Endometrial Ablation and fibroids

blog pic 19Endometrial ablation was definitely a term I was unfamiliar with until all hell broke lose in my uterus!  It was presented to me as one of the options to try to deal with my ‘issues’ (other options presented included an IUD, changing my birth control, and as a last resort, a hysterectomy).  Even now, I find it challenging to find much information online about what it is exactly.  This article presents this option quite positively though I was told it is not without its risks and drawbacks (one being that it may only be a temporary solution).  Of course, it was a decision I never had to make due to my emergency hysterectomy surgery but for those of you looking into your options, perhaps this will help:

Endometrial ablation is one of the many minimally-invasive methods used to treat heavy menstrual bleeding due to fibroids or other causes.  It  is very effective in treating the bleeding that can accompany uterine fibroids in 40-60% of those treated, causing endometrial ablation to gain popularity, among other options, for the treatment of fibroids.

How It Works

Ablation procedures remove (destroy) the lining of the uterus, thereby eliminating heavy menstrual bleeding, in some cases, or simply decreasing the bleeding in others.  Abnormal bleeding is typically a result of bleeding from the uterine lining , destruction of this lining can lead to decreased bleeding or no menses without having a hysterectomy.  Because the uterus is preserved, this is also called a  uterine -sparing procedure.

There are no incisions and this procedure can be done in as little as five or 10 minutes in the office or in a hospital out-patient setting.   No recovery time is necessary, and,therefore, no time off from work is required except for the day of the procedure.

The amount of anesthesia needed is minimal, and it can even be performed using local numbing medicine placed in the cervix (a small local pain killer similar to what is done in the dentist’s office).

Things To Consider

As the inside lining or nest is essentially destroyed, the procedure should not be considered if there is even a remote chance that you may want children.

Not only will the nest or cavity of the uterus be unable to properly receive the embryo, if a pregnancy successfully attaches to the nest/ lining, the pregnancy could be frought  with potentially life-threatening difficulties such as placenta acreta, a condition where the placenta or afterbirth does not separate/detach after a delivery as it should.  This can lead to extreme bleeding and possibly an emergency hysterectomy under some circumstances.

There are numerous types of endometrial ablation methods. A consultation with your doctor to discuss your family planning wishes, while providing you with options for treatment will be a good time to address these concerns.

Originally retrieved from here.

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Types of Hysterectomy Surgeries

ImageThere are several types of hysterectomy surgeries that can be performed and they all have certain benefits as well as challenges/risks.

Abdominal hysterectomy:  As the name suggests, this surgery involves an incision in your abdomen, often 5-7 inches long.  It may be vertical or horizontal depending on a number of factors.  The recovery time for this type of surgery tends to be the longest out of all of the options.

Vaginal hysterectomy:  The surgeon will make a cut in the vagina and remove your uterus that way.

Laparoscopically-assisted vaginal hysterectomy:  The uterus is still removed through a cut in the vagina but the surgeon will use a laparoscope to assist in this process.  It involves 3-4 small abdominal incisions in order to insert the laparoscope.  The recovery time tends to be shorter with this type of surgery.  This is the procedure I had.

Robotic-assisted hysterectomy:  This is also referred to as the DaVinci method.  It utilizes a small robotic machine that works through small incisions similar to laparoscopic surgery.

There are numerous factors that impact which of these surgeries is best for any given patient including weight, recovery time, and the reason for the hysterectomy.  I will post more about the benefits and challenges of some of these surgeries in a future post.

Types of Hysterectomy

This appears to be one of the most misunderstood aspects of hysterectomy.  I was not clear on this either, before I had a hysterectomy.  I found people would hear about my surgery and then would label it with terms that they were familiar with but did not accurately describe my surgery.  Here are the three types of hysterectomy surgeries as found on the Mayo Clinic Site:Image

Supra-cervical hysterectomy (also referred to as a partial or subtotal hysterectomy): This is the removal of the upper part of the uterus only and leaves the cervix in place (first image pictured above).

