Ablation...I'm concerned

[Bert Notorius]

My wife has been suffering from heavy periods and dangerously low blood iron levels and has been advised to either have a hysterectomy or undergo a procedure called ablation. Ablation sounds horrible but seems to be the lesser of two evils. After trying to put aside my own selfish concerns about the future of our sex lives, I have decided to use the 'net' to wade through the endless pages of often contradicting information to help her get the best solution her her long term health.

She has undergone several tests to rule out other problem areas, and she has commented that she's glad she's run out of orifices to probe.

I guess my question to this forum would be if anyone has had any first hand experience or knows anyone who has undergone this procedure? What to expect in the short and long term? We have about a month to prepare. Please, any information would be helpful.

-Bert

 

[SweetErika]

I can't help you with experience since this is the first I've heard of ablation, Bert, but have you checked out this endometrial ablation discussion group and looked around for others? I'm guessing you'll find lots of good information and opinions on sites/pages like that.

After reading on a few sites, I'd go for ablation over a hysterectomy for excessive bleeding any day. It's safer, less painful, doesn't seem to cause long-term or emotional problems, is a quicker recovery and has a 90% success rate. It seems like the main points are to choose a highly skilled, experienced surgeon who plans on using the best technique (from what I saw, some are safer and more effective than others). I'm guessing you've gotten several opinions and found the best doctor already.

Best of luck in your search and with the procedure, and I'll be interested to know the outcome if you get a chance to check back in afterwards!

 

[buxxxom]

After many years of "womanly" complications, I finally opted for a hysterectomy at the age of 34. I know, that seems young, but when you are ready for it, you are truly ready. Now, looking back, I wish I had not waited as long as I did. I was able to keep one ovary to prevent hormone therapy, and went from being in pain with every single step I took, to pain free, not to mention free from monthly periods. Those two factors led to a much improved sex life. That was my choice, and it worked out beautifully for me. If you are not concerned with fertility issues, it may be something to consider in more depth. Please ask your physician any questions you may have and get all the answers you can to make your decision easier.

 

[Eilan]

My mother had this done four years ago when she started having post-menopausal bleeding. IIRC, it was an outpatient procedure and I'm thinking that she went back to work the next day even though the doctor had written her an excuse saying that she could have a week off. She has a desk job, though, so she didn't have any problems.

She ended up having to have a hysterectomy about a month later, but it wasn't because the ablation failed.

If there's anything you want me to ask my mom about the procedure, just let me know, either via this thread or PM.

Good luck.

 

[Cathleen]

Bert, I wish I could give something more then more web pages to read but I did a few searches of my favorite sites (Mayo Clinic, NIH). The Mayo information was basic and didn't give anything more then anecdotal words. The NIH has some more interesting thoughts.

I wish you and your wife luck.

NIH

 

[Bert Notorius]

Thanks for the responses. Were both pushing 50 and a tubal has put us out of the baby race. Factors I have found that put up a red flag are:
1. 22% failure rate
2. different results for different methods

SweetE-

Thanks for the link. I will check it out. The ablation sounds like the place to start. She has only consulted 1 gyno, but has a GP and an endo guy involved. We were hoping for a hormonal treatment but the anemia is bad enough to warrant agressive steps.

Bxm-

Gald to hear you've had positive results with the hyst. After 23 years of practice our sex life is pretty good. The hyst. part had me very concerned. The gyno throws the term around like its no big deal, like removing a splinter. I don't have any parts down there that I could lose and still be 'effective'.

Eilan-

Post menapausal bleeding? I thought the only good part of mp was that 'it' was suppose to go away for good. That would be hard to deal with. My only experiece with the pause was watching my own mother go through it when I was a teenager. It wasn't pretty. I hope you mom is well.

Cath-

I will definitely check out your links. Thanks. That is why I'm trying to get some first hand testimony because the pamphlets and dr.s can only be expected to tell a part of the story. Fortunately my wife is very a positive and strong willed person, and I plan to do all I can.

