Three Questions to Ask Your Surgeon Before Your Operation
Most endometriosis patients have similar experiences when it comes to finally being diagnosed with the disease. It starts with the appearance of a host of inexplicable unpleasant symptoms that show up a few years after menstruation begins. Many women go from doctor to doctor, trying to figure out what exactly is wrong with them. Some women will come across a knowledgeable gynecologist and figure out early on that it is endometriosis. Some women will not be diagnosed with endometriosis until they are having fertility issues.
For most women, their first surgery to treat endometriosis is not performed by an expert endometriosis surgeon. For most women, their first surgery is performed by a well-meaning gynecologist or reproductive endocrinologist. These doctors go in and ultimately do more harm than good. They will prematurely do hysterectomies on patients because they feel it is the only solution. They can damage vital organs in the body while trying to remove the endometriosis due to their inexperience. By performing ablation and not excision, the often just burn away the tip of the disease leaving the rest behind. Or they simply leave endometriosis in places they do not feel comfortable operating on. Some doctors open a patient up and quickly close them up after seeing how bad the disease is. They realize immediately that they are over their heads. Patients may get temporary relief from these surgeries but often, within months, they feel worse than they did before the surgery.
Here are three important questions to ask your surgeon before agreeing to be operated on:
Do you use the excision method to remove endometriosis?
Expert endometriosis surgeons use the excision method to remove endometriosis. This is the best way to remove the disease. Endometriosis is like an iceberg, with the bulk of the disease infiltrating tissue and organs below the surface. A number of gynecologists and reproductive endocrinologists use laser ablation and vaporization to remove the endometriosis. When a doctor burns away the endometriosis, it turns the tissue black, making it very hard to see if there is further disease that needs to be removed from the surrounding tissue. Ablation does not remove the deep infiltrating endometriosis that lies beneath the surface. Only excision can address that. When a surgeon cuts out the disease using the excision method, biopsies can be sent to pathology and endometriosis can be pathologically confirmed.
If I have endometriosis on my bowels, ureters, nerves or any other places that is not related to my reproductive system, will you remove it? Will you have other experts involved in my surgery who know how to treat endometriosis?
Unfortunately, many doctors who treat endometriosis do not primarily focus on the disease in their practice. Gynecologists and reproductive endocrinologists will ablate endometriosis off reproductive organs with the hope of giving their patients temporary relief or helping them achieve pregnancy. When they go in and see that a patients’ bowel is connected to her uterus or her ureters are attached to her pelvic wall, they are often ill prepared to treat extensive disease. Some medical professionals will not even check the bowels, bladder, appendix or gallbladder, where disease can be found. The bulk of the disease will remain after surgery as will the pain and often the fertility struggles. There are experts who will meticulously remove endometriosis throughout the entire pelvis. For a patient who may have suspected extensive disease, the surgeon may gather a team of professionals to assist in the surgery including a gastroenterologist, a urologist, a cardiothoracic surgeon or a neurologist. It is important that your doctor has a plan for treating ALL of your endometriosis.
Can you make preserving my reproductive organs a priority?
Sadly, Lupron and/or a hysterectomy are two popular options given to suffering patients by doctors whether that patient is 19 or 46. Expert endometriosis surgeons will try their best to free and preserve the fallopian tubes, ovaries and the uterus of their patients. Studies have shown that after excision surgery chances of conceiving spontaneously increase. Unfortunately, sometimes even in the most expert hands, fallopian tubes or ovaries are removed to preserve the quality of life with a patient. But, this possibility should be discussed before surgery and should not be done without the consent of the patient. For those patients with adenomyosis, the hard decision of a hysterectomy might be made to provide relief for the patient.
Search for the Best Care
For many patients, when their doctor finally puts a name to their lifelong symptoms, there is an immediate sense of both gratitude and fear. There is the attitude that since this is the one doctor that could finally put a name to my misery, than he/she must be able to fix it. In this time of crisis and acceptance, endometriosis patients must seek out the best, most knowledgeable endometriosis surgeons to ensure quality care and treatment of this debilitating disease. Hopefully one day, expert care will be available in every city, covered by every insurance plan, to lessen the already heavy burden of the patient.
A version of this article was first posted on http://www.drseckin.com/