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Results from my 2nd opinion Dr. Results from my 2nd opinion Dr.

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  #1  
Unread 05-20-2003, 05:13 PM
Results from my 2nd opinion Dr.

Hello Ladies! Well today I went to another Dr. to get a 2nd opinion on what's going on. My Dr. had a medical student with him and spent a long time talking to me. I really appreciated that. However, I just don't know what to make of it all. He tried to explain how that probably what's going on is that my ovary is trying to make bad eggs and that can cause cyst type things and that can last two to three days but in my case sometimes it can last a whole month and cause a lot of pain and that the cyst thingies usually take care of themselves. Does this make sense to you all? I really did listen but with me, I have to hear things two or three times to really get it down. But once I get it , I really get it. He suggested another type of pill as I was allergic to the other one. He put me on ONCON. I haven't started taking it yet. He said that the other had two hormones wheras this one only has one. If I understood him right, he's trying to shut my ovaries down. He also gave me a pain pill to take two times a day for a couple of months. I haven't gotten the precription filled yet and I can't read his writing so I'm sorry, I can't tell you what it is just yet. He did say I wouldn't be fuzzy headed from it. I also have to keep a chart of everything that happens daily. He didn't seem to think doing a blood test for my hormones would help my situation. There weren't a whole lot of options. He said he could take out my ovaries but then I would still have to take hormones. He said he could do a pelvic ultrasound. Well, I was just overwhelmed by it all I went with the birth control option until I could think and research all this. I don't think I liked any of the options and I feel like having a . However, I'm too tired and to do this. And then he said if the pills don't work for the pain, he might recomend an internalist. Once again, I'm somewhat confused and just don't know what to think. I feel like a person right now. Well, I have to go take care of the household. It's seems as if all the radars on everyone's heads told them I sat down to post you alland of course everyone wants me now. I haven't been able to type one sentence w/out having to stop. I'll post when all in the house is quiet as a mouse tonight. Bye for now. I hope this all makes sense as I have had a lot of interuptions.
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  #2  
Unread 05-20-2003, 09:07 PM
Results from my 2nd opinion Dr.

Hi Cathleen.

I am sorry your appt was so confusing for you. I too have a hard time getting things and that is why I usually take someone with me to my appts. I get overwhelmed with what I need to say and have a hard time hearing anything else.

I dont understand why he would want to shut down your ovaries, you would have menopausal symptoms. If your producing cysts that bad every month I would probably opt to have them removed. That is a PERSONAL choice I would make and it may not be right for you. You have alot to think about and I know it is hard because you really did not understand all of the options in the first place. I was like that before my hyst. It took 2 visits and 3 phone calls for me to GET it all!!

I will keep you in my prayers and hope that whatever you decide works for you. You may have to do the trial and error system. Fortunatly I had no choice in the matter and had to have mine removed, GOOD thing I did because they were both pre-cancerous.

Get some rest and things will be less fuzzy tomorrow I hope. Do you have a follow up appt with him?

Take care and here is a HUGE for you!!
  #3  
Unread 05-21-2003, 12:05 PM
Results from my 2nd opinion Dr.

Pam, thanks for your reply. I really enjoyed reading it. I don't have a follow up appointment with the docter yet. I'm rather afraid to try the birth control pill he gave me. I don't want to have another allergic reaction. But if I do, then we will probably have to go another route. I myself wondered what he meant by shutting down the ovaries after I left. It all made sense when he was talking. It seems I always have so many more questions after I leave. I am going to do a little bit more research while I am proceeding with this route of treatment and schedule another appointment with this docter. Once again, thank-you for your reply. I really am glad for this website and people like you.
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  #4  
Unread 05-21-2003, 03:05 PM
Results from my 2nd opinion Dr.

Cathleen,

Just a thought. Perhaps your RX is for progesterone only BCPs. Maybe it was the combination pill causing the problem (estrogen and progesterone).

