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Novasure ablation for adenomyosis
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sizzled posted:
I had the procedure done yesterday, after being advised by Doc #1 that a hysterectomy was my only option due to apparent adenomyosis. (Tentative diagnosis based on vaginal ultrasound views.)

Doc # 2, whom I went to because of her expertise in bio-identical hormone replacement, strongly encouraged me to try the ablation. My uterus is not too enlarged (about 9.5 cm) and ridiculously heavy bleeding and clotting are my main issues--cramping is controllable with a few Motrin. This doc has herself had the Novasure done twice for similar issues. Two of the three nurses also told me they has done it. (One was "due" for another, as the bleeding was coming back after three years.)

Biopsy was clear, and I don't have fibroids. I have driven myself crazy researching this, and almost cancelled my appointment. Everything I read seemed to confirm what Doc #1 said might happen--scar tissue would cover up possible deep-seated endometrial tissue invading the uterus wall, and leave me worse off than before. From what I read, there is definitely anecdotal evidence to support this! HOWEVER, I also read a few medical journal study reports which suggested that ablation IS often a good treatment for adeno and should not be discounted. Really, it seems to be all about A) the size of the uterus. (Too big, and the equipment can't handle it and will leave too much un-ablated tissue.) how deeply the adenomyosis has invaded the muscle. This used to be impossible to tell until the uterus was removed via hyst. but now imaging improvements can allow them to see things a little better. Unbearable cramps each month might mean that the adeno is deep. C) presence of fibroids--from everything I've read, this can lead to a poor outcome.

My adeno appeared "diffuse" not "deep" although it is impossible to know for sure. I am keeping my fingers crossed and hoping for at least a few years of diminished bleeding and relief from severe anemia. (My hemoglobin was down to 7 after one particularly horrible month.)

The procedure was done in her office with Percocet and shot of some other pain killer. (I forget!) They numbed my cervix with something lidocaine-like. I watched the laproscope beforehand-very interesting! Yes, it was quite painful for those 90 seconds, but hardly bad enough to consider general anesthesia. I'm surprised that so many people go under general for this procedure.

My doc told me I'd have a few "honeymoon hours" because of the pain shot, and then cramping would set in if I didn't stay on top of it. I took 4 Motrin at the beginning of more cramping and have no been in pain or taken anything since. It has been about 28 hours. Very light brownish discharge--hardly enough for a liner, even. I know that the discharge will probably increase as the wounded tissue starts "weeping".

I'm writing this because there aren't many adenomyosis+ ablation threads. Will keep y'all posted on my eventual outcome!

Best of luck to everyone looking for answers and information!
Reply
 
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Jane Harrison Hohner, RN, RNP responded:
Dear sizzled: We owe you a debt of gratitude for both your articulate description of the procedure, and the review of medical literature about ablation for adenomyosis. You have done a superb job of summarizing the many factors which might influence the success of an ablation. I could not have written a better entry myself!

In Appreciation,
Jane
 
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sizzled replied to Jane Harrison Hohner, RN, RNP's response:
Jane,

Such high praise, coming from you!! All of your resposes are so thoughtful and knowledgeable. Wed MD readers are so lucky you're here for us. I can only hope that my understanding of my situation is accurate....

I am on Day 5 and have not had even the tiniest bit of pain. Discharge continues to be so light, it is almost nonexistent. I am keeping my fingers crossed, as my period is due next week.
 
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Jane Harrison Hohner, RN, RNP replied to sizzled's response:
Dear sizzled: Do keep us appraised as your entry, with it's descriptive subject line, will be an important resource for women with adenomyosis contemplating an EA. Thanks for your kind words as well.

In Gratitude,
Jane
 
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sizzled replied to Jane Harrison Hohner, RN, RNP's response:
It has been almost two weeks since the Novasure procedure, and so far, so good! Still almost no discharge, no pain. I *think* I may have gotten a period, but not sure. It was due, and my tiny amount of discharge had a pinkish cast for a few days.

I do use natural progesterone cream and take Apple Cider Vinegar every day. No idea if these have helped make my recovery such a breeze, or not. They certainly both helped with the heavy bleeding, clotting and cramping I had pre-Novasure.
 
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Jane Harrison Hohner, RN, RNP replied to sizzled's response:
Dear sizzled: Thanks for the follow up. It is possible that the sudden pinkish cast at the time of an expected menstrual period MIGHT represent a tiny bit of remaining uterine lining shedding.

It sounds like you have been using daily progesterone cream. IF there is a pharmaceutical amount of the natural progesterone in your cream (and very few of the over the counter products have this), that could also contribute to keeping any remaining uterine lining inactive. This would make you less likely to have a "real" period.

Yours,
Jane
 
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Anon_61862 replied to Jane Harrison Hohner, RN, RNP's response:
Dear sizzled:
Please keep us updated on your progress. I am in the exact same situation as you. I was diagnosed with Adenomyosis about 6 years ago & told a hysterectomy was the only option. I inquired about ablation but according to my dr, it wasn't a procedure that would work for Adenomyosis.

