March 2, 2005

Smallest Complaints

I'm feeling damn normal.

I noticed that I'm ovulating this morning.

My only complaint at this date is vaginal dryness. It only bothers me during intercourse and my husband and I have solved it quite neatly with some astroglide. But it still bugs me that it's changed so markedly. And the weird thing is that before the surgery I had what I considered a problem with a bit too much lubrication.

Starting this morning I'm using some progesterone cream again, and this stuff that I've chosen has some phytoestrogens in it. I'm thinking maybe that will have some effect on the vaginal moisture.

The other thing I've noticed is that my skin is much better than it's been in years. I've had this cystic acne around my jawline, neck and chest since I went off the pill in 1990. It's always bad during my premenstrual time, but lately not so much. I still have acne, don't get me wrong, but it's certainly more manageable and I actually now have days where I'm blemish free!

Posted by Elizabeth M. at 10:41 PM | Comments (1)

March 5, 2005

Options

I talk a lot about what I've done for fibroids, which was a hysterectomy.

But there are now lots of options:

Abdominal Myomectomy - surgical procedure where just the tumors are removed and the uterus is left intact.

Laproscopic Myomectomy - smaller incisions for this surgical procedure that is assisted by a small camera. Shorter recovery time and some doctors can't remove larger tumors.

Uterine Fibroid Embolization - small pellets are fed into blood vessels that supply the fibroids, the pellets clog the blood vessel, choke off the fibroids, which eventually die.

SonoWave - focused sound waves are used to destroy tumors. A very new treatment available in limited areas.

Not all doctors are versed in these procedures, so get informed if you have fibroids that warrant intervention.

Posted by Elizabeth M. at 10:36 PM

March 6, 2005

Disturbing Development

I'm a little worried. Last night as I got ready for bed I felt along my incision line and there was a distinct bump on the left end of it. I looked at it and there's a swollen spot that looks like it's filled with pus. Not a pimple, but deeper than that. I guess this is what's called an abcess?

I put a liberal coating of neosporin on it and went to bed. It was a little less red this morning, but still tender to touch.

I might take a photo of it and post it.

The thing that worries me is that the area under it, the intestines feel a little tender too. I don't know what caused this. I was playing pretty rough with the dog yesterday afternoon and she jumped up with her big claws a few times and might have given me a bad poke there (though the infection part baffles me). I also thought it could be an ingrown hair, which I've had trouble with, though those are usually rather shallow little pimple looking things. The other possibility is my body pushing out a little stitch or something. It's not a normal thing, but not unheard of to have stitches rejected by the body and have them work their way out even months later.

My lower belly is a bit unhappy, some gas, so maybe that's why it hurts under that part of the incision.

If it looks even the same tomorrow, I'm going to call the doctor and see if she can see me right away.

Posted by Elizabeth M. at 9:31 AM

March 7, 2005

Going Away

The little abcess on the side of my incision seems to be going away. I have no idea if it's because of my liberal applications of neosporin or my body is just doing what it's supposed to do.

I didn't let it bother me on Sunday, I went and met up with a friend who was walking the Los Angeles marathon and walked for two miles with him (delivered some much needed sustinance in the form of a fruit smoothie for him too). So couple that with my walk back to my car (a mile), and I did just fine for my first power walk since getting over the bronchitis.

Posted by Elizabeth M. at 3:59 PM

Doctor Bound

I'm going to the doctor tomorrow. It's a new doctor. I'm switching primary care doctors so this'll be my first appointment with him.

I've got mild asthma and since I'm getting over bronchitis I need a new prescription of Advair. I figure I'll also get him to look at my little abcess, which is looking okay, but what the hey, I'll be there.

Posted by Elizabeth M. at 9:11 PM

March 9, 2005

Abcess on Incision

I went to the new doctor yesterday.

He was great. Attentive to the whole picture. He asked about my hysterectomy and seemed dubious about it for fibroids and asked how big and I said "one pound--" and I didn't even get to finish because he nodded and said "too big", so he didn't think it was the wrong decision.

We didn't talk about my cyclical bleeding. Mostly the appointment was about my recent bronchitis and asthma/allergies.

He put me on a new treatment - singulair. I'll give it a try.

Then he looked at my tummy and the little infected site. It's not gotten better over the past few days, so I'm glad I mentioned it. I was also running a low grade fever of 99.2 - so this is not a tiny skin infection. He probed it a bit and agreed that it's either a very ingrown hair or a stitch being rejected by my body. Either way, he told me to keep up with the neosporin, to heat compresses four times a day and he put me on seven days of keflex.

