what do do-liver issues

I am so glad to find this site-hopefully some helpful advice will come.

I am 42, dx with unexplained infertility @32, no children. Monthlies were always unpleasant but in the past 9-12 months became very difficult. Was hospitalized 1/07 with liver damage secondary to medications; also 7/07 with viral meningitis and again elevated liver enzymes. Also have fibroids. Hormnal treatment is out due to migraine issues. IUD was given as an option but it was the one with the hormones in Provera, which I have tried for 5 months with no results.

This is the issue: before the second illness, I was going to have the EA with tubal. That was cancelled and now what to do. Anesthesia is a risk with liver issues. However, periods are beyond help. Right now living with it, treating with lortab rx'ed by OBGYN reluctantly. As I see it these are options:

1. live with it
2. give it a few months to try to see if liver functions remain normal and treat periods with lortab (not sure Dr. will go for treatment because is reluctant to use medication)
3. go with the original plan of EA/tubal and look at alternative to general anesthesia
4. choose hysterectomy to get it over with, knowing risks

My liver specialist is reluctantly ok with the idea of anesthesia if OBGYN is ok.

Any thoughts would be appreciated as I have a consultation appointment tomorrow afternoon.

Take this for what it's worth, since my situation is not the same as yours, but here are my thoughts. Why not try the IUD? I do have one and it has greatly decreased bleeding. I take it that's one of your symptoms since you are thinking about ablation. I don't have pain with my period so I can't tell whether it will help you there. There's no anesthesia required for insertion, so your liver issues won't come into play with the IUD. The hormone in the IUD goes direct to the uterine lining rather than having to survive going through digestion as with oral forms, so maybe it will work for you better than the Provera did. I did have some hormone related headaches while taking BCP to try to control my bleeding. (BTW, I would suggest not taking BCP along with using the IUD. I used them for some months after I had the IUD put in, and not only did they fail to reduce bleeding before the IUD, I didn't get the reduction in bleeding with the IUD until after I stopped taking them). I still get hormone headaches sometimes even with the IUD, but they are much less severe and not as frequent. You will know within a few months whether the IUD will help or not. If it doesn't you are no worse off than before and still have the other options you mention.

I am biased against ablation, so again, take what I say with a grain of salt. I have fibroids which in the past have caused heavy bleeding, now largely controlled by the IUD, but also some irregularity of cycle and sudden episodes of bleeding/clotting, which it hasn't gotten rid of. (That may be perimenopause though--I'm going on 52.) Anyway, from everything I've read of ablation it could make my most bothersome symptoms worse before it made them better—IF it made them better. And I have read numerous threads here on hystersisters about ladies who have tried ablation and gotten relief, but only for a few months or a year. Then their bleeding came back with a vengeance, sometimes worse than before the ablation. Some ladies end up with pelvic pain they didn't have before the ablation, or they find that ablation reduces their bleeding but doesn't affect the pain. Seeing all that, if I had your symptoms and was not planning children (you said you were thinking of a tubal ligation), if the IUD was not working I would probably skip ablation and have the hysterectomy. That would be only one anesthesia, rather than two if you try ablation and it doesn't help.

But, I say again, I am not impartial about ablation, and also not a doctor (in fact not in any health care profession), so take what I say with many grains of salt.

hope this helps,
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	Quote:
Originally Posted by waitingforsign I am so glad to find this site-hopefully some helpful advice will come. I am 42, dx with unexplained infertility @32, no children. Monthlies were always unpleasant but in the past 9-12 months became very difficult. Was hospitalized 1/07 with liver damage secondary to medications; also 7/07 with viral meningitis and again elevated liver enzymes. Also have fibroids. Hormnal treatment is out due to migraine issues. IUD was given as an option but it was the one with the hormones in Provera, which I have tried for 5 months with no results. This is the issue: before the second illness, I was going to have the EA with tubal. That was cancelled and now what to do. Anesthesia is a risk with liver issues. However, periods are beyond help. Right now living with it, treating with lortab rx'ed by OBGYN reluctantly. As I see it these are options: 1. live with it 2. give it a few months to try to see if liver functions remain normal and treat periods with lortab (not sure Dr. will go for treatment because is reluctant to use medication) 3. go with the original plan of EA/tubal and look at alternative to general anesthesia 4. choose hysterectomy to get it over with, knowing risks My liver specialist is reluctantly ok with the idea of anesthesia if OBGYN is ok. Any thoughts would be appreciated as I have a consultation appointment tomorrow afternoon.