DEAR DR. DONOHUE: I am a 42-year-old woman, childless, but still with hopes of having a child. I have several fibroids, and recently I have had to get up during the night to urinate more frequently. An ultrasound shows that one of the fibroids has grown to approximately 7 cm (2.8 inches) and is pressing on my bladder and causing me to have the urge to urinate.
My doctor says I have three options: 1. leave it alone; 2. have a hysterectomy; 3. remove the problem fibroid. I am opting for No. 3. What are the pros and cons of having it removed? – M.D.
ANSWER: You have made a good choice. The pros of having the fibroid removed will most likely put an end to your nightly visits to the bathroom. Furthermore, a large fibroid might be a cause of infertility. The cons are few.
Leaving it alone does not make a lot of sense. It’s causing trouble. The only problem you have is deciding which is the best way of getting rid of it.
A myomectomy is removal of the fibroid only. The uterus is left in place. Such an operation preserves a woman’s fertility, something you are desirous of.
Uterine-artery embolization is another way of removing a fibroid without disturbing the uterus. A catheter is inched from a surface blood vessel to the blood vessel that feeds the fibroid. When the catheter reaches that site, beads are released that occlude the blood vessel and deprive the fibroid of its blood supply. In time, the fibroid shrivels up and is shed.
A brand-new procedure is MRI-guided focused ultrasound ablation. Here, powerful sound waves are targeted at the fibroid under the direction of an MRI machine. The sound waves generate heat that destroys the fibroid. This technique is not available in all places, and its effect on fertility is not known. You still have many options.
The fibroid booklet discusses these common benign tumors and their treatment. Readers can order a copy by writing: Dr. Donohue – No. 1106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: My 17-year-old daughter was diagnosed with long-QT syndrome. At first the doctors thought she was having seizures or faints. However, an ECG indicated the syndrome, and she now has an implanted defibrillator. She also takes beta blockers and has not had another episode.
Would you alert people to this disorder, because it can cause sudden death in young people? – K.H.
ANSWER: The Q and T of long-QT syndrome are two waves seen on an ECG. Too much time elapses between these two waves in people with the syndrome, and that can give rise to fatal heart rhythms.
Thankfully, the syndrome is somewhat rare, and death from it is also rare, but, as you say, people should be aware of it since it can cause sudden death. Often that happens to athletic young people while playing sports.
How do people know if they or their children have this syndrome? For one, it runs in families, so when there is a family history of sudden death in young people, this syndrome should be considered. Secondly, unexplained episodes of fainting spells are another sign, one that should be investigated for this syndrome.
DEAR DR. DONOHUE: My mother has high blood pressure. She had a ministroke and recovered. Prior to the stroke, she was given medicine for blood pressure but refused to take it because of side effects. What are the consequences of refusing to take medication for high blood pressure? – K.L.
ANSWER: Your mother, regardless of age, is playing fast and loose with her health and her life. She has had one small stroke. She is at serious risk of having a large stroke if her blood pressure isn’t controlled. She is also at serious risk of dying from uncontrolled high blood pressure.
There are so many high-blood-pressure medicines that one – and more likely, quite a few – can be found that will not give her side effects. She has to reconsider her position. It’s a foolish one.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.
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