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D & C, Hysteroscopy, Ablation, Tubal and biopsy D & C, Hysteroscopy, Ablation, Tubal and biopsy

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Unread 02-23-2010, 02:25 PM
D & C, Hysteroscopy, Ablation, Tubal and biopsy

Well, it has been quite a week of ups and downs for me. I’ll give you guys the shortened version (ok. It is really long for being a short version!).

My period lasted from January 28-February 15. I was passing HUGE clots and bleeding like I had an appendage cut off. I was starting to get weaker and weaker and having grey-outs and had a horrible pounding in my ears. I figured I was a little anemic, but didn’t make much of it until I had trouble walking from my car to the office, or from one room to another.
I finally bit the bullet and called my doctor thinking they would do a blood draw and tell me to eat some liver and take some iron pills.

02/16 I went in to the doctor. They stuck me three times and couldn’t get any blood at all. I was told to come back the next day and try again. They also set up a transvaginal ultrasound for Thursday.
02/17 I was so tired I left work an hour and a half early so I could take a nap before my doctor appointment. Made it there and they were able to get the blood drawn with little trouble after I water loaded the whole day. I went home and turned off my phone to charge.
02/18-I got up and was getting ready to go for the ultrasound when my fiancee came in with my phone. The doctor’s office had been trying to contact me since 8:40 the night before. I was to come in right away and get a blood transfusion because my hemoglobin was critically low at 5.1. Went to my ultrasound, then went up to the special procedure clinic and got set up for the transfusion. They had decided to only give me one unit, then another the next day. After one unit I went to the bathroom and almost passed out coming back across the hall so the nurse and the tech made the decision to give me a second unit of blood and they stayed after the clinic closed so I would go home with two units, then come back for a third the next day. They were very, very sweet.
02/19-Went back for my third unit of blood. When I was leaving I got a call from my Doctor’s office. My ultrasound came back abnormal and they wanted me to see the OBGYN on Thursday of this week. Then they called back to say that the OBGYN HIMSELF had called my doctor’s office and told them to change my appointment to Monday. The words carcinoma and cancer started to get thrown around pretty freely.
02/20-Fiancee and I went away for the weekend. While shopping at the mall at 5:40 PM I get another call my doctor’s office. Keep in mind this is SATURDAY AFTER 5:30PM. I’m freaked out. We talked for about 20-30 mins and I was told to be prepared for a total radical hysterectomy within 48 hours of seeing the OBGYN.
Needless to say Fiancee and I were a little preoccupied to have the kind of fun an adult couple away from kids with a big king-sized bed should be having.

Went to the OBGYN. I have an enlarged ovary with a cyst that they didn’t specify if it was simple or complex, I have a large fibroid, I have cysts on my cervix, and the most troubling thing is my uterus is enlarged and the lining of my uterus is 10 times as thick as it should be at 29mm. The doctor said that if I was a couple of years older he would automatically say it is cancerous, but because of my age he needs to take a biopsy because perhaps it is only precancerous. If it is, then he’ll refer me to GYN-ONC…but in the meantime we’re going to assume that it isn’t cancer and do the following.
1. A D & C
2. A hysteroscopy
3. An ablation
4. A tubal ligation
5. A biopsy of my uterine lining

My surgery is scheduled for 03/03. They wanted to get me in on the 25th, but I needed a little more time psychologically since it was all happening so fast.
If my biopsy is ok, or in a wait and watch then I won’t have to have anything else done except a couple of follow-up ultrasounds. He said we should have the results of the biopsy within a couple of days of the surgery.
The doctor said there is a chance that he won’t be able to do the ablation if my internal uterine structure is any more abnormal. If that is the case then he wants to get me on a hormone therapy. The tubal is only if he’s able to do the ablation because if I get pregnant in the future I would probably lose the baby in the second trimester.
So now I have a week or so to get everything in order to rest at home for a few days. I’ll worry about the biopsy after I wake up from the surgery.

I’ve probably left a lot out, but the scary thing is how serious everyone is taking this and how fast they set everything up and the rather cavalier sprinkling of the ‘C’ word in their discussions.

I'm so glad I found this site! I hope to hear some stories from the ladies that have been there before.

What should I expect as an outpatient with those proceedures?
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Unread 02-24-2010, 12:45 AM
Re: D & C, Hysteroscopy, Ablation, Tubal and biopsy

Hi Figaro-wow you've been through the wringer in the past few weeks!
Cancer is scary but endometrial cancer is one of the most treatable and is usually very slow growing, so waiting a little bit will probably not affect the outcome.

You didn't mention your age but I'm assuming you are still premenopausal. I'm 55 and 4 years post menopausal. My endometrium from trans vag ultrasound was 23 mm. My doc tried to do an endometrial biopsy in her office, but failed so I had a D&C and hysteroscopy on Jan 18. My pathology was proliferation due to unopposed estrogen and I'm now on a trial of Prometrium for 3 months. I don't understand why your doc is throwing around the CA word as it seems a little premature given your circumstances. Just in the last 2 months many women here have gone though a D&C and have not gotten a CA diagnosis. I know it's hard but try not to go nuts in that direction until you have a more definitive diagnosis.

When I first started this "journey" in nov, I asked my gyn if I cold just do a hysterectomy and be done with it. She explained that they had to first do the D&C to determine the cause of the bleeding, because if in the event that cancer was found the type of hysterectomy would be very different and she would refer me to a gyn-onc. For now I don't have to worry about it.