Maybe when he said "shut down your ovaries" he really meant "supress ovulation". Those mean different things to me. "Shut down" means stopping all hormone production. "Supressing ovulation" means no release of eggs, but you still produce hormones.

I am on a combination BCP continuously to suppress ovulation. It seems to be helping a great deal with the pelvic pain I was having which my doctor felt was at least somewhat related to ovulation.

Best of luck with your new meds. If I were in your shoes (still having quesitons) I'd call the doc's office and try asking his nurse. I find that is sometimes very helpful and quicker than making an appointment. Worth a try, anyway and you deserve to understand your treatment fully.
  #5  
Unread 05-21-2003, 07:59 PM
Results from my 2nd opinion Dr.

Michelle, Thanks ! It's starting to make sense now. I was glad to hear that your treatment helped you. I sure hope I get rid of the pelvic pain also.
  #6  
Unread 05-22-2003, 11:05 AM
Results from my 2nd opinion Dr.

(((Cathleen))),
I'm so sorry to hear about your experiencing & complications
Good for you for doing your research on your treatments options & outcomes they may carry! Ovarian cysts Post-Op seems to be a somewhat common occourance... I remember reading why it occured so much but , for the life of me, cant find the source IMO, I would exhaust all viable options at stopping the cyst from forming before even considering Ovarian removal. Surgical Menopause can bring on a whole other set of symptoms & for many, finding that right balance can/has become a very long, frustrating struggle. If you get a chance take a peek over in The Hormone Jungle.
Should your Ovaries shut-down, they will continue to produce small amounts of those much needed Hormones. Researchers are discovering more & more, just how important they are & exactly what they add to a womans over-all health.
There are many different types of BCP's available today, lots more than what was made available to us just a few yrs ago!! Hopefully, you can find some relief in the use of them but you'll never know unless you try In your quest to do more Research, I wanted to list some very helpful articles & links discussing the topics above. I hope they are able to provide you w/ some more insight to help with your treatment/decision:

Should I leave my ovaries in?

  Quote:
This is a difficult decision and outside of needing to have them removed in the cases of cancer or severe endometriosis, the decision is best made after a thorough discussion with your doctor.

Having your ovaries removed means you will be in menopause and will have all the manifestations of menopause if you do not take hormone replacement (hot flushes, bone loss etc.)._ With this in mind, if you are not close to menopause it is probably better to leave them in so you will still have all the benefits of hormone production from your ovaries._ If you are in menopause or very close to it (average age is 51) then some would advocate taking your ovaries out._ The rational is that they are minimally functioning at this point, but still susceptible to ovarian cancer._
Or that you should have them removed to decrease your chance of getting ovarian cancer later and requiring another surgery._ Keep in mind, the overall chance for a woman to develop ovarian cancer is 1/70.
Should I Keep My Ovaries?
http://drn4u.com/keepovaries.htm

Hysterectomy-Leave the Ovaries-Gabe Mirkin, M.D.
http://www.drmirkin.com/women/W126.htm

Surgical Menopause:

http://www.surgimenopause.com/
http://www.menopausehysterectomy.com/Menopause.htm
http://webmd.lycos.com/content/article/1680.50792
http://my.webmd.com/content/dmk/dmk_article_5963052
http://members.tripod.com/fiona_51/faq.html
https://www.hystersisters.com/surg.php

WHY IS IT IMPORTANT TO KNOW ABOUT MENOPAUSE?
http://drn4u.com/Menopause.htm

HRT: The Whole Story:
http://health.discovery.com/centers/...hrt_whole.html

The role of ovarian hormones upon brain:
http://www.bbsonline.org/Preprints/O...bbs.fitch.html

Old Ovaries-still of value?
https://www.hystersisters.com/vb2/sho...threadid=10987

hormone replacement after complete hysterectomy: http://www.medicinenet.com/script/ma...MNI&qakey=2339

