Serous Cystadeoma/Hysterectomy/NewCystsOBGYN or Gastroenterologist or WHO

[Teresa210]

I previously had a 12 x 11 x 11 serous cystadenoma removed and total hysterectomy 10/05 - last 1 1/2 months bad pain, not so much constipation but seeming inability to push though - sticky bowel, and throwing up - sometimes low grade fever, but not always - norm 97.6 now 99.1. I thought adhesions - obgyn sends for CT Scan but told to give to gastroenterologist and/or internist as she thought it was out of her area.  CT scan shows "2.5 x 2.3 cystic appearing structure with slight thick borders with surrounding haziness - appears separate from bowel and on the left lower quadrant anteriorly just below the peritoneal surface there is suggestion of 2.0 x 1.5 cm cystic structure.  Appears adjacent to bowel but is likely separate from bowel since ...bowel loops demonstrate good opacification with oral contrast".  Gastroenterologist says he thinks adhesions as I reported unable to get appt for so long I tried ball rolling abdomen area and felt relief of pain and able to go, but still with severe pain.  He is going to do a colonoscopy in THREE WEEKS, but says the cysts are the OBGYN area of trouble not his.  I am in so much pain and in Nevada they have great problems with my ins. co. so I feel like they could care less but to take my money.  Does this sound like a Gastro area or an OBGYN area?  I can't just keep setting appts for 2 and 3 wks down the rd like this to only get this little bit of info at a time, yet still getting nowwhere while in this pain, missing work, costing each time.  I have been to ER once, quick cares twice, OBGYN once, 2 gastroenterologists, first gastro will no longer accept insurance, second just got as far as the first, schedule of colonoscopy.  They leave it to me to diagnose, I am thinking benign pathology report was wrong after hysterectomy and I have some sort of cancer or ORS. Please let me know what you think.

[Kevin Pho, MD]

It is difficult to say without examination.

If there is evidence of a cyst or mass that is apart from the bowel as well as the gynecological organs, a referral to a general surgeon is recommended for further evaluation.  

Adhesions apart from the GYN organs again can be evaluated by a general surgeon.  A gastroenterologist can help with a colonoscopy.  

The CT scan normally is pretty good for imaging this area.  If there is areas that are not clear, an MRI can be considered to further define the area.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[Teresa210]

I forgot, sometimes the pain and pressure gives me lower back pain and every morning I wake up with numb or asleep hands to where I cannot turn off the alarm clock button.

[Thuney]

Don't know if it is correct--but when they thought I had cyst, they sent me to GYn and when they thought adhesions, they sent me to Gastro for colonoscopy--which I am having on Monday.

It is VERY frustrating, I know.  Why not call your regular DR's office and put your question to his nurse.  She will generally ask him and call you back.

God Bless!

[Teresa210]

Thank you Thuney.  It's more than frustrating with the medical community the way it is here in Nevada right now and on top of it my work changed our insurance to a well known insurance company that is in the process of cutting doctors fees for contracts even more than the 40% they already had cut on their previous contracts.  Of course when the contract time period is up, the doctors drop off and will no longer accept that insurance.  My new GP does not accept this insurance now, so I have to find another one again and am in the process of trying to find one in a city with an extreme shortage of doctors.  I actually am thinking of dropping even looking for one as they can't do anything but charge you and refer you somewhere else in this situation anyway.  Why do we have a shortage, because here in Sin City, Las Vegas area, doctors were getting sued left and right for medical malpractice.  Their insurance rates were shooting up sky high, so they started packing up and leaving.  As it continually got worse, they (the doctors) got their point across to the government, we are now the only State across the nation who has created laws that spare the doctors no matter what they do to anyone.  They can now commit malpractice on anyone and only be sued for as much as $350,000, not a cent more, county hospitals and doctors can only be sued for $50,000 which keeps their insurance rates low.  What happens when an attorney or a heart surgeon who make $500,000 to a million a year is permanently 100% handicapped due to medical malpractice in this scenario, much less a 20 year old who has a lifetime ahead of them.  Everyone is in an uproar.  When you are sick and have to deal with this, knowing the insurance companies bottom line is money and doctors bottom line being money, having them herd you through like cattle, and drop you when your hard earned insurance means nothing anymore and realizing the oath they take really means nothing - it feels a lot more than frustrating.  I am at the point of disgust and total dispair. It feels more like, if they are going to leave me out to suffer, I might as well do what they do with horses when they are suffering.  It is an impossible situation and I don't see it getting any better.  

Back to the point of getting to see the right type of doctor, there is such a shortage, it takes weeks or months to get in, then weeks or months to get the tests, then weeks or months to get to the referred doctor who can help.  Now, I have already gone through with this for about at least a month and a half if not two and have two doctors telling me, its not their area, but the other doctors area.  At this point, I took Dr. Kevin's advice and called around for a general surgeon half the day today.  After several calls, the soonest I can get in to see one is July 27, 2006.  

That's how my serous cystadenoma got so big, play the hurry up and rush them through like cattle bit, it was missed.  Seven doctors appointments telling them something was wrong that year, every time them telling me nothing was wrong.  Even told I was fine after a complete physical according to my GP, which consisted of blood pressure, blood work and a prescription for lung x-rays, two weeks before it was finally found large enough to be sitting just at my heart all the way from my right ovary.  Remember I just had a physical and told I was fine, I didn't pass the EKG in prep for surgery and didn't last 30 seconds on the tread mill before they yanked me off because my heart rate went wild.  I had to have an angiogram and other heart care before I could get the cystadenoma removed.  Now I am stuck with them, as much as I know I have to get the hell out of this damn state, I can't because it is pre-existing and I am already broke from prior surgery deductibles and co-pays.  

Makes sense huh, keep their insurance rates low, drop the insurance that doesn't pay them well (who cares about the patient) and herd them through like cattle, creating a whirlwind of patients that have to keep coming back while they just keep making more money until the patient is either broke and can't afford to live or dead.  Not an exaggeration, what if that serous cystadenoma was cancer and missed over that year after 7 doctor appointments?  It happens here every day.  Sorry to rag off, but it can't be helped, I am just at the end of my rope, I don't know how I am going to get through it this time.  

[Thuney]

I understand your frustration and your problem.  We are not quite that bad YET here in PA, but we are getting there.  Lots of doctors, esp Ob/Gyns are closing up and moving to other states because of the malpractice insurance.  Our state also wants to limit the amt they can be sued for--so we shall see.

I hate to hear what you are going thru, though.  It just makes you sick that this kind of thing happens in the richest country in the world.

[Mommybug]

Perhaps you coould try bringing the whole scenario to the attention of your local tv news station?  Sometimes THEY can get results, once things are brought out in the open.  They may even be able to get you the specialist you need, sooner than your July appt.

[Teresa210]

I have so often thought of that, but I am just mentally and physically wore out, I can't take on another battle.  They win!