What to expect with a Hysterectomy

A hysterectomy is the surgical removal of the uterus. It can be a daunting experience, this post was written with the intent to provide you with a patient’s perspective on the pros, cons and realities of a hysterectomy. This post is not intended to replace medical guidance or treat any condition. Please discuss the risks and benefits of hysterectomy with your doctor if you are considering a hysterectomy.

Different types of a hysterectomy-

Subtotal hysterectomy- removal of the upper part of the uterus, leaving the cervix in place.
Total hysterectomy- removal the entire uterus and cervix.
Radical hysterectomy- removal of the entire uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina. (Typically is only done when cancer is present.)

Reasons to have a hysterectomy-

Uterine Fibriods- Fibroids are benign tumors that grow in the muscles of the uterus.
Endometriosis- Endometrial tissue grows on the outside of the uterus and on nearby organs, causing pain, infertility and endometriomas.
Cancer
Uterine prolapse- Benign condition in which the uterus abnormally moves and shifts into the vagina.
Hyperplasia- The lining of the uterus becomes too thick and causes abnormal bleeding.
Unresolved Pelvic pain
Unresolved Abnormal bleeding

Different Surgical Techniques-

Vaginal hysterectomy- The surgeon makes a cut in the vagina and removes the uterus through this incision.
Laparoscopic hysterectomy- This surgery is done using a tube with a camera and surgical tools inserted through incisions made in the belly. The surgeon performs the hysterectomy with the use of surgical tools by viewing the operation on a video screen.
Laparoscopic-assisted vaginal hysterectomy- The surgeon removes the uterus through an incision in the vagina assisted by laparoscopic surgical tools.
Robot-assisted laparoscopic hysterectomy- The surgeon controls a robotic system of surgical tools to perform the hysterectomy by using laparoscopic incisions.
Abdominal hysterectomy- Hysterectomy done through an open abdominal incision, giving the surgeon broad access to the pelvic organs.

Patient’s Perspective-

Deciding to have a hysterectomy is a daunting decision. You and your doctor need to have an extensive conversation regarding the risks and benefits of whether this life changing surgery is the best choice for you.

Things to consider-

Your quality of life.

Is your pelvic pain inhibiting your life? Is it impacting your ability to work, sleep or function normally?

Is your cycle normal? Are you bleeding heavily or more than once a month?

Is it impacting your intimacy?

Are you missing work or social functions because of your symptoms?

Are your hormones out of balance?

Do you have fibroids, endometriosis or frequent ovarian cysts?

Are you in pain?

Do you frequently rely on pain killers (such as NSAIDS, tylenol or prescription pain medication)?

The answers to these questions are what you need to speak with your doctor about if you are considering a hysterectomy.

Your quality of life is what matters.

A hysterectomy is a tough choice. It renders a woman unable to ever carry a biological child. It is life changing surgery and should not be taken lightly.

That being said, if you are suffering and a hysterectomy can help you….it is all but worth it.

Personal Note-

At 25 years old, I had to make the tough choice to have a hysterectomy due to uterine fibroids, endometriosis and severe pelvic pain. I tried every viable option before making this difficult, heartbreaking choice. I tried every form of birth control, natural hormone, pill, cream, IUD and surgical option- all to no avail.

I have aggressive endometriosis. Since the age of 12, I have suffered with agonizing periods, abnormal bleeding, menstrual migraines and pelvic pain. It only seemed to get worse the older I got.

I had my first gynecological surgery at age 18 after endometriosis was discovered during an appendectomy/cholecystectomy. I had a pelvic D&C surgery done just about every year after that due to the endometriosis, fibroids and pain.

I tried birth control pills.

I tried bio-identical hormone therapies.

I tried alternative therapies.

I tried progesterone cream.

I tried estrogen patches.

I tried two different IUDs. (Skyla and Mirena)

I tried several surgical options.

Nothing seemed to quell my symptoms or stop the aggressive endometriosis.

