Definitions of (girlie) bleeding

In the time I've hung out online with women trying to get pregnant I've had the chance to learn more of the nuances of spotting. I've heard women say that if there is any blood contained in your cervical fluid they they considered it spotting. At the end of your period though it it more residual flow, I have that too. This type of spotting tend to be brownish.

[added in this article link 2/4/06]
Menstrual Mysteries -- more info about determining problems with your menses based on quantity.

Spotting is bleeding outside of your period. I've had spotting this month and it just continued as red coloration to my cervical fluid, this is dysfunctional uterine bleeding related to my miscarriage.

Spotting also is the first sign of an impending period for many women. I'm pretty sure that this is light pinkish, with maybe a little brown as the blood oxidizes.

Heavy menstrual flow is when you need to use more than one pad an hour, though I consider this really heavy, medically referred to as Menorrhagia. Because your body is bleeding so much the chemicals that are supposed to keep the flow fluid can't work as well and you do get some coagulation -- the clots, or liver-like lumps. I find that when I have clotting I tend to get really nauseous kinda intense cramping feelings -- I think this might be the clot passing through the cervix -- when I miscarried there was a similarity to the sensation though the miscarriage was more painful in my opinion.

My previous period was unusual, again it seemed to be related to my body trying to get rid of retained tissue from my miscarriage. I had bleeding for 3-4 days that was bright red and had no clots. On toilet tissue it looked like I was dabbing at a wound, it was plain blood and without the mucus component of a normal menstrual flow. I consider this abnormal for me, though women with fibroids contacting the endometrium might experience this as a frequent event.

"Women lose between 20 and 80 cc's (1-2 ounces) of blood during a normal period." (hah! right)
http://www.fwhc.org/health/moon.htm

This page includes diagrams and links to more information about normal/abnormal menstrual bleeding and includes a reference to fibroids (scroll down the page)
MENSTRUAL ABNORMALITIES

I found a lot of mention of the fact that doctors often underestimate women's blood flows and that there is a pictorial chart (see link below) that women used in one study that was a clearer indictator of blood loss. I'm sure many of us have experienced this underestimate by docs -- perhaps if those of us with heavy periods would catch the blood that pours out of us when we go to the toilet and bring it to the doctor's office they might be able to see what we go through.

The Medical Algorithms Project has a copy of the The Pictorial Blood Loss Assessment Chart (PBAC), an excel spreadsheet that helps calculate blood loss
http://www.medal.org/

So if you have the fibroid out, can you deliver the old-fashioned way?

In all that I've read the horizontal vs. vertical incision hasn't been an issue of health for the most part, it is aesthetic (someone please correct me if I'm wrong about this). It would be great if your doc could do a bikini incision, and maybe to do the ovarian surgery laparoscopically but doctors have to make that call. Since you have been experiencing serious bleeding problems it is pretty certain that your fibroid has contact with the endometrium and your incision will go the full thickness of the uterine wall.

Since I've been researching the possibilities of vaginal delivery post myo I thought I would share some of the other information I've collected related to pregnancy post myo....

With incisions into the uterine wall (especially those that go the full thickness) there is a greater risk of uterine rupture during pregnancy it seems, even if you don't go through labor, but it is a very RARE event. I will add the exception in cases of laparoscopic removal of fibroids because they often don't suture the uterus as well through that procedure -- though this is likely dependant on the size, type and position of the fibroids being removed as well as the skill of the surgeon. You should ask your doctor to try to preserve as much of the myometrium (muscular wall of the uterus) outside of the endometrium as possible and also to make sure that they are going to stitch up the uterus wall in more than one layer -- to help retain integrity of the wall and to reduce the risk of adhesions as well.

"The chance of postoperative uterine rupture increases with pregnancy; the rate reported is five percent."
http://www.uterine-fibroid-treatment.com/html/myomectomy.php3
(note this is across all types of myos - lap and abdominal)

Discuss rupture risk with myomectomy patients - Uterine Rupture in
Pregnancy
http://www.findarticles.com/p/articles/mi_m0CYD/is_20_37/ai_93531937

Pregnancy outcome and deliveries following laparoscopic myomectomy
http://humrep.oupjournals.org/cgi/content/abstract/15/4/869

Other risks in pregnancy post myo include placenta acreta and of course growth of new fibroids (boo hiss!):

"Placenta accreta is a disorder in which all or part of the placental villi are in direct contact with the myometrium and are anchored to the muscle fibers rather than to decidual cells. It is attributed to lack of decidua beneath the placenta, which allows placental villi to invade the uterine wall. Risk factors include old cesarean section scars, fibroids, prior myomectomy, and uterine malformations. Clinically, placenta accreta presents as a failure of the placenta to separate spontaneously from the uterus after the birth of the child."
From: http://www.neonatology.org/syllabus/placenta.html (scroll down for reference)

Many women undergoing laparotomy (abdominal myo surgery) will be advised against attempting labor and will be steered towards c-section due to a greater change of uterine rupture at the scar site. Here are some quotes and links you might find informative, related to VBAC (vaginal birth after cesarian, being a close cousin to delivery post myo) and pregnancy delivery post- myo.

