Has anybody's wife/SO had a D&C lately?

Dueller · 04-09-2010, 08:45 PM

What is involved in recovery. I know its outpatient. Also need an idea of what the cost was in your area...we will be no where near our deductible.

Hernia repair last year...now this. The hits just a keep on coming....

Tobra · Tobra's Garage

You want to be certain she does not develop a post op infection, can be pretty devastating, as in sterility. Heating pad will help with the cramps. They should tell you what the deal is, written instructions and what not, no doubt there are box docs on here could say more.

Good luck with that, if it is a miscarriage situation, the emotional part will be pretty important too

Dueller · 04-09-2010, 08:53 PM

Thanks, Tobra...infertility is not a problem. Seems to be a problem with menopause (she just turned 50) and uterine walls thickening that's causing spotting/severe cramps.

If she gets preggers a star better appear in the east

crustychief · crustychief's Garage

Mrs Crusty had one about 2 years ago because of a miscarriage. She had to take it real easy for a couple of days. The emotional part was a little tough. I have no idea what it cost as I was active duty at the time.

scottmandue · 04-10-2010, 07:13 AM

My wife is 46 and thinking hysterectomy... is that the same thing you are talking about?

I know notheing... only that it sound pretty seriouse and the idea scares me.

She talks about it like changing the oil in your car.

I'm like "THEY ARE GOING TO KNOCK YOU OUT, CUT YOU OPEN, AND TAKE PARTS OUT?!?!?"

Dueller · 07:39 AM

Quote:

Originally Posted by scottmandue

My wife is 46 and thinking hysterectomy... is that the same thing you are talking about?

I know notheing... only that it sound pretty seriouse and the idea scares me.

She talks about it like changing the oil in your car.

I'm like "THEY ARE GOING TO KNOCK YOU OUT, CUT YOU OPEN, AND TAKE PARTS OUT?!?!?"

No hysterectomy at this point...just D&C (dilation and curettage...going in and scraping the lining of the uterus (endometrium))...basically honing the cylinders

More like having polyps removed rather than a colectomy if I hadd guess.

My wife's OBGYN tries to avoid hysterectomy if possible. There is a less radical procedure they are calling for later to go in and pressure wash (for lack of a better term) the uterine walls to stop menstruation while leaving in the ovaries etc. Don't know what its called but much less invasive. Fortunately there is no hx of cervical/uterine cancer in my wife's family.

And I thought maintaining an old Pcar was expensive

Moses · 04-10-2010, 07:42 AM

It's rare that I would do a D&C under those circumstances. It's not dangerous, but it's just a band-aid. The problem usually returns within a few months. If the doc just wants a tissue sample to rule out cancer, an endometrial biopsy can be done in the office. It takes less than a minute. No recovery.

So here are the reasonable options, starting with the least aggressive.

1) Endometrial biopsy in the office. Cycle for three months with oral contraceptives if not contraindicated. This approach works just as well as a D&C and is cheaper.

2) If bleeding is a big, recurrent problem, Endometrial biopsy followed by endometrial ablation procedure. (Novasure). Sometimes done in an office, sometimes a surgery center. Most women never have another period.

3) If the uterus is enlarged or bleeding is uncontrollable, laparoscopic or Da Vinci hysterectomy. A big abdominal incision is usually unnecessary for modern Gyn surgery.

Dueller · 04-10-2010, 07:55 AM

Moses...thank you, thank you, thank you for weighing in. My wife has had this gyn for many years...really trusts him. Of the snippet I get from her, uterine walls are thicker than they should be? No evidence of cysts...severe cramping, heavy flow during regular cycle, light spotting occsionally. Normal pap smear etc. I don't expect you to make a cyber diagnosis, just need to understand so I can ask the right questions.

Thanks again.c

Moses · 04-10-2010, 08:10 AM

Quote:

Originally Posted by Dueller

Moses...thank you, thank you, thank you for weighing in. My wife has had this gyn for many years...really trusts him. Of the snippet I get from her, uterine walls are thicker than they should be? No evidence of cysts...severe cramping, heavy flow during regular cycle, light spotting occsionally. Normal pap smear etc. I don't expect you to make a cyber diagnosis, just need to understand so I can ask the right questions.

Thanks again.c

I like option #1. There are risks with oral contraceptives in a 50 year old woman, but they are small if she's a healthy non-smoker. But the risks definitely need to be evaluated.

