Letters to the Editor
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Fibroids aren't a big deal if you have insurance...
I had to pay upfront for my fibroid removal. I couldn't walk because I'd lost so much blood, but no money no op. I understand (sort of) that my doc couldn't work for free and all, but hold my op hostage until I fronted over 3,000 for the operation (2,000 of which I had to beg off of a dear old friend...and thank sweet charity for him forever) It's all very theoretical until your GP mentions that you are hours away from being hospitalised and transfused.
I just had to say something, because small problems become impossible nightmares when you are uninsured. In NYC where I live health insurance that covers more than emergency care costs over $250.00 more like $400.00, try paying that out of pocket while you work your entry-level job with "perks" instead of a bonus). Getting another job with healthcare is easy to say, but hard to do when you can't think because you have no blood in your veins. (Of course I got another job - months after the op...)
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Consider uterine artery embolization with caution
Two years ago, my gynecologist offered me the UAE option to shrink my fibroids and relieve the awful bleeding and anemia. I felt fortunate to have that option, to have insurance coverage, and to live in a metro area where the treatment was available.
A few weeks after UAE, I started expelling large fibroid chunks, which I didn't expect. Cutting to the chase, I ended up in the emergency room with a very painful, serious abdominal infection and life-threating sepsis. My doctor gave me the option to try to save my uterus, but she couldn't guarantee that the procedue would resolve the infection. I chose the hysterectomy.
Afterward, I did a medical literature search and learned that submucosal (just under the surface of the uterine lining) fibroids carry a higher risk of rupturing through the uterus after UAE. But that information was not in the literature I got from interventional radiologist's office. The submucosal fibroid that caused my problems was BIG! (The medical notation says as big as a baby's head.) My gut feeling is my doctors should have considered the size and location of the fibroid before going ahead with the procedure. And of course, I should have done more to educate myself beforehand.
I think UAE is a great option for a lot of women. But please do everything you can to educate yourself before you go through with it. Be careful if you have big fibroids that are submucosal.
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a hysterectomy does not mean a loss of ovaries
I had a hysterectomy at age 45 due to fibroids. I tried very hard to keep my uterus but it was not possible. When I decided on surgery my gyn put me on lupron to shrink my fibroids enough to allow me to have the surgery done vaginally with laproscopic assistance. The lupron did make them shrink, but when one of them shrank it pulled away from the wall of the uterus causing a uterine hemorage. It's a rare but life threatening complication and I had the surgery several days later. It was relativly easy, I had minimal pain, and I was back at work 2 weeks later. BUT...just because you are having your uterus removed you do not have to have your ovaries also removed. Your doc may tell you that it is a good idea because you will not have to worry about ovarian cancer but that is a decision only the woman having the surgery can make. I chose to keep my ovaries and take the (small) risk of someday developing cancer. A hysterectomy does not have to mean an instant menopause. The day I had my surgery was one of the happiest days of my life since my activities no longer had to revolve around always being within 45 minutes of a ladies room. My advice is that if you decide surgery is the answer, find someone who can do it vaginally and keep your ovaries. BTW, my sex life improved after the surgery. Once I was free of all that bleeding and pain sex was a lot more appealing to me. My orgasims are a bit different but no less enjoyable and I feel like having them a lot more often than I did in my pre-surgery days.
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There is hope and it is called ExAblate!
Three years ago I found out I had a Uterine Fibroid when they put in my Mirena IUD. At the time I was told that the IUD might shrink the fibroid and we should just keep a watch on it. Well, three years later the fibroid had grown to the size of a large orange and was causing me much pain and discomfort. The first doctor I went to who was suppose to be a highly respected GYN and fertility specialist asked me why I hadn't had children yet (I was 40 at the time)and then quickly told me the best way to remove it was with laparoscopy to try and "save" my uterus. I scheduled the appointment for a month later and submitted the request to my insurance company, Humana. Lo and behold I was rejected by Humana because I did not have fertility coverage. I never said I was having the procedure for fertility issues but because the doctor noted my file with the one question I asked about the state of my uterus afterward I was rejected. So now I was faced with a $20K+ bill and a possible three weeks of down time. As a Real Estate Broker I don't make money unless I am out there working for it so this really freaked me out. I cancelled the procedure and started doing my own research for other options. To my great relief I found ExAblate which is a MRI Guided Focused Ultrasound procedure. While the article states that this is a "new" option it really isn't. The procedure received FDA approval in 2004 and they have been doing this in Israel, Germany and Japan for many years before this. I spent days online reading everything I could on it. After extensive research I decided that this was a good route for me since it was a two day recovery and totally non-invasive. When I found out that the doctor here in Florida running the ExAblate office was highly regarded and had been awarded numerous accolades from the medical community I was sold. I had to have a special MRI to see if I was a candidate before they could move forward. Needless to say I was ideal and was able to set a date for the procedure. I had the procedure in November last year and would tell anyone this is a fabulous option for women with uterine fibroids (if you fit the criteria). I was up and fully functioning the next day. Within two weeks I no longer had the excruciating pain and discomfort. The one hurdle is the insurance companies. They are still deciding if this is covered even though it is less expensive than all the other medical procedures available and in theory, safer since it is non-invasive. Once they get past the bureaucratic BS, I believe this will become the option of choice for many women suffering from uterine fibroids. I personally could not recommend this enough and am grateful to the wonderful doctors and staff that literally held my hand through this experience.