 

[Cathleen]

You're welcome Bert, I'm glad to hear your wife is positive, it can make all the difference in the world.

I was going to post this site but thought it was silly - I've found good and useful information about menopause, etc. It might be worth a look and maybe a smile too. (The page linked is about ablation.)

Power-Surge

 

[Bert Notorius]

You're welcome Bert, I'm glad to hear your wife is positive, it can make all the difference in the world.

I was going to post this site but thought it was silly - I've found good and useful information about menopause, etc. It might be worth a look and maybe a smile too. (The page linked is about ablation.)

Power-Surge

1 1/2 years !?! I need to do more research.

 

[Swingercast]

I often turn to this site for help. webmd.com

Good luck and take care.

John

 

[Cathleen]

1 1/2 years !?! I need to do more research.

Yeah, that is another reason I hesitated posting the link Bert.

I forgot about another site I like. Cleveland Clinic. Here's a page from a search there.

Cleveland Clinic page

 

[SweetErika]

Thanks for the responses. Were both pushing 50 and a tubal has put us out of the baby race. Factors I have found that put up a red flag are:
1. 22% failure rate
2. different results for different methods

Thanks for the link. I will check it out. The ablation sounds like the place to start. She has only consulted 1 gyno, but has a GP and an endo guy involved. We were hoping for a hormonal treatment but the anemia is bad enough to warrant agressive steps.

I didn't link to it originally because I figured you'd already found it, but this doctor seems to know what he's talking about and does a good job explaining his rationale for the different methods.

One thing I've learned is the top doctors usually know other highly skilled professionals around the country and world. If you find a doc online that sounds good and experienced, you might as well try to contact him/her to see if they can refer you to someone in your area/state. Whatever you do, make sure you consult with several other experienced ablation practitioners though -- Endos and GPs have nothing to do with the procedure, and this is not something you want to leave to chance.

I'm sorry, but I have strong feelings on getting multiple opinions because my family and I have had really bad luck with doctors at times when we haven't done so, found the best in their field or cross-checked enough.

The hyst. part had me very concerned. The gyno throws the term around like its no big deal, like removing a splinter. I don't have any parts down there that I could lose and still be 'effective'.

I don't blame you for being concerned; a hysterectomy --or ANY surgery-- should be a last resort, yet many doctors hand them out like band-aids (this article is downright scary ). I'd run like hell from any doc who suggested surgery before trying all of the reasonable alternatives, and likely wouldn't stick with one who didn't treat a hysterectomy like the major procedure it is.

 

[Bert Notorius]

SweetE-

Well, it's kinda complicated. My wife worked for the guy far a while (the gyno). She's worked in all the area hospitals so she knows who's who. I like the guy, he's been around forever. I watched him do my last kids c-section birth 14 years ago. Plus he actually went in there with the scope to see what was giong on. So he's seem the territory and knows what's going on. But you are right about a second opinion. I just don't see her doing that. I just don't know if they've been doing this procedure long enough to know the long term results/complications.

 

[Eilan]

Eilan-

Post menapausal bleeding? I thought the only good part of mp was that 'it' was suppose to go away for good. That would be hard to deal with. My only experiece with the pause was watching my own mother go through it when I was a teenager. It wasn't pretty. I hope you mom is well.

Well, my mom had endometrial cancer, hence the postmenopausal bleeding. The doc did a uterine biopsy before he did the ablation.

She's still under the care of her gyn-oncologist, but she's been cancer-free for about four years now.

 

[eudaemonia]

I don't blame you for being concerned; a hysterectomy --or ANY surgery-- should be a last resort, yet many doctors hand them out like band-aids.

I cannot backstop you on this enough, although for the opposite caution.

Awhile back I had an emergency consultation with a surgeon for my ruptured Achilles. I felt he wasn't performing the diagnosis properly, because I knew all too well that it was very, verly like a complete tear. (I had heard the telltale "pop!" when it happened, as well as felt the immediate, intense burning all up and down my lower leg. I just knew.) The surgeon insisted it wasn't torn ... the same "specialist" who'd brushed off my prior complaints about the same tendon as "not chronic."