"The type of uterine incision made at the previous cesarean section is important in evaluating suitability for a VBAC. The scar visible on the skin does not necessarily predict what type of uterine incision might be found underneath. Where in the uterus the incision was made affects its strength and integrity after healing. The upper part of the uterus is composed of a different type of tissue than the lower uterine segment and cervix. The fundus, together with the upper three-quarters of the uterus, is composed of a thick, muscular tissue that does not heal with a very durable scar, while the lower uterine segment is composed of a fibroelastic tissue that heals quite well and is more flexible and elastic when stretched after healing. Virtually any scar is weaker than the surrounding native tissue (like the old episiotomy scar that springs open during the most gentle birth). Usually the forces of labor will dilate a ripe cervix but labor will open the path of least resistance, which in a few cases will be the previous uterine incision. In addition, any incision that extends into the muscular portion of the uterus is much more vulnerable to disruption in a subsequent pregnancy and labor because of the poorer integrity of scars in the muscle. A low transverse, or low cervical, incision is the preferred uterine incision in any VBAC"
from: A VBAC Primer: Technical Issues for Midwives
http://www.midwiferytoday.com/articles/vbacprimer.asp

"Among the 21 pregnancies which resulted in live births, 8 (38%) were delivered by Caesarean Section (one case because of fetal distress, two cases because of delay in progress of labour, three cases because the uterine incision involved the whole thickness of the uterine wall, and two cases due to patient request), and the remaining 13 (62%) had vaginal delivery. There were no instances of premature labour (<37 weeks), preterm rupture of membranes, placental abruption, intrauterine growth retardation, scar rupture or post-partum haemorrhage."
from: Myomectomy: a retrospective study to examine reproductive performance before and after surgery
T.C. Li1, R. Mortimer and I.D. Cooke
http://humrep.oupjournals.org/cgi/content/full/14/7/1735

Doppler Sonographic Evaluation of the Vascularity of the Myomectomy
Authors: Alfonso Rossetti M.D., Ornella Sizzi M.D., Giuseppe Florio M.D., Giulietta Tancredi M.D., Pierluigi Paparella M.D., Salvatore Mancuso M.D.
http://www.thetrocar.net/view.asp?ID=2
(Talks in more detail about how the uterus heals and why there is a risk of rupture sometimes)

UTERINE RUPTURE AND VBAC
http://hometown.aol.com/melissaem1/myhomepage/baby.html
(VBAC stands for vaginal birth after caesarean)

Meditatations

Most of the alternative medical practitioners have recommended meditation to me and it is refererenced in a lot of information about infertility as well as for fibroids. Here are some links to info that I've found along the way.

MEDITATION

Anji - highly praised relaxation CDs
http://www.anjionline.com/

Guided Imagery
http://www.guidedimageryinc.com/guided.html

What is Guided Imagery?
http://www.healthjourneys.com/what_is_guided_imagery.asp

Learning Meditation - Meditation Room
http://www.learningmeditation.com/room.htm

Cultivating Positive Emotions to Optimize Health and Well-Being
http://journals.apa.org/prevention/volume3/pre0030001a.html


SELF HYPNOSIS

Hypnosis Downloads
http://www.hypnosisdownloads.com/
Low cost MP3 files you can use to do self-hypnosis. My friend recommended this site to me.


LABRINTH - Walking Meditation
A labrinth is a type of maze that you walk for medidation. I found that if I walked and thought about a particular thing, like my fibroid or my miscarriage, my mind would show me truths and I could release fear and accept hope. Here are a couple of links to learn more about them:

The Labrinths of Grace Cathedral
http://www.gracecathedral.org/labyrinth/

Worldwide Labrinth Locator
http://wwll.veriditas.labyrinthsociety.org/



QI GONG - Chinese Meditation/Movement
Qi Gong (pronounced chee gong) was my real favorite while I was on my health spa retreat, the thing I did every day except for the one day where the instructor had off. It was amazing and helped me feel open, relaxed, stronger, and peaceful. I had never done it before but I could completely feel the energy flowing through my body on the first time. It also helps you to open up and use the whole of your lungs in a way like I've never felt before -- most of us do only shallow breathing normally. What was even cooler was that I found out that the sequence we were doing was developed by a buddhist pristess named Kwan Yin and that she is also a goddess of fertility in Buddhism. The thing that was most amazing about it was that while doing these slow flowing, graceful movements my body was telling me to keep doing them and it would help with my fibroid -- this was days before I heard about what Kwan Yin was.

