Texas Woman Picks
Atlanta Surgeon for Hysterectomy
after what used to be considered major abdominal surgery.
Cheryl Rossi of El Paso, Texas, interviewed seven
surgeons in four cities before deciding to have her hysterectomy performed
by Tom Lyons, M.D., of the Center for Women's Care & Reproductive Surgery
in Atlanta. Before flying to Georgia recently, the 46-year-old nurse
anesthetist, Director of Obstetrical Anesthesia at Sierra Medical Center
in El Paso, understood the medical system very well from the perspectives
of both caregiver and patient.
In fact, only in June, 1994, she finished six
months of grueling chemotherapy and thirty days of radiation therapy for a
particularly virulent form of breast cancer. The treatments put her cancer
into remission, but in the process caused her reproductive organs to
atrophy. It was recommended that she have her uterus and ovaries removed.
As a very active runner, Ms. Rossi didn't
want any potential complications associated with traditional abdominal
hysterectomy--such as a long recuperative time of six to eight weeks after
surgery. Nor was she interested in the possibility of vaginal adhesions or
pelvic pain associated with a vaginal hysterectomy. She had heard of
supracervical laparoscopic hysterectomy, which is performed through tiny
incisions on the abdomen with a laparoscope, and has a recuperative time
of less than ten days. But she searched in vain in her own city to find a
surgeon skilled in the procedure.
"El Paso is still into frontier medicine,"
laughed Rossi the day before the procedure was performed at the Advanced
Surgery Center of Georgia north of Atlanta. "No one in my city could do
it, and as a medical professional, I know how to network." Her search took
her to Dallas and San Francisco, which she strongly considered because she
could have stayed with family while recuperating.
Friends in the medical profession recommended
Dr. Tom Lyons, originator of the procedure, as the best.
And she also conferred with an R.N. who'd had
the procedure performed by Dr. Lyons. "Being a nurse, I respect another
one's opinion. Nurses are in the trenches and they know what's going on;
and they know how much a doctor cares about his patients."
According to Rossi, Dr. Lyons was the only
physician she spoke with who gave her the option of removing her cervix or
not. "There is no known link between breast cancer and cervical cancer,
and with all the functions that the cervix performs, such as support of
the bladder, sexual feeling and vaginal lubrication, I decided that it was
important to keep it in place. I was surprised that no other doctors
brought it up as an option. This underscores the fact that women MUST be
extremely well-educated or they'll get something they may not have
bargained for." She emphasized that she learned during cancer treatments
that many health changes aren't revealed until after they happen, often to
the patient's unpleasant surprise.
Not only did she like the fact that Dr. Lyons
gave her power and choices, she also liked the speed with which he would
perform the procedure--in 45 minutes to one hour--because the less time
one spends under anesthesia, the better. And since the surgery was
performed in an outpatient surgery operating room instead of a hospital,
the chances of her catching a disease from hospital germs were virtually
"In El Paso it was their way or the highway,"
said Rossi. "Dr. Lyons asked me about my ultimate goal and gave me a way
to achieve it." She had decided to take estrogen and he told her she could
go on it immediately for its positive effects--decreased osteoporosis and
decreased risk of cardiovascular problems associated with menopause.
Her outpatient surgery was performed on
Monday and she stayed at the Advanced Surgery Center of Georgia as a 23
hour patient. Wednesday morning, two days after the procedure, she flew
back to Texas unassisted. Feeling fine, she resumed work on the Monday
only two weeks
The most common reason for a woman in her reproductive
years to see the gynecologist is because of abnormal vaginal bleeding.
Most often, this problem is caused by one of two abnormalities, either
altered hormonal function or a "mechanical disorder". By a mechanical
disorder, we mean some problem such as a fibroid or a polyp in the lining
of the uterus, which could cause the bleeding to occur. Hormonal
Irregularities can be caused by a myriad of problems but regulation
medically is usually successful.
After the diagnosis has been made, by sampling the
uterine lining and looking into the uterine cavity with a telescope
(hysteroscopy), the patient can choose a number of potential therapies
depending upon the diagnosis. If there is no overgrowth of the lining
(hyperplasia) and no evidence of large fibroids in the uterus causing the
bleeding, then one method of treatment may be endometrial ablation. Of
course medical treatment should first be tried but if these efforts fail
to correct the problem and if pain is not a significant part of the
patients symptoms then ablation can be performed.
Endometrial ablation s a simple procedure in
which the uterine lining (endometrium, not to be confused with
endometriosis) is removed either with the laser or electrosurgery while
looking through the hysteroscope. The procedure can be performed under
local anesthesia if the patient wishes or general anesthesia is available
if so desired. The recovery is very rapid and most patients are able to
leave the surgery facility in a few hours and are able to return to normal
activity by the following day. There is frequently a vaginal discharge for
several days but significant problems with recovery such as pain,
infection, or bleeding are rare. Today, because endometrial ablation seems
to be a very safe procedure, the procedure is beginning to be performed in
the physicians' office with new types of devices made especially for this
purpose. Cryotherapy (freezing) has now been used in this area to
successfully ablate the uterine lining.
It's important to realize that these
procedures are not guaranteed to produce ammenorrhea (cessation of
menses). Most studies including our own have shown that the rate of
absolute stoppage is 50%, while another 25% have very little bleeding, and
90% of the individuals are pleased with the result. Failures of the
procedure have been ascribed to adenomyosis in most cases and patients
with significant pain should be counseled against ablation.
Endometrial ablation gives today's women
another alternative to hysterectomy when abnormal bleeding occurs and is
persistent despite other treatments. This is a minimally invasive option,
which spares the patients anatomy, allowing acceptable results and rapid
recovery. If you have questions about abnormal bleeding, endometrial
ablation, or other solutions call the Endometriosis Care Center or the
Center for Women's Care & Reproductive Surgery.
Email the Center for Women's Care
Center for Women's Care &
Reproductive SurgeryŠ 2006
1140 Hammond Drive, Suite
Atlanta, Georgia 30328.
Toll Free 1 (888) 545-0400
Metro Atlanta (770) 352-0037
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