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Fear and Doubt
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11-07-2003, 08:28 AM
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Guest
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Posts: 2
Hysterectomy:
Surgery Type: LAVH
Ovaries: Removed both
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Fear and Doubt
I went to a new gyn. on Friday 10/31/03 and he talked to me about having a hys. or ablasion because I have VERY heavy periods, I have always had heavy periods and thought this was normal or at least I was just living with it. He also feels I should have a hys. because my mother died of ovarian and breast cancer at 54. I have thought of nothing else since last Friday. I am so scared and it's like I want to make the right decision and I want a guarantee that everything will be ok after.
I'm 45, I have 4 grown children. So, I'm not concerned about having more children. My concerns are....I'm a vegan (I don't eat meat or dairy) I have tried to go on birth control pills, creams, herbs to control the bleeding and because I'm so sensitive to any meds none of them have worked. So, I'm afraid if I have to take hormones after the hys. and can't because I'm so sensitive. I also struggle with depression and the Dr. said that it had to do alot with my hormones so by removing my ovaries that might help. But, I think what if it makes it worse????? My other concern is what I have read about having bladder and bowel problems after the hys........So......I'm in a place of what if's..........any imput would be helpful.
Thank you,
Tammy
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11-07-2003, 10:25 AM
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HysterSister
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Posts: 1,707
Hysterectomy: March 8th, 2001
Surgery Type: TLH
Ovaries: Kept 1 or both
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Fear and Doubt
I would be concerned about taking my ovaries out because it might help depression. Hormones are so tricky, that taking out the ovaries can possibly (as you suspect) leave you with new and different problems, and there's no guarantee they'd be better problems (though they might be). Have you had a psychiatrist review any meds you're on for depression and does he/she agree that your hormones are involved?
Maybe you could get a second opinion from a gyn-oncologist about your cancer risk and how that should affect your decision about hysterectomy. I know, you just got this doctor and now I'm suggesting you go to yet another one, but this is a big decision. You might also ask your gyn for more information on the risks and benefits of ablation--since you could keep your uterus and ovaries that way, it might be worth a try.
I hope this gets you started on your road to making your decisions. Overall, it's a good idea to keep asking questions until you are satisfied with the answers. Unfortunately, that's a LOT of work. But no one cares as much about your health quite as much as you do, so keep on asking!
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11-07-2003, 12:32 PM
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HysterSister
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Posts: 4,889
Hysterectomy: May 15th, 2002
Surgery Type: SAH
Ovaries: Removed both
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Fear and Doubt
Tammy:
(((Denise))) has given you excellent advice, and I just want to follow up on the ablation angle. First of all, though, what diagnostic testing have you had already? Dysfunctional bleeding can be due to hyperplasia, fibroids, cancer, hormonal imbalance, or adenomyosis -- and each of those diagnoses might be treated differently. An ablation would work for pure hyperplasia, and might help if it's also a hormonal issue; however, adeno is only "cured" with a hyst, and cancer of course requires a hyst WITH a GYN-oncologist, as Denise recommends.
In any event, I would get a second opinion, and ask about D & C, biopsy, hysteroscopy, ultrasound and/or MRI. The MRI is the only modality that MIGHT define adeno: it's so hard to diagnose, that some GYNs think there's a lot more of it out there than is given credit! And with your cancer history, I'd want to be very sure that there ISN"T cancer before making any final decision!
This is the type of decision that takes time and some investigation -- and especially if you have doubts, or want to explore supracervical options or ovary questions, a second, third, or even fourth opinion isn't too much to consider. This IS permanent, as you obviously are considering.
I have found, BTW, that my moods are improved with the oophorectomy and HRT -- but I take only the bio-identicals (same molecule your body made, also known as "natural" HRT but not to be confused with herbals). If I'd known about bio-identical progesterone years ago, I might have saved myself and my family years of distress. However, you HAVE to know what's going on before going to any therapy.
Good luck, and stay in touch -- but get that second opinion! You owe it to yourself...
