My fibroids surgery experience

By Meluse Kapatamoyo

A conversation with a friend who recently underwent an operation to remove fibroids brought back memories of my own surgery a few years ago. Prior to the operation, I had tried my best to encourage her to remain positive, remembering my own fears when I was first diagnosed. Fibroids are abnormal growths that develop in or on a woman’s uterus. The growths are typically benign (non-cancerous).

 

Meluse

Although I only had the operation in 2008, the diagnosis was made in 2006 after I noticed a small growth protruding near my pelvic area. At the time, apart from the occasional pain, it did not give me problems. But that did not prevent me from going into research mode. I was shocked to learn that fibroids are a common condition among women all over the world.  Not only do they come in different types, they are in different shapes and sizes too. What’s worse is that there is very little that women can do to prevent fibroids.

When I went for consultation, the doctors at Zambia’s University Teaching Hospital (UTH) located in the capital Lusaka, were assuring too, telling me it was a common condition among women of child bearing age, but more importantly that successful operations to remove fibroids were conducted regularly at the institution.

But even with such assurance, I was still fearful of many things. Not being able to wake up from the anaesthetic or my wound not healing properly, so, I made the decision not to have the operation.

Unfortunately, it didn’t take too long for the symptoms to start showing. My once flat stomach started to bulge and with it came rumours that I was pregnant. In addition to that I started to experience shortness of breath, simple activities that required me to bend over like painting toe nails or sweeping the floor. But even with that discomfort, I was determined not to have the operation.

But in late 2006, tragedy struck. My father died suddenly. I was in so much emotional pain that for the first time in my life, the thought of death did not scare me. Four months later, my sister died, not too long after I decided to have the surgery. I wish I could say the decision was thought out but I made it out of pain, hoping I would not wake up from that operation.

The D-day was January 31, 2007. As I slept in my hospital bed the night before the operation, I allowed my wonder. The doctors had diagnosed me with Pedunculated fibroids.

These are fibroids which are attached by a stalk to the uterus. The fibroids had also entered my uterus, the doctorssaid they would have to remove my uterus too. Unmarried and without a child, I asked myself how I would feel afterwards. But being the last born in a family of 11, I have many nieces and nephews, so my comfort was that I would be surrounded by many children regardless.

I had not slept much when the nurse came in to check my temperature and my blood pressure. Thinking I had researchedenough on the surgical procedure I was to have, i was shocked and felt violated when the nurse said she needed to insert a catheter (a tube tied to a bag which collects urine), as I would not be able to go to the bathroom on my own for several days. I tried to protest but according to the nurse, it was all mandatory for anyone undergoing such an operation. I gave in. Unfortunately, while I waited to be wheeled into the theatre one of the nurses noticed that the catheter was leaking, so it had to be removed and then inserted again, this time, by a male nurse.

 

I was so frustrated going into surgery. The last thing I remember before the anaesthetic took effect was protesting about the largenumber of people in the room.  Being a teaching hospital, when such operations are conducted, student doctors are usually present to observe. And while it’s understandable, I found it rather intimidating and an invasion of my privacy but I was knocked out before I could continue complaining.

I woke up several hours later, mouth dry, drifting in and out of sleep but was not allowed to eat or drink anything that day. It was only until the next day that I began to feel the pain of the operation. In-fact my entirebody hurt, if not from the operation located just above my pubic hairline, it was the cannula on my right hand where I was receiving a dose of injections. My left hand hurt too, which had a drip to replace fluids in my body because I was vomiting, so did my buttocks where I was being given another set of injections.

Perhaps the worst day was when I collapsed in the bathroom after the nurse’s insistence that I get out of bed to exercise my wound. Unfortunately, I was still weak. I don’t remember how long I was out for but I experienced a profound moment. For the first time, since my father’s death, there he was standing before me clear as day light. I was on the floor reaching out to him to help me get up but he kept pushing my hand away. 

 

I continued with my attempts to stand up until he aggressively pushed my hand away shouting ‘shala’ which in my local language Kaonde means stay.  When I came to, the nurses were fussing over me. My sisters and cousin who were at my bed side were in tears. It is the only time I ever dreamed about my father.

I spent five days in hospital. The wound healed quickly, the most pain I experienced was the time I had to clean it. I had to be helped to bath too, at least during the first week after I was discharged from hospital.I was also unable to walk straight for two weeks, afraid that I would rapture the operation. Something the doctors assured me would not happen.A month later, I was completely back on my feet, with only occasional pain on the wound whenever I exposed myself to the cold.

Years down the line, the scar is almost non-existent (will thank my dark skin) but seriously I believe it was mostly the expertise of the doctors. I have heard stories of people that say they have never completely healed and complain of constant back aches, headaches and pain in their pelvic area. I thank God I do not experience any of that.