The clotting, extremely heavy bleeding and severe anemia all contribute to a reduced quality of life. I cannot go anywhere or do anything the first few days of my period unless I have my period pad diaper on (4 heavy duty overnight pads). Prescription medications are available for reducing heavy bleeding but I am not a fan of taking medicines. Acupuncture has provided some relief and made my clots smaller. Would still prefer to get rid of the problem all together. If the ablation continues to work for you, I definitely want to obtain another Gyn's opinion on the ablation. Good Luck and look forward to updates!

Thanks,
D
 
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An_245648 replied to sizzled's response:
Hello Sizzled,

I plan on having the procedure in a couple of weeks. Thanksfor your insight I really appreciate it with all the good and bad flying around

Can you tell me how you use the progesterone cream and Apple Cider Vinegar, is it topical or a bath?

Thanks,
Lisa
 
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brewcrewbaby responded:
" I have had enough of this!" I told my husband regarding my cramps that I had the night before. My cramping was so painful that it kept me awake in pain and groaning. I'd taken as many acetometaphin as humanly possible with no relief. He got up out of bed and took me into the bathroom and ran a hot tub of water, after sitting in that for about half an hour the pain had started to subside.
The next day I decided to go to one of the more well known gynos in our area at the time. He listened to my complaints about the heavy bleeding, cramping and short time frame between periods. Some months I'd have my period twice, lasting for a good 5-7 days. This all took place btw after I had gone off of the pill so we could see if we would get pregnant again.
I've had problems all my life with my downstairs, at 23 I had my first bad pap. Had a cone biopsy and had to go back for a repeat pap every 3 months for a year. Passed all of those so I graduated to once every 6 months for a year. The last one came back bad again. Another cone biopsy and several pap smears later, along with quitting smoking, solved the problem.
But, at 35 we were on our last legs for having a baby and I wanted a girl because we had 3 boys already. Didn't happen after I had gone off the pill though but, what did was all the other stuff. So when I talked to the Dr. about my maladies, he did ANTOTHER pap and put me on horomone therapy. I did not like the horomones! They made me feel out of whack or mixed badly with my depression meds but, the main thing they didn't do was help with the bleeding. So upon a return visit to the Dr. he took me off the pills and ordered an internal ultrasound exam.
After that exam is when he told me I had Adenomyosis. He told me about the NovaSure procedure and that's what I decided to go with. So we set up the appointment and at that time I didn't have the choice to stay awake or be put under, they just put you under. Which after having been awake in the intitial biopsies back when I was 23 to see if I needed a cone biopsy or not, I was happy to get put under (I'll never forget those long handled scissors going into the downstairs and then the burning pain they caused when they came out)
There wasn't much out on the web about Adenomyosis then and there still isn't but, I went out and searched for as much as I could. Then I researched the NovaSure procedure and had assured myself that I made the right choice. The day of and the day after were the worst as far as cramping afterwards but, I haven't had a period since then. I believe I had the procedure done in '06 or '07. Since then the most I've had was a crampy day here or there and a little spotting now and again but, for the most part I'm happy with what I chose. I don't know how old you are but, I'm 44 now and really haven't missed having to ride the cotton pony one bit.
I have done some looking since then and the newest thing I've seen is that supposedly Adenomyosis is usually accompanied by some form of Endometriosis as well... whether that's true or not I'm not sure.. but, my mother had the Endo so maybe?
 
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b4_gurl replied to brewcrewbaby's response:
b4gurl responding.
I've had endometriosis all my life it seems. I was put on both depo-pravera and the pill more recently when the pain got excruciatingly worst and my doctor said it wasn't the endo that was causing this but I now had adenomyosis. I haven't had any children yet so he's holding off on the surgery for now, he recommended hysterectomy. So far so good in terms of not having any pain or clotting since I don't have a period, which at my age of 40, I'm a bit concerned about. I do experience once in a while some sharpe stabbing pain back there, which doesn't last for more than a second or two. I'm open to any advice or suggestion nurse or anyone may have. btw thanks for posting this, it seems as if only a few of us experience this hell and the support is needed.
 
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sizzled replied to b4_gurl's response:
Hi B4gurl. brewcrewbaby, anon61862 and an 245648,

I feel for you all!!! This adenomyosis thing is the worst. I am 44 (I didn't mention age in my first post) and have had heavy, miserable periods since my first one and the adenomyosis symptoms for about 8 years although did not diagnose until about a year ago. I hemorrhage every month for about 1.5 days of a 5-day period. It comes every 21 days. Clots are constant and make a big old *splash*!! I have been in the ER from blood loss and of course I am anemic and have all those symptoms.

