Wednesday, July 05, 2006

Six days, not that I'm counting

Just got back from Dr. L's office. Filled in the necessary papers and sat down with her, and then went off to have blood drawn. This time V. wasn't able to make it because he wasn't able to get away from the office. I would have liked him there, but I understand the necessities of his job and being on call this week.

Anyway, she rattled off what she was going to do, what could potentially go wrong all the while appending "I have to say this" to each thing. Perforating the bowel or the ureter are both very bad things, also worse case scenario if there was uncontrollable bleeding, she'd have to perform a hysterectomy but we AREN'T going there. But as she said, she's never had to do so when performing a myomectomy. And the chances of the former happening she said is less than one percent. She was very confident which I liked.

She explained about making the incision just below my navel and going in that way, making an incision in the uterus, removing the fibroids to outside the uterus, suturing me up and then removing the fibroids piece by piece. The steps below came from here and are basically what she's doing except that she performs step 12 as step 10 and continues from there.

To perform a laparoscopic myomectomy, the surgeon will:

1. Perform laparoscopic access procedure to patients abdomen
2. Administer blue dye that stains the uterine cavity
3. Locate the fallopian tubes and uterus to determine which tissue is fibroid tumor and which tissue is normal tissue
4. Determine which fibroids to remove and in which order
5. Inject a drug into the fibroid tumor to shut down the blood supply to the tumor and to "blanch" it to make it easier to see
6. Make an incision in the wall of the uterus where it covers the fibroid
7. Perform adhesiolysis (if necessary) to gain access and visibility of the fibroids
8. Grasp the fibroid tumor with a clamp and hold it under slight tension
9. Incise the fibroid tumor from its surrounding muscle tissue at the pedicle (attachment site) of the fibroid tumor
10. Morcellate the fibroid tumor (cut the fibroid tumor into pieces)
11. Remove the fibroid tumor pieces from the patient
12. Repair the tissue severed by the incision by suturing a layer of tissue at a time
13. Repeats steps 7-11 to remove fibroid tumors not accessible through the initial incision

Anyway, if you feel like a bit more detail and some photos of the procedure, go here. This is essentially what she'll be doing next week.

I don't have a time yet for surgery. The hospital will call on the morning of the 10th to let us know when we have to be there and what time the surgery is. I can't have anything but clear liquids from the 10th to after the surgery.

V. is on call for 3 straight weeks, starting last week. So when he showed me the schedule the other week, neither of us remembered I would be in the hospital over night. He had already made arrangements to be off call on the 11th, but now needs to make some arrangements in order to pick me up. I know he'll figure something out.


Anonymous said...

Our thoughts are with you Pam.
All our love

Famine & Devoide and kids

Anonymous said...

Hi Pam, I underwent an abdominal myomectomy 5 years ago - technology has changed! I loved the mophine...but I was in the hospital for four days. I hope your experience is somewhat uneventful. It will be great when this is over and you can look ahead to new things. Damn fibroids...

Penny said...

To say that I'm excited for you is an understatement.

If there's *anything* I can do (yes, including picking you up), let me know.

Wishing you nothing but the best and speediest recovery!!!!!

x said...

I have never understood what is involved in a "lap", thank you for the description. I hope that everything goes well.