Find us on Google+ Gastroparesis: December 2013

Saturday, December 21, 2013

Ovarian Cyst on Top of Gastroparesis

I went to the emergency room tonight because not only do I have an allergic reaction from adhesive tape and/or latex, but now I have a right ovarian cyst.

The allergic reaction happened after the doctor removed my Impanon. He put a strip of tape on my arm to stop the bleeding that I wasn't supposed to take off for another two days. However, I removed it when I saw this reaction:

My allergic reaction.

It was bothering me and really burning, so I called the doctor and sent him a picture on my cell phone. He wanted me to come to his other office today (more than an 1 & 1/2 away) but I wouldn't make it before he closed. I was in so much pain and I thought it was from the procedure yesterday. After I sent him the picture and waited a bit, he called me back to tell me to go to the Emergency Room.

We got there at 6pm and left at 1:30am. I thought I was going to die of boredom after my Kindle died. I didn't think to bring my charger and my husband tried his best to distract me. The nurse came in and gave me morphine and steroids in my IV. At least they got my IV on the first try but I would have loved to see my labs.

They came and got me for an ultrasound - regular and vaginal. I made them call my doctor because I didn't know if I could have the latter yet but he OK'ed it. It HURT like hell. They stopped and made me empty my bladder, so I went until I couldn't go anymore and went back in for the pelvic. That made me want to cry and jump off the table. This was around 12am, so my morphine had worn off. It was like torture and usually ultrasounds aren't bad. When they finished, they told me that the doctor would take 30 minutes to get the results.

When we got to my room, I waited more. The nurse came in and gave me Toradol, which helped with the cramping day before yesterday. Then, the doctor finally came in. He told me that I had an ovarian cyst on my right ovary and that my GYN will see me on Monday. I've seen my GYN twice this week, I should just put a cot in his office. So, I'm going Monday to see the doctor. I have an ovarian cyst on top of Gastroparesis now. I just want to scream!

The ER Doctor gave me prescriptions for codeine and for steroids. I put cortisone on the allergic reaction to speed up healing a bit.

Information about ovarian cysts can be found here: http://www.mayoclinic.com/health/ovarian-cysts/DS00129

You can read it here:

Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. Women have two ovaries — each about the size and shape of an almond — located on each side of the uterus. Eggs (ova) develop and mature in the ovaries and are released in monthly cycles during your childbearing years.

Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months.

However, ovarian cysts — especially those that have ruptured — sometimes produce serious symptoms. The best ways to protect your health are to know the symptoms that may signal a more significant problem, and to schedule regular pelvic examinations.


Symptoms:

Most cysts don't cause any symptoms and go away on their own. A large ovarian cyst can cause abdominal discomfort. If a large cyst presses on your bladder, you may feel the need to urinate more frequently because bladder capacity is reduced.

The symptoms of ovarian cysts, if present, may include:

Menstrual irregularities

Pelvic pain — a constant or intermittent dull ache that may radiate to your lower back and thighs

Pelvic pain shortly before your period begins or just before it ends

Pelvic pain during intercourse (dyspareunia)

Pain during bowel movements or pressure on your bowels

Nausea, vomiting or breast tenderness similar to that experienced during pregnancy

Fullness or heaviness in your abdomen

Pressure on your rectum or bladder that causes a need to urinate more frequently or difficulty emptying your bladder completely



When to see a doctor:

Seek immediate medical attention if you have:

Sudden, severe abdominal or pelvic pain

Pain accompanied by fever or vomiting

These signs and symptoms — or those of shock, such as cold, clammy skin, rapid breathing, and lightheadedness or weakness — indicate an emergency and mean that you need to see a doctor right away.


Treatment:

Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor may suggest:

Watchful waiting. In many cases you can wait and be re-examined to see if the cyst goes away on its own within a few months. This is typically an option — regardless of your age — if you have no symptoms and an ultrasound shows you have a small, fluid-filled cyst. Your doctor will likely recommend that you get follow-up pelvic ultrasounds at periodic intervals to see if your cyst has changed in size.

Birth control pills. Your doctor may recommend birth control pills to reduce the chance of new cysts developing in future menstrual cycles. Oral contraceptives offer the added benefit of significantly reducing your risk of ovarian cancer — the risk decreases the longer you take birth control pills.

Surgery. Your doctor may suggest removal of a cyst if it is large, doesn't look like a functional cyst, is growing, or persists through two or three menstrual cycles. Cysts that cause pain or other symptoms may be removed.

Some cysts can be removed without removing the ovary in a procedure known as a cystectomy. In some circumstances, your doctor may suggest removing the affected ovary and leaving the other intact in a procedure known as oophorectomy.

