Wednesday, July 31, 2002

I was diagnosed with fibroids more than ten (10) years ago.  Almost as soon as the first fibroid appeared, my gynecologists (a total of two) began talking hysterectomy.  No other options were discussed.  I chose to take the ‘wait and see’ approach.  Being in my early thirties at the time, and not having any symptoms I was in no rush to do anything drastic.   I started having a yearly ultrasound to monitor the size of the fibroids.  Although they were growing, they were still not causing me any problems, so I chose to wait.  

It wasn’t more than a few years after I was diagnosed that I began to research other options for the treatment of fibroids.  That is how I first found out about Uterine Artery Embolization.  UAE’s were not widely performed eight years ago as they are today.  In fact, my gynecologist knew nothing about the procedure when I explained it to her during my next yearly exam.  (This is a procedure that is performed by interventional radiologists, not by gynecologists).   I told her that I was seriously considering this as an option to major surgery.  The fact that she never encouraged me to consider options and never really discussed any options is, I have since discovered, more the norm than the exception for gynecologists.

About two years ago, I began noticing symptoms related to the fibroids.  There was bulk crowding of the bowels and bladder, severe cramps, back pain.  At that point, my fibroids had grown to a rather considerable size—one was about the size of a grapefruit while the other was about the size of a tangerine.  The overall size of my uterus was about the size of a 14-week pregnancy and my energy level was beginning to decrease.  But I continued to live with the fibroids.  The discomfort was not unbearable (although later my doctors told me they were amazed that I had tolerated the fibroid symptoms as long as I did). 

By August of 2001, I knew I had to take action.  I met with a local interventional radiologist for an evaluation in September and scheduled an MRI for the following week.  Before the MRI, the radiologist thought that I would be a good candidate for the UAE.  Upon reviewing the MRI, he changed his mind.  His recommendation was that the fibroids were too big to treat with UAE.  But he had only performed the procedure a dozen times.   I thought that my options were running out.   I scheduled an appointment with a new gynecologist to discuss my situation.  He was wonderful—he discussed all of the options available to me.  I had told him about my interest in UAE and what had transpired with the local radiologist.  Thinking that a UAE was not a viable option for me and ruling out other options, I scheduled a date for my hysterectomy.

Two weeks before the surgery date, I came across an article in Today’s Harrisburg Woman about a local woman who had a UAE performed by the foremost expert on UAE’s in this country, Dr. Robert Worthington-Kirsch.  This woman was kind enough to include her phone number in the article.  I called her and she encouraged me to meet with Dr. Kirsch.  I scheduled an appointment with Dr. Kirsch for the next week.  He reviewed the MRI that I had from a few months earlier and told me that he thought I would be a good candidate for the procedure.  I was excited and nervous.  I had new hope.  I immediately cancelled the hysterectomy surgery and scheduled a date to have the UAE.

Dr. Kirsch performed my UAE on March 14, 2002.  I can’t say that the first week or two were easy, but I can say that I am so pleased with my decision to proceed with the UAE.   When I had my three-month follow-up ultrasound, the report was very encouraging.  My largest fibroid inside the muscle wall of the uterus was reduced by approximately 30%, as was my uterus.  The other large fibroid (on a stalk outside of the uterus) was reduced by 80%.

Today, I am symptom-free and my fibroids continue to decrease.  I would encourage anyone who had symptomatic fibroids and is considering UAE to make sure that you get the best interventional radiologist available.

Even though this is a much less invasive procedure than major surgery, it is not without risks.  These risks are less of a concern when your interventional radiologist has a lot of experience and success with the procedure. -  Mechanicsburg, PA