This is my first post and hope it is not TMI!
Background: I was first diagnosed with fibroids in my college years. I am now 53 years old. Until I was 50, the fibroids (or should I say singular fibroid--see more later) really didn't bother me so I was following the "watchful waiting" protocol with regular appointments with my gynecologist. Every six months he would do a sonogram to monitor the size of one particular (subserosal) fibroid, which while large 12cm x 11cm x 10cm was (unbelievably) not really causing any recurring problems or symptoms. Also, the ONLY option that my gynecologist proposed was an abdominal hysterectomy with a vertical incision! When asked about a bikini incision, he said it was "too large" and wouldn't be possible. He also said a myomectomy would be "too bloody." Given the choice of living with my "alien baby" or having major surgery, I chose the former.
Well, the need to get up 2-3 times each nite to pee was getting old, but I just grinned and beared it. But that changed on November 19, 2012. That night (which was the evening before my father's funeral :-( ) I woke up with my stomach hard and distended and got up to urinate. Well, guess what? I was totally unable to void. While this was not the first time that I had a hard time "getting started," this was different. All the tricks that worked in the past relatively quickly (e.g., going back to bed and doing inverted yoga poses and listening to running water) didn't work. They just made it worse. Finally, after an agony-filled hour, I was finally able to dribble out some urine. The constant feeling of still needing to void, however, stayed with me for about five full days. It was time to do something.
What I did: I'm providing this information for others so they can see at least one person's "due diligence" and thought process. Because everyone is unique, take it as only one person's perspective on this vexing issue.
* Urologist visit - Visited urologist who performed a cystoscopy. This is a test that allows your doctor to look at the inside of the bladder and the urethra using a thin, lighted instrument called a cystoscope. The procedure confirmed that the fibroid was "flattening" my bladder. OK, at least I know that the fibroid is the likely cause of my urinary problems. (I was concerned that the stress of my father's passing could have somehow caused some weird reaction, but this was not the case.)
* Got a second opinion from a different gynecologist - This was the BEST. DECISION. EVER. Wow, what a breath of fresh air. I did a LOT of research to find a gynecologist/surgeon and it was well worth it. I highly recommend that everyone do as much research as possible to find someone who is regularly performing surgeries, not just pap smears..... He performed another sonogram and explained the options that could be possibly considered including LAVH, MrFUS, Uterine fibroid embolization, and laparoscopic myomectomy. He recommended getting an MRI to really know what we were dealing with, as it is more precise that the sonogram images. He also ordered hormone level tests to see where I was regarding menopause. Unfortunately, it came back showing the menopause was still a while off.
* Second MRI - The alien baby had grown to 15cmX12cmx11cm. No wonder I was having increased "bulk symptoms", When I viewed the MRI the fibroid was taking up a LOT of pelvic real estate and the poor little bladder looked like a smushed peanut lying helplessly below the hulking alien fibroid. I really think that my hormones were causing this thing to have a "growth spurt."
* UFE and MfFUS ruled out as possible options - Once the images were in, the size of the fibroid did not make me an "ideal" candidate for UFE. While the interventional radiologist was willing to perform the procedure, he warned that the recovery would be unpleasant/painful and I might not experience relief, due to the size. MfFUS wasn't an option now due to the close proximity of the bladder. (Don't' want to accidentally "burn" organs you still need!) (I was lucky to have a great medical insurance coverage. Typically, this procedures isn't covered by most plans.)
* Laparoscopic myomectomy selected as treatment option - After a lot of research and reading, I settled on having a myomectomy. Due to the size of the fibroid, my dr. would use a morcellator. This is a surgical instrument used for division ("morcellation") and removal large masses of tissues during laparoscopic surgery. My dr cautioned that it might be necessary to "convert" to a LAVH, depending upon what he actually found once in surgery, e.g., how the subserosal fibroid was attached to my uterus. While this was riskier than a LAVH, the time and effort I took to initially SELECT the physician was key to my decision. His references and prior role as a surgical trainer of other physicians gave me the confidence I needed to make the decision. Also, he was also an expert in pelvis prolapse surgeries, and if the LAVH was needed, would also be able to ensure that the pelvic floor would be properly supported if a LAVH was needed. The choice of your doctor is where YOU have control! Don't settle on someone you don't have confidence in--Once you make the decision, you are turning control over to them---so make sure you are comfortable with the handoff!
The Myomectomy Procedure / Thoughts during recovery:
* Myomectomy surgery was successfully performed on June 19. The took almost twice as long to perform (4.5 vs. 2.5 hours) because the subserosal fibroid was soundly attached to the outer wall of my uterus. When describing the procedure to me afterwards, my dr. used the word "tedious" at least three times. BUT, he honored my request and did NOT take the easy route. He also said that the fibroid had grown to the size of a volleyball--.and showed me the pictures to prove it. (I asked beforehand to see photos if possible.
I'm now in the 5th day post surgery. The first three days were the worst--but still tolerable.
Post surgery-to hospital release - LOTS of brain fog due to anesthesia and painkillers. That was the worst part for me. Since I was under for over 5 hours, it will take a while for all to work out of my system. I didn't research anesthesia and, in hindsight, might have considered this more beforehand. Once in my hospital room, I was on IV pain killer, but luckily did not need to use the patient hand held button to provide a boost dosage.
Early the next morning, the charge nurse took out my catheter and told me it was time to walk the halls. It was hard, but walking and movement makes all the difference in recovery!! I tried to get up and walk about once every 1-2 hours. Each time was easier than the previous. Was able to dribble out enough urine, so was released. (Nurse reminded me to turn on and leave water running so that it triggers urination---good tip to remember!) When I came home, drank a glass of "Smooth Move" tea which was recommended in the HysterSister forum. It got things moving in the other department, so another good tip.
Since coming home, I've focused on:
* frequent, periodic movement (e.g., yoga bridge pose to move fluids that tend to pool around pelvic area, "bicycling legs in the air ", walking, stretching to prevent adhesions) followed by periods of rest/napping. This cycle seems to work for me.
* eating healthy - I have smaller portions since I've gained weight after the procedure--I think because of all the fluids I received. Eating a few prunes each day to keep things moving. A friend who is a former doula recommended raspberry tea to tone the uterus, so I'm drinking that in addition to water. Also, I have been avoiding alcohol, at least so far!
* Hormone patch - I have one. I didn't know I was going to get one so if you want to discuss beforehand with your doctor, do so. Some other forum posts indicate it COULD be a cause of the water retention?? I don't know about that but I'll definitely be asking about it at my 2 week post-op appt.
Other stuff: I'm wearing the ugly white compression hose since I've had swollen ankles/lower legs. I learned that you can alternate between both Tylenol and Ibuprofen as they have different chemical compositions, and may give more relief than can be provided using either alone. I was using both through day 4 post op. Today (Day 5) I'm just using ibuprofen alone and it seems fine. I have a small pillow to fit between my legs when sleeping at night. It help keep from compressing the swollen pelvic area. (Recent development, as last night I was able to roll to side for sleeping: previously I was on my back.) The same pillow is good for coughing and for car travel.
Back to work: I officially took off two weeks and, so far, it seems like it will be sufficient. I will probably try to do some remote work at home next week to see how that goes.
In conclusion, I hope that this gives someone some perspective. I was a mess beforehand worrying about all the negative things that could happen--none of which I could control or do anything about. However, a friend who is a cancer survivor, reminded me that the surgeon has a job and you have a job--and to focus on what you can control and pray for what you cannot. Good advice in my opinion. Good luck in your decision making and recovery!
Laparoscopic Myomectomy - what do I need to know?