The keflex is trashing my bowels, I've had diarrhea since early this morning. I'll start up on the probiotics next week.

Posted by Elizabeth M. at 7:57 PM

March 11, 2005

HRT After Menopause Increases Bladder Incontinence

HRT has been shown to be worse for bladder troubles than nothing at all. We all thought it was the opposite, didn't we? We all recognize that one of the side effects of menopause is an increase in urinary incontinence so one of the benefits of HRT was always supposed to be a decrease in bladder problems.

Not so, unfortunately.

A new study published February in the Journal of American Medicine found that:

The researchers found that menopausal hormone therapy increased the incidence of all types of UI at 1 year among women who were continent at baseline. The risk was highest for stress UI (1.87-fold increased risk with CEE + MPA; CEE alone, 2.15-fold increased risk), followed by mixed UI (1.49-fold increased risk with CEE + MPA; CEE alone, 1.79-fold increased risk). The combination of CEE + MPA had no significant effect on developing urge UI, but CEE alone increased the risk by 1.32 fold. Among women who reported having UI at baseline, both frequency and amount of UI worsened in both trials. Women receiving menopausal hormone therapy were more likely to report that UI limited their daily activities and bothered or disturbed them at 1 year. (conjugated equine estrogen = CEE / estrogen plus progestin CEE plus medroxyprogesterone acetate = MPA)

On that page with the article is also a rebuttal which emphasizes that this was merely one attempt at studying estrogen, which was conjugated equine estrogen. Some people believe very strongly in finding sources of bioidentical estrogens and that medroxyprogesterone acetate is NOT the same as the progesterone our body produces. No study as been released yet that studies the effectiveness of estrogen creams on the same urinary incontinence problems either.

Until then, keep your ovaries if you can!

Posted by Elizabeth M. at 3:49 PM

March 14, 2005

Weekend Freedom

Here's the good news. I went to Catalina over the weekend. I went last May and spent the day there and experience four bathrooms while I was there.

This time - it was a nine hour trip and I had a huge cup of coffee and a quart of water and needed to pee only once - perfectly normal.

How cool is that?

Posted by Elizabeth M. at 7:40 PM

March 18, 2005

Commonly Asked Questions

I'm happy to answer any questions anyone wants to pop me in an email (fibroidlizzie -at- yahoo.com).

Here are some things Cindy asked in the comments area. I figure for every person that emails me or leaves a comment, there must be others wondering the same thing.

The recovery time for your incision or scar seems to be a long time. And you state that the swelling and tenderness still seems to bother you at times even up till this month. I was wondering if this is normal? It just floors me to think that even after 6 or 8 weeks you are still to have problems.

I don't really consider them problems. First of all, I heal very slowly. I don't know why, but my husband and I can go out hiking and get scratched up and his will heal over in a few days and mine will still be there weeks later. So the slow healing of the incision area for me is probably not typical.

Also, I keloid. I think some of my discomfort at the moment is the incision area creating a scar. I've noticed more a white fiberous line in the center that is spreading. There's not much I can do about this, but it does itch a bit. If I weren't keeping a diary specifically on this subject, I'd never mention it.

As for the infection - again, if it's my body rejecting a stitch, that's probably an immune response that's atypical. I mention it because it's what's going on with me, so that other women like me will be able to see someone else's experience, but it's not something everyone will experience.

Also did you read anywhere about possible problems with your pelvic floor or bowel problems because the support is no longer there from the uterus? Also are you still suppose to have a period after your uterus is removed? So many questions I hope I am not over whelming you. But it sounds like you are doing great.

No, you're not supposed to menstruate after you have your uterus removed. Studies have shown that 5-10% of women who retain their cervix and one or both ovaries will have cyclical bleeding. But, it really doesn't bother me. I know it bothers some women, but I just think it makes me feel normal.

If you keep your ovaries you should still have hormonal cycles. You'll ovulate (the egg is just reabsorbed from wherever it lands in the uterus), you'll get PMS and you might have some symptoms that you used to associate with your period.

As for my pelvic floor support, I'm having no issues at all with that. My bladder is behaving perfectly normally, my cervix is in the right position, etc. In fact, fibroids are probably bad for the pelvic floor - they're heavy and press on things. Also, I think genetics may help out here. Some women have great pelvic floor muscles and ligaments. My sister had a TAH about six years ago and has not had any prolapse issues. Neither did my grandmother who had a SAH/BSO.