I also have the full range of estrogen dominance symptoms, which I believe has contributed greatly to the adenomyosis. After doing a lot of research trying to avoid the hysterectomy my DR thought I should have, (also tried Yaz for TWO DAYS whatta nightmare) I realized I would be crazy not to try bioidentical progesterone to balance out the estrogen. I got serious about eliminating all of the xenoestrogens I was using. No more body lotions or shampoos with parabens, pthalates,etc. The progesterone cream I use, (from Source Naturals brand-it is a good one) pretty much saved my sanity. I was hoping to help with the periods, yes, but it made me feel like a new woman, or rather, like my old self from 10 years ago. The depressing FOG lifted within about 24 hours. I was dumfounded and angry that I didn't know about this stuff before. You can all research this very easily--there is a lot of info out there. Suzanne Somers books (I know, eyes rolling) are actually wonderful. I am now in the process (have saliva testing kit from my new doctor) of nailing down which hormones I need and how much-and will get the pharmaceutically compounded versions. What I have been doing is haphazard but it still worked so well that I am excited to do it properly.

It is very important to note the difference between bioidentical hormones and synthetic ones in birth-control pills and "hormone replacement therapy" of old. I would never, EVER take those.

The progesterone cream made my periods more regular, so at least I knew when it was coming. It also helps with cramps and "flooding" DURING my period, when I spread some directly on my lower abdomen. I asked the DR if this is really possible, or maybe it was in my head(?) and she said yes, it definitely relaxes the smooth muscles of the uterus and I wasn't imagining it. I think it is not so effective if you have much fat on your abdomen but I don't.

Sorry to ramble on, but the cream was nothing short of a miracle for me and the only bright spot in my search for relief. I kind of want to shout it from the rooftops to all the miserable premenopausal women out there having the same issues! I use about 1/2 teaspoon 2x per day, spread out on thin-skinned areas like inner arms and lower belly. (I am down to 1x per day nowadays but you need to hit hard in the beginning.) During cramping or flooding i put about another teaspoon on the lower abdomen.

About the Apple Cider Vinegar, I take one tablespoon per day in a small glass of water. You can research in over at Earthclinic site--but beware, you'll be stuck at Earthclinic for days, sucking up all your free time on the computer. It really, really works for so many things but I'll sound like a crackpot if I go on and on so just check it out on your own. (I started on it for hayfever and sinus infections, not realizing it would help the periods, too.)

Brewcrew, I am SO GLAD TO HEAR THAT THE NOVASURE WORKED FOR YOU!!! "Riding the cotton pony"--you made me laugh so hard. My Dr. #2 was SO certain it would help me, and yet everything I read said not to do it. Of course, if it works and everything's fine and dandy, you won't end up on these forums looking for answers so there are very few success stories.

I am a research hound and it DOES seem like the Novasure is the best option of all the different types. (Thermal balloon, rollerball, etc.)

I'm still feeling 100% great and keeping my fingers crossed.
 
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sunflower62509 replied to Anon_61862's response:
I have same diagnosis of Adenomyosis,I read all of your posts but I remain puzzled. I have horrible bleeding, probably 10 days from spotting till end of period, maybe more..my period is at least 6-7 days of super tampons and overnight maxipads for at last the first 3 days of my flow. But my HGB/HCT remain perfect, I'm also a nurse, so I might have a bit more insight regarding lab values.... but I bleed horribly. This month for the 1st time a full 7 day period on may 13th, started spotting on day 14, day 17 bright red blood, no real flow. Just had D&C, Hysteroscopy, transvaginal ultrasound nd FSH levels....all normal except FSH of 21.
 
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sunflower62509 replied to sunflower62509's response:
Also. I have no cramping/pain issues. My period issues are due to heavy bleeding.....and now spotting/bleeding from day 1 till now(started day 14..again)
 
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An_245677 responded:
I'm glad this procedure worked for you. I just hope women will realize it doesn't always work. For me it was a nightmare. Not only did I bleed for 2 months afterwards and my doctor would not listen to me, until I made an appointment and faced him with this fact. He did apologize. But by this time I was done with being his practice patient. I looked hard for another gyn and finally got some help. After finding out about cyst on both ovaries, time after time. Much pain and bleeding. I had a total hysterectomy and I'm so glad I did. I wouldn't advise anyone do this without much thought and discussions with a good doctor that actually listens to you and act like he/she wants to help you. For me it was a good decision.
 
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brewcrewbaby replied to sizzled's response:
Happy I made you laugh! I mainly wrote my story down so that you and others would know that it can work over a long period of time.. they tell you that eventually your bleeding can come back and I dread the thought but, so far so good! I know the thickening never stops so yeah it's a possibility I suppose but, 5 or 6 years without any of that mess was kind of an inspiration to older women that are done having children I thought. Like I said there are some crampy days and then there's spotting days but, it's so light (like the few days after the procedure) that it's not worth worrying about. The cramping days are the ones that make me believe that the thickening just never stops, I guess it's how fast it occurs that determines if the bleeding will come back. And I suppose the older you get it slows due to metabolism changes that make a difference as well. I hope that you're very pleased with the end result as I am sizzled! Sounds like you are... I'm gonna have to check out that website you mentioned to see about sinus infections and maybe thyroid problems... thanks for the info!


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