Would I recommend that a person with fibroids has them removed? My answer would be yes, but of course doctors will advice when and if that should happen. There are many health risk factors especially for women within child bearing age. Sometimes fibroids can cause infertility, miscarriages and as was in my case, increased blood flow during menstrual periods. Fortunately for women who are menopausal, it is possible to live with them as fibroids feed on oestrogen which is high in women of child bearing age but is low in those who nearing menopause.

 

Overall, when faced with the decision whether to have an operation or not, i hope you choose the right method of treatment that is appropriate for you. And by the way, incase you are wondering, i still have my uterus. PYM

 

Fibroids: A readers personal account

Today I take a back seat role - let me put aside my writing and be a reader. Great contributions have come on POKEYOURMIND as will be affirmed in the story you are about to read from one lady whose mind was poked and she decided to share her personal story on fibroids. Do we share the same experiences? Here is her story...unedited.

FIBROIDS : A PERSONAL ACCOUNT

To wake up in a foreign country in a hospital is the last thing that anyone would like but that is exactly what happened to me once.

I woke up one morning and felt like the bed was spinning, I thought I was groggy from my sleep. I got out of bed and tried to stand up but fell to the floor. Lucky for me, my house mate then heard the thud, called for me and as there was no answer, she opened the door to my room and found me on the floor. When I opened my eyes, I was in the hospital.

I was found with low blood pressure, my blood levels where very low and thus the weakness. The good news is that I was given medication and treated but it didn’t end there.

After a year of staying in a foreign country, I finally came back home. A few months later, I went for a check- up and the doctor asked me about how my bleeding was during my menses, I told the doctor that they were very heavy. After a thorough examination I was finally given the bad news that I had the dreaded fibroids and that they were still quite small. I was asked all sorts of questions and we came to a conclusion.

The heavy bleeding continued but these came with excruciating violent period pains. I would have diarrhea and vomit and just fail to get out of bed for hours on end.

After two years of ignoring them and hoping a miracle would happen, my stomach started growing such that people would ask me whether I was pregnant. Sleeping became a problem because the fibroids grew so big that even my stomach felt hard to the touch. Eating became a problem too. I would eat small portions of food and feel so full, even drinking water would make me full as if I ate a full meal.

At the end of 2011, I traveled to work outside the country. On the first night I started experiencing this pain that I had never felt before. I went to the toilet and bled like never before. This happened twice and stopped, I prayed that I would just get home and get treated from there.

As soon as I arrived home, I made an appointment to see the doctor, we did the tests all over again, and I was told I needed to undergo surgery almost immediately as the fibroids had grown to sizes larger than my fist and there were three large ones and some small ones.

At this point, it was becoming impossible to do almost anything. I would tired easily, even lifting my hand for less than a minute was like I had done a very heavy job. I almost hated eating and drinking anything but at the same time when I got hungry I had pain in my tummy, basically everything was uncomfortable.

MY D-DAY

My surgery was scheduled for a Thursday so I checked into the hospital on a Wednesday evening as requested so that the nurses could prepare me. Very early in the morning, we (me and other ladies scheduled for various operations) were told to go to the theatre room. My turn came and I lay on the operating bed (or table). The anesthetist then gave me an injection that was shot through my leg and in a few seconds I was numb from my stomach down. Funny thing is I was actually chatting with my doctors. I could hear them pluck out chunks of the fibroids, one team member actually showed me what they were taking out of me.

The surgery was completed in about two hours. I was then wheeled back to the ward to start recuperating. But instead of that happening I started having this excruciating pain and I must have cried for what looked like hours for help from the nurses until one lady doctor (my angel) who personally knows me happened to be doing her rounds and found me. Am assuming because of my screaming, she had a look at me and found that I had started to bleed once again.

The doctor quickly made arrangements to take me back to theatre and made a few calls to some specialists. Apparently I bled so much I turned purple. I was opened and sewn three times in the same place where I was sewn the previous day. My chances, I am told were 50/50. I could have died but the almighty God decided to spare my life.

Oblivious to me and after being opened three times, as I had lost a great deal of blood and was literally on my death bed, I was wheeled to the Intensive Care Unit (ICU) again to recuperate but this time with extra care.

UNCONSCIOUS BUT ON THE MEND

As I lay in my unconscious state in the ICU with blood drips all over my body, my very loving family called everyone in my phone contacts and notified them about my situation, the doctors had said it was 50/50 so you can only imagine how frightened my family members were. People streamed in from everywhere to see me in my unconscious state not knowing whether I would make it or not. As everyone came to see me, I could see and hear all of them but all I could do at the time was shed tears, lots of tears. Now I know not from the movies but from my own experience that when people are unconscious, they can hear everything.

CONCLUSION

Statistics say that eighty percent (80%) of women on the streets have fibroids. They may seem simple because they do not hurt but when they grow very big, in my view, they can be very dangerous. I encourage all ladies to get examined especially if ones menses are heavy.