Remember that though most women are cleared for normal activity at 6 to 8 weeks, you're not fully healed internally for 6 months to a year. There's a lot going on inside of use, stitches dissolving, tissues knitting together and blood supplies being restored. I've been getting the swelly belly because my body has not restored all the little blood vessels in my abdomen to cart off the fluids that seem to gather there.

Think about it like you broke your arm. The cast comes off, but that doesn't mean that it's healed completely. Just healed enough for the restriction of the cast to be gone.

Some women make the mistake of thinking that the swelly belly is fat and needs to be exercised away. It's really the worst thing you can do for it. It irritates the tissues and keeps the body from concentrating on healing. You wouldn't exercise on a swelled ankle thinking that it'll heal faster, it's the same way with abdominal surgery.

A support site like hystersisters helps to give you a much more accurate picture of what happens after a hysterectomy, short term and long term. Doctors really aren't aware, because they only see their patients when they're brave enough to call back with a problem.

Let's face it, my complaints are small. And mostly of my own doing by not allowing myself the time to recover properly. Some was forced on my, and some I forced on myself. I went back to work too soon, I took on too many activities too early and then I had to travel for a funeral at 12 weeks (a red eye and carry my own luggage).

Everyone else - feel free to add your questions.

Posted by Elizabeth M. at 10:54 AM

March 22, 2005

Hysterectomy Raises Cardiovascular Disease Risk

A study released by the American Heart Association to be published in Circulation: Journal of the American Heart Association reports that women who’ve had hysterectomies have more cardiovascular disease (CVD) risk factors – making them more prone to heart disease and stroke than women who have not had their uterus removed.

This is sobering news for women who are considering a hysterectomy for non-life threatening reasons such as fibroids.

In a study of nearly 90,000 women, researchers confirmed that women who had undergone a hysterectomy had a 26 percent higher risk of a cardiovascular event compared to women who had not undergone hysterectomy. CVD events in this study were defined as having coronary death, heart attack, stroke or coronary revascularization procedures.

What seemed clear though is that women who have hysterectomies also already have higher risk factors for CVD. These risk factors include a higher incidence of hypertension, diabetes, obesity and family history of heart disease.

The most important thing to take away from this, I think, is that if you can keep your uterus, you should. It's unknown at this time if uterine problems are perhaps caused by the same things that cause CVD or removing the uterus hastens CVD. What is clear is that women who have had their uterus removed have a 26% increase in the incidence of CVD - and those with oophorectomy have a 28% increase. So making your doctor aware of your hysterectomy is vitally important to your ovarall health.

Posted by Elizabeth M. at 10:27 AM

March 24, 2005

Rethink Every Once In A While

I went to the doctor a couple of days ago to follow up on my bad bronchitis a few months ago.

I was diagnosed with asthma when I was a teenager. I get bronchitis a lot. There was a period of time when I was in college where I was getting it twice a year. When I moved to Southern California it got better and I only seemed to have trouble about every two or three years. Then last year I got the worst bronchitis I'd ever had. I coughed so hard I tore two intercostals. They hurt for six months.

Then I got the flu/bronchitis again this year and something's got to change. I can't keep doing this every year.

So, I talked to the new doctor and said, "let's start at the beginning with the asthma diagnosis." They gave me a standard breathing analysis and we found that I have no impaired lung function.

What does that leave? Allergies. Very bad allergies.

This was a doctor who actually looked in my nose and saw how inflamed it all is in there.

You're wondering what this had to do with my hysterectomy.

Not much.

Except to make the point that sometimes you need to go back and rethink stuff from top to bottom.

Some women go through terrible bleeding every month and find themselves on the road to a hysterectomy when in reality their menstrual bleeding is only a symptom of a bleeding disorder like von Willebrand's disease.

This doctor sat down and rethought this problem from the beginning - what were my symptoms and were they really asthma or were they actually something else.

Now I have to clean up my house, get rid of the down comforter, and start taking my allergies pills. We'll be able to tell in a few months if it's making any difference.

Oh, and he's also going to give me a full workup on my next visit. I'm going to have my cholesterol tested and I'm going to try to drop 10 pounds (or convert those ten pounds of fat to muscle, I don't care which) to get back to where I was two years ago.

Posted by Elizabeth M. at 7:56 PM

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