If a cystic mass is cancerous, however, your doctor will likely advise a hysterectomy to remove both ovaries and your uterus. Your doctor is also likely to recommend surgery when a cystic mass develops on the ovaries after menopause.




Brief drawing of the cyst that I have. Image found: http://www.mayoclinic.com/images/image_popup/r7_follicularovary.jpg




According to http://www.medicinenet.com/ovarian_cysts/article.htm#what_is_the_ovary_and_what_are_ovarian_cysts

Ovarian cysts facts:

Ovarian cysts are closed, sac-like structures within the ovary that are filled with a liquid or semisolid substance.

Ovarian cysts form for numerous reasons.

Pain in the abdomen or pelvis is the most common symptom of an ovarian cyst, but most are asymptomatic.

Most cysts are diagnosed by ultrasound or physical exam.

The treatment of an ovarian cyst depends upon its likely diagnosis and varies from observation and monitoring to surgical treatment.


What is the ovary and what are ovarian cysts?

The ovary is one of a pair of reproductive glands in women that are located in the pelvis, one on each side of the uterus. Each ovary is about the size and shape of a walnut. The ovaries produce eggs (ova) and female hormones estrogen and progesterone. The ovaries are the main source of female hormones, which control the development of female body characteristics such as the breasts, body shape, and body hair. They also regulate the menstrual cycle and pregnancy. Ovarian cysts are closed, sac-like structures within an ovary that contain a liquid, gaseous, or semisolid substance. "Cyst" is merely a general term for a fluid-filled structure, which may or may not represent a tumor or neoplasm (new growth). If it is a tumor, it may be benign or malignant. The ovary is also referred to as the female gonad.



What causes ovarian cysts?

Ovarian cysts form for numerous reasons. The most common type is a follicular cyst, which results from the growth of a follicle. A follicle is the normal fluid-filled sac that contains an egg. Follicular cysts form when the follicle grows larger than normal during the menstrual cycle and does not open to release the egg. Usually, follicular cysts resolve spontaneously over the course of days to months. Cysts can contain blood (hemorrhagic cysts) from leakage of blood into the egg sac.

Another type of ovarian cyst that is related to the menstrual cycle is a corpus luteum cyst. The corpus luteum is an area of tissue within the ovary that occurs after an egg has been released from a follicle. If a pregnancy doesn't occur, the corpus luteum usually breaks down and disappears. It may, however, fill with fluid or blood and persist as a cyst on the ovary. Usually, this cyst is found on only one side, produces no symptomsand resolves spontaneously.

Endometriosis is a condition in which cells that normally grow inside as a lining of the uterus (womb), instead grow outside of the uterus in other locations. The ovary is a common site for endometriosis. When endometriosis involves the ovary, the area of endometrial tissue may grow and bleed over time, forming a blood-filled cyst with red- or brown-colored contents called an endometrioma, sometimes referred to as a chocolate cyst or endometrioma. The condition known as polycystic ovarian syndrome (PCOS) is characterized by the presence of multiple small cysts within both ovaries. PCOS is associated with a number of hormonal problems and is the most common cause of infertility in women.

Both benign and malignant tumors of the ovary may also be cystic. Occasionally, the tissues of the ovary develop abnormally to form other body tissues such as hair or teeth. Cysts with these abnormal tissues are really tumors called denign cystic teratomas or dermoid cysts.

Infections of the pelvic organs can involve the ovaries and Fallopian tubes. In severe cases, pus-filled cystic spaces may be present on or around the ovary or tubes. These are known as tubo-ovarian abscesses.



How are Ovarian Cysts Treated:

Most ovarian cysts in women of childbearing age are follicular or corpus luteum cysts (functional cysts) that disappear naturally in one to three months, although they can rupture and cause pain. They are benign and have no long-term medical consequence. They may be diagnosed coincidentally during a pelvic examination in women who do not have any related symptoms. All women have follicular cysts at some point that generally go unnoticed.

Ultrasound is useful to determine if the cyst is simple (just fluid with no solid tissue, suggesting a benign condition) or compound (with solid components that often required surgical resection).

In summary, the ideal treatment of ovarian cysts depends on what the cyst is likely to be. The woman's age, the size (and any change in size) of the cyst, and the cyst's appearance on ultrasound to help determine the treatment. Cysts that are functional are usually observed unless they rupture and cause significant bleeding, in which case, surgical treatment is required. Benign and malignant tumors require operation.

Treatment can consist of simple observation, or it can involve evaluating blood tests such as a CA-125 to help determine the potential for cancer (keeping in mind the many limitations of CA-125 testing described above).

