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I am going to a new GYN tomorrow to get assessed for my current symptoms, including a large fibroid and a cyst on each ovary. What questions should I be asking?

By March 25, 2013 - 11:50am
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I went to my gyn 2 years ago and told him I had been feeling some tenderness in my lower abdomen, coming from what I thought was my uterus. He checked and noted he could feel I had a fibroid and my uterus was a "two month" size. He said he was going to watch and wait and see if got smaller. He did notify me at the time if it didn't and increased, we may have to remove them or if severe enough my uterus. He said let's just start with monitoring my periods length, heaviness, etc - gave me a little card to do so and come back in 6 months. That was March 2, 2011 (I thought it had only been a year and a half, but I just called the office to double-check and - my, how time flies! This is the longest I have ever gone without a checkup). I never went back for my 6 months because the week I was supposed to go, he had to reschedule due to a delivery that had to be made. They apologized and asked me to reschedule. At the time, I was working 60-70 hour weeks and no time was a good time. I said I would call back. I never did. I left the job May of 2012 telling myself I need to schedule it.... I continued to have dull aches in that area, but figured the fibroid was there, nothing was more significant, so I ignored it. My new job didn't immediately have health insurance, and being sales, by the time it did, I couldn't afford it. So I kept telling myself I need to eventually go...

