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Surgery Scheduled Surgery Scheduled

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Unread 04-12-2002, 10:15 PM
Surgery Scheduled

I guess I get to "graduate" from the "alternatives" message board to the "pre-op hyst" board. I have scheduled my surgery!

You all already know what a difficult decision it is to make. I have a hx of endo (sucessfully treated about 15 yrs ago) and fibroids (UAE 2 1/2) yrs ago. During an MRI for repeat UAE when fibroids were suspected to have returned, I learned NO new fibroids (good !). The problem was a dermoid (large!) on (what used to be...) right ovary (not so good). I've struggled with decision--just doing surgery for cyst removal only or hyst. No current symptoms and I have a very active 2 year old at home. You know the old saying, "...if it's not broken, don't fix it...."

On the other hand. I'm over forty and we're not planning any more children. I guess the swaying factors included the fact that there is coronary artery/heart disease in my family (although I currently have no problems), so preventive HRT would be important for me. However, with a hx of fibriods, HRT is contraindicated. Even with successful UAE, my uterus is (always will be) enlarged, which complicates pelvic exam for ovaries. So the fear of un-dx cerv. cancer would always be with me. So, it makes sense for me to reduce my risks now.

Ultimately----I now have the option to decide either way. I is MY choice, not some MD dictating to me. Telling me "there are no alternatives. Just do it and get over it!" (Fortunately that's not my current MD's attitude although I (we all?) have experienced those.)

I can choose to be conservative and take some risk. I can choose to have one surgery now to deal with one problem and "bet" that other problems will not develop later.

The reasoning of "do it all and get it over with" has always seemed to me to belong in an auto mechanics vocab (i.e. "We're changing the oil on the old clunker, so we might as well replace the fan belt, yank out that old muffler and replace and balance the tires while we have it up on the lift.") It doesn't seem to fit in healthcare (i.e. "Well Mr. Smith, while we've got you open on the operating table to remove your appendix, we'll just look around. We've got a special this week on gall bladders. 25% off when we remove it with the spleen. And the prostate is known to cause older guys problems. Even though you're only 28 and problems usually effect guys over 60, why wait? We might as well take yours out now...")

Sorry. I'm a bit radical about patients' rights, especially womens'.

The fact that I can tell the MD, "this is what we're gonna do. This is how I want to handle this situation, how I want the manage my life!" does matter.

Boy, that felt good!

Thanks so much for letting me "ramble on". This is a "new day" for me--a turning point of sorts. I felt so good about making my decision that I scheduled a salon appointment this morning and even got in this afternoon. I now have a new, shorter, care-free hair style! (Always wondered what that would be like; having sported longer, high-maintenece styles all my life.)

Oh, my surgery is May 8th at 8 am! First one and my MD is not on call the night before, so there should not be any delays in starting....
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Unread 04-13-2002, 05:24 AM
Surgery Scheduled

Hi Beatrix,

Sounds like you have thought this through and have made all of your decisions for you. I have been there too. I have fought abnormal bleeding and ovarian cysts for years. My wonderful Dr. has let me make all of the decisions by just giving me the options. We have done all of the alternatives without success. He did suggest that we might want to think about a hyst after the last ovarian cyst ruptured, but he also gave me the chose of the alternatives. I have one ovary that is the real problem child, but the other has cysts also. I am44 (ok, almost 45) and am perimenapausal. He gave me the option of trying to clean up the other ovary and keep it or remove them both. Initially I had said try to save it, but am leaning toward getting rid of it also because of the family history of cancer and heart disease.

The new research that is out now is that the first year of HRT actually increases the risk of cardiac problems for people with "pre-existing heart disease". But after the first year, their cardiac risk actually goes down. So my thinking is that I should get onto the HRT before there are any pre-existing heart problems. I have been to my internist to have a cardiac evaluation and all is well. Since I believe I have both ovarian (my grandmother died of some unknow abdominal "female" cancer in the years before they talked about those things) and breast cancer (my mother), I am more concerned about the ovarian cancer risk as it is harder to detect early. So I will take my chances with HRT and the added breast cancer risk and just have dilagint breast check ups.

Welcome to the pre-op boards. Glad to have you. There is so much info here on what to ask before the surgery. I am a nurse and thought I knew what needed to be asked. Boy was I wrong!! There is lots of great info here.

Unread 04-13-2002, 10:21 AM
Surgery Scheduled

Dear Caren:

Thanks for sharing. That first year of HRT was a concern for me also. However, my research (and my MD) confirmed that it is only an increased risk for women who have entered menopause (began decline in estrogen production). If HRT is begun without lapse after surgical menopause, e.g. continuous estrogen, no increased risk was reported. So that did factor into my decision as well.

Beatrix "in waiting"
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Unread 04-13-2002, 11:29 AM
Surgery Scheduled

That is interesting. I had not heard that before. But since I believe my ovaries to have been in decline for several years, I am still concerned about that. But I also believe that it would be better to face the 1st yr of HRT now vs 5 yrs from now as I am certain my heart is as healthier now than it will be in 5 yrs strictly due to age.

Sounds like we have both been looking into this matter seriously. My father died at 39 of a heart attack, so it is a concern to me.

Unread 04-13-2002, 12:08 PM
I've learned something new

Hi, Beatrix--

Thank you for sharing your thoughts on making your decision. Yes, we do get our physician's recommendations, etc., but I still have a great need to hear from others who've experienced what I'm going through!

I was just wondering what a dermoid is. I've never heard that term before.

Just another reason I like this site so much. I learn something new all the time
Unread 04-13-2002, 03:32 PM

Hi Laura Jean--

Sorry for my "short hand". A dermoid is an ovarian cyst. As the medical texts report "... the most common neoplastic tumor of the ovary...." A bunch of "stray" cells get lost during the fetal development and make their home in the tissues that eventually develop into an ovary. So you have it from before birth. Of course, not eveyone has them and they usually are just dormant. Even those that do have them, may never know it. But in some of us, for some unknown reason, they begin to grow and form a cyst than can be filled with fluid, fatty tissue or any type of body tissue (teeth, hair, yuck!!). I've just recently learned that dermoid cysts can also be present on almost any body part, skin for example. They are benign. But because there is a tiny chance they may become malignent (less than 2%) and can become quite large, impinging on other organs, they do need to be removed.

My problem is I didn't have any sytmptoms, so my cyst was quite large by the time it was diagnosed, eliminating the possibility of a laproscopic procedure.

I agree with you about the need to hear from others. The medical profession is supposed to be here for us. Unfortunately, all to often many of them seem to become an advesary rather than our advocate.

I'm trying really, really hard to be open-minded and positive about this experience. However, I spent so many years working in health care and have seen what can happen "behind the scenes". I have developed some rather agressive methods for dealing with the medical profession/insurance, etc. out of necessity. Reading through many of these postings, I see that I'm not alone in my experiences.

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