I am always so thrilled when I hear from our Dr. Greene. She has been my doctor for 27 years and delivered three of my grandbabies!! I love when she gives us insight into some issue that she has diagnosed and most of the time resolved. If she drank the Kool-Aid, then I’m all in!
A patient came to my office today and it reminded me of a story that took place several years ago:
I had been seeing a particular patient in my office for several years. She is a lovely, pleasant woman who never complains. However, a few years ago, for the past few visits, she started to complain of a pain on the left lower mid, to left region of her belly. At that time she was 53 years old, and never had children or pelvic surgery of any kind. She was postmenopausal. She did not have vaginal bleeding.
A pelvic sonogram was done and revealed a normal uterine cavity and normal ovaries, with a fibroid within the uterus, (a common subserosal fibroid). Not thinking that the fibroid was an issue (I thought maybe something else was going on), I sent her for a CAT scan to see if I wasn’t missing something deeper in the abdomen or something more obscure. Nothing came up.
Maybe it was skeletal, so I sent her to a Rehab doctor for evaluation, a neurologist, and a urologist: Again, nothing came up. I just couldn’t figure it out. I was at my wits end.
I even tried to inject the area on the skin with lidocaine, thinking it was a trigger point of pain….to no avail; the patient simply had this pain, which would not resolve.
Six months later the patient returned. I examined her and pressed on the area where the fibroid was located and sure enough the patient shouted an “Ouch!!!” “Is that your pain,” I asked. “Yes,” she stated. “Just there, that is my pain.”
I stepped back and thought…. It must be the fibroid. We are against removing ‘asymptomatic” fibroids, but we lose sight of the fact that perhaps a mass effect of the fibroid, in fact, can be a source of pain.
I told her that I thought this was her fibroid. She said “Take it out, not just the fibroid, but the uterus as well.” I did, and you know what….. I saw that patient today 6 years after that hysterectomy. That pain was resolved after the hysterectomy and NEVER CAME BACK!!!
We are told so often to think that fibroids are probably benign and asymptomatic. We look past what is most obvious, trying to avoid performing unnecessary surgery. I drank the Kool-Aid because I forgot that fibroids can cause pain and discomfort. Some pain will only be resolved by removal, which is what I did with this particular patient.
My point? Don’t drink the Kool-Aid. Don’t listen to what the media says is right or wrong or what’s necessary or unnecessary. Each patient should be looked at individually and treatment should be guided to do what’s best for you.
My patient was relieved of her pain by removing her uterus. Having a hysterectomy was right for her.