Chronic Pelvic Pain Diagnosis and Management: http://www.obgyn.net/displayarticle....ter/cpp_carter

http://www.aafp.org/afp/991015ap/1753.html
http://my.webmd.com/content/article/52/50300.htm

  Quote:
The basic types of ovarian cysts:

(1) functional cysts
(2) endometriomas
(3) benign ovarian cystic tumors
(4) malignant ovarian tumors

FUNCTIONAL CYSTS:
Functional cysts include the developing follicular cyst, the hemorrhagic corpus luteum cyst and the unrupture follicular cyst (also called a simple cyst). The developing follicular cyst is found in the ovary during the first two weeks of the menstrual cycle. This is the egg sac, including the egg, the support cells and the surrounding fluid. Normally these cysts enlarge to about one inch. The egg is then released during ovulation and the cystic fluid drains out of the ovary and thus the cyst goes away. This cycle of events happens almost every month in a woman with normal menstrual cycles. These cysts rarely cause pain unless the ovary is surrounded by adhesions (scar tissue). A hemorrhagic corpus luteum cyst forms when the egg breaks a small blood vessel in the ovary during ovulation. The broken blood vessel can bleed into the ovary and develop a blood clot or what is medically called a hemorrhagic corpus luteum cyst. This type of cyst can get pretty big and has an appearance similar to an endometrioma. A hemorrhagic corpus luteum cyst will appear suddenly and the body will reabsorb it over a month or two. The only way an endometrioma will disappear on a sonogram, other than surgery, is if it ruptures. Once in a while the developing egg is not released resulting in an unruptured follicular cyst. Ovulation does not occur. This condition probably occurs in most women once in a blue moon (the second full moon occurring in the same month). Unruptured follicular cysts occur more often when the ovary is surrounded by adhesions (it is more difficult for the egg to escape from the ovary) and is probably more common the first month after pelvic surgery since the hormone production fluctuates with the stress of surgery. Some women are genetically predisposed to developing this type of cyst. Some physicians believe this is one cause of fertility and is called luteunized unruptured follicular (LUF) syndrome in women who repeated do not release the egg. The majority of the time follicular cysts will eventually resolve on their own.
http://www.pelvicpain.com/askdoctor_QA.html#endogen
http://www.cyst101.com/summary.htm
http://www.nlm.nih.gov/medlineplus/e...cle/001504.htm
http://womenshealth.about.com/librar...ariancysts.htm
http://www.tjclarkinc.com/d_ovarian_cysts.htm
http://health.yahoo.com/health/centers/women/index.html
http://www.gynsecondopinion.com/OvarianCysts.shtml
http://www.reproductivecenter.com/cysts.html

Ovarian Cysts -- What Are They, And What To Do About Them: http://www.obgyn.net/displayarticle....ey/banter_0708

Laparoscopy for ovarian cysts:
http://12.31.13.84/library/healthgui...?HWID=hw199854

FAQ'S-Ovarian cysts:
http://www.womenshealthmatters.ca/ce...an_cysts/FAQs/

WHAT CAUSES MOST OVARIAN CYSTS?
  Quote:
The most common types of ovarian cysts are called functional cysts, which result from a collection of fluid forming around a developing egg. Every woman who is ovulating will form a small amount of fluid around the developing egg each month. The combination of the egg, the special fluid-producing cells, and the fluid is called a follicle and is normally about the size of a pea. For unknown reasons, the cells that surround the egg occasionally form too much fluid, and this straw colored fluid expands the ovary from within. If the collection of fluid gets to be larger than a normal follicle, about three-quarters of an inch in diameter, a follicular cyst is said to be present. If fluid continues to be formed, the ovary is stretched as if a balloon was being filled up with water. The normally white covering of the ovary become thin and smooth and appears as a bluish-grey. Follicular cysts may rarely become as large as 3 or 4 inches. The majority of these cysts, even the large ones, go away after a month or two as the extra fluid dissolves back into the blood stream.

