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[entwife]

Well, so I got to see a PA who thinks it was not a fibroid because of the clean ultrasound a month ago; she thinks it was a "cyst that came out because the birth control pills shrunk it and it will probably never happen again so do not worry".
Well honestly I like her version, although I thought estrogen would usually grow things, not shrink them...Of course who knows what all that OTC progesterone creme was doing other than make me feel better than I've had in a long time...
The PA and the dr are way more interested in making me go see a psychiatrist than a gyn or endocrinologist. Apparently, I am nuts if I tear up when talking about gross stuff coming out of me...

[wet_blanket]

entwife, neither the PA nor the doc inspire confidence.  I'd be looking elsewhere.

Anyway, please allow me to say oooooooowwwwwwwww!  Farking cramps.  I actually fainted today.  Admittedly I'd also skipped breakfast, but the only times I've fainted before have been because of pain, not low blood sugar.  Now, I can't sleep.

My usual drug cocktail (naproxen, codeine, paracetamol) is failing.  I'm deciding whether to take another naproxen.  In the past, taking above the recommended dose of NSAIDS has helped the cramps, but left my stomach so upset that it isn't an improvement.

Maybe an extra codeine.  Should help with sleep, at least.

[llanfair]

Well, so I got to see a PA who thinks it was not a fibroid because of the clean ultrasound a month ago ...

Entwife, my uterus was riddled with fibroids and none of them showed up on ultrasound.  

(What does PA stand for?)

Wet_Blanket, that absolutely sucks.  Sending analgesic vibes to you.

[dept_geek]

Well, so I got to see a PA who thinks it was not a fibroid because of the clean ultrasound a month ago ...

Entwife, my uterus was riddled with fibroids and none of them showed up on ultrasound. 

What's a PA?

(PA -> Physician's Assistant)

And "same here" - you may want to ask for a look around the inside - either with a trans-uterine ultrasound or a hysterscope.  Neither are fun tests, but will show exactly what is going on.

And ... find a better doc if you can. If they tell you "it's in your head" without doing all the tests, they are quacking up the wrong tree. (to horribly mix a metaphor)

[keineidee]

The PA and the dr are way more interested in making me go see a psychiatrist than a gyn or endocrinologist. Apparently, I am nuts if I tear up when talking about gross stuff coming out of me...

entwife, there were at least three years (in my late 20s) when I was bleeding quite excessively, but the health clinic people insisted my problems were "just stress" (I was still a grad student.) Didn't even do an ultrasound. They repeatedly sent me on my way with OCPs and a recommendation that I resume Prozac. It wasn't till I had a real job elsewhere that I had the hysteroscopic resection, where they found the 20+ small, submucosal fibroids that had been causing the problems. They'd been expecting 2 or 3 based on the ultrasound. I'll never forget the description by the gyno: "just like a bunch of grapes."

wet_blanket, I'm so sorry! I hope you got some sleep. Sometimes that is the only escape.

[bibliologos]

The PA and the dr are way more interested in making me go see a psychiatrist than a gyn or endocrinologist. Apparently, I am nuts if I tear up when talking about gross stuff coming out of me...

You're not nuts.  Only babies and normal fluids should come out of there.  Anything else, well sure, cry if you want!

[biomancer]

The PA and the dr are way more interested in making me go see a psychiatrist than a gyn or endocrinologist. Apparently, I am nuts if I tear up when talking about gross stuff coming out of me...

You're not nuts.  Only babies and normal fluids should come out of there.  Anything else, well sure, cry if you want!

Agreed - with the amendment of "normal amounts of normal fluids."  Your physician and PA are the ones who need psychiatric help - they seem to have lost their capacity for empathy.

Wet_Blanket, I hope the drugs are helping now!

[gennimom]

Entwife, this expectation that you should see a psychiatrist is usually what people suffering from fibromyalgia or Isaac's Syndrome usually hear when the docs can't come up with a diagnosis that makes sense (to them). If I'd had as much pain as you described at that event, you can bet I'd be tearing up, and no doc better tell me to see a psych.

Get another doc!

I can't imagine a cyst detaching and making its way that far down the tract to come out of me. And from what I understand, a cyst is supposed to be fluid-filled. What you described didn't sound like a cyst.

[periodically]

entwife-
Another voice suggesting that you find another doc, or at a minimum, get a second opinion.