If I do not thank my God for preserving my life and giving me a second chance at life, then I do not deserve to be walking the earth today. God gave me a second chance. I thank him and only him.

Fibroids : A woman's enemy

By Meluse Kapatamoyo

A visitor to my blog recently requested that I do some research on fibroids. Here is an interview I had with Dr Mulindi Mwanahamuntu, a gynaecology consultant at the University Teaching Hospital (UTH) in Zambia’s capital, Lusaka.



Dr Mulindi Mwanahamuntu, a gynaecology consultant at the University Teaching Hospital (UTH)



Fibroids in Zambia

Fibroids, also called Leomyoma, are new overgrowths of the fibrous muscles of the uterus. Although they are essentially one and the same type of tumour, they are given different names according to the part of the uterus they occupy. Intramural fibroids are located in between the uterine muscle while the ones that push into the uterine cavity are called sub-mucous and those on the surface of the uterus are known as Sub-Serosa fibroids. The sub-serosa fibrods can even be in a suspended position from the uterus surface like fruits hanging from a branch, these are referred to as Pedunculated fibroids. All these are seen in equal measure at the University Teaching Hospital (UTH) but they present with different severity of problems (symptoms).

AGE GROUP

Fibroids occur in the years of child bearing age and most symptoms culminate when a woman is in her 30s. This is because fibroid growth is aided by prolonged presence of the hormone, oestrogen. Oestrogen is only opposed by the hormone progesterone when a woman is pregnant and this may explain why women that have never experienced a pregnancy-related-protection by progesterone are more prone to fibroids.

Early Detection

It is important to mention that of the diseases associated with the uterus, cancer of the cervix is the commonest cause of severe illness and responsible for 98.1 percent of all deaths related to new growths on the uterus. The preoccupation of women and care givers should be to discover cervical cancer cells early and not fibroids. That said, fibroids are responsible for much suffering and poor quality of life that include bareness, heavy menses leading to anaemia, life threatening infections, pain and occasional death to mention but a few.

What are the statistics of fibroid cases at UTH?

Fibroids are common among women such that slightly over 10 percent of women live with fibroids and only 2 to 3 percent of these actually have them large enough to cause symptoms of pain, menstrual disorders and sub fertility thus requiring treatment.

Preferred Treatment

Treatment of fibroids ranges from simple implantation of anti oestrogens under the skin to surgical procedures such as uterine curettage, open surgical procedure referred to as myomectomy (operation conducted on the uterus to remove fibroids) and to hysterectomy - the total removal of the uterine.

What determines the treatment?

The location of the fibroid and accompanying symptoms all guide to the selection of the method of treatment. Location, size and symptoms are most crucial determinants of mode of treatment. However, age of the patient, general condition, fertility wishes and previous intra-abdominal procedures all contribute to the choice of treatment. Patients are part of the process of choosing the mode of treatment but basic medical principles mentioned should not be breached. Most importantly, the cost of treatment, thoroughness of treatment and safety of the patient should not be confused. In navigating between these principles, many patients at UTH rightly end up undergoing surgical procedures.

The treatment can even cause death. Poor evaluation of pelvic and back pains has led into fibroid “operations” and the pain continues or worsens alongside many other irreversible complications. Treatment of fibroids is a specialist undertaking which does not entertain shortcuts.

Can a woman who has undergone a fibroid operation before get pregnant?

Part of the evaluation and counselling process in treatment of fibroids include preserving or enhancing chances of fertility. Treatment of fibroids when fertility issues are pertinent, it is not an event but a process. Majority of women treated for fibroids even surgically fall pregnant but the doctor must continue to look after such a pregnancy until delivery. For example, a third of fibroids are treated because of demand to restore fertility and 70 percent of such treatments are successful.

Every single operation is different from the other and doctors will advice since they are aware of how mutilative the procedure is. For example, after curettage, a month is all the rest you need while after a myomectomy, anything up to one year’s rest from pregnancy may be required.

Fibroids and Pregnancy

Fibroids undergo a painful degenerative process because of hormone changes during pregnancy. Sometimes labour can be difficult or even impossible when fibroids impinge on the pathway of a baby. Further, this uterine anomaly can be responsible for increased post-delivery bleeding. All this constitutes interference with pregnancy.

A woman has a 70 percent chance of normal vaginal delivery. But an evaluation of this possibility needs to be made by specialists and not by trial and error.

Statistical Occurrence

This is not studied but fibroids will keep coming if the contributing condition continues to persist. Interestingly the majority of fibroids stop growing or even shrink after menopause. Doctors do not usually wait for this natural “self-treatment” of menopause since some fibroids are known to become cancerous and in any case, cancers in their own right increase at this age.

Recommended Diet

There is no known dietary connection to fibroids. However heavy menstrual bleeding related to fibroids requires replenishment of iron by foods rich in iron such as greens, fish and stake.

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(A huge thank you goes to Mrs Annoymous to whom this article is dedicated. I hope all your questions have been answered)