The tumor can be surgically removed either with laparoscopy,, or if needed, an open abdominal incision (laparotomy) if it is causing severe pain, not resolving, or if it is suspicious in any way. Once the cyst is removed, the growth is sent to a pathologist who examines the tissue under a microscope to make the final diagnosis as to the type of cyst present.




What are the risks of ovarian cysts during pregnancy?

Ovarian cysts are sometimes discovered during pregnancy. In most cases, they are an incidental finding at the time of routine prenatal ultrasound screening. The majority of ovarian cysts found during pregnancy are benign conditions that do not require surgical intervention. However, surgery may be indicated if there is a suspicion of malignancy, if an acute complication such as rupture or torsion (twisting of the cyst, disrupting the blood supply) develops, or if the size of the cyst is likely to present problems with the pregnancy.

Medically reviewed by Edmund Petrilli, MD; American Board of Obstetrics and Gynecology with subspecialty in Gynecologic Oncology
REFERENCE: eMedicine.com. Ovarian Cysts.
http://emedicine.medscape.com/article/255865-overview

Previous contributing author: Carolyn Crandall, MD, FACP




Friday, December 20, 2013

Essure Permanent Birth Control and ThermaChoice

Yesterday, I had my procedure for essure permanent birth control control done. I have decided to have my tubes tied, and this is a big decision for me. After years of begging for the doctor's permission to tie my tubes, because of my endometrosis and ovarian cysts. But, the doctors decided, albeit probably correctly, that I was too young.

However, on the 17th, my doctor finally recommended it. The best thing of all was that I had no copay! It was covered completely! I also want to mention that I've lost 30 pounds since July of 2013 when I went into the doctor's office.

He suggested Essure. To read more about it please click here: http://www.mwobg.com/services-procedures/library/how-essure-works

He suggested ThermaChoice in addition. To read more about it please click here: http://www.pelvichealthsolutions.com/thermachoice-expectation

I never planned on having children, so if I decide to have a baby later, I will adopt. I've come to peace with that. I just want some of this pain to end. I deal with enough pain in my stomach and digestive system, if I can get rid of the pain in my reproductive system, I might have sort of a chance to leave a better life with this procedure.

Gastroparesis seems to make the endometrosis worse, so if I can eliminate some of that pain, that would be amazing. Additionally, to get me ready for the procedure so I wouldn't feel any pain, he gave me two dilaudid, a valium, toradol, and a nerve block. I felt pressure but not a whole lot of pain.




According to Planned Parenthood's website, they describe the Essure procedure and benefits:

Permanent contraception (sterilization) is the most common form of birth control for women over the age of 30 and the second most common birth control method for all women of child-bearing age.

Essure offers women whose families are complete a proven and easy birth control choice that doesn’t require incisions, hormones or slowing down to recover. Women who choose Essure never have to worry about birth control again – no daily pill, no side effects, no quick trips to the pharmacy.

We are pleased to offer Essure, a permanent birth control procedure that works with your body to create a natural barrier to prevent pregnancy. The Essure procedure offers women benefits that no other permanent birth control can.



The Benefits of Essure:

Surgery-free

During the procedure, the Essure inserts are placed in the fallopian tubes through the natural pathways of the vagina and cervix, with no incisions and no surgery.

Hormone-free

Unlike many temporary methods of birth control, the Essure inserts do not contain hormones. Therefore, they will not interfere with your monthly cycle nor cause the side effects that many women experience with hormone-related birth control.

Virtually recovery-free

Following the Essure procedure, most women return to their normal activities in less than a day.
Most effective

Essure is proven to be the most effective permanent birth control available, based on five years of clinical data.
Trusted

More than half a million women have chosen Essure as their permanent birth control since 2002. Additionally, the Essure inserts are made from the same proven materials that have been used in heart stents for many years.


What to Expect:

During the procedure, your doctor will slide small, soft inserts through the natural pathways of your vagina and cervix into your fallopian tubes. No incisions are necessary, and this process typically takes less than 10 minutes. The inserts are designed to allow your doctor to see immediately that they have been properly placed. Anesthesia is not required for the procedure, although some doctors may offer it. Some women report mild discomfort or cramping during or after the procedure that is similar to a normal monthly cycle. Most women go home within 45 minutes of having the Essure procedure, and return to normal activities in less than a day.

Over the next three months, your body works with the Essure inserts to form a natural barrier within your fallopian tubes. These barriers prevent sperm from reaching the eggs so that pregnancy cannot occur. During this time, you and your partner will need to continue to use another form of birth control.

