Still looking for answers

[Carolscrw]

Hi
I'm a 42 year old mother of 5..
Have been struggling for months now with fatigue and various pains throughout my body.
As of late they have localized mostly in my lower left abdomen and back.. throbbing , aching pain .. even sharp stabbing pain.(persistant pain)  At times in the upper right as well.
I have  a small fibroid I am told in my upper middle part of my uterus and my uterus has tipped
I have had chronic fatigue for well over 6 mths now.. and not sure for how long before really noticing that I was not functioning well. I was found to be only slightly anemic and this has been corrected for months now.. I am told my ovaries.. are of "normal size".. but as far as I can tell they haven't compared too much one sonogram to the other.. just that they are normal.
I am to see my OB in a few days to discuss the fact that the fibroid they found is growing .. apparently more rapidly than the norm..   I am not sure where I should be focussing my questions at this point.. the pains I am having definitely feel like Ovary pain to me.. I have brief periods of feeling "normal".. but they dont' last .. I am not even sure what normal is anymore.. I used to be quite active .. exercising daily.. now I cannot even begin to do those things.. I have to reserve all of my energy for my family.. and force myself to work 3-4 hours a day. I feel I can't continue at this pace much longer without some kind of help or answer..
My Regular MD did put me on antidepressants.. I am taking Welbrutrin.. which does help me at least have less fatigue for some of my day.. without it I am not sure how I would be functioning.
I am wondering if fatigue can be related to undiagnosed cancer , even if it is in beginning stages? I have been checked by CT scans in chest and abdomen.. nothing significant found
any suggestions or clarity would be greatly appreciated
thanks for listening!!!
Carol

[Carolscrw]

Thank you Dr for your repsonse

what ever it is is getting more and more bothersome in many ways and if it isnt' my Uterus there has to be something else there.. I definitely feel it.. even far down in the rear hip area when I bend over..
but I know the Uterus itself is favoring the right side.. If it is my Uterus I really fear that i will be a hystorectomy candidate...

thanks for your concern.. I'll let you know when/if i get some results

Carol

[Annekathryn Goodman, M.D.]

Dear Carol
thank you for your thoughtful question. I wonder if your fibroid is pressing on the inside of your left hip and pushing on the nerves in that area. That might explain the leg pain.

As far as pain from an ultrasound, that can occur if your have some inflammation in the uterus or cervix. In that case, touching the uterus hurts. Or it could be that the ultrasound probe is pushing the fibroid into the pelvic nerves and exacerbating the pain that you already have.

Women with retroverted uteruses (uteri) seem to have more pain . Perhaps because when the uterus is tipped backward it presses more on the sacrum.

take care

[Carolscrw]

If I can possibly ask one more question , since you haven't gotten to my response yet...
I asked my OB if it was normal to feel pain when having a transvaginal ultra sound.. and she answered.. somewhat annoyed.. and said.. No... but wouldnt' elaborate.
when the probe was to the left it was quite painful.. and the left side has been the focus of most of my pain and discomfort..I am definitely feeling pressure .. even more so now. it is very uncomfortable on the left side.. when I checked for myself I am realizing that my retroverted uterus.. may be right there.. thing is it leans to the right side.. is it possible this is the culprit.. or should I push for more answers.. well I know  Ineed to do something.. but don't want to be told without a more in depth explaination that I would need a hysterectomy... my uterus has always tilted.. but recently seems to have moved more.. there is definitely somoething other than my uterus it seems causing the tenderness on the left.. would it be possible to miss that on the ultra sound.. would it even see that area?  Sorry for  so many questions.. I know you have so many others to get to.,
if you can i will greatly appreciate your reply.. if not I will wait until I can ask another OB
thank you again!
Carol

[Carolscrw]

Thank you Dr for your response and input.. I'm stepping back a bit before starting any more testing..
My Primary Dr and I have considered the depression angle due to the fatigue.. at first we had not wanted to cover up symptoms.. but then it got the point that I needed SOMETHING to help me .. I couldn't deal with all of it at once.. so we decided on the antidepressants..
The question of course being is the depression causing the fatigue or vice versa..

What I am upset with My OB about is her not even wanting to hear or explore the continuing signals that I am having.. pain in ovary... very painful at times.. pressure in my pelvis. even a feeling as if something is Inside causing discomfort in the vaginal canal.  I do feel something from the outside that feels like possibly an enlarged lymphnode??.. it isn't all that big.. size of a large pea.. very large.. but not something that would explain to me the pressure.. I still have weakness in my legs and continuing leg pains.. the leg weakness is very bothersome as well as shortness of breathe for minimal excursion. finding the time and the energy it takes to explore this is difficult.. I have to take a break .. see if anything changes and then start again I guess...
thanks for listening!
Carol

[Annekathryn Goodman, M.D.]

Dear Carol,
Thank you for your question. Rmarie and AJAY - thank you for your input.