Audre
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11-08-2003, 10:37 AM
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Guest
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Posts: 2
Hysterectomy:
Surgery Type: LAVH
Ovaries: Removed both
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Fear and Doubt
Thank you so much Denise and Audrey for the input. I have gone to a psychiatrist and he put me on a low dosage of meds and I cut them in 1/4. But, I still had a bad response to them, so, I stopped taking them. I didn't ask him if it could be from my hormones. I'm also seeing a therapist. She thinks it is my hormones. I see her next week and will talk to her about having a hyst. I did talk to my Dr about having the ablation and he said that if I did get ovarian cancer it would be very difficult to detect. I am scheduled for an pelvic ultrasound on Nov 20. I had a pelvic ultrasound last year and one 3 years ago. They all came up normal. I had a biopsy 3 years ago and it came up normal also. Audrey what is adenomyosis? And what is the difference between a gyn and gyn-oncologist?? What is BTW?? This is all so new to me!!Over the years I have gone to several Dr's and they all say I should have a hyst. Thank you again and I will keep asking questions.
Tammy
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11-08-2003, 12:31 PM
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HysterSister
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Posts: 4,498
Hysterectomy: February 9th, 2001
Surgery Type: TAH
Ovaries: Kept 1 or both
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Fear and Doubt
(((Tammy)))
It can be very difficult to gather and analyze all the information, can't it? A gynecologic oncologist is a doctor who specializes in female cancers. They have EXTENSIVE training--I believe it's 3 additional training years beyond that of our ob/gyn's. You might like to strongly consider requesting a referral to see one if your primary concern is about ovarian cancer. We have several ladies here who have had ovarian cancer, and it seems that the typical follow-up for their sisters and daughters is close observation (regular US, CA125 test, pelvic/rectal exam--close being every 6-12 months).
Now, if you're having the hysterectomy because of abnormal bleeding, I would guess that your ovaries would be removed at the same time due to your family history. Please keep in mind that removing your ovaries does NOT eliminate totally the possibility of ovarian cancer. It reduces the risks significantly, but you can still turn up with primary peritoneal cancer which acts very much like ovarian cancer and may be related to it. My understanding of it is that when our ovaries are migrating to their location while we are still in the womb, they shed ovarian cells throughout the pelvic cavity. One of those cells could turn cancerous. Again, that does not happen often, and your risks are markedly reduced by having your ovaries out, but there is still that chance.
Did you discuss your drug sensitivity with your psych? I only ask because my sister is dealing with depression, and when she started her medication she felt much worse. We convinced her to stay on the medication, and when she went back to her doc a few weeks later, he said that that was a common response and he tripled her dose. Three days later, she felt like a new woman and I can't believe the change in her.
Good luck with your decision-making. I hope you are able to find a path that you are comfortable with.
BTW means "by the way"--kind of short-hand.
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11-08-2003, 02:21 PM
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HysterSister
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Posts: 1,707
Hysterectomy: March 8th, 2001
Surgery Type: TLH
Ovaries: Kept 1 or both
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Fear and Doubt
Good luck with all your decisions. I would echo Jeanine's suggestion to call the psychiatrist again. There are a LOT of meds out there for depression and I went through seven (SEVEN) before I found the right one for me. I'm pretty sensitive to meds, too, and was never able to take birth control pills, sinus medications, all sorts of things. Even if hormones are causing your depression, the right meds can help control it while you decide what to do. Most people don't go through seven. But it can take a few tries to find what works for you.
Adenomyosis is the tissue that normally lines the uterus growing inside the uterine muscle--either dispersed in little tiny bits, or in sort of blobs in there. Because it's so dispersed, it's very hard to detect on biopsy and MRI, and as far as I know almost never shows up on ultrasound. Adenomyosis was what led to my hysterectomy (a lot of pain and only moderate bleeding compared to some here) and we really weren't sure about the diagnosis until after the surgery when the pathologist had the whole uterus to examine. Because the tissue is so dispersed, there's no other effective treatment for this disorder besides hysterectomy, so sometimes if it is causing you big problems and it's the best guess as to your diagnosis, hysterectomy is your best shot. The uterus can be so tricky, can't it?
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