Total hysterectomy:  This involves the removal of the uterus and cervix and is the procedure I had (bottom left image).  However, if I told people I had a total hysterectomy they assumed that meant the removal of ‘everything’ which is actually a:

Radical hysterectomy: involve removal of the uterus, cervix, fallopian tubes and ovaries (far right image).  This occurs most often when cancer is present.

To add to the confusion, these are types of hysterectomy based on what is removed.  Types of hysterectomy can also be classified based on the type of surgery performed.  More on that in the next post!

What you can expect – anesthetic (article from Mayo Clinic)

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There are lots of things that you learn about when you decide to go in for a hysterectomy.  Unfortunately, some of these things are only learned after we actually went through the surgery.  For me, one of those things was about anesthetic.  I had ‘been under’ twice before – once for removal of tonsils and once for removal of wisdom teeth – wow, doctors apparently really like taking things out of my body!).  I knew I always woke up very nauseated and both previous times I threw up in short order – something I really wanted to avoid right after a hysterectomy!  Well, apparently, it was not the anesthetic but the codeine that made me sick.  I had no codeine this time and woke up feeling pretty good.  However, what I did have was a sore throat and no idea why.  This post from the Mayo Clinic explains why.  It was from the tube they inserted in my throat while I was under.  It was fairly minor overall, but just one of those things that I didn’t learn until after it actually happened.  Hopefully this post will help you be a little more prepared for these effects than I was!

From the Mayo Clinic: http://www.mayoclinic.com/health/anesthesia/MY00100/DSECTION=what-you-can-expect

Before general anesthesia
Before you undergo general anesthesia, your anesthesiologist will talk with you and may ask questions about:

  • Your health history
  • Your prescription medications, over-the-counter medications and herbal supplements
  • Allergies
  • Your past experiences with anesthesia

The information you provide will help your anesthesiologist choose the medications that will be most appropriate and safe for you.

During general anesthesia
In most cases, your anesthesiologist delivers the anesthesia medications through an intravenous line in your arm, but sometimes the anesthesia may be given as a gas that you breathe from a mask. For example, children may prefer to go to sleep with a mask.

Once you’re asleep, a tube may be inserted into your mouth and down your windpipe to ensure you get enough oxygen and to protect your lungs from blood or body secretions, such as from your stomach. You’ll be given muscle relaxants before doctors insert the tube, to relax the muscles in your windpipe. In some cases this breathing tube isn’t needed, which reduces your chance of a sore throat after surgery.

Your doctor may use other options, such as a laryngeal airway mask, to help manage your breathing during surgery.

A member of the anesthesia care team monitors you continuously during your procedure, adjusting your medications, breathing, temperature, fluids and blood pressure as needed. Any abnormalities that occur during the surgery are corrected by administering additional medications, fluids and, sometimes, blood transfusions.

Blood transfusions may be necessary in some situations, such as complex surgeries. Anesthesiologists and other members of the anesthesia care team monitor your condition and deliver blood transfusions when necessary. However, blood transfusions may involve risks, particularly in people who are older, who have low blood red cell volume or who are undergoing complex heart surgeries.

After general anesthesia
When the surgery is complete, the anesthesia medications are discontinued, and you gradually awaken either in the operating room or the recovery room. You’ll probably feel groggy and a little confused when you first awaken. You may experience common side effects such as:

  • Nausea
  • Vomiting
  • Dry mouth
  • Sore throat
  • Shivering
  • Sleepiness
  • Mild hoarseness

You may also experience other side effects after you awaken from anesthesia, such as pain. Side effects depend on your individual condition and the type of surgery. Your doctor may give you medications after your procedure to reduce pain and nausea.

Hysterectomy Does Not Increase Risk of Cardiovascular Disease, Study Finds

blog pic 25Here is some good news for those of you needing a hysterectomy (or who have already had one).  Contrary to earlier reports, it seems like there is not a link between having a hysterectomy and an increase in cardiovascular disease.  Read on for more information about this recent study.

