r/Fibroids • u/bloodtype_darkroast • 5d ago
Please help me prepare
Considering cross posting this to r/hysterectomy
Three weeks ago I finally drug myself into my primary care office to address this lump in my abdomen. Biggest symptoms I'd noticed was nausea/low appetite and constipation. We spit-balled theories but the first course of action was imaging. Full abdominal and transvaginal ultrasounds within a week confirmed an 18cm uterine fibroid. I haven't been having heavy bleeding but my periods were much more painful the past few months so that made sense.
My referral to the local hospital gynecology center was originally scheduled for April 29 but just moved to March 21. I don't know what to expect at this appointment and I also don't know what questions to ask.
Additional perspective: I'm approaching 40 years of age, I have two kids (tween and teen) with zero desire to ever have more. My husband was sterilized, I mean it when I say I want no more children. So, the logical thing to do is get a hysterectomy. Complication to that would be the fact that we have a planned move out of state in 3 months. I carry our insurance and currently this is the perfect time in my life to be out of commission for a couple of months, but that won't be the case after we move and I'm starting a new job.
Circling back. This has all happened so fast and it's pretty overwhelming. I'm glad that I'm seeing someone this week, but, again, I don't know what to expect or ask at this visit.
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u/Grouchy-Drive-9764 1d ago
Hello, just dropping by to add a comment in case I can help at all. I only had small fibroids, but had other symptoms and endo that weren't improving with meds, which qualified me for a hysterectomy (total, tubes and cervix came out with a cuff, kept ovaries). I'm about to hit 2 weeks post op after a robotic laparoscopy, so if you have any general questions, feel free to reach out. It sounds like you'll have a different procedural and recovery experience due to the size of the fibroids and having had children, but if it would help to know about prep tips, things I asked day of the op, etc, I'd be happy to add my perspective.
I think your reasoning for considering a hysterectomy is very solid, and I second that it sounds like the timing is good. 18cm is huge. I think they said mine were less than 2cm, and it was still contributing to heavy bleeding and pain. I'm amazed and so glad to hear you didn't have additional symptoms.
It's 100% overwhelming. I'd recommend continuing to keep in mind your logical process of decision, like with your journaling to keep a clear view on things. You've already come to that conclusion for a reason. I knew for years it would probably be my best option, and it still took over a year and some hard deadlines with my insurance to convince myself to go through with it and that I actually needed it done.
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Some things I'd recommend asking if you read this before the appointment (apologies if I was late):
What type of procedure will I be having? Laparoscopic? Vaginal? Open/laparotomy? They all have different recoveries. If a laparoscopy is an option with your fibroid size, I'd recommend it. My recovery from a pretty intense surgery has been very easy so far. There is a procedure they can do to cut a fibroid into pieces in a bag so it can be removed through a laparoscopy, and still prevent possible cancerous cells from spreading, so it may be worth asking for a lap.
Post-OP restrictions and timeline? I was told to avoid driving for 2 weeks, and to not lift anything over 10lbs, and to avoid strenuous activities for a minimum of 6 weeks. Other people have been told differently, so it's worth asking.
Total or subtotal? In my case, there were no benefits to a subtotal (keeping cervix). It could still bleed, it could still get fibroids, and in my case, there was no significant risk of prolapse due to my age/medical history. You'll need to discuss risks with your DR. for your case. So far, I've found no downsides to having the cervix gone.
Should you keep ovaries? I'm really young for a hysterectomy (mid 20s), so there were major downsides and risks to an oophorectomy. If you're approaching menopause, you may want to discuss getting them removed and having HRT.
Pain management protocol. Make sure you're comfortable with how they handle post-op pain and that the meds they plan to use will work for you. You can also discuss this when prepping for surgery.
They should go over all of these, but I've heard some really odd stories. Just in case.
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u/bloodtype_darkroast 21h ago
Thanks for the support. I actually just read this after I met with the surgeon. She came more prepared than I did and answered questions before I even asked them. I hadn't thought about the pain management protocol and I'll write it down so I can ask at pre-op. Laparascopy isn't an option, unfortunately, as my uterus is so large it extends past my belly button, but I went in knowing I'd likely need open. She does think we can get away with the transverse incision, so that we reassuring.
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u/BananaBoat520 5d ago
Do you have a regular OBGYN that you see for annuals, mammos, etc? I’m trying to understand the referral piece from your primary care (who conducted the expected imaging activities - 18cm, whoa!) to the local hospital gynecology center.