Many Worries...

A month ago, after years of trying many treatments for persistent and copious menstrual bleeding, I decided to have a hysterectomy. I am 50, married 26 years, no cancer or family history of cancer, and am not yet menopausal. I had my tubes tied 18 years ago. I have suffered a life-long battle with depression had have been hospitalized twice for suicide attempts, which is a major reason I sought a tubal rather than continuing on BCP for decades.

Over the past 12 months I have had three Lupron shots, which stopped my cycles but never stopped the bleeding. After the crisis on July 31 I have been taking mega-doses of BCP and had a fourth Lupron shot. The result has been wild mood swings and horrible black suicidal depressions.

Another cause of my distress has been the refusal of the hospital where my insurance covers me to perform the procedure because of my weight. I am certainly a fat woman, but I am also active and healthy, with the exception of these "female problems" which have nothing to do with my weight. I have been referred to a doctor at a hospital 75 minutes west of my home and it took me a month to get an appointment and now I have to wait another four weeks (while continuing these hormones that are wrecking havoc with my moods) to have my operation.

I am a candidate for a laparoscopic hysterectomy, which pleases me because the risk for post-operative infection IS greater for heavy people, not to mention that the fewer holes carved into your body the better. But the doctor I saw insists on removing EVERYTHING - uterus, ovaries, and cervix. I explained that I had wanted to retain my ovaries and cervix, but he pretty much said that it was impossible to do that and do laparoscopic surgery. From reading posts on these boards I now believe that that is not the truth.

I am terrified of the effect the sudden hormonal change from my ovaries removed will have on my depression. I DO NOT want to stay on synthetic hormones any longer than I need to, but once my ovaries are gone synthetic hormones will be my only option.

The doctor assured me that I would still be "fully sexually functional" after the operation, but I believe that his definition of that term and mine are radically different. We all know what the surgery he is proposing to perform on me would be called if it were performed on a man, and we all know just how "fully sexually functional" that man would be afterwards.

And yet I feel trapped. I will only see this doctor three times - the visit I just had, the operation, and one post-op appointment. I think he is operating on me just as a favor to my OB/GYN (who I love, by the way, but who doesn't perform surgery) and I don't feel I have room to bargain. This is a "take it or leave it" deal. No one wants to provide health care to a fat woman and I am lucky to find a doctor who will consent to treat me.

I don't feel there is a way to have a dialogue with him say by e-mail or over the phone, and continually taking time off from work to drive the 2.5 hours round trip to see him isn't feasible either.

I am terrified that after this operation I will be left a psychological/emotional cripple, not only tormented by depression, but deprived of any sexual pleasure or identity I may once have had. I cannot imagine wanting to continue living under those circumstances, a feeling that I have had repeatedly over the past few weeks as I grappled with being too fat to be worth receiving basic health care.

ANY feedback from women who can relate to ANY of the crap I have just poured out. Can I really have a laparoscopic hysterectomy and keep my ovaries and cervix? Am I over estimating the hormonal/emotional impact the removal of my ovaries would have? Are there other large women out there who have had successful hysterectomies of ANY kind who can share their stories? Any correspondence/support/input would be HUGELY appreciated by this befuddled HysterSister

Myvanwy

Myvanwy,

Wow you are really having a tough time....First I want to tell you that I have just had a laporospic surgery...4 small incisions (about 1 inch long)....I only had my uterus removed and kept both my cervix and ovaries...we scheduled to have my left one removed because of cysts, but when she got in there it was free and clear....I have had 1 hot flash in 11 days since surgery, they say is normal sometimes if your ovaries go into shock.....you do not seem to trust this doctor or have very good repore with him as he doesn't seem to want to listen to your concerns...wonder if your gyno can recommend someone else....not sure about your insurance problems...is there some sort of charity care in your area for people without coverage????.......now regarding your emotional status...are you seeing a regular doctor for that.......wonder if a hormonal imbalance could be the cause of your excessive bleeding, depression/suicidal tendencies.....are you taking any meds for that???....it is not unheard of to take something to get you over the rough patches...or sometimes the right meds could make all the difference in the world....I think I remember one of the side effect of BCP was mood flucuation, weight gain, and depression....wonder if the meds you are taking are right for you......did the doc talk to you about any alternatives other than surgery???....I think there is a whole forum here for alternatives to hysterectomies...sometimes they can burn off the inside lining of the uterus to stop bleeding......there is a light at the end of the tunnel...you just have to find the right way thru it

It sounds to me like you're going to have to keep looking for anothr surgeon, you are not going to feel confident going ahead with this person. I still have my ovaries, never any problem with them, but my cervix is gone, and my sex life is just fine. I know it's not a comfortable idea to go even further away from home for your surgery, but this can't be the only surgeon who performs this in your area? I would urge you to keep exploring your options.

Hello.
I was reading your post, and can relate to much of what you are experiencing. I had to have both my ovaries and cervix removed during my hysterectomy because of severe endometriosis. I have suffered depression since I was very young, due in large part to the hormonal imbalances that I had. However, since my hysterectomy in November, I have seen a great improvement in my depression and am on Estriadiol 2.0 mg every day. I am also on Lexapro 10 mg to help with issues related to anxiety, but overall, would say that things are much better. I'm not sure what the answer is for you, but I just wanted to send you some encouragement that you won't lose your sexual identity or become an emotional cripple after a hysterectomy. I hope that you will find some peace! I'll be praying for you.
Shannon

please get a second opinion. i had just the body of my uterus removed laparoscopically and retained my cervix and ovaries. i dont see in your post why your dr said it wasnt possible. are you talking about a vaginal hysterectomy? if so, your cervix has to be removed but ovaries can be kept. i know its confusing but youre in a great place with lots of info...you can gather up a lot of information and do research on your own...and seek another opinion.

Hi there,
I am so sorry to here that you have had such a tough time. You should definitely seek another opinion. I have not been through my surgery yet,
but good luck to you!

wooshmoosh

I had a laparoscopic hysterectomy and kept my ovaries, even though I am 48. I was not able to keep my cervix, however, because I had an abnormal pap smear 12 years ago, most likely related to a strain of HPV. My doctor told me that a history of an abnormality is a reason to remove the cervix because if I had a recurrance of the problem I would be "very sorry."
There is no reason why you shouldn't keep your ovaries, especially if you have no history of ovarian cancer in your family. That is the only reason for removal - where the risk of keeping them due to a potential risk of cancer outweighs the beneifts. I would get another doctor's opinion, because having a laparoscopic hysterectomy does not mean that you have to have them out. I was told, however, that although I wanted to keep them, they might be more closely attached to the utuerus necessitating the removal of them once they got inside, but it did not happen. From research I have seen, those who keep their ovaries often go into menopause 2 years earlier than they would have in the first place, so at 48, I'm not sure if I really made the right choice, but I think natural menopause is better than surgical, even if it happens sooner than it would have, because even after menopause they continue to emit hormones.