May 14, 2013 — Having a hysterectomy with or without ovary removal in mid-life does not increase a woman’s risk of cardiovascular disease compared to women who reach natural menopause, contrary to many previously reported studies, according to research published online today in the Journal of the American College of Cardiology.

“Middle-aged women who are considering hysterectomy should be encouraged because our results suggest that increased levels of cardiovascular risk factors are not any more likely after hysterectomy relative to after natural menopause,” said Karen A. Matthews, PhD, lead author of the study and a distinguished professor of psychiatry and professor of epidemiology and psychology at the University of Pittsburgh.

Hysterectomy is the surgical removal of a woman’s uterus; it is sometimes accompanied by the removal of the ovaries to decrease the risk of ovarian cancer. Hysterectomy is a common surgical procedure for women, but the benefits must be weighed against potential long-term related health consequences. Cardiovascular disease is the number one killer of women and many studies have shown increased risk of cardiovascular disease to be a health risk associated with hysterectomy, especially accompanied by ovary removal. Researchers in those studies usually evaluated cardiovascular disease risk factors years after hysterectomy and/or ovary removal and did not assess individual risk factor levels pre-surgery.

For this study, investigators followed 3,302 premenopausal women between the ages of 42-52 for 11 years who were enrolled in the Study of Women’s Health across the Nation (SWAN). Researchers compared cardiovascular disease risk factors in women prior to and following elective hysterectomy with or without ovary removal to the risk factors prior to and following final menstrual period in women who underwent natural menopause.

This is the only multiethnic study that has tracked prospective annual changes in cardiovascular disease risk factors relative to hysterectomy or natural menopause.

Investigators found that several cardiovascular disease risk factor changes differed prior to and following hysterectomy, compared to changes prior to and following a natural menopause, but those changes did not suggest an increased cardiovascular disease risk following hysterectomy, independent of body mass index, which did increase after hysterectomy with removal of ovaries. These effects were similar in all ethnic groups in the study.

Dr. Matthews said it is unclear why this study’s findings differed from other studies exploring hysterectomy and cardiovascular risk, but likely factors include the age of participants since hysterectomy that occurs earlier in life may present more cardiovascular risk. Also, earlier studies included women who had hysterectomy for any reason, whereas the SWAN study excluded women who had hysterectomy because of cancers.

“This study will prove very reassuring to women who have undergone hysterectomy,” said American College of Cardiology CardioSmart Chief Medical Expert JoAnne Foody, MD, FACC. “As with anything, if a woman is concerned about her risk for heart disease she should discuss this with her health care provider.”

Found at: http://www.sciencedaily.com/releases/2013/05/130514185330.htm

Women Overcome More than Breast Cancer

I’m torn about ‘think pink’ as well. I definitely need to look into it further. I highly recommend watching Pink Ribbons Inc if you’re interested in the idea of ‘pinkwashing’ at all. Here are some great links of other organizations doing good work in women’s reproductive health.

HysterRunner

This post has been a long time coming.  I am a bit tired of the pinking which occurs in response to Breast Cancer Awareness Month.  Earlier this month, I saw this tweet which really spoke to me.

 In addition to DVAM it’s Breast Cancer Awareness Month. Watch Pink Ribbons Inc & stop buying pink stuff #rethinkpinkpic.twitter.com/vEqXXFCuTm — Lauren Chief Elk (@ChiefElk) October 6, 2013

Not that there aren’t organizations out there which work hard to provide research support for breast cancer as well as those who provide support for women who are undergoing breast cancer treatment and their families.  But, there are so many products out there which appear pink-washed this month that aren’t actually associated with anything except profits.

Because of that, I felt that I should make you aware of some of the reasons why women get hysterectomies and organizations which support them.

endometriosis ribbonteal_ribbon_of_words_zip_hoodie_dark

Endometriosis – this occurs…

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