Submucosal fibroids, surgery, and cramps

I had 3 submucosal fibroids, sizes of golf balls, removed in May 2009 via hysteroscopic myomectomy. I had very heavy bleeding pre-op where I had leaked, used Depend and still double pad, changed pads hourly. I was diagnosed very anemic 2 years ago, which they think was caused by the fibroids.

Finally, my hemoglobin has gone back up, to the lower end of the 'normal range'. I still bleed alot, although the surgery did control it a little bit, still using Depend and myabe changing every 2 hours. Feeling very weak and exhausted pre and post op. We still dont know what causes that. I get very winded and out of breathe walking up 1 flight of stairs, dizzy bending down.

I used to get debilitating, paralyzing abdominal cramps and some months it was worst than others. After the surgery, these cramps stopped. Still discomfort and on occasion cramps, but not as sharp and manageable. however, this past weekend, I started getting these sharp cramps and they were repeated episodes. Cramps were within 10 seconds or so but repeatedly in the morning. I went to the ER because they were so paralyzing. They did the blood and urine tests, EKG, and pelvic exam. When they found nothign wrong, they proceeded to do an ultrasound but found nothing and I got released.

Could someone tell me why this is happening? I was told by the ultrasound tec that fibroids shoudn't regrow that quickly and i thought i had them completely removed.

[Elaine Brown, MD]

Hi!
When I remove fibroids hysteroscopically, I usually am able only to scrape off the part of the fibroid that protrudes into the uterine cavity.  The "roots"  if you will--are usually left behind.  Because this is the case, the fibroids can re-grow, or continue to cause the same problems that they did pre-op.
From your symptoms, it sounds like you are still quite anemic.  If you were my patient, I would normalize your blood count (see below) and check to see if your symptoms resolved--if not, you may need to see a cardiologist.
To normalize your blood count, I would give you a few options.  More surgery is possible--an laparotomy with myomectomy, OR hysterectomy, OR endometrial ablation, are some possibilities--I don't know if you want babies or not.
The other option would be a trial of depot Lupron.  This medication shrinks fibroids and stops periods temporarily( there are some minor side effects).
You could use the lupron for 3 months and then re-check the fibriods and remove any "roots" that remain.
I hope this helps!
Dr B