It is hard to narrow down why you feel so awful. This is a situation where the primary care doctor can be very helpful becasue they have a big global view of health and health care.

For instance fatigue can be from:

chronic fatigue syndrome
Lyme disease
thyroid dysfunction
depression
anemia
malnutrition
undiagnosed infections and parasites
and so on

The question is: what is relevant to you in your life right now?

It sounds like your PCP thinks you are depressed. That may be so. the 40's are a tough time. With 5 kids, I am guessing that some or all of them are at challenging and demanding ages. Do you have time for yourself?

Lots to ponder.

As far as the gyn piece of this - it is important to feel heard. It is important to get a good check with pap smear, rectal exam, breast check, mammogram. If your ultrasound shows a fibroid that is growing, you should have that rechecked in 3 months. Benign Fibroids do seem to grow for women in their 40's. I do not know why but it may be  something about the changing hormones of the perimenopausal state.

it is rare for a muscle tumor of the uterus to be a malignant sarcoma. However one of the reasons to do a hysterectomy for rapidly growing fibroids is to make sure sure the fibroid is not a sarcoma.
Your follow up ultrasound will be important.

best wishes

[rmarie]

Hi Carol, I really didn't say much, other than I don't know anything about ajay other than suddenly his postings have apperared pushing Pet scans.  What I really wanted to say was to wait for Dr, Goodman to respond, she is wonderful.  It sounds like you have a fibroid that is growing and that may be of concern because it is a change.  I am not totally sure but I think a tipped uterus can give back pain.  And yes, if you are not satisfied with one physican go for a second opinion or switch, one thing I do is get copies of all diagnostic tests that I have done.  With the privicay act HIPPA, this is the easiest way to move your records from Dr to Dr., you can't always depend upon the office to get them to the next Dr.  So call and get copies of your scans, they are appreciative if you can pull out the report.  Good luck to you.  

[rmarie]

Come over to the patient to patient ovarian cancer and we discuss your experience with ovarian cancer.  Do you have it?

[AJAY115]

Hi ,

im not pushing any one to do a PET-CT, i just gave you an suggestion so that you can rule out any chances of cancer and if also you have any you can catch it at an early stage, because early stage cancers are now a days nearly curable.

[Carolscrw]

Thank you Marie... I am really not exactly sure what you said.. :-) but thank you...
I am feeling better than I was earlier today and after reading more on uterine fibroidds/sarcomas and the fact that they can grow slowly or may have originated elsewhere.. I will seek a second opinion. Hopefully from someone far less condescending than the current OB I have.  She almost seemed to think I was laughable to be concerned even  after all of the symptoms I have been having. she was the one that called me in to her office.. was I not supposed to ask questions? Seems like there is so much of this attitude out there.. she wasnt' the least bit concerned with any of the pains I was having in what I percieve to be my ovaries and all throughout my uterus.. nor did she want any details about them , or to exam me .. Proof is in the pudding i guess and there just wasn't enough pudding for her to look at on the screen so she sent me on my way to look elsewhere.. not sure where else to look when my symptoms are OB related.. I really am almost positive it is not in my colon.. I am getting ovary pain on both sides but moslty the left..I am familiar with this sensation.. as are many woman without serious illness due to OV pains etc..
Anyway.. I will keep searching for answers.. but am still feeling pretty warn out and not wanting to do much! thanks again for listening.. sorry to run on.. not too many people around to talk to or that I want to burden with this dead end road..

Carol

[rmarie]

Carolscrw.  I would wait for the Dr.  I don't know wher AJAY has come from all of a sudden, or why he is pushing pet scans with his phone number in India.  The phone code is AFGHANISTAN.  

[Carolscrw]

Thank you AJAY115..
I so appreciate your comments..
I guess I neglected to say that I have done most of those... that was how they found the fibroid in teh first place..
but just came back from OB.. she wants to shrink my Uterus and see what happens.. says there absolutely no chance I have any form of cancer and will not take any other action before seeing if this works.. In 3 months or so... the CA125 is out of the question.. and I am not sure I am up to seeking out a 2nd opinion right now.. I'm very discouraged and worn out..
thanks for listening
Carol

[AJAY115]

hi ,

if you are that much worried that you hold some chances of having cancer then why and for what are you waiting for?

Do a  PET-CT as soon as possible as this imaging technque is very accurate in diagonising cancer and also do a pap-smear test(for cervix cancer), trans-vaginal ultrasound, CA-125 AND LIVE A TENSION FREE LIFE THERE AFTER AS YOUR AGE IS 42 AND THIS AGE IS VERY VULNERABLE FOR CANCERS , SO DO A REGULAR HEALTH CHECK UP , AS THIS CAN SAVE  YOU FROM MANY GYANEOLOGICAL CANCERS , ALSO DO A MAMMOGRAM ALSO TORULE OUT ANY CHANCES OF BREAST CANCER.