The Mission of Qigong
http://www.shengzhen.org/the_mission_of_qigong.htm

Kwan Yin
http://www.crystalinks.com/kwanyin.html

About Kwan Yin and images of statues
http://www.siamese-dream.com/page/siam1/CTGY/Kuan-Yin-Statues

I didn't feel like I was praying to another religion, I felt like I was tapping into the energy of the universe. It was amazing. There is a book on the shenzhen.org site, also available through Amazon that has all of the movements and descriptions of what they are for.


Dr Northrup's site has a bunch of different audio/video materials for sale that might be of interest as well:
http://www.drnorthrup.com/health_store-cr-video.php

The HealingFromFibroidsNaturally Yahoo Group also has lots of information about alternative treatments for uterine fibroids, you might look there as well:
http://health.groups.yahoo.com/group/HealingForFibroidsNaturally

Preparing for surgery with homeopathy/naturopathy

I was directed by my naturopath to take phosphorus c, a homeopathic remedy, prior to having the surgery to help my body with nausea from the anaesthesia.

Homeopathic arnica was advised to help deal with the swelling and bruising. I am supposed to start taking this several days beforehand and several friends swear by it.

She also recommended Rescue Remedy from Bach's Remedies, flower essences, to help deal with the stress prior to the surgery. And Gelsemium 30c, 2 pellets as needed for anticipatory anxiety.

These "meds" are at worst sugar pills and quackery, at best they work wonders. They should not interfere with the procedure or anaesthesia and if you believe they will work then placebo affect or not they will provide you with some relief. I think I'll give them a go since I've got nothing to lose.

I will also be taking Traumogen, a vitamin supplement that helps aid the body with nutrients that aid in healing tissue.

Here are some links about natural medicine and surgery to check out:

Homeopathy and Surgery
http://www.drfeder.com/general-health/healing-surgery.htm

Surgery Recovery Program
http://www.naturodoc.com/library/surgery/surg_recovery.htm

Laparoscopy - how to prepare for your surgery
http://www.endo-resolved.com/laparoscopy_advice.html

Is Arnica montana safe to take after plastic surgery?
http://www.eclecticphysician.com/archive.php?action=Nbr&Nbr=235

How I decided to have a myo

You know, having to go through the d&c to terminate my failed pregnancy helped me to get to this place mentally. The nurses and doctors wanted to help me and they didn't want me to have pain or discomfort. And then all the post myo success stories on the NUFF boards make me feel more confident as well.

Since I'm 34 and a good ways away from menopause I really should get this lump out of me now -- it isn't going to get any smaller on its own, though chinese medicine did seem to be working but not fast enough. My fibroid has been an angel of change for me so far, I had to reconsider a lot over the past two years from what I ate, to how I worked, to how much I excercised or visited with friends. I think I'm in a much better position health-wise now and hope to stave off any other diseases that might have met me along my previous life path. I'm an Cancer, I'm allowed to be sentimental :)

Thanks again and good luck to all my fellow myo compatriots in the next few weeks. I'm going to buy my purple (fuzzy) socks of courage this weekend and help get the house cleaned up and in order so I won't have to do much post surgery. My dog Lula and my cat Seymour are ready and waiting to keep me company during my recuperation.

Watch a myomectomy surgery or UFE procedure online

You know you are obsessed with learning about all the procedures when you watch videos of medical procedures for their entirety. I liked these webcast and if any of you are interested in seeing what happens during a myomectomy or UFE and you can deal with watching surgery, I encourage you to check it out.

Replay of: Abdominal Myomectomy-
A Treatment for the Removal of Fibroids
http://www.or-live.com/lich/1190/

Dr West's site has some video clips of myo surgery as well (there is
a link in the blue box to see images and clips)
http://www.manhattanfibroidassociates.com/

Here's the link to the Thomas Jefferson University Hospital doing an
embolization producedure (UAE/UFE)
http://www.or-live.com/jeffersonhospital/1140/

What should I do?

