Personal Opinions Please!

Hello,

As I'm reading posts this morning, I'm wondering what some of your opinions are on this:

If you decide to proceed with a hysterectomy because of your symptoms and your decision to not have children, why do some doctors seem to want you to do some "medical management" first?

I'm hoping it's NOT for the $$$. So far, I had a hospital stay in November which ran over $4K and then this last procedure was over $8K...............what do you gals think?

I don't want to have children so I am NOT going to do any "medical management", try this, be on lupron for 6 months and if all that doesn't work, then we'll do the hysterectomy kinda thing.

I believe that if we have painful medical problems, understand the "finality" of a hysterectomy and it's an option to cure us once and for all of this endo/fibroid stuff, we should be able to do it without feeling guilty.

In the past, it was common practice to do a hysterectomy on anyone who had a complaint! It was discovered to be the most common surgery volume wise and done in many cases without necessity. I think the government did an in depth investigation many years ago to discover this. Then the insurance companies jumped on board, hysterectomies are expensive with inpatient hospital stays and outpatient treatments whether medication trials or outpatient surgeries (D&C and/or thermal ablation etc) were much less expensive and in many cases solved the problems for the patient without the expense of the hysterectomy. Most insurance companies now want a track record of some sort of conservation treatment prior to hysterectomy, except in some special cases. A lot of docs want to do a D&C prior to hyst to rule out cancer as the cancer would have a decision making effect on the next step for the patient. I am not saying that this is always the best practice, but we find ourselves at the mercy of the insurance companies!

I think that doctors have an obligation to offer the best treatment but necessarily the most extreme treatments right up front. There are other options that might be successful for some patients, that don't require such a huge invasive and permanent surgery.

There has been much controversy in recent years that doctors were performing too many hysters, too freely...it was the most commonly performed surgery for women (it may still be!) I think that if things can be done without resorting to it, doctors will offer those treatments first, and rightly so.

A hyster will definitely "cure" our fibroids. No uterus, no fibroids. But there is much evidence that a hyster does not necessarily "cure" endo...just take a look the posts on The Road here. It's no sure thing.

I think there needs to be a balance between playing out a patient for $$$ and as a guinea pig, and giving alternative treatments a fair chance. I'd advise you to talk to a few more doctors for other opinions before you make your final decisions. I know it's hard and we just want this OVER, and that's a valid perspective, but it's not one your doctor should "foist" on you...you need to get there on your own after considering all your options.

Hang in there!!!

Karen

It's "required" by the insurance companies in opposition to the statistics of when "too many unnecessary" hysterectomies were done. However, there are docs who recognize that your endo and fibroids are valid "reasons" to list a hyst. as one alternative ... and some who may be willing to listen to your feelings and "dance" around that game a bit faster (by ruling out the other "management" options, etc.).

Bottom line, it's your body and, if your current doctor won't proceed directly to the hyst., you may need to call around with the current diagnoses and treatment plan and request 2nd opinions, stating your reasons for prefering hyst. over the long plan.

I have simple hyperplasia that the first doc wanted to burn off with bcp ... with my family history of uterine cancer, my age, and the fact that I smoke! She refused to address my multiple prolapse problems that have to be addressed sooner than later and was even very abusive. I took this to another doc who did consider my whole picture, and whose response was truly one of offering me the options. When I told her I wanted it all over with in one shot, she said that that's okay, it's my choice what I want to do with my uterus.

Don't give up ... you have to be your own well-informed medical-treatment director as much as you possibly can.

(((((Donna)))))

Hi! Thanks for you question, it is a really good question to ask! I don't have any kids, and my experience was the my GYN sent me to a fertility specialist prior to the hyst. She wanted to make sure I checked out ALL my options since there is no reversal for a hyst.

I think (and this is my own humble opinion) that they want to make SURE that even though you are in pain you have weighed the possibility of wanting children later in life.

