time for the biopsy after that. If it thickened between the first two sets, why in the devil wait for the third set?? It was at the MAXIMUM thickness for a menopausal endometrial lining at the first ultrasound. Probably gotta justify it to the insurance company. Snort.
Don't you just HATE the waiting? I swear it is the WORST part, the waiting and not knowing. Hope you are still doing great. Its encouraging to hear that you and Shelley are happy with and doing great after your hysterectomies. I'm certainly not looking foward to a recommendation for hysterectomy but its better than waiting, not knowing ..... anticipating ...
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