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Ovarian cyst questions
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Hi,
I'm hoping someone can relate to my wife's story and give some input about how you proceeded.
My wife is now in her very early 40s and has had a long history, since her teen years, of heavy, painful periods with lots of cramping. She has been on birth control and had an IUD in the past, but did not like the side effects. She had a tubal ligation about 4 years ago. While this wasn't done specifically to help her symptoms, her uncomfortable periods/cramping have not decreased. If anything, it's getting worse and she has an appointment with a gynocologist in a few months to discuss a partial hysterectomy.

On Wednesday she had a car accident and noticed increasing pain in her lower left abdomen, to the point where she was at Emergency on Friday and was given opioids. The pain continued to increase and she was back at Emerg last night. They did a CT, and found a 5 cm cyst on her left ovary. Later an ultrasound was done to comfirm this. The cyst was not present at an ultrasound done last June. She was told no torsion and likely no bleeding from the cyst. She was on hydromorphine for most of the night. The doctor ( female, if it matters) she saw originally on Friday and again last night said she would likely get an in-hospital gyno referal and talked of a partial hysterectomy and the possible relation of the cyst to tbe issues with her periods. The doctor ( male, if it matters) was that was on shift by the time the ultrasound was done was quite dismissive and said it was a benign cyst and there was nothing to be done. Go home and take Tylenol and Advil and talk to you MD. Follow up ultrasound in 6 weeks.
Currently she is using perocet to control the pain, but that can't go on for ever.
The change in concern levels between the two MDs is odd to us and the attitude of the discharging doctor didn't help.
Does anyone have any input?
Thanks
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Re: Ovarian cyst questions [sonofdad] [ In reply to ]
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Sorry to hear about all of this. I'm unable to comment on the appropriate clinical care. However, I encourage you and your wife to get another opinion (or two) from a trusted doc before considering surgery--particularly a partial hysterectomy. Be sure to get CDs of the CT and ultrasound images, as well as copies of the radiology reports. Those may help fill in the blanks for you, and could speed up assessment by another doc. Also get copies of any blood work that was done.

If it was me, I would not wait six weeks. Keep us posted.

"Ain't no shortcuts to the Opry."
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Re: Ovarian cyst questions [sonofdad] [ In reply to ]
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Hi. I don't know if you are aware, pathology of the hip labrum can refer pain to the pelvis, groin, buttocks, leg. Labrum tears can be caused by a variety of things, one of which is automobile accidents. Could she possibly have a hip issue that was worsened in the accident?

I had a labrum tear. During one MRI, an ovarian cystic lesion was found. Ultrasound indicated it was just a clear fluid filled cyst. I'm unsure the size but believe it was smaller than what your wife has. It hasn't led to any pain for me, unless it (on the left) is what causes my right psoas to flare.

Speaking of psoas flare - I've had issue with this for some time. Not sure what caused it initially. But I can say that after I was thrown from a snow mobile, it hurt a bunch worse. In researching causes for psoasitis (I believe it's called), seems a variety of things can be culprits, such as digestive disorders or brought on by inappropriate use of a shoe shim. Widely varying things. Sometimes my psoas cramping feels a bit like having menstrual cramps; other times it seems to irritate my diaphragm right under my rib cage. I haven't found most stretching to help at all, but what does is taking a firm ball (I think it's 4" in diameter) and lying on it (face down) with it pressed into the soft tissue between my hip and rib.

I hope her personal gyn can help provide some answers, or maybe a Physiatrist? Getting blown off by doctors disinterested in helping is a terrible feeling, especially in the face of pain. She has my sympathies.

To breathe, to feel, to know I'm alive.
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Re: Ovarian cyst questions [Tri3] [ In reply to ]
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 I would to get a second or even third opinion. I had a cyst and it was growing too quickly for the doctors liking and ended up having surgery. Best thing I ever did

clm
Nashville, TN
https://twitter.com/ironclm | http://ironclm.typepad.com
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Re: Ovarian cyst questions [sonofdad] [ In reply to ]
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Thanks to those who responded. Things are not totally resolved yet, but here is an update, for anyone who cares to read it.

The first emerg doctor that my wife saw jumped back in to follow up with her and was of much more help than the male she saw. She expedited a visit to the gyno, and helped with treating the pain.
ER doctor said it was a gyno issue, gyno said it was a physio issue, physio said it was a gyno issue. The cyst that was found on the ER CT was a follicular cyst and as a result was gone at the follow-up CT.
Currently she is doing physio to strengthen her pelvic floor and hips (congratulations to who ever suggested looking into this) with improvement in her symptoms. It looks like this probably was an aggravation or injury to her hip/pelvis.
The gyno put her on depo-prova for her period related symptoms, which has helped to a certain degree, but she has had ongoing bleeding issues. She has been angling for a hysterectomy for a number of years and has decided to go ahead with it at the end of June. 6 weeks recovery, at minimum, is expected. She is looking forward to having not period!
Thanks again.
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Re: Ovarian cyst questions [sonofdad] [ In reply to ]
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I'm glad she's experienced some relief.

To breathe, to feel, to know I'm alive.
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Re: Ovarian cyst questions [sonofdad] [ In reply to ]
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Improvement is always good.

It sounds like she already has a plan for the hysterectomy, but for anyone else reading this - endometrial ablation is another less invasive option. My mom had it done many years ago and it made a huge difference for her. I'm sure the process has been refined further since then.
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Re: Ovarian cyst questions [edbikebabe] [ In reply to ]
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edbikebabe wrote:
Improvement is always good.

It sounds like she already has a plan for the hysterectomy, but for anyone else reading this - endometrial ablation is another less invasive option. My mom had it done many years ago and it made a huge difference for her. I'm sure the process has been refined further since then.

Maybe yes, maybe no. I had EA which helped for maybe a year. Hindsight I would have skipped that and had a hysterectomy earlier.

clm
Nashville, TN
https://twitter.com/ironclm | http://ironclm.typepad.com
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Re: Ovarian cyst questions [sonofdad] [ In reply to ]
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Any updates post surgery? How did the operation go? Was it all done keyhole?
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