Had I not sought a second opinion from a top sports-injury surgeon in my area, I could well have developed gangrene or serious tissue damage due to prolonged immobilization, as suggested by the first surgeon.

The suggestion above to be your own advocate and seek out the best minds in the business for local referrals is excellent advice, IMO.

 

[Bert Notorius]

...first described in 1981. 37 years of clinical results should be available.

 

[Sunnygrl]

It really depends on how old your wife is...above the age of 40...get the hysterectomy. It will save her from it later...once childbearing is done, there is no biological need for the uterus...it just sits there waiting for cancer to attack. If the hormones are the issue, leave an piece of the ovary a size of a pencil eraser, that will give her enough hormones for life.

 

[SweetErika]

I cannot backstop you on this enough, although for the opposite caution.

Awhile back I had an emergency consultation with a surgeon for my ruptured Achilles. I felt he wasn't performing the diagnosis properly, because I knew all too well that it was very, verly like a complete tear. (I had heard the telltale "pop!" when it happened, as well as felt the immediate, intense burning all up and down my lower leg. I just knew.) The surgeon insisted it wasn't torn ... the same "specialist" who'd brushed off my prior complaints about the same tendon as "not chronic."

Had I not sought a second opinion from a top sports-injury surgeon in my area, I could well have developed gangrene or serious tissue damage due to prolonged immobilization, as suggested by the first surgeon.

The suggestion above to be your own advocate and seek out the best minds in the business for local referrals is excellent advice, IMO.

I should have phrased that differently, and meant unnecessary surgery, of course. I had a similiar experience as you with my knee, and it's just as (if not more) horrible as having surgery unnecessarily. I suppose you could call me a big fan of the, "we'll do whatever it takes to find and fix the problem, but won't pile on unnecessary treatments to please the drug reps or pay for my summer villa" attitude.

 

[uncutdad54]

My wife had an ablation 2 years ago this summer. She was, and still is anemic. The gyno performed the surgery with the hopes of helping her anemia. As far as our sex life goes it has never been better. She was 47 at the time of surgery.
She has never had any concern for cancer.
Her periods stopped for awhile, but she now bleeds lightly. Don't think I was much help but good luck to you both.

 

[Bert Notorius]

My wife had an ablation 2 years ago this summer. She was, and still is anemic. The gyno performed the surgery with the hopes of helping her anemia. As far as our sex life goes it has never been better. She was 47 at the time of surgery.
She has never had any concern for cancer.
Her periods stopped for awhile, but she now bleeds lightly. Don't think I was much help but good luck to you both.

That is bad and good news, but I thank you for the info. Has your wife had any success with other methods of iron replacement? Evidently, your wifes anemia is tied to something other than mstr blood loss. I'm trying to avoid "throwing the baby out with the bathwater" because I expect my wife could see the same result.

 

[mrs.jeepman6]

My wife has been suffering from heavy periods and dangerously low blood iron levels and has been advised to either have a hysterectomy or undergo a procedure called ablation. Ablation sounds horrible but seems to be the lesser of two evils. After trying to put aside my own selfish concerns about the future of our sex lives, I have decided to use the 'net' to wade through the endless pages of often contradicting information to help her get the best solution her her long term health.

She has undergone several tests to rule out other problem areas, and she has commented that she's glad she's run out of orifices to probe.

I guess my question to this forum would be if anyone has had any first hand experience or knows anyone who has undergone this procedure? What to expect in the short and long term? We have about a month to prepare. Please, any information would be helpful.