Here's my problem with a D&C: The expense is high because of operating room time and anesthesia. And the results are temporary. If you're going to go that route, you might as well take an extra TWO MINUTES and do an endometrial ablation and stop the periods forever.

NovaSure (Endometrial Ablation): Heavy Period Treatment

Novasure has an impressive track record.

scottmandue · 04-10-2010, 09:43 AM

Duelly, hope I'm not hijacking your thread. If so, whack me on the nose with a newspaper.

Wife went for a "endometrial ablation procedure" (had to cut and paste that) but half way through the procedure she started bleeding excessively so they had to stop before finished.

So now we are talking hysterectomy, wife was adopted and brought to America as a baby so she had bad (or nonexistent) prenatal care and has no family medical history.

t951 · t951's Garage

There is a great resource on rennlist, his name is Bigs. He is a ob/gyn. I would ask him. He is always very helpful.

Moses · 04-10-2010, 10:27 AM

Quote:

Originally Posted by scottmandue

Wife went for a "endometrial ablation procedure" (had to cut and paste that) but half way through the procedure she started bleeding excessively so they had to stop before finished.

I've done hundreds of these. Never had that happen. Unusual for sure. Hard to imagine with a Novasure device.

scottmandue · 04-10-2010, 10:42 AM

Quote:

Originally Posted by Moses

I've done hundreds of these. Never had that happen. Unusual for sure. Hard to imagine with a Novasure device.

This was her second one (which is weird because it is supposed to be a one time deal right?)

And the doc was at the center of the uterus when she started bleeding (perforated?)and they had to stop.

This was at Kaiser in Portland OR.

Again... only married for six months for the first time... know nothing about such things... it is all Greek to me.

Moses · 04-10-2010, 10:45 AM

Quote:

Originally Posted by scottmandue

This was her second one (which is weird because it is supposed to be a one time deal right?)

And the doc was at the center of the uterus when she started bleeding (perforated?)and they had to stop.

This was at Kaiser in Portland OR.

Again... only married for six months for the first time... know nothing about such things... it is all Greek to me.

Oh boy... Lots wrong with this story. PM me if you feel like it.

scottmandue · 04-10-2010, 01:28 PM

PM sent, but you are probably out enjoying that dang motorcycle!

Anyhoo... just want to know if the hysterectomy is a good idea or not. Can't really change what has already happened.

The first procedure was in 2008

Moses · 04-10-2010, 02:01 PM

Quote:

Originally Posted by scottmandue

PM sent, but you are probably out enjoying that dang motorcycle!

Anyhoo... just want to know if the hysterectomy is a good idea or not. Can't really change what has already happened.

The first procedure was in 2008

A second endometrial ablation is always a bad idea. The cavity is scarred from the first procedure and a uterine perforation is very likely. I've never attempted a second ablation procedure. It's foolish.

A hysterectomy does not have to be a big deal. Almost all hysterectomies should be performed laparoscopically. If the surgeon isn't an accomplished laparoscopic surgeon, run away!

If you still have Kaiser insurance there is an outstanding two surgeon team at Kaiser Los Angeles. Their hysterectomy patients typically leave the hospital just a few hours after surgery and return to full activity in a week or two.

scottmandue · 04-10-2010, 02:10 PM

Thanks,

She is still in Portland and will be for about another year until she can move, I don't think (pretty sure) her Kaiser insurance will not work down here (Los Angeles).

Moses · 04-10-2010, 02:41 PM

Quote:

Originally Posted by scottmandue

Thanks,

She is still in Portland and will be for about another year until she can move, I don't think (pretty sure) her Kaiser insurance will not work down here (Los Angeles).

The Kaiser Los Angeles team takes referrals from all over the Kaiser network. I would INSIST. They are that good. Considering they've already screwed up in Portland, they'll probably be happy to refer her down to L.A.

scottmandue · 04-10-2010, 02:52 PM

Thanks again!

And now that you mention it, I have heard of Kaiser doing referrals.

Only on PPOT!

Dueller · 04-10-2010, 05:38 PM

scottman...not at all...appreciate hearing of your experiences.

Moses...the novasure ablation was what I was stumbing around with in earlier post. Showed wife thread and she says thank you also. Her doc has discussed the novasure procedure as an possible alternative...but according to wife he feels the fact she is undergoing menopause it would be redundant/unneeded? That's the gist. Those are my words...not hers or doctors'. That sound right or are we misunderstanding him?

Wifety appreciates your input so she can talk to him and ask some questions. TY.