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Fibroid surgery: doctor recommendations for laparoscopic myomectomy

  1. #1
    Yarrr Girl is offline Registered User
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    Fibroid surgery: doctor recommendations for laparoscopic myomectomy

    Hello everybody! I've been working up to posting this for a while but finally registered tonight.

    In a nutshell... DH and I have been looking for "Dr. Right" in terms of gynaecologists to perform a laparoscopic myomectomy on me. I want the relatively smaller incisions and relatively quicker recovery generally associated with laparoscopy vs. a large incision. Other considerations: we're hoping to conceive once I'm completely healed and, if at all possible, to avoid a c-section when the time comes.

    Any recommendations?

    Longer version:

    According to the ultrasounds that I've had done, I have multiple fibroids with the largest measuring about 6cm in diameter. My periods are long and quite heavy and I tend to bleed a bit in between. Then, there's the pain/discomfort and the slightly-protruding-but-noticeable-to-me tummy they've given me. Oops! I forgot the mild anemia. *groan* Anyway, for some time now, I've been taking doctor-prescribed meds during my periods to keep the symptoms under control but they've been a huge, unwanted distraction for far too long and I'm ready to get them taken out.

    My regular gyno has been taking care of me so far and is a totally OK doctor, but for various reasons he's not the one that I want to handle this surgery. DH and I have made the rounds and had consults with several doctors, none of whom were terrible, but none of them really felt like "the one" either. We've also been educating ourselves quite a bit about fibroids and the various treatments available for them. With me reaching the limits of my tolerance for discomfort/hassle, we had all but resigned ourselves to settling for "Dr. Goodenough". [DH was more than willing to continue looking and has accompanied me to every single doctor's appointment I've had since we moved to HK -- and we're both grateful that his work makes that possible. It was me who was exasperated and wanted to get it done ASAP.]

    Anyway, we got as far as tentatively scheduling the surgery with a particular doctor who had followed the usual script: ultrasounds and whatnot followed by a brief sales pitch for the surgery that described what would happen in the operating room in very broad strokes. This particular doctor seemed to have a bit of verve/energy and our first impression of them was more favorable than that of any of the others.

    The problem came when we got down to brass tacks and began asking some informed questions about how they were going to be doing the operation. DH and I had reviewed the information we had gathered and worked up a list of questions. They ranged from obvious stuff that other gynos recommend you ask -- like how they were trained to do that type of op, how many they had done, how frequently, whether they'd had complications, etc. ... to asking whether it would be possible to receive injections that would boost my red-blood-cell production ahead of the surgery in order to minimize the chance that I would need any transfusions during/afterwards (since HK doesn't seem to allow people to easily bank their own blood ahead of surgeries).

    We're not doctors, obviously, but we are certainly intelligent enough to be able to understand some lucid explanations and answers.

    We were completely polite and non-confrontational throughout, but the doc was surprised that we had any questions at all and, after fielding a couple with a strained smile, patronizingly told DH that he should have been a doctor. They urged us to trust them and that asking so many questions was pointless.

    Obviously, scolding patients for trying to perform a minimal bit of due diligence is not acceptable, so we're looking again.

  2. #2
    Honkyblues is offline Registered User
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    Have you seen Dr Christine Choy? She removed a polyp for me - very quick and professional. She's also a great fertility specialist if you need help conceiving afterwards.

    She's in New World Tower, Central.
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  3. #3
    newbiekt is offline Registered User
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    I would try Dr Grace Cheung at Central Health. I know she is experienced in this area and according to friends who see her has a very nice bedside manner.
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  4. #4
    Yarrr Girl is offline Registered User
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    Thanks Honkyblues and Newbiekt!

    In a different thread, I read that Dr. Cheung wasn't accepting new patients, but that may apply to deliveries only.

    DH and I will talk tomorrow and figure out next steps.

    If doctors don't want to spend the time to discuss procedures sensibly with patients, they should be willing to write up a basic sheet listing the steps involved (with photos and brief descriptions), the prep before, and the aftercare. Then they could save their energy and only have to handle concerns not addressed in the writeup.

    Patient-targeted informational materials, videos of the procedure that I'll be having, etc. are available online but not everything is done in the same way here as in the places (mostly the USA and UK) where the doctors/institutions that are publishing those articles and videos are based.