You will continue to have a regular menstrual period, but some women who have had the Essure procedure find that their period changes afterward, becoming slightly lighter or heavier. These changes may be due to discontinuing hormone-based birth control, such as the Pill, and returning to your normal cycle. Your ovaries will continue to release eggs, but they will be absorbed through your body’s normal process.

That’s it! Now you can focus on yourself, your family and the life you have created, with the confidence that you are protected from unplanned pregnancy.

Like all permanent birth control procedures, the Essure procedure is not reversible. You should make sure you do not want to get pregnant in the future.

The Wikipedia article for Essure can be found here: http://en.wikipedia.org/wiki/Essure

He also gave me a shot of Depo Provera, so I would be covered until things heal over.



ThermaChoice

This is a procedure the doctor is going to do for me in three months. He wants to make sure that the Essure procedure has completely blocked off before he does this.

You can read about it more at this link (http://www.pelvichealthsolutions.com/thermachoice-expectation but this is what the website says,

GYNECARE THERMACHOICE® Uterine Balloon Therapy with Fluid Circulation offers an effective, nonhormonal treatment for heavy periods, also known as menorrhagia. GYNECARE THERMACHOICE® is a minimally invasive, 8-minute procedure that can be performed in your doctor's office or in a hospital. What happens during the procedure? GYNECARE THERMACHOICE® uses a method called global endometrial ablation (GEA) to remove the endometrium, the lining of the uterus (womb).

Under local anesthesia, the doctor inserts a small silicone balloon into your uterus, which is filled with fluid and then gently heated to treat the lining of your uterus. No incision is required. You may feel a slight warmth or pressure during the treatment time, which is 8 minutes; the entire appointment usually lasts approximately 30 minutes. See step by step how GYNECARE THERMACHOICE® works.

In most cases, patients can resume their normal activities the next day.



What happens after the procedure?

The first postoperative check-up usually occurs within 7 to 10 days after the procedure, and your doctor may determine that sexual activity can resume after that check-up. Your first few periods after the procedure may continue to be heavy, with improvement thereafter. Some women experience a pinkish watery discharge for about 2 weeks that can last as long as 1 month.

All medical procedures carry risks. Talk to a doctor to determine whether GYNECARE THERMACHOICE® might be the right choice for you. Find a doctor familiar with GYNECARE® products who can provide treatment.
What are the risks with GYNECARE THERMACHOICE®?

All medical procedures present risks, so talk to a doctor about whether GYNECARE THERMACHOICE® is right for you. Find a doctor familiar with GYNECARE® products who can provide treatment.

As with all procedures of its type, GYNECARE THERMACHOICE® poses a risk of injury to the uterus and surrounding tissues. Most common side effects include discharge, cramping, nausea and vomiting.

Global endometrial ablation procedures, including GYNECARE THERMACHOICE® III Uterine Balloon Therapy System, are intended for pre-menopausal women with heavy bleeding due to benign causes who do not wish to become pregnant in the future. It is not appropriate for a patient who is pregnant or wants to become pregnant in the future. Becoming pregnant after this procedure can be dangerous for both the mother and the fetus.

Pregnancy after ablation is unlikely, but if it does occur, you and your baby could be at risk because the endometrial lining of the uterus has been removed. After treatment, you will need to continue to use a birth control method that is appropriate for you. There are several options available for birth control. You should discuss these options with your doctor.

For a complete description of risks related to this treatment, please see the Potential Adverse Effects section of the Risk Information.

The information represents no statement, promise or guarantee by Ethicon, Inc., concerning insurance coverage, levels of reimbursement, payment, or charge. Please consult your payor organization with regard to local or actual coverage determination processes.


This will get rid of my painful periods permanently. That would be amazing because they hurt and are erratic. So, I will be sterile with no periods, but I get to keep my ovaries so I don't need hormone replacements. This was a tough decision for me but I knew I could never carry kids to term. So, I figured that this would help the pain. And I need all of the help I can get with pain because Gastroparesis causes enough pain in itself.

So, I am very happy and a little sad, but I'll be OK. I think I've done the best possible thing that I could do for me and wanted to write about it because I had never heard of these procedures before.



Disclamier

My friend Stephanie wrote this for her group and I figured it was applicable to this site as well.

DISCLAIMER: THIS BLOG DOES NOT PROVIDE MEDICAL ADVICE

The information, including but not limited to, text, graphics, images and other material contained on this blog are for informational purposes only. The purpose of this blog is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Reliance on any information appearing on this blog is solely at your own risk. That said, I try to do research to support my claims but always check with a physician first.

Thank you!