The Final Straw-

I had to travel back to North Carolina from Florida due to Hurricane Irma. I was stuck in NC for over a month and had my period the entire time. Already fighting Addison’s disease and Medullary Sponge Kidney, the strain on my already taxed body was just too much. The agonizing cramps, non-stop bleeding, menstrual migraines HAD to come to an end. I knew that a pregnancy would be dangerous if I ever attempted it. The odds of me successfully carrying a baby full term were slim to none.

I made an appointment with my GYN and voiced my concerns. He agreed with me that a hysterectomy was my best option.

On November 22, 2017 I had a total hysterectomy. The surgeon informed me that I made the right decision and my uterus could not have been saved. My endometriosis was so aggressive that it had covered my uterus, cervix Fallopian tubes and created an endometrioma on my left ovary- all of which had to be removed.

As a woman who wanted children, I was devastated but knew I made the right choice.

-What to expect-

Emotional Impacts-

As prepared as I thought I was, emotionally this surgery hit me hard. I do not regret my decision, but it is hard knowing that I will never be a mother. Prepare yourself for the loss. It is, indeed, a loss. This surgery takes away your ability to conceive a child, but it doesn’t take away your ability to be a mother, to nurture and to love.

This surgery also takes away horrible cramps, seemingly endless menstrual periods and fears of miscarrying and passing on horrible genetics.

Focus on what you are gaining from this surgery, not what you are losing.

If you are still struggling with emotional balance, seek help. Inform your doctor. There are many options for dealing with post-hysterectomy depression.

Physical Impacts-

I am not going to sugar coat it, this surgery is a painful one. Be sure you have a conversation with your surgeon about post surgery pain relief because you will need it.

Be sure you have pain medication, proper hydration and nutrition during your recovery.

You will need to sleep a lot to recover. There is no shame in this. Pushing through the pain will stall your recovery. Give your body what it needs, be gentle with yourself.

You will struggle to sit on wooden chairs, walk up stairs and bend over to grab things.

Ask for help if you need it. Don’t push yourself.

After my hysterectomy, I struggled to urinate on my own. This can be a complication from anesthesia. You may require urinary catherization post surgery. Be sure to communicate with your healthcare team if you are having trouble urinating to prevent discomfort and infection. Do not strain to pee! This can cause you to rip your incisions! If you are struggling, communicate with your nurse/CNA.

Relationship Impacts-

A hysterectomy doesn’t change who you are as a person, but it does change your physical ability. Some people may not understand what you are going through. Some people may say mean things like “You are selfish for choosing not to have children” or try to place guilt or blame on you.

DO NOT ALLOW THIS!

You had to make this difficult decision, if anything YOU ARE the victim here and NOT at fault.

You are not less of a woman just because you cannot have a baby.

You are not less of a woman because you no longer have menstrual cycles or a uterus.

You are not at fault. You are not to blame.

Your quality of life is what is important.

Those who truly love you will understand.

I hope this article helps you understand the reality of a hysterectomy.

Below is the video of my personal story with my hysterectomy.

Wishing you hope & healing,

-Win

To read more from Winslow click the link below-

https://winslowedixon.wordpress.com/

March 14, 2016June 21, 2019

Things All Women Must Know About Polycystic Ovary Syndrome (PCOS)

Women in their reproductive age carry two special hormones that keep them fertile. Those hormones are progesterone and estrogen. In Polycystic Ovary Syndrome (PCOS) these two hormones get out of balance. The disturbance in these hormones leads to the development of cysts in the ovary. Most of these ovarian cysts are non-cancerous and do not cause any harm, but they can create complications in some cases. The prolonged disturbance in hormone levels can lead to many changes in fertility, physical appearance, menstrual cycle, and cardiac function.

Frequency of PCOS

This disease is very common. The research of the US Department of Health and Human Services shows that 1 in every 20 women in their fertile age is suffering from PCOS. In some regions, this rate is almost 1 in every 10 women. According to one estimate, in the United States almost 5 million women are suffering from this disease. In the UK, studies have shown a rate of 1 in 5 women suffering from this disease but more than 50% of these women don’t show any kind of symptoms. These stats are alarming because they show a high percentage of women being affected but who aren’t being treated for the condition. This is dangerous because PCOS can lead to additional very serious issues.