So I still have retained POC (products of conception) from my miscarriage in July. It is likely that my fibroid has contributed to this situation by not allowing my uterus to contract as well as it might (8x10cm intramural fibroid, uterus wrapped around fibroid). My RE wants to go in with a hysteroscope to aid in the removal of the 2x3cm piece of tissue in my endometrium -- the fibroid doesn't allow for a very clear image of what is there.

She mentioned that while I'm under she could remove my fibroid as well. It isn't the largest fibroid that she's operated on, but it isn't small either. She thinks that if I have the surgery done now I should be all right to travel to Ecuador for Christmas -- about 6 weeks post-op -- to go on a birding tour.

My fibroid hasn't shrunk at all since August, though it is smaller than the largest measurement right before my d&c of 9x11x11cm or so. On the day I got my BFP it measured 6.5x7 -- so it is now twice as large and I'm feeling it everyday.

Tthis RE does surgery twice a week only and I like her, she's been practicing since 1983 and does on average one myo a month -- but she's regularly doing reproductive surgeries. I'm feeling pretty good about her and she said that she would consider my desire for a vaginal birth as she did the surgery.

If you were going to be put under right now for another procedure would you opt to have your large fibroid removed as well?

Contribute $ to fibroid research/ what do we need studied?

So what if you want to help give money to support firbroid research? Here are some ideas based on my research.

Brigham and Women's Hospital Fibroid Research Center is a possibility, they are doing the sister study and many others -- exciting stuff. I gave money last year to a specific researcher at the University of Toronto, Galene Pron, Ph.D., who is studying fibroid embolization and fertility.

I did a search on Yahoo of the words "fibroid research" and got some interesting results as well. You also can search through the PubMed site or anywhere online and see what research has been done and contact the researchers directly if they provide email addresses.

Also the March of Dimes is doing a push again premature delivery of infants but they aren't talking about fibroids. We might be able to help drive the point home by sending comments and cash at them.

Oh, by the way, this reminds me that I was in touch with the Women's Clinical Research Center here in Seattle and suggested some study ideas to them. They evidently are only doing pharmaceutical industry funded studies which irked me. Here is a list of the things I sent to them:

What happens to fibroids after menopause? Anecdotally they are supposed to shrink but there is no research evidence to refer to.

I would love to see a study that would help get women in for a routine ultrasound at age 25 and then 30-32 to help catch fibroids early since pelvic exams are often useless.

How about diet/dietary changes and how that affects growth? I think that stress and restrictive eating contributed to my fibroid growth.

What hormonal profiles and body types are linked with fibroid growth.

What about pain from fibroids – I have it but it isn't my fibroid that is hurting me, it is adjacent. I'd love to see imaging that would demonstrate what exactly is hurting. Lots of doctors dismiss this type of pain.

What about a comparison of waiting until menopause for symptoms to recede versus having a hysterectomy on quality of life.

In reading this study report, Myomectomy: a retrospective study to examine reproductive performance before and after surgery (http://humrep.oupjournals.org/cgi/content/full/14/7/1735),
I noted the following mentions of incomplete research
on the topic:

"Many reports have considered intramural fibroids and subserosal fibroids as a single group, and little attempt has been made to analyse the two groups separately. However, it is possible that the impact of intramural fibroids on reproductive outcome is quite different to that of subserosal fibroids."

"few studies have considered the reproductive performance prior to myomectomy, including the presence of infertility and miscarriage, and hence have not examined how myomectomy alters the reproductive performance."

"there are no prospective data to suggest whether or not intramural or subserosal fibroids increase the rate of pregnancy loss, and to what extent they are the cause of recurrent miscarriage"

"The value of myomectomy for subserosal fibroid is a particularly controversial issue. Our series included 10 cases whose outcome appeared encouraging (conception rate, 80%). However, its effect upon the rate of pregnancy loss requires a much larger observational or randomized control study."

"In our study the reproductive outcomes before and after myomectomy were compared and the subjects did not undergo myomectomy as part of a prospective randomized controlled trial. So far, no such trial has examined reproductive outcome following myomectomy. Until a multicentre study has been carried out, the only available, retrospective, data suggest that myomectomy may improve reproductive outcome."


As a patient I have been told, though I have been unable to find research that backs up these assertions, that:

* c-section will be required post myomectomy

* doctor would be unwilling to work with me as a fertility patient unless I have a myomectomy

My bad bleeding

Starting approximately two weeks ago I started feeling wired like I had too much drip coffee, and kind of anxious feeling as well. I don't drink caffeine regularly and rarely have coffee at all so this was weird. I also didn't have a lot of stress at work or at home so it was even weirder. Then last week I started having insomnia, I was getting up in the middle of the night for hours an ultimately only having 5-6 hours of sleep. It kept getting worse and that anxious feeling kept building. I also had a loss of appetite. It was like something was seriously off in my system.