While the ablation and tubal ligation can be done after the Hysterocopy and D&C is finished, it seems a little premature to add on those procedures. Maybe you won't even need them. Since you don't get a pathology report until afterwards, I question why your doc is tacking on the extra procedures? Maybe a second opinion is in order.

Regading the D&C and hysteroscopy, it's an outpatient procedure. The choices of anesthesia are IV sedation (twilight sleep), general aneshesia or spinal anesthesia. I though I was going to have general, but when the time came my anethesiologist offered me what he called a short spinal. It's like an epidural that they use for C-sections, but there is no catheter left in. The doc injects a large bolus of lidocaine and you feel nothing from the waist down. It lasted for about 1.5 hours and then wore off. The D&C only lasted about 40 min, and I did not feel anything except a little tugging sensation. No Pain at all. He gave me a little IV sedation but I really didn't feel that and I was pretty much wide awake the whole time and I watched the gyn do the hysteroscopy on the monitor! I thought it was pretty cool. If you want to be asleep-just let them know. (I had a colonoscopy in nov and I was "out" for 20 minutes with IV sedation) I went in to the same day surgery dept at 6:30 am and was out by about 12:30pm. My gyn said I'd have really bad cramps- but I never did, just light bleeding for about a week.

I hope this puts you at ease a little bit. I know it's easier said than done-the not worrying, but the procedure itself was relatively easy. Waiting for results is the hard part. I pray you get good news. We all think the worst, but try not to let your fear consume you. Good luck and <<HUGS>> Lynne
Unread 02-24-2010, 06:31 AM
Re: D & C, Hysteroscopy, Ablation, Tubal and biopsy

Oh THANK YOU for posting!! I've been desperate for people to talk to who have been through similar situations!

Yeah, the rather cavilier use of the 'C' word has been as frightening as well as how fast they've been moving on this. They wanted to get me in to do all of this this week, but I felt that I really needed a little more time to prepare. It was too much to try and absorb and I felt that I needed a little more education on what was happening and what was GOING to happen. The talk of the 'Big C' while panicing me has been especially frightening to my fiancee's family. He lost his mother to breast cancer when she was only 42-43 years old. So any mention of it sends his family into panic mode. I've been feeling so guilty that I've been causing them to have flashbacks of what they went through.
I'm only 41 and I'm already having second thoughts about the Ablation and Tubal. I would love to have a child even at my 'advanced age.' Is it selfish of me to want to keep my fertility for as long as I can? Before all of this started happening my fiancee and I were talking seriously about the possibility of having a child. I don't want to feel like that decision has been taken from me, or worse yet, to make a PERMINANT decision that I find out later was the wrong one. Heck. I know the possibility of me having another child is remote to say the least, but I wouldn't want to say 'no' if we can.

I mean, I've had the transfusion. The D & C SHOULD take care of some of my bleeding for a while if I've done my research correctly. I don't have any health insurance right now because I got laid off from my job and I'm currently working as a temp. So I would rather get health insurance and make it through the pre-existing-condition-waiting-period so I don't have to pay so much out of pocket.

I think I'm going to have a long talk with my fiancee and see if he wants to go back in to the doctor's office with me and have a little more in depth talk...because the more I think about it, the less convinced I am. I hope I'm just not going through some sort of denial, you know?

Thank you again for answering my post. I've felt so scared and alone and confused. I guess I just need to hear from other people that I'm not overreacting and I'm not being selfish.
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Unread 02-24-2010, 08:50 PM
Re: D & C, Hysteroscopy, Ablation, Tubal and biopsy

figaro 1, so sorry for all you are going through, the docs really dont want to take organs if they are still pink and functional, recently had a cancer scare and my nurse friend explained that docs are free with the word because either way you go they appear as heroes, if there is cancer they are revered and if it is not they are courageous for looking for it and you are relieved...take one step at a time, one procedure at a time, most times these things are not cancerous....think of your general health and how you are feeling on a day to day basis , i was extemely anemic and that in itself is not ballgame...tired and pale you have to take care of you and put yourself first right now and think about how you want to take care of all this so you can be here for those who surround you and love you.....good luck...ang133
Unread 03-01-2010, 09:08 AM
Re: D & C, Hysteroscopy, Ablation, Tubal and biopsy

I think I'm going to put off the Ablation and the tubal and just get the hysterscopy, D & C and biopsy done on 03/03.
Maybe I can limp through for a while until I get health insurance and make it through the 'pre-existing condition' waiting period. Maybe the D & C will take care of my bleeding. So many 'maybe's' it is enough to make you crazy!
The transfusion worked pretty well. My hemoglobin level is up to 9.2 so I'm still a bit anemic, but no where near as bad as I was.
I have to wonder how often I'll need to get a repeat CBC done now?

So, what happens if they go in for the D & C and find something abnormal? Is there a possibility they could get in there and need to do something else?
Unread 03-01-2010, 09:57 AM
Re: D & C, Hysteroscopy, Ablation, Tubal and biopsy

just to let you know there is a silver lining out there sometimes hun,
im 3 weeks post op hysterectomy,cervical and uterine cancer.
i feel better already,after tests and scans etc,they said it was really compacted and its a very slow growing cancer. ive got another op in 3 months time,but the future is looking rosy!
i hope all goes well with you and try not to worry too much,easier said than done i know.
take care

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