Although there are a number of things that might explain what happened, I know someone who had something similar happen, and was diagnosed with uterine cancer a short time later.  After her hysterectomy, she's alive and well, and cancer-free 6 years later. 

[entwife]

Yeah, I have a hard time imagining how a cyst would make it all that way down (and through the tubes!), although I understad that there are different types of cysts, and it is not impossible that what I was looking at could have been a deflated cyst sack. The fibroid version makes a lot more sense though. In which case, I do not see how getting back on birth control pills can be a good idea...

Of course when I was paying all that $$$$ for PPO I never used it, and now that I could use it I have a stinking HMO in this stupid state with #$%& healthcare system.

Wet_blanket, I hope something is working!

[unoriginal]

Entwife,  I was put on BCP for fibroids - sometimes they can control excessive bleeding from them.

But not for me.

My story, in short.

Excessive bleeding - periods lasting 8-9 days, cycles lasting about 24 - finally drove me to ask for a Mirena IUD in June.  At U/S to check placement, lots of fibroids discovered.  Not a surprise, I've had them (without incident) for years.  3 months of bleeding on the IUD, which was, if near constant, at least lighter and so more manageable than periods without IUD.  Then the IUD fell out.

Switched to BCP to control the bleeding.  Called doctor's office because bleeding seemed a little excessive.  Told not to worry because breakthrough bleeding is common for first 3 months of this type of pill.  Resolved to deal with the nuisance - which was daily bleeding like a 'normal' period, so light for me.  But daily.  For 8 weeks. 

Tuesday.  Yearly appointment with doc, where I didn't 'get' to undress but we did talk more about bleeding issues.  She puts me on new bcp, *twice* a day to try to stop the bleeding.  Orders bloodwork 'just in case'.

Two hours later - phone message from nurse.  Urgent.  Call back.  Hemoglobin is extremely low (5.5 - normal range is 12-16) and I need to be admitted to hospital NOW for blood transfusion.

Hospital stay.  3 units of blood.  IV Premarin (estrogen) to stop the bleeding NOW.  I think it worked, but had a biopsy yesterday to make sure it really is 'just' the fibroids and not something more insidious and that may have started off a bit more bleeding.  Still on Premarin.  Doctor appears to have ditched all ideas of controlling bleeding via bcp and is now talking uterine artery embolism (because I'm really not excited about hysterectomy).  I need to make an appointment for a consultation with a radiologist next week.  Fun times.

[entwife]

Holy &#$# unoriginal! What a nightmare! I've read that embolism can work really well - I hope it does for you!

[ucprof]

My usual drug cocktail (naproxen, codeine, paracetamol) is failing.  I'm deciding whether to take another naproxen.  In the past, taking above the recommended dose of NSAIDS has helped the cramps, but left my stomach so upset that it isn't an improvement.

I suggest one of the cox2 NSAIDS.  Can you get a hold of a script for celebrex (US name) or celecoxib ?
Much easier on the stomach and you must always take any NSAID with food.  I was taking ibuprofen like M&Ms before I finally got a script for vioxx, and then they took the stuff off the market, the bums - something about heart attacks but only for people who take it continuously for months.  After losing my miracle drug (vioxx)
I got a script for celebrex, which works better than than the OTC NSAIDS, but I
even so, I would typically have to go `off label' meaning a higher dose than recommended to get enough relief.  That said, I only needed the high doses for a couple days a month so it worked and I never worried about taking too much.  On vioxx, one pill every 12 hrs did it (unbelievable).  On celebrex during the peak days I'd need
300mg every 4-6 hours (and the dose on my bottle is 200mg/day or something like that) but I could tolerate the higher does for a couple of days as long as I took it with food, and the pills really worked wonders.  No need
for any narcotics, nor tylenol, etc.  Also MUCH easier on the stomach than ibuprophen and/or naproxen since they are both older NSAIDS, not the cox2.

Also, on top of this, I never found naproxen to be that effective for cramps.  Maybe it's just not as good for the prostaglandins.  Also you need to start taking the NSAIDS early - if you wait until the pain is strong you
are missing out on the most effective way to take them.  Ideally you should start a day or two before you get the period if you can predict that, otherwise start taking them at the very earliest sign because you have to shut
down the prostaglandins before they get going.  Finally I note the codeine will do a number on your GI tract
on top of the nsaids (nausea) so I recommend only taking codeine at night and otherwise stay on the NSAIDS
early and often, with food, during the day.