Then I started feeling vague pregnancy symptoms last week as well, like a vague recap of my first week pregnant including some itchiness, breast fullness, light nausea and my thyroid felt funny again as well. I had two faint positive pregnancy tests on Friday and Saturday but they didn't get darker. On top of everything I was experiencing I felt utterly confused. On Monday I had a beta HCG draw and it was 13, down from 46 a month ago (or perhaps I had a chemical pregnancy?) The nurse called and said that it was probably residual beta from my miscarriage in July.

I continue to feel awful and anxious and tired and then Monday night my period arrives, the second one since my miscarriage. It is very red and very viscous, there is no slimy mucus to it, and not really clotting either. It just is very runny bright red blood. I easily bled 2 cups worth at least, it is hard to estimate since I would have gushes when I went to the toilet. I had a headache, my body felt full of cold water, my thyroid felt strained. I also had odd cramping. I stayed home from work yesterday and took ibuprofen and vitamin C which did seem to help control it somewhat. I also went for an acupuncture treatment and that helped with some of the symptoms, I didn't feel so watery inside any longer. I woke up this morning and had hardly bled at all overnight, practically just spotting. I feel dry and clotting in my abdomen.

I called my RE this morning because I want to get to the bottom of this. It isn't just my fibroid, it isn't just the miscarriage and I'm not taking meds or herbs so something is just out of whack with me.

Since someone posted about von Willebrand's Disease (VWD) in the past year I've thought that I had a predisposition towards it. I brought up my long periods and nosebleed problems as a child, plus my anemia but no doctor has responded to the symptoms (tell me the patient doesn't need to suggest the disorder and I won't believe you). My father is very prone to bruising and I am a bit as well. We'll see. I did see this page on the All About Bleeding/VWD site that talks about how some hormones can influence bleeding problems. As I recover hormonally still it is very possible and also women in my family have noted thyroid problems post pregnancy. I did ask for a check of my thyroid hormones weeks ago as well as on Monday but they didn't write the script for that. I'm going to ask the doctor about getting it checked.

http://www.allaboutbleeding.com/vwd_and_you/view.asp?id=4634

Oh, and you know how I love my links, I found this one that I thought was a good reference about NSAIDs and menstrual bleeding:

Nonsteroidal anti-inflammatory drugs for heavy menstrual bleeding (Cochrane Review)
Lethaby A, Augood C, Duckitt K
http://www.update-software.com/abstracts/AB000400.htm

My Ghost Pregnancy

I had a massage appointment yesterday, the first one with this practitioner since my loss in July, though I did have a massage after my m/c just at a spa with a couple friends. I highly recommend getting a massage after you have a miscarriage especially one with some abdominal work, you will probably cry during it but you are crying anyway so why not let it out while you reconnect and take back your body. It really helped to get rid of the pain in my abdomen.

After my appointment my practitioner asked me about my massage. I talked to her about it in great detail, from the physical pain, to the emotional anguish, the heightened physical sensations I experienced and the continued sorrow. I cried and used up quite a few of her tissues. I told her about how most people want miscarriage to be as long as the word is -- over in an instant. But miscarriage as we all have seen is a process and even after your body heals there is a lot of emotional trauma of the experience that needs to be worked through.

I told her about my ghost pregnancy now, the one that has me comparing calendar dates and events to where I would be in my pregnancy, should I have stayed pregnant. I told her how hard it was as I approached the dates around the end of my first trimester, and as August closed and I should have been shopping for maternity clothes.

I also confided that I can stand the thought of seeing my pregnant SIL who is due a week later than I was in February. And how every pregnant belly jumps out at me. Or how I can't really look at babies anymore because it hurts.

I talked about things that people had said or done for me that were helpful, more than half of them were things that women said to me here on the Internet. We talked about how miscarriage is combination of life and demise, birth and death take on new meaning in this process.

She thanked me for sharing with her, and admitted that she had never really known what happened in a miscarriage or that it could take so long. She also asked if there was anything she could do, or that I could do to make sure others in my life knew how I continued to feel. I'm not sure though writing a letter comes to mind. I also feel, though perhaps it isn't fair or nice, that I should share this experience in such a way to make it a tear-jerker, like in the movies where they make you cry. Then I would know that I had gotten through to them and made them hurt too.