Symptoms of PCOS

The internal symptoms of PCOS generally appear when a girl starts to menstruate, and observable symptoms appear in late teens or early twenties. There are many symptoms of PCOS, and the occurrence of symptoms varies with each person. PCOS decreases the production of female reproductive hormones in the body, and some of the main symptoms include

• Change of voice
• Thinning of hair on the head
• Noticeable decrease in the size of breast
• Development of excessive hair on various parts of the body including face, toes, stomach, thumbs, and chest

Other symptoms include
• Oily skin
• Hair loss
• Anxiety and depression
• Weight gain
• Difficulty in losing weight
• Irregular or non-existent menstruation
• Acne on face and body

Your Doctor will also look for
• Increase in the size of your ovaries and the presence of cysts
• Decrease in the production of estrogen and progesterone
• Increase in the production of androgen

Diagnosis of PCOS

According to the Mayo Clinic, there is no specific test for Polycystic Ovary Syndrome, rather your doctor will come to the diagnosis after multiple tests and exams rule out other conditions.

“During this process, you and your doctor will discuss your medical history, including your menstrual periods, weight changes and other symptoms. Your doctor may also perform certain tests and exams:

Physical exam. During your physical exam, your doctor will note several key pieces of information, including your height, weight and blood pressure.
Pelvic exam. During a pelvic exam, your doctor visually and manually inspects your reproductive organs for signs of masses, growths or other abnormalities.
Blood tests. Your blood may be drawn to measure the levels of several hormones to exclude possible causes of menstrual abnormalities or androgen excess that mimic PCOS. Additional blood testing may include fasting cholesterol and triglyceride levels and a glucose tolerance test, in which glucose levels are measured while fasting and after drinking a glucose-containing beverage.
Ultrasound. An ultrasound exam can show the appearance of your ovaries and the thickness of the lining of your uterus. During the test, you lie on a bed or examining table while a wand-like device (transducer) is placed in your vagina (transvaginal ultrasound). The transducer emits inaudible sound waves that are translated into images on a computer screen.” (Quotation taken directly from http://www.mayoclinic.org/diseases-conditions/pcos/basics/tests-diagnosis/con-20028841)

Causes of PCOS

Doctors still have not found a direct cause for this condition, but there are a few factors they believe have an effect.

Excess insulin. Insulin produced in the pancreas helps your body process sugar, which is your body’s primary energy supply. Excess insulin might affect the ovaries by increasing androgen levels, which may interfere with ovulation.
Low-grade inflammation. White blood cells produce substances to fight infection in a response called inflammation. Research shows that women with PCOS often have low-grade inflammation that stimulates polycystic ovaries to produce androgens.
Heredity. If your direct blood relative has or had PCOS, your chances are high as well. Researchers also are looking into the possibility that specific genes are linked to PCOS.

Treatment of PCOS

Polycystic ovary syndrome treatment usually will focus on management of your individual symptoms, such as infertility, acne or obesity. According to the Mayo Clinic:

“Your doctor may prescribe a medication to:

