March 2, 2012

Unrelated - Gynaecologist

Why are all my referrals to parts of the city I never drive in?  Stress upon stress!

But it feels so good when it’s over.  I didn’t know what to expect from this consultation, what they’d found on the latest ultrasound, and even if they’d be able to speak to my concerns about the severe pain I sometimes got in my lower abdomen.  I really hadn’t had any full-blown attacks since that one in August 2010, the one that spurred me to tell the endo that being on Spiro by itself might be making the attacks more frequent.  It had been a year and a half since the last bout.  Were they going to laugh at me for asking them to explain exactly what is on my ovary and what it means for me, and shoo me out of the office for wasting their time?  Was the pain going to be completely unrelated to the cyst they found in the ultrasound and I’d be back at square one?  Was I going to get intimidated and forget everything I wanted to say?  I’d gone so long without knowing, too scared to find out what it was.

I waited for half an hour in the examination room, the ominous bed with stirrups, two stainless steel kidney-shaped bowls and a tube of lubricant for company (none of them ended up applying to me, since being a virgin they can’t do the physical exam).  So I reviewed the list I’d spent the last couple of evenings compiling, with records of every episode of that particular abdominal pain, the ultrasounds, and medications I was on at the time, as well as compiling a list of questions to ask (for which the Mayo Clinic website was helpful). 

They’d told me a resident would be coming in first, and I liked her right away.  She was very sympathetic, paid close attention to what I told her and took lots of notes.  I was glad I had prepared so diligently the last few nights, because it made me more aware of the key things to tell her so I didn’t rely on her promptings to share all my observations.  She happily explained exactly what kind of cyst I had--which is a simple cyst caused by an egg-bearing follicle failing to reabsorb into the ovary.  It’s filled with fluid, which is a good sign its benign, and apparently this kind is very common in women; most don’t know they have them, as they do eventually reabsorb without pain.  Sometimes, as it seems to be in my case, they rupture, causing that severe but  fairly brief pain I have been experiencing at random.  My latest ultrasound showed that this one on my right ovary is still stable, and in fact possibly shrinking a little bit.  And the fact that I haven’t had any full-blown attacks of pain since starting birth control proves that the medications I’m on right now are controlling the problem, since my ovaries are not being told to release eggs.

The thought of cysts bursting and draining fluid into my abdominal cavity causing irritation and pain was not too encouraging, but I was told this is generally not a danger with small fluid-filled cysts.  The real danger is when the cysts get larger (2 or 3 times the size of mine) and can shift things around in your abdomen.  Really all that can be done for me is to wait and see--if I elected to have surgery to remove it, I could lose the ovary.  It is stable, and will likely reabsorb in six months to a year or so.  If this cyst bursts, all they can really do is give me a stronger pain killer to ride out the painful bit.  It was definitely reassuring to hear that other women have described this as some of the worst pain they’ve ever experienced.  And it’s gone pretty quickly.

She explained this all to me so clearly and patiently, I wanted to cry.  If only I could have had this answer years ago when I first told my family doctor.  After the resident made her diagnosis, she took it out to the gynaecologist, and who then came in to meet me and agreed with her conclusion.  She was just as sweet as the resident, and neither of them made me feel like my problem was trivial.  The OBGYN even gave me a lab requisition so that I could check the progress of the cyst in six months for my own peace of mind.  I felt grateful tears in my eyes.  A simple “thank you” was all I could give.  My second most troubling health concern (under hirsutism) has an explanation. 

Because the medications I’ve been taking for the hirsutism were relevant to the symptoms of pain I was experiencing, I did talk to the resident a bit about that part of my life.  I was impressed with how knowledgable she was about it.  Because hair growth is always a hormone problem and not always caused by the ovaries, I preferred going to an endocrinologist and never expected an OBGYN to be as familiar with all the tests and medications.  But I have to say I wouldn’t have had any qualms with that office treating my hirsutism if it had worked out that way.  I was just so pleased.  (She also said she could see no indications of hirsutism on me.  Thank you, Spiro and Cover Girl!)


Anonymous said...

You know this pain you're talking about - is it just under your tummy? And does it feel like someone punched you there?
None of my doctors ever addressed any cysts but for a couple of months, every so often, I get this huge pain. It comes suddenly and at random but it feels like I can't breathe nor move and nothing seems to help until it goes away few hours later.
Does it feel the same? .... ..... .... s.

Allerleirah said...

For me, it was very low in the abdomen, about level with where you would feel the anterior of the iliac crest of the pelvic bone poking up front, if not a bit lower. I would not describe it as being punched; it felt like a sharp, stabbing pain, as if standing upright would tear something inside me.

But that's my experience. I would advise keeping track of when in your cycle it happens, if you haven't been doing that already. Is it around ovulation time? Menstruation? This is probably the most valuable thing I did before finally going to the doctor again.

Anonymous said...

That is an obvious (erhm) and very smart advice - to make notes about what's going on when. Gotta start doing that...

I really cant be bothered to see another doctor right now but (knocking on wood like crazy) this pain has not happened in some time so fingers crossed. s.