I am 35 now, but I was having problems "down there" for about 4-5 years. The GYN just didn't want me making any drastic decision if there were alternatives to the hyst. She also encouraged me to try to conceive prior to the hyst, saying "if it's meant to be, then let it happen." WELL, not only did I not conceive, but after the hyst she told me that she was GLAD I didn't...there was far to much diseased tissue in there and I would have ended up not being able to carry.

This is just my experience and my opinion, but somehow I just knew that I wouldn't have any children. People ask me now (very tentatively) if I'm "okay" with my decision, and I can HONESTLY say "yes!" I have no regrets whatsoever!

Please don't let anyone lead you into your decision. Only YOU know what is right for you, and only YOU have to be able to live with the decision that you make. If you can look into your heart and say "I did the right thing" and be at peace with your decision, then my sister, you have done the right thing.

Sorry this is so long, but you have to remember that this surgery is just as much emotional as it is pyhsical.

I am wishing you health and happiness, my you find the peace within youself. If you ever need to talk, please email, I would love to offer you ANY support you find that you need. Also, stop into the Chat Room. There you can get "real time" support and hugs from sisters who are going through the same things you are.

Love, ers, and 's

Hi. In my personal situation , my gyn suggested a hyst along with other treatments for several years. I personally wasn't ready to do a hyst so I tried other options first. When they all failed , I decided it was time to go through with it. When I finally gave consent , the first thing my nurse did was to look through my chart and said that my insurance will probably ok the surgery since I have been struggling with this problem and tried different options first. So I believe part of it is due to the different ins. companies. I had to come to peace with my decision , no one could do that for me but if I had been ready at the very beginning , I would have talked with my gyn and see what needed to be done to get the surg approved. I am so glad that I went through the surgery. I am 5 days post op and feel really good. I will look back and be one of the ladies who will say "Why did I wait so long?"
Best Wishes to you. Trust your feelings and do what you feel is right for you. I'll be thinking of you.
Terri

Hey Donna,

I am 32 years old a a mother of one 8 year old son. I started having problems 6 years ago when my son was only 2. At the time we (DH and I) knew that if we ever had other children, that they would not be close together in age. I struggled through 7 doctors in the same office and the "opinions" of these men ranged from, nothing wrong with you to it's all in your head, blah,blah,blah. Time to move on. My current doc tried changing bcp's several times, doing Laproscopic surgery to remove adhesions,back to bcp's, then a D&C, back to no bcp's (let body regulate itself), back to bcp's, then Depo, then Depo plus bcp's, then offered the option to do another D&C and try Lupron. All the while, he put the bug in my ear that a Hyst was a good possibility in my future that I should consider it, but he would try anything and everything first. As long as I was willing to try then he was willing to try, only because it is such a final decision. When I made the decision to have the surgery he plainly asked me how I had come to the decision to have the surgery and I told him. He agreed because I was confident in my decision. The right Doctor will go with your wishes, the trick is finding the right Doc.

I will be thinking of you. Good Luck,

Moe

In the past I had a couple of polyps that caused continuous bleeding. Those could be taken care of with a D&C. Three years ago the bleeding started again and polyps were diagnosed. My pcp sent me to a gyn. At that time with my fibroids my uterus was the size of a 6 week pregnancy. She told me then that a hyst was in my future, but she needed to try alternatives first. She put me on provera 11 days a month. It controlled the bleeding until last fall, but I became a crazy person while I was on it. I called it "drug enhanced PMS" At one point I asked if the insurance company would think homicide was preferable to surgery. Last fall when it was determined that I needed surgery my uterus had grown to 16 week size. A vag hyst was no longer an option. The pathology report showed many, many fibroids, another polyp and polycistic ovaries.

I am 6 1/2 weeks post op now. Except for the bleeding and the PMS I didn't think my symptoms were too bad, compared to some that I have read. I feel so good now that I realize I really must have felt awful before. I have a lot more energy and ambition than I've had for ages. It really is too bad that we have to be held hostage by the insurance companies.