Last night I had a dream, I've been having such vivid dreams this whole summer. In this dream I was in a clinic and I was losing a second pregnancy. In the next bed over was a woman who was losing a baby in her second trimester and there was blood everywhere. I remember wrapping my arms around her and crying into her hair and she wailed on my shoulder and I told her how sorry I was. It isn't the kind of dream one can forget about easily. I know that it was triggered in part from talking about my miscarriage in such detail, but it shows me how changed I am in that I had no horror at the blood, only sorrow.

Miscarriage Factoid

I had a miscarriage in July, actually it was more like an abortion since my body didn't miscarry on its own. Having seen the dark side I would like to share some information with you that you probably don't know.

Miscarriages are not like in the movies, over in one scene. They take time, they are painful, and recovery takes weeks if not months. Also, miscarriages are really awful and anguishing. I used to think when I heard about someone's miscarriage "oh that's so sad". To go through one is a 4-dimensional experience of hell and enlightenment. It's more than sad. To the pregnant mother her baby, this idea of baby or embryo or fetus, it died. It doesn't matter that something was wrong with the pregnancy, we have really strong instincts to take care of our young and being pregnant is no different. Even if you couldn't see the baby it was still there and it died along with the idea of being a mother, your new family and all the planning and changes that one would have to make in preparing for the baby's arrival.

If you hear about someone having a miscarriage you need to reach out to that person and at least say you are sorry for their loss, no different than if you heard that someone's parent died. Don't start trying to think of things beyond that such as "it was for the best", "it wasn' t your time" or "it's God's will" -- you don't know and those things aren't helpful. Things you can do are send flowers or drop them off yourself, send cards or letters of condolence. Don't expect the greiving mother to take phone calls, it is really hard to talk on the phone I've found when you can't stop sobbing.

Also, the pregnancy might have ended but that pregnancy has marked time for the mother and father. The due date is supposed to be a difficult time, any other events one had imagined from clothing or furniture shopping to holidays are reminders of the non-pregnant state, that baby that isn't coming. Keep your love and support coming if you can, it is greatly appreciated.

I'll do a separate posting about what to do if you are having a miscarriage or are helping someone through the actual physical process.

Between a fibroid and a hard place

I've been on this long journey over the past 2 1/2 years. I went from not being ready to get pregnant, panicked about the thought of it, to where I am today which is still recovering emotionally from the loss of my first pregnancy.

Along the way it hasn't been easy, I found out I have a large tumor in my uterus which is called a fibroid. It is benign but they don't really go away on their own. It may be compromising my fertility but the only treatment offered to me was to have major abdominal surgery to have it out which could cause pelvic adhesions which could really compromise my fertility. I'm damned if I do and I'm damned if I don't (I'm beginning to notice that theme in my life...hmmmm...)

My fibroid and I are having our second anniversary this week since we first met. Maybe I'll bake a cake. I have not named my fibroid though I know women who have. And I only have the one, I'm monogamous when it comes to uterine fibroids.

At any rate I've done a lot of research into male and female fertility, hormones, supplements, diet, lifestyle, and a ton about fibroids and other gynecological conditions and I'd like to share with you what I have learned. I do think there is more than one way to skin this cat and I hope you find my research worthwhile.

(This was my very first post here.)

Other Causes of Pelvic Pain Besides Fibroid Degeneration

A common complain of women with fibroids is abdominal Pain. This pelvic pain can come from from fibroid degeneration, when the fibroid outgrows its blood supply and dies, but that's fairly rare and there are other possible causes of pelvic pain including (an incomplete list):

Appendicitis

Constipation

Adenomyosis -- endometrial tissue grows into the wall of the uterus and can form pockets that bleed each month

Endometriosis -- endometrial tissue grows on other pelvic structures outside of the interior of the uterus and swell and bleed with the hormones produced as a part of your menstrual cycle

Ovarian Cysts -- mature follicle that does not rupture and can grow pretty large, if they rupture they can be quite painful. Some cysts are normal and most of the time they are just reabsorbed. There are other forms of cyst which require medical intervention such as dermoid cysts, endometrioma, and sometimes chocolate cysts.