-Bert

I had the ablation done 4 years ago and couldn't be happier with the results. My libito has more than tripled since then and my periods which were always heavy have decreased in intensity by about 70 percent. I would get more than one opinion though as we are all different and do some research on your own through a site like web md or google it to get as much info as you can as its always best to make informed decisions

 

[Bert Notorius]

Mrsjpm6-

Thanks for your response! I will put your experiece down in the plus column. Did you seek the procedure because of anemia, or just relief from monthly symptoms? Having seen my wife's blood count slowly drop, and her resulting fatigue, I can imagine how the extra energy from a sucessful procedure would recharge your sexual batteries.

One factoid I have found states that 90% of women who have had the ablation done have not required a hystectomy within 5 years of the procedure due to worsening of symptoms. That fact seems a little open to interpretation, but hints at some sort of success rate.

 

[Bert Notorius]

It really depends on how old your wife is...above the age of 40...get the hysterectomy. It will save her from it later...once childbearing is done, there is no biological need for the uterus...it just sits there waiting for cancer to attack. If the hormones are the issue, leave an piece of the ovary a size of a pencil eraser, that will give her enough hormones for life.

Any surgical procedure that requires 4 to 6 weeks recovery can't be taken lightly. There is no real history of cervical cancer in her family. There is no real biological need any more for my testicles, but I am still fond of them. I just find it hard to accept that the 3 days a month is enough to be the sole cause of the anemia.

But I understand what you are saying.

 

[Private_Label]

Any surgical procedure that requires 4 to 6 weeks recovery can't be taken lightly. There is no real history of cervical cancer in her family. There is no real biological need any more for my testicles, but I am still fond of them. I just find it hard to accept that the 3 days a month is enough to be the sole cause of the anemia.

But I understand what you are saying.

For various causes of anemia here is a FAQ from the National Women's Health Information Center.

There is also a wikipedia article on it.

An article on iron deficient anemia


I know it wasn't exactly what you were asking about (Ablation of the uterus vs. hysterectomy or other surgery), but it might help to know which type of anemia it is before doing any surgery at all. If it is an iron deficiency then the uterine surgeries may well help, but if it is a different vitamin deficiency or a loss of intreinsic factor that helps you absorb vitamins from your gut, then no uterine surgery will help repair the issue.

If it is Iron deficency, has your wife attempted to change her diet to be higher in Iron? If not, then I would think that it should be tried before any surgery.

If it is a loss of B-12, there are sub lingual (under the tongue) sprays that can help replace the missing nutrient, as well as shots.

It could be that the gyno is throwing around the hysterectomy and ablation surgeries because he has a profession relationship already with your wife, and she may have heard how he feels about the outcomes of various surgeries before.

You need to know the underlying cause before you can decide which surgery, if any, is right for your family.

Has your wife seen a hematologist (blood specialist)? If so what did they recomend?

 

[Bert Notorius]

Private_label-

Lots of good points. Thanks. She is working with her GP (who I don't have alot of faith in) and a pretty good hemotologist as well as the gyno guy. Little things like near anaphalactic shock when they tried to administer IV iron and severe stomach cramps while taking the most absorbable oral iron sold suggest to me the problem isn't the bleeding. Stopping the bleeding is a stop-gap measure slow the amemia. As far as diet, she's 115# soaking wet and would live on noodles if she could.

I'm slowy coming to realization that the ablation, though not risk free, is perhaps a logical next step. I have not found one case where a woman has said specifically to stay away from the procedure. Dr's. tend to downplay the failures on websites (and in person), which is why I'm seeking first hand experience. I do know the gyno is not hyserectomy crazy, my wifes sister has been begging him for one and he keeps talking her out of it.

The one link you posted says to give the iron time to work its magic. 6 months to a year. She has a blood test Thursday. We will know more then.

 

[Jilly J]

My only experience with ablation is with cardiac ablation, so I don't have much advice to offer on the procedure. I can only say this, it is critically important for you and your wife to be the primary advocates for her health. Second opinions and feeling comfortable with and trusting your doctors is critical. Not all doctors are created equal, and unless you do the research you won't know what you're getting. Ask lots of questions and don't stop asking them until you're satisfied with the answers. And if the doctor won't give you the time you need then he/she's not worth your time. Good luck.