12 Days Post Mastectomy Recovery

Although not hysterectomy related, I have noticed how many people who read this blog, are doing so because of a cancer diagnosis. This person writes really well of her experience and has a wealth of information for those who may be experiencing the same diagnosis.

BRCA2: In This Together

The truth is, this is a very invasive surgery with an intense recovery. If you are prepared, stay on a schedule, and have a supportive caretaker (or community help), it’s very manageable. I had a prophylactic bilateral (right and left) skin and nipple-sparing mastectomy with immediate reconstruction using tissue expanders (the final implant exchange will be in the spring).

Preparation: I wrote about preparing for surgery here.

2 Days In Hospital: You will likely wake in a recovery area or your hospital room. I only remember waking as I was being wheeled into my private room, seeing my husband Jeffrey exiting the elevator on his way to be with me. Much of it is a fog now.

My chest was encased in a dressing that was a bit binding and I couldn’t initially see the work that was done. It felt like a shelf.

I was weak and my…

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Endometriosis: My Journey

A Life Worth Living

“This disease can be like having tens or hundreds of excruciatingly painful blisters covering the inside of the pelvis.” That’s one of the best descriptions I’ve read in regards to what Endometriosis is like. I found the quote on this Endo blog. Skim through the information there. It paints a very real picture of how Endometriosis can impact a woman’s life. It may not be life threatening, but it is a daily struggle.

In middle and high school I would stay home. On the days it hit after I was at school, I would go to the nurse’s office and was told to “lie down” for a little while. Once 30 minutes was up the nurse would call my mom. I would lie in bed at home writhing in pain, tears streaming down my face, and feeling the constant need to use the bathroom. The headaches were icing on the…

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It’s More than “Just Cramps” for the Holidays

While researching hysterectomies, one topic comes up again and again, and that is endometriosis. That’s not what led me to having a hysterectomy, but it does seem to be the case for many women. Here’s one post that talks about that.

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Being in physical pain sucks it.  Not getting much relief other than just barely taking off the edge sucks it.  Not knowing for sure what’s wrong or for how long the pain will last?  Yeah, that sucks it, too.  The prospect of going to the emergency room again, knowing that it’s entirely likely I’ll be treated shitty with less than professional and adequate care?  That definitely sucks it. 

But maybe the most hurtful thing of all is trying to explain the severity of this pain to doctors and people with some reactions ranging from skeptical to condescending to all-out disbelief with clear signs that they think I’m either “making this up” or “being dramatic.”  And the “joking” remarks about how I must have like NO pain tolerance or the questions that imply I should/would be doing “more” if it really is as bad as I say it is…Not funny, helpful…

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Why does race affect surgery procedures?

 
I found this article interesting.  It discusses how race seems to be a factor in type of hysterectomy surgery performed.  These numbers are American so I would be interested to know if such statistics would be true elsewhere.

Race, ethnicity influence chances of minimally invasive hysterectomy

By: MICHELE G. SULLIVAN, Internal Medicine News Digital Network

NATIONAL HARBOR, MD. – Race and ethnicity still appear to play a role in determining which patients receive a minimally invasive hysterectomy, and which undergo a traditional abdominal procedure.

Black, Hispanic, and Asian women were up to 50% less likely to have either a laparoscopic or vaginal hysterectomy, compared with whites, Dr. Katharine Esselen reported at the AAGL global congress.

The findings remained statistically significant even after Dr. Esselen and her colleagues controlled for a variety of patient, financial, and hospital characteristics.

“Racial disparities exist in the mode of hysterectomy in endometrial and cervical cancer, and must be further investigated to better understand the contributing factors so that they may be eradicated,” said Dr. Esselen, a clinical fellow in gynecologic oncology at Brigham and Women’s Hospital, Boston.

The researchers extracted their data from the 2009 National Inpatient Sample. It included 1,000 hospitals and more than 8 million patient stays – representing 20% of the discharges in the country for that year.

In 2009, there were 64,410 hysterectomies performed for gynecologic malignancy. More than half (54%) were for endometrial cancer, followed by cervical cancer (23%), and ovarian cancer (19%). Other cancers made up the remainder.

The majority of surgeries in all these categories were abdominal: 72% of the endometrial cases, 56% of the cervical cases, and 95% of the ovarian cases. Laparoscopic hysterectomy was the surgical mode in 26% of endometrial cases, 23% of cervical cases, and 4% of ovarian cases. Vaginal hysterectomies were performed for 2% of endometrial cases, 21% of vaginal cases, and just 1% of ovarian cases.

A multivariate regression analysis controlled for demographic factors (age, race/ethnicity, insurance); patient factors (cancer diagnosis, fibroids, endometriosis, prolapse, menstrual disorders, age, severity of comorbidities, obesity); and hospital factors (urban/rural, teaching status, size, and region of country).

After adjustment for all of these factors, black women were 43% less likely to have a minimally invasive hysterectomy for endometrial cancer than were white women – a significant difference. Hispanic and Asian women were also significantly less likely to have minimally invasive surgery (MIS), with odds ratios of 0.61 and 0.63, respectively. Native American women, however, were more than five times as likely to have such a procedure compared with white women (OR, 5.26).

Insurance also played a role, Dr. Esselen said. Those with Medicaid were significantly less likely to have a minimally invasive procedure (OR, 0.64) than were those with private insurance.

The findings were similar for ovarian cancer. Black and Asian women were significantly less likely to have MIS than were whites (OR, 0.41 and 0.44, respectively). There was no significant difference seen for Hispanic women.

Medical comorbidities were significantly related to the chance of MIS as well. MIS was significantly less likely in women with moderate loss of function due to comorbid conditions (endometrial OR, 0.47; cervical OR, 0.62; ovarian OR, 0.38). Those with major to extreme loss of function had an even smaller chance (endometrial OR, 0.23; cervical OR, 0.21; ovarian OR, 0.10). The P values on these were all less than .0001.

Obesity only affected MIS odds in endometrial cancer, significantly increasing the chance of such a procedure (OR, 1.27).