Regulate your menstrual cycle. To regulate your menstrual cycle, your doctor may recommend combination birth control pills — pills that contain both estrogen and progestin. These birth control pills decrease androgen production and give your body a break from the effects of continuous estrogen, lowering your risk of endometrial cancer and correcting abnormal bleeding. As an alternative to birth control pills, you might use a skin patch or vaginal ring that contains a combination of estrogen and progestin. During the time that you take this medication to relieve your symptoms, you won’t be able to conceive.If you’re not a good candidate for combination birth control pills, an alternative approach is to take progesterone for 10 to 14 days every one to two months. This type of progesterone therapy regulates your periods and offers protection against endometrial cancer, but it doesn’t improve androgen levels and it won’t prevent pregnancy. The progestin-only minipill or progestin-containing intrauterine device are better choices if you also wish to avoid pregnancy.
Your doctor also may prescribe metformin (Glucophage, Fortamet, others), an oral medication for type 2 diabetes that improves insulin resistance and lowers insulin levels. This drug may help with ovulation and lead to regular menstrual cycles. Metformin also slows the progression to type 2 diabetes if you already have prediabetes and aids in weight loss if you also follow a diet and an exercise program.
Help you ovulate. If you’re trying to become pregnant, you may need a medication to help you ovulate. Clomiphene (Clomid, Serophene) is an oral anti-estrogen medication that you take in the first part of your menstrual cycle. If clomiphene alone isn’t effective, your doctor may add metformin to help induce ovulation.If you don’t become pregnant using clomiphene and metformin, your doctor may recommend using gonadotropins — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications that are administered by injection. Another medication that your doctor may have you try is letrozole (Femara). Doctors don’t know exactly how letrozole works to stimulate the ovaries, but it may help with ovulation when other medications fail.
When taking any type of medication to help you ovulate, it’s important that you work with a reproductive specialist and have regular ultrasounds to monitor your progress and avoid problems.
Reduce excessive hair growth. Your doctor may recommend birth control pills to decrease androgen production, or another medication called spironolactone (Aldactone) that blocks the effects of androgens on the skin. Because spironolactone can cause birth defects, effective contraception is required when using the drug, and it’s not recommended if you’re pregnant or planning to become pregnant. Eflornithine (Vaniqa) is another medication possibility; the cream slows facial hair growth in women.” (Quotation from http://www.mayoclinic.org/diseases-conditions/pcos/basics/treatment/con-20028841)

Lifestyle changes or home remedies recommended tend to center around losing weight and dietary adjustments in order to help manage insulin production.

If you think you may have PCOS or if you’re having any of the symptoms listed in this article, please consult your doctor for diagnosis and treatment.

February 25, 2016March 2, 2016

Spoonie Storie: Amanda

Hi, Amanda here. A spoonie still searching for answers.

Since birth I’ve struggled with allergies to everything, a comprised immune system, and issues with my feet (club feet & poor blood circulation). As I grew into puberty my female pain began, 11 years old. Asthma set in, allergies ruled my world. OCD was also a huge part of my life, eventually in my early 20s I was diagnosed with BiPolar Disorder after suffering 4 miscarriages(these turned out to be a result of my ex-husband having Balanced Translocation of 2 Chromosomes). The fight for mental stability coupled with allergies, asthma, fibroid tumors, PCOS, and never ending foot and spine issues have ruled the last 20 years.

In 2013 I had surgery on my feet with great hopes for relief, sadly more damage was done than I had before. This year I had my gallbladder removed, still fighting chronic kidney infections and stones, two hernia repairs, and finally in June a full hysterectomy, though I was able to keep my ovaries, praying they don’t fail on me. I’ve had Shingles the last two months, on my face so I’m fighting now to keep my left eye and left hearing.

Three weeks ago I fell down a flight of stairs while having a spasm in my eye, yes I was stupid for even being on a staircase. Now I’m laid up, going Friday for an MRI and scared to death of the damage I’ve done.

I’m still searching for answers concerning my immune system, last week they took 10 vials of blood for testing, I have no name for my endless fatigue, constant fevers, nights sweats, muscle pain, hair loss, hand tremors, migraines, swollen adrenal glands, inability to swallow, and a list of other endless strange symptoms that nobody can SEE! I’m searching, I’m so tired, I just want to know finally what is wrong, yes I have severe allergies and asthma, but that doesn’t explain all this other!

My mother is the only person who has stuck by my side, my father did as well, in fact he helped me escape my very dangerous marriage, but sadly we lost him in 2006. My mother and I are it, all we have are each other, she never gives up on me and I feel like such a burden. We are both on disability, she has so many health problems yet just today she sewed me heat wraps for my neck and feet! Without her I would give up.

I’m searching for answers, I’ve lost a marriage and have no children or siblings, sometimes my Bipolar is almost to much to bare. I’m still here though. I’ve not given up, I can’t, somewhere inside me I have hope, such a small little hope but it’s there.