Ovulation -- mittelshmerz is pain that is felt around ovulation, perhaps from the release of the egg or perhaps from irritation from fluid released from the follicle

Pelvic Inflammatory Disease -- bacterial vaginosis, gonorrhea, and chlamidia can all cause infections in the pelvic cavity

Pelvic Adhesions from prior abdominal surgery or infection -- a d&c or IUD can sometime result in an infection as well

Fibroid Pressing on blood vessels or other abdominal structure

Cystitis -- bladder infection

Kidney infection

There is also a diagnosis in traditional chinese medicine/acupuncture called blood stagnation which can cause pelvic pain and is generally associated with gynecological conditions such as fibroids. Liver stagnation is usually part of the diagnosis as well, the liver being the major detox organ in the body and one that is also associated with emotion and grief in chinese medicine. I've found acupuncture to be helpful in managing my pelvic pain, as well as breathing exercises that promote movement in the abdomen. Here's a link about blood stagnation that you might find useful.

All About Blood Stagnation
http://www.acupuncture.com/Herbology/bloodstag.htm

If your doctor checks you out and you are still having problems then
you might consider the blood stagnation possibility.

I finally got my period, the first one since my miscarriage in July, this past Saturday (Yeah! Time for a party!). My beta was still up last Friday, I hope to have another draw today to see if it has gone down more.

In the meantime I've noticed that my fibroid has gotten dramatically smaller over the past couple weeks (even more cause for celebration!) I've got a call into the doc to see if I can get another u/s to check on it as I'm starting up on my chinese herbs again and I want to know what we're working with. We'll start trying on the baby-making in October to give some time to treat my fibroid with herbs and acupuncture.

Now if this extra fat around my middle would just go away then I would be back to normal....

It's raining, it's pouring...

After I found out about my fibroid I cried a lot. I cried for 3 days when they told me about my fibroid. I was so upset that my eyelid twitched for 3 months after that! After every doctor's appointment I had I was an emotional wreck afterwards.

A mean RE at the local university fertility clinic told us on a Friday that we needed IVF with ICSI and that we woudn't be able to conceive on our own. The next day we had to go to a wedding and someone from asked me discreetly about my fibroid (we lied and said that was what the Dr's appt was for, we didn't want any one to really know about our fertility problems) and I lost it and had to leave the wedding before the toasts. My partner couldn't get out of there as quickly for social reason so I just sat in the car and cried for 20 minutes by myself on a side street.

I had another time last spring, right after my HSG when I found out my uterus was wrapped around my fibroid and my doctor told me I should probably have the fibroid out. I went to dance class a couple days later -- surely dancing would help me feel like my body was mine again. But there was a guest instructor and when she wanted me to correct my pelvis alignment and I left the class sobbing.

Over Christmas my OB that I had made 2 months beforehand come up so I decided to get another opinion. Aside from crying the entire time in her office when I left I started sobbing in the parking garage and had to wait a long while until I was settled enough to drive.

Another time, at the beginning of the year, after yet another Dr appointment I had to leave dance class again and just cried in the hall while I waited for my partner to finish. It was all so stressful, I was unclear as to what to do, and it seemed like we would never have children without some major medical interventions.

Nutrition and medicine

"The doctors of the future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease."

--Thomas Edison


In case you didn't know, most medical schools do not offer adequate training in nutrition to medical students -- even today. Ever notice that most doctors won't even ask you if you are getting enough rest or drinking enough water? We could be living on potato chips for all they know.

Naturopathic medicine in contrast focuses on the body's ability to heal itself and nutrition is a key part of this -- hence why some of us have had some improvement of health while under the care of naturopaths. In the ideal world of the future all doctors will look at us holistically and help identify imbalances before they become issues. I'm not saying naturopathy is better than allopathic (western) medicine, but I am saying that you will feel a bit better cared for since they try to get to the bottom of the causes of what ails you -- including psychological, spiritual, emotional, causes, etc. I got my anemia finally in check after other doctors telling me that it was normal for some people -- and I'm feeling much better now.

Since we know that western doctors aren't getting this training it is important that we seek out information about the role of nutrution in our health issues on our own. Doctors might even agree with you when you ask if you should be taking B-12 for instance, it just might not be something they offer you on their own.

Here are a couple links to learn more:

Nutrition Education in U.S. Medical Schools (1985)
Commission on Life Sciences (CLS)

Naturopathic Medicine - Philosophy

Oh, and if you are interested in controlling bad cramping pain then you might consider some of the suggestion for controlling prostaglandin production on these pages:

What causes Menstrual Cramps and Pain (Western and Oriental Medical
Perspective)

25 Ways To Handle PMS

Beta Numbers

Here are the blood test results after my retained POC was diagnosed in mid-August.