At the time of ovulation, the covering of the ovary tears open in order to release the egg. Within hours, this covering heals, and the cells in the ovary form a structure called the corpus luteum. The corpus luteum produces progesterone, the hormone that prepares the uterine lining cells for the arrival of the fertilized egg. Every menstruating woman, every month, forms a corpus luteum. However, cells can produce fluid within the corpus luteum and form a cyst. While a corpus luteum cyst is usually no larger than a small marble, sometimes so much fluid is produced that a cyst of a few inches results. The good news is that, like follicular cysts, practically all corpus luteum cysts will go away by themselves in a few weeks. Follicular cysts and corpus luteum cysts are collectively referred to as functional cysts.
CAN LAPAROSCOPIC SURGERY BE USED TO TREAT AN OVARIAN CYST?
http://www.gynsecondopinion.com/ovarian-cysts.htm
  Quote:
"Because the removal of the ovaries may have a substantial impact on other health risks and quality of life, further research is needed to determine who is the best candidate and what is the best timing for this procedure," said Dr. O.
The research was conducted by a multi-disciplinary team of medical oncologists, genetic counselors, surgeons, and other scientists specializing in cancer genetics at Memorial Sloan-Kettering.
http://www.mskcc.org/mskcc/html/9140.cfm
Symptoms:
  Quote:
Cysts may grow quietly and go unnoticed until they are found on routine examination. However, if they are ruptured (by sexual intercourse, injury or childbirth) and/or become large enough, the following symptoms may occur:
  • Intense abdominal pain (symptom in all types of cysts)
  • Menstrual changes such as late periods, bleeding between periods or irregular periods (symptom occurring in corpus luteum cysts and polycystic ovaries)
  • Heavy menstrual flow (symptom occurring in polycystic ovaries)
    I
  • nfertility (symptom occurring in polycystic ovaries and endometrial cysts)
  • Internal bleeding (symptom occurring in endometrial cysts)
  • Severe menstrual cramps (symptom occurring in endometrial cysts)
  • Pain with sexual intercourse (symptom occurring in endometrial cysts)
  • Pain during a bowel movement (symptom occurring in endometrial cysts)
  • Weight gain (symptom occurring in polycystic ovaries and endometrial cysts)

Treatment:
Treatment depends on many factors, including the type of cyst, its size, its location, the type of material it contains and the woman's age. For functional cysts a "watch and wait" approach is taken. Functional cysts tend to dissolve over time and treatment is not needed. The doctors do, however, require the woman to return after two menstrual cycles to get a pelvic exam and/or ultrasound again. If the cyst is still present and growing (over 2 inches) the doctor may recommend a laparoscopy to remove the cyst. If the cyst comes and goes, the doctor may prescribe birth control pills. These pills reduce the hormones that promote growth of cysts and prevent formation of large cysts.

What are the treatments for ovarian cysts?

If you have not yet gone through menopause, you may not need any treatment, unless the cyst is very big or causing pain. Sometimes, taking birth control pills will make the cyst smaller. Surgery may be needed if the cyst is causing symptoms or is more than 2 inches across.If surgery is needed, often the cyst can be removed without removing the ovary.

Treatment options include:
  • Watchful waiting
  • Hormone therapy to reduce the size of the cyst.
  • Cystectomy to remove the cyst.
  • Oophorectomy to remove the affected ovary.
Pros and cons of hormone replacement therapy :
http://womenshealth.about.com/library/blmeno4.htm

  Quote:
A risk-benefit analysis of elective bilateral oophorectomy: effect of changes in compliance with estrogen therapy on outcome.
Speroff T, Dawson NV, Speroff L, Haber RJ
Department of Epistemology and Biostatistics, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio

A bilateral oophorectomy at the time of elective hysterectomy is often performed to prevent ovarian cancer. The assumption that endogenous estrogen can be easily replaced with supplemental medication fosters the decision for routine oophorectomy. Published reports on the use of postmenopausal estrogen indicate that compliance is less than perfect. This fact could affect the overall outcome. Decision analysis techniques with Markov cohort modeling were used to evaluate the policy of elective bilateral oophorectomy. Results from studies judged methodologically sound were combined to determine values representing the influence of estrogen on coronary heart disease, breast cancer, and osteoporosis fracture. The decision tree also explicitly incorporated patient compliance. When compliance with estrogen therapy is assumed to be perfect, oophorectomy yields longer life expectancy than retaining the ovaries. When actual drug-taking behavior is considered, retaining the ovaries results in longer survival. This analysis highlights the importance of including the effects of patient compliance with treatment recommendations when the impact of a health policy decision such as prophylactic surgery is assessed.
What You Don't Know Can Hurt You: Knowledge Is Power In A Doctor/Patient Relationship:
http://www.obgyn.net/displayarticle....ort/comfort006

BSO:
http://www.gyndr.com/salpingo-oophorectomy.htm

Ovaries: Should I Have Them Removed? http://www.ivillagehealth.com/expert...46_526,00.html

Ovarian Failure:
http://www.emedicine.com/med/topic1700.htm

Facts About Hormonal Replacement Therapy: http://www.healthy.net/library/books/lark/fc_a_hrt.htm

What IS Early Menopause?
http://www.earlymenopause.com/whatis.htm

bilateral salpingo-oophorectomy (BSO):
  Quote:
Oophorectomy is the surgical removal of one or both ovaries. It is also called ovariectomy. Oophorectomy is the surgical removal of one or both ovaries. It is also called ovariectomy.
Oophorectomy is performed to:
remove cancerous ovaries
remove the source of estrogen that stimulates some cancers
remove a large ovarian cyst
excise an abscess
treat endometriosis

Until the 1980s, women over age 40 having hysterectomies (surgical removal of the uterus) routinely had healthy ovaries and fallopian tubes removed at the same time. This operation is called a bilateral salpingo-oophorectomy. Many physicians reasoned that a woman over 40 was approaching menopause and soon her ovaries would stop secreting estrogen and releasing eggs. Removing the ovaries would eliminate the risk of ovarian cancer and only accelerate menopause by a few years.
In the 1990s, the thinking about routine oophorectomy began to change. The risk of ovarian cancer in women who have no family history of the disease is less than 1%. Meanwhile, removing the ovaries increases the risk of cardiovascular disease and accelerates osteoporosis unless a woman takes prescribed hormone replacements.

Risks:
Oophorectomy is a relatively safe operation, although, like all major surgery, it does carry some risks. These include unanticipated reaction to anesthesia, internal bleeding, blood clots, accidental damage to other organs, and post-surgery infection.Complications after an oophorectomy include changes in sex drive, hot flashes, and other symptoms of menopause if both ovaries are removed. Women who have both ovaries removed and who do not take estrogen replacement therapy run an increased risk for cardiovascular disease and osteoporosis. Women with a history of psychological and emotional problems before an oophorectomy are more likely to experience psychological difficulties after the operation.
http://www.hendrickhealth.org/healthy/000985.htm
I didnt mean to write a book here..lol..it's just considering Ovarian removal can carry some serious consequences that should be known about..Good Luck (((Cathleen))) I hope you can find some answers & relief to your pain soon..pls keep us posted..((((((((((((hugs))))))))))))))))
  #7  
Unread 05-22-2003, 11:43 AM
Thanks!

Sherri, Thank-you so much for all that information. I am so happy to see so much of it. Everyday when I recive such wonderful support from Hyster Sisters like you, it means so much to me and I am so glad for this website. Have a day! Once again Thank-you!
  #8  
Unread 05-22-2003, 12:33 PM
Results from my 2nd opinion Dr.

You are soo very welcome (((Cathleen))) Pls let me know if there is any particular issue you would like more info & I'll be glad to post some info for you
(((hugs)))
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