Happy Labor Day weekend! :-) I hope everybody's having a wonderful time where ever you are. Anyways, today I would like to share w/ you my experience this past Friday at the hospital. I had a lovely female client in her late 40's who was diagnosed w/ uterine fibroids.
Uterine fibroids are noncancerous tumors that develop within or attach to the wall of the uterus, a female reproductive organ.
Uterine fibroids are the most common pelvic tumor. Fibroids may be seen as many as 1 in every 5 women in their childbearing years (the time after starting menstruation for the first time and before menopause.)
Fibroids usually affect women over age 30. They are rare in women under 20 or in those who have gone through menopause. They are more common in African-Americans than Caucasians.
The cause of uterine fibroid tumors is unknown. However, fibroid growth seems to depend on the hormone estrogen. As long as a woman with fibroids is menstruating, a fibroid will probably continue to grow, usually slowly.
Fibroids can be so tiny that you need a microscope to see them. However, they can also grow very large. They may fill the entire uterus, and may weigh several pounds. Although it is possible for just one fibroid to develop, usually there is more than one.
Symptoms include:
* Abdominal fullness, gas
* Bleeding between periods or very prolonged bleeding with periods
* Increase in urinary frequency
* Heavy menstrual bleeding (menorrhagia), sometimes with the passage of blood clots
* Pelvic cramping or pain with periods
* Sensation of fullness or pressure in lower abdomen
* Sudden, severe pain due to a pedunculated fibroid
Note: There are often no symptoms.
Based on the symptoms, tests are performed to reach a diagnosis. These test include:
A pelvic examination, which, may reveal an irregularly shaped, lumpy, or enlarged uterus. Frequently, this diagnosis is reliable. In some cases, diagnosis of fibroids is difficult, especially in obese women. Fibroid tumors have been mistaken for ovarian tumors, inflammation of the fallopian tubes, and pregnancy.
A transvaginal ultrasound or pelvic ultrasound may be done to confirm the diagnosis of fibroids.
An endometrial biopsy (biopsy of the uterine lining) or a pelvic laparoscopy may be needed to rule out cancer.
After the client is diagnosed a treatment plan is determined.
Treatment depends on various factors, including:
* Age
* General health
* Severity of symptoms
* Type of fibroids
* Whether you are pregnant
* If you want children in the future
Some women may just need pelvic exams or ultrasounds every once in a while to monitor the fibroid's growth.
Treatment for fibroids may include:
* Birth control pills (oral contraceptives) to help control heavy periods
* Iron supplements to prevent anemia due to heavy periods
* Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naprosyn for cramps or pain with menstruation
Some women may need hormonal therapy (Depo Leuprolide injections) to shrink the fibroids. This medicine reduces the production of the hormones estrogen and progesterone. The hormones create a situation in the body that is very similar to menopause. Side effects can be severe and may include hot flashes, vaginal dryness, and loss of bone density. Hormone treatment may last several months. Fibroids will begin to grown as soon as treatment stops. In some cases, hormone therapy is used for a short period of time before surgery or when the woman is expected to reach menopause soon.
Surgery and procedures used to treat fibroids include:
* Hysteroscopic resection of fibroids: This outpatient procedure may be needed for women with fibroids growing inside the uterine cavity. In this procedure, a small camera and instruments are inserted through the cervix into the uterus to remove the fibroid tumors.
* Uterine artery embolization: This procedure stops the blood supply to the fibroid, causing it to die and shrink. The long-term effects of this procedure are still unknown, and the safety of pregnancy after this procedure is a concern.
* Myomectomy: This surgery removes the fibroids. It is frequently the chosen treatment for women who want to have children, because it usually can preserve fertility. Another advantage of a myomectomy is that it controls pain or excessive bleeding that some women with uterine fibroids have. More fibroids can develop after myomectomy.
* Hysterectomy: This invasive surgery may be an option if medicines do not work and other surgeries and procedures are not an option.
In the case w/ my client, her treatment consisted of analgesics (i.e. pain medications) such as Dilaudid PCA; in addition, she was prescribed a clear liquid diet. A diet of clear liquids maintains vital body fluids, salts, and minerals; and also gives some energy for patients when normal food intake must be interrupted. Clear liquids are easily absorbed by the body. They reduce stimulation of the digestive system, and leave no residue in the intestinal tract. This is why a clear liquid diet is often prescribed in preparation for surgery, and is generally the first diet given by mouth after surgery. My client was a 2nd day Post Op therefore that explains the rationale behind the clear liquid diet. She had a Total Hysterectomy with Bilateral Salpingoopherectomy (TAH-BSO)which is the removal of the uterus, both Fallopian tubes, and both ovaries. Ouch! I know ladies...crazy, right? But hey, it's the reality of life. Things happen.
On a more positive note, my client was a WINNER in my eyes. She had came in w/ a condition that was causing her pain, she had the issue corrected, and as a result she'll be BETTER than she ever was when she fully recovers. That was my outlook on the situation as well as my promise to my client. All in all, I must say: "It's such a gratifying experience to help another in need." I left the facility that day knowing that I made an impact in my client's life and for me...there's no better feeling in the world! This is 'thedoc' and I ABSOLUTELY POSITIVELY LOVE what I do. Thank you for taking the time to read this post and I hope you find inspiration from my experience. My words of wisdom for today are: "Don't ever give up on your dreams. Find your passion in life and make that passion come to life. Life is what you make it! Therefore, do what you love and do it well!!!
No comments:
Post a Comment