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S/P Surgery and Chemotherapy for Endometrial Cancer
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CindyNimmo posted:
I have had persistent and possibly increasing (albeit slowly) water balloon type feeling and difficulty with my abdomen since my surgery and chemotherapy about 3.5 years ago. I, of course, am worried that I have a recurrence and have tried to be vigilant with my self care routine of walking daily and eating really well. I had a CT scan a couple of years ago and they did not come forth with any significant finding. But it has not been easy for me to be relaxed about this situation since then because of the feeling that no matter what type of restrictions I put on myself, I cannot get rid of this pendulous abdomen that feels like a water balloon. At times, I have some pain in my abdomen too. The pain is recurrent aching up under my right rib cage and into the back. I have had this previously and thought it was my gall bladder. But when they did the CT scan the gall bladder apparently looked fine. I additionally have had perfect lab work over the last two years with no increase in my CA 125 and no problems with anemia or blood cell count problems. I have an EXCELLENT appetite and have not lost weight/nor gained any this years despite vigorous exercise routines and trying to go vegan in my diet. I do have a bulge in my middle and think there is a hernia there which has gotten a bit larger appearing. It does not give me pain in that site though and I have had that hernia since my first pregnancy.

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I am going to see my OB/GYN this next week and get a recheck. What should I be asking for in regards to my symptoms? What could I expect in the way of diagnostics which might be helpful?
  • CT Scan
  • Ultrasound
  • cytology of the abdominal fluids
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Jane Harrison Hohner, RN, RNP responded:
Dear CindyNimmo: It sounds like you have a good understanding of your anatomy and health. For example, the understanding the role of an abdominal hernia in producing an obvious bulge. I had a patient with this situation who had abdominal measurements like a 20 week pregnancy! But you are correct it would not usually cause a right upper abdominal pain.

In terms of testing, your GYN might choose to do an ultrasound to see if fluid is actually present. No cytology would be done if there is not appreciable fluid. Then too they might do a CT given that you have a prior scan for comparison. Your own GYN is in the best position to determine follow up imaging. Unfortunately, adhesions (filmy bands of scar tissue which can form from surgery or any inflammation) do not visualize very well with most imaging techniques.

I would urge you to make a rank ordered list of the most troublesome symptoms. This can give your GYN the information with which they can make the best imaging decision. We hope that the bloating is from a GI origin and not ascites.

In Support,
Jane


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