543 on 8/12

259 on 8/17

145 on 8/23

78 on 9/1

46 on 9/10

Beta HCG - What it is

Beta HCG is the pregnancy hormone. The fertilized egg and embryo produce it and it cause the corpus luteum to sustain and continue producing progesterone to support the pregnancy. It come from the embryo, not the ovary, uterus or fibroids. I don't know if it contributes to fibroid growth directly, but the progesterone/estrogen produced in pregnancy sure do.

BASELINE ULTRASOUND

A baseline ultrasound just helped to provide a comparison measurement before and after treatment. My RE wanted to see how it was doing since it had been almost a year since the previous scan. Without it I would have no way of knowing if it was larger or smaller than it had been so how would I be able to just if the treatment was really working.

I arranged for a second ultrasound to see if there was any change
from the acupuncture and chinese herbs, but note that I waited 4 months with continuous treatment -- change if any would come slowly
my acupuncturist assured me. I mentioned that I was pregnant for this second ultrasound so it is possible that there was additional
shrinkage but the pregnancy hormones didn't provide a clean comparison.

Your doctor may do yearly ultrasounds to monitor your fibroid, you
may want to go more frequently if you feel a lot of changes, every 6
months perhaps. If you are wanting to try to evaluate the affects of
a particular treatment a baseline comparison before and after will
help you to see the affects.

Fibroid Growth in Pregnancy - SIZE CHANGE

Considering that my fibroid only grew in the 18 months prior to treatment and then shrank back 2 cm I think that is a pretty big change. I knew that when I got pregnant I might experience growth (though I hoped I was the rare girl for which it would shrink) but it was important to me to try to shrink it beforehand.

It did grow, and quite a bit but what can one do. We were ecstatic
that we got pregnant and were taking it all in stride, unfortunately
no embryo developed so I had to have a d&c to terminate since my body was happy cooking along. It also shrank back some right away, I'm hoping we can shrink it some more.

My fibroid I could feel prior to my getting pg and it was 6x7cm. It
grew a lot, at its peak measurement it was up to 9x11x11cm. A couple
weeks ago it was dropped to 8x9cm. When my bladder is full it is
really bad, when I'm lying down you can see it bulging out and it is
more uncomfortable than prior to my pg. Some pairs of pants I have
are also uncomfortable now because they put too much pressure on my
lower abdomen (I know you are probably clucking your tongues at me
telling me not to wear them then).

So, I know I have beta still in my system so it probably isn't
shrinking as much as it might eventually. If you have fibroids and
know by measurement or physical sensation (pelvic pressure, etc.),
how long did it take for them to shrink down for you?

I could live with the pressure prior to my pg but now I feel the
pressure so much that I keep thinking I might want to have it out.
Still, I will first try to shrink it back with acupuncture and herbs
which worked before.

So, can anyone share with me how long until their fibroids shrank
post pregnancy?

Frankincense and Fibroids?

I found this page while surfing that mentions some additional herbal treatments, what got me curious was that this one mentioned frankincense which is one of the ingredients in the chinese herbs my acupuncturist had me taking in the spring -- when my fibroid shrank.

http://www.nspforum.com/faq/bbs.cgi?read=938

I started acupuncture treatment in January and had an ultrasound a couple weeks later to help provide a baseline measurement. My fibroid at the beginning of February was 6x6.5x9cm which was larger, mostly longer than the 5.9x6cm in September 2002 when it was discovered, or 6x7cm in March 2003. I started on herbs in March and took them for about 6-7 weeks only, all the while going for weekly hour-long acupuncture treatments. I stopped taking the herbs because I had an issue with bad bleeding during my period which freaked me out, these are strong herbs and not to be used during pregnancy or during menses. My acupuncturist said the herbs are intended to "break the blood". I scheduled a follow-up ultrasound for the beginning of June and as it would happen I had a positive pregnancy test that same morning. My fibroid was back to 6x7 though the ultrasound was not taken on cycle day 3 since my period never arrived. I'm amazed that there was that much of a change.

Here are the ingredients in my supplement, TumoSolv which is formulated by LongLife (http://drhuang.biz/LongLifeMaster.asp):

Bureed tuber, Zedoary, Fritillary tuber, Prunella, Sargassum, Frankincense, Myrrh, Angelica

I don't know if they sell to the public but I would advise anyone interested in trying it to seek treatment though a licensed practitioner of Oriental Medicine and Acupuncture.

My fibroid is still enlarged from my pregnancy, my body is still producing beta HCG though it is slowly dropping. I'm back in weekly acupuncture treatment and soon I'll start using the herbs once again.

I just thought I would share since I did try very hard to be controlled in my evaluation of my fibroid size before and after treatment and I did have positive results. I hope that this gives you hope and inspiration as well.