Since my hysterectomy I've not had to deal with the intense pain, but I had it for about 33 years of my life.
If you don't want kids you can always get an H - now a days they can take it out laparoscopically and leave
your ovaries so you function just like before only no period and no cramps (but still have the hormones and the rest of the cycle).

Also not sure how old you are, but if you are older with intense pain you should get checked for endometriosis - maybe try OC's for a spell and see if it improves.  If you are young then the pain will get better with age and certainly once you have kids - so they tell me.

[ucprof]

Doctor appears to have ditched all ideas of controlling bleeding via bcp and is now talking uterine artery embolism (because I'm really not excited about hysterectomy).  I need to make an appointment for a consultation with a radiologist next week.  Fun times.

Speaking as someone who had a myomectomy for fibroids and then a hysterectomy, I really wish I had the H sooner.  I was scared silly about having an H - it seemed too radical.  Now I am thinking I should have done
it YEARS ago.  I know you can not put it back, but when the surgeon went in to take it out he said my uterus was like cement - lots of dead tissue, around 10 fibroids, like a 16 week pregnancy.  There is no way they would have been able to see the bad tissue with just embolism.  My H was conservative.  Honestly life is much much better.  I still have all the normal cycle things like before but no
periods and I am not running to the toilet all the time because of pressure on my bladder.  Whatever you do, I hope it works out well for you.  You can PM me if you want to know more about the H.

[wet_blanket]

My usual drug cocktail (naproxen, codeine, paracetamol) is failing.  I'm deciding whether to take another naproxen.  In the past, taking above the recommended dose of NSAIDS has helped the cramps, but left my stomach so upset that it isn't an improvement.

I suggest one of the cox2 NSAIDS.  Can you get a hold of a script for celebrex (US name) or celecoxib ?
Much easier on the stomach and you must always take any NSAID with food.  I was taking ibuprofen like M&Ms before I finally got a script for vioxx, and then they took the stuff off the market, the bums - something about heart attacks but only for people who take it continuously for months.  After losing my miracle drug (vioxx)
I got a script for celebrex, which works better than than the OTC NSAIDS, but I
even so, I would typically have to go `off label' meaning a higher dose than recommended to get enough relief.  That said, I only needed the high doses for a couple days a month so it worked and I never worried about taking too much.  On vioxx, one pill every 12 hrs did it (unbelievable).  On celebrex during the peak days I'd need
300mg every 4-6 hours (and the dose on my bottle is 200mg/day or something like that) but I could tolerate the higher does for a couple of days as long as I took it with food, and the pills really worked wonders.  No need
for any narcotics, nor tylenol, etc.  Also MUCH easier on the stomach than ibuprophen and/or naproxen since they are both older NSAIDS, not the cox2.

Also, on top of this, I never found naproxen to be that effective for cramps.  Maybe it's just not as good for the prostaglandins.  Also you need to start taking the NSAIDS early - if you wait until the pain is strong you
are missing out on the most effective way to take them.  Ideally you should start a day or two before you get the period if you can predict that, otherwise start taking them at the very earliest sign because you have to shut
down the prostaglandins before they get going.  Finally I note the codeine will do a number on your GI tract
on top of the nsaids (nausea) so I recommend only taking codeine at night and otherwise stay on the NSAIDS
early and often, with food, during the day.

Since my hysterectomy I've not had to deal with the intense pain, but I had it for about 33 years of my life.
If you don't want kids you can always get an H - now a days they can take it out laparoscopically and leave
your ovaries so you function just like before only no period and no cramps (but still have the hormones and the rest of the cycle).

Also not sure how old you are, but if you are older with intense pain you should get checked for endometriosis - maybe try OC's for a spell and see if it improves.  If you are young then the pain will get better with age and certainly once you have kids - so they tell me.

Hmmm. Wasn't it celebrex for which that Pfizer guy admitted fabricating data?

There's been a Cochrane review on NSAIDS and primary dysmenorrhea.  All were better than both paracetamol and placebo, but they couldn't find any differences between them.  Small studies, though, so they probably weren't powered to find a difference anyway.

I tolerate codeine pretty well, generally.  It's definitely the Naproxen that gives me stomach issues.

You're right, of course, about needing to take it in advance.  I always tell myself that I shouldn't be reliant on drugs and so don't take anything, and it becomes unbearable.  You'd think I'd have learned by now though.