  5. #5
    dimsum mum is offline Registered User
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    A few years ago Dr Joe Chan removed some fibroids at Canossa Hospital for me. I thought he was brilliant. Great bedside manner, and a fabulous job. I have nothing but good words to say about him.
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  6. #6
    Yarrr Girl is offline Registered User
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    Thanks Dimsum Mum!

    DH and I saw JC some ways back. He was completely courteous and seemed perfectly competent (and I'm aware that he has glowing reviews in other threads here) but he was one of the gynos with whom we just didn't "click".

    Update:

    Since posting this thread, DH and I saw the somewhat energetic, but has-a-bit-of-a-god-complex doctor I'd been planning to have do my surgery again to discuss the results of an MRI that DH had insisted that I have done. Just getting the MRI was a hassle since the doc seemed to interpret it as a sign of our not trusting their judgement.

    The doc insisted that the information from the ultrasounds was altogether adequate and that an MRI would be a waste of time and money. They were so adamant that it was unnecessary that even I wavered a bit, but DH pushed back and handed the doc a printout of a scientific journal article he'd found online showing that MRIs gave docs a much more precise idea of the number and sizes of fibroids. Doc wouldn't even look at the article and fired back with the line that the exact sizes didn't matter and that counting all of the teeny tiny fibroids that might show up on an MRI was pointless since we were only going to be taking the largest ones out. Thankfully, DH wouldn't take no for an answer and I had the MRI a couple of days later.

    Lo and behold, I also have an ovarian cyst. UGH. Doc sheepishly conceded that the cyst may be contributing significantly to my painful periods.

    Even then, when DH tried to ask a few more questions, the doc copped the same attitude as last time. Fairly shameless.

    This incident has really driven home to me the value of having someone to advocate for me, fiercely if necessary, when it comes to medical care.

    We're going to be seeing a new gyno later this week and I'm keeping my fingers crossed that they're less rushed, more conscientious, and more willing to explain things.

  7. #7
    Yarrr Girl is offline Registered User
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    Update: We saw another doc, at what seems to be a highly-regarded practice in central. Whereas god-complex dr. is very confident about doing the laparoscopic surgery, this other doctor insisted that an open surgery would be better, but their measure of better seemed to equate to a faster operation, which would be great for them (they'd be able to see more patients or perform more procedures that day) but not so great for me (longer recovery time etc.).

    DH gently probed the doc and they they basically conceded that lap vs. open was a matter of doctor's surgical skill. The doc then encouraged us to see a more senior gyno at the same practice who would presumably be more willing to go the laparoscopic route in my case.

    Doc also repeatedly tried to get us to let them do an ultrasound on me, which didn't make much sense since (1.) they wouldn't be operating on me (they had already said they'd be referring me to that older doc) and (2.) we had brought my (very recent) MRI report and the hardcopy images and DVD of "slices" from the MRI and an MRI is much clearer than an ultrasound. When DH pointed this out, the doc came back with something about the ultrasound giving them a chance to "know me better". When we asked why _they_ would want to do an ultrasound since they were referring me to that other senior doc, they finally gave up and said that that other doc would want to do an ultrasound.

    The whole experience was very odd and we're thinking that many gynos use ultrasounds as a bit of a money-spinner. Patients are inclined to go for an ultrasound since it's convenient (can be done right in the doc's office, as part of the visit) and much cheaper than an MRI and docs love it since they (or their practice) gets the entire ultrasound fee, which seems to be as much as the consultation fee at many gyno practices. If they refer a patient for an MRI, the patient might complain about the cost and, crucially, in many cases at least, they probably don't get any of the money that the patient spends on the MRI.

    We're thrilled that I got an MRI since it found that cyst. It saved me a lot of potential frustration (I can imagine being surprised and depressed if I continued to have considerably painful periods) and the expense and risk of a second surgery (cystectomy) assuming that we would have discovered it later on.

  8. #8
    yogi1 is offline Registered User
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    Dear Yarrr Girl, I found this thread in an online search. Which surgeon did you go with in the end? Did you have a laparoscopic myomectomy? How was your recovery? I have encountered the same frustrating issues in my search for "Dr Right". I would love to hear about your experience if you have time.

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