Over the last 6 months I started to gain more weight and it was unusual because none of my eating habits or otherwise changed. I am 44 and surmised, along with now my periods that were initially heavier, then longer, then shorter and sparser, and then longer in-between them I must be perimenopausal - after all, weight gain, menstrual cycle changes, tired, I'm mid-40's, right?
Then, about 3 weeks ago that little belly that was developing that I didn't have until 6 or so months ago started to expand, to the point that my pants' waistline was too tight. Even my guy said, "Aw, hun, we're getting older. I still love you." I wondered if I was overthinking it.
My back had also been hurting since last summer. I went to a chiro and he made everything but my lower left back feel better. It seemed like it would only "crack" half or less of the time. But with the rest of my back feeling better and less sharp zaps, I felt I was on the way to recovery. It was end of the treatment I paid for and stopped seeing him. That was Sept 2012. I had dismissed that symptom as being unrelated. I have to admit I didn't do any real research.
Then, as my abdomen was expanding, I realized "something" wasn't right. You know that little thing inside you that says you can't make anymore logical excuses for your symptoms? Not that I was trying, but I didn't want to go to the doctor to be dismissed. Especially since I had mild IBS now and again bother me. But now I'm thinking to ignore it, I'm just being stupid. I was working 6-day work weeks since Jan 2nd and had put it off the irregular periods before the belly expansion.
I say all this first because I DID start reading, as much as I could, especially when I put my symptoms in Google and ovarian cancer was one of the first things that came up. I started on my search of reading everything I could crop up on it, and on fibroids. Honestly, it scared me. I consider myself a reasonably intelligent woman, but I just realized how stupid I was being by pushing it off because I was "too busy" with work and that I was probably overdramatizing things.
I have no health insurance because I make "too much" for medicaid and "too little" to afford a few hundred dollars from my pay every month. The kids were covered and that's what meant the most to me. But us mothers sacrifice ourselves without thinking if WE are down, what good are we to our kids?
I remember one of my friends saying I should "get rated" on a sliding fee scale at one of the hospitals closer to downtown. It wasn't super close, nor super far, yet another reason I didn't do it when she suggested.
Now with my research and my symptoms, I thought I better find a way to get seen. When I really started investigating, many hospitals have a discount plan/sliding-fee scale to accommodate people like me. After I got assessed financially (hospitall's financial counselor), which took time out of only ONE day, I could set an appt. It was for 2 weeks. I said to the lady, is there ANY way to get one sooner? Urgent care maybe? She asked what was going on and said she thought urgent care wouldn't be best, that I really needed the GYN to see me. She check the schedules again and said she thought she could squeeze me in a few days from then - she had to confirm and check with the doctor. When she came back, she said the doctor wanted an ultrasound (traditional abdominal) and to do that first and she would also schedule my appt for follow-up. The follow-up was in 2 weeks. I went to the ultrasound 2 days later. The tech told me I had an "impressive" size fibroid. Thing is at this point I found a few days ago I also had a palpable small mass about where I figured my ovaries were, and mentioned I felt a bump. He found it easily on the ultrasound. He left afterwards for a few minutes came back and said I was good to go, that my result would be available in 24 hours and I could call or wait until my doctor's appt.
Next day I called and the nurse told me I had a simple cyst on each ovary and a large fibroid. Nothing urgent, I can talk to my doctor more about it next appt.
I really didn't want to wait almost 2 weeks to find out something else might need to be done (SOMETHING - please!) and then schedule that another 2 weeks out. I called back and asked if I could check if there had been any cancellations. Yes, one for over a week sooner. AND I could be put on a list to be notified if there were any sooner cancellations. Why didn't someone mention this sooner? This is where my reading about being your own best advocate is really ringing true.
Okay, so my symptoms, especially after having done some research and realizing these are very possibly all interrelated symptoms are: noticeably increased abdominal girth/abnormal bloating, pain in the abdomen - from belly button down, but esp in the southern regions, about an inch bump I can feel on my lower mid region, I can feel and see my uterus is swollen, dull back pain pretty much all the time with the nice shock now and again based upon position, pain down my inner thigh or back of left leg, feeling like sometimes I want "out of my own skin", lack of periods now (going on 60 days), frequent urination/sometimes urgent - I go and feel like 2 minutes later I want to go again - I had that as long as my back pain, "unsettled" feeling in my abdomen sometimes, heaviness in my abdomen - like I am pregnant, had gas everyday for awhile - now minimal, I eat half of what I eat before - I am just not as hungry, can't lay on my left side for long in bed or anywhere. Tired - but I am a mom so I am always tired - but occasionally feel tired enough to go to sleep at like 9:30 pm. Occasional nausea out of nowhere.
So, all that to ultimately ask - considering I have two simple cysts and a fibroid, I am about to get a pelvic exam and have no history with this doctor (my old GYN is not a part of this hospital system), what questions should I be asking? I worry a bit about ovarian cancer because of the related symptoms. I don't see many places discussing LACK of period for any of these conditions either. I just want to make sure I am making sure I am thorough, since I realize in the end, I AM my own best advocate. And what tests ideally are recommended under these conditions based on what I had told you?
P.S. Not only did I want to give my history - but wanted to make a point for anyone else reading - that work, apprehension about a doctor's opinion that it is "nothing", and lack of insurance shouldn't hold you back from getting checked. They really aren't THAT important, your family is. Even if it is "nothing", or "something else", why suffer or be unnecessarily concerned? Do it for our kids, our partners, our parents if you won't do it for yourself.
Also, being our own best advocate. ASK, ASK, ASK. IS there an earlier appointment or cancellation list? IS there a better option? CAN I have that test anyway? WHY didn't we or did we? HOW BIG? etc. Don't be afraid to ask questions and expect action or answers. I am learning!!!!!

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HERWriter Guide

Hi Jill Harvey

Thanks for your post!

The first thing you need to do is have your medical records transferred to your new doctor. Contact the your former doctor's office for this information - you have the right to access your own records. Have them send the record to your new doctor (find the email or fax number they'll need so it's easier for them to do with without delay) and nicely remind them that they should do this in a timely fashion.

Like you've done on this post, do a timeline of your symptoms. Also write down when symptoms or pain levels and swelling changed. Advise them of your current symptoms.

Ask for a physical check up (they will want to do one anyway) and also ask if blood tests or any other tests  would be beneficial and if they would be, make an appointment right away.

Truth be told, the more educated you are and the more prepared you are, the better the doctor will be informed and take everything you say into account. The average doctor-to-patient face-time  is only about 8 minutes in a regular setting so time is of the essence.The better the patient you are, the better the doctor will be! It's very much a joint effort.

Make sure they know about your increased discomfort and symptoms and your history, even if they have your records. Write down questions you have (like some of the ones I suggested above) in case you forget them. It's amazing how we really want to know a certain thing and bam! We leave the office and think "how could I not have asked that!" I've done that too!

It's great to see you advocate for yourself this way, it's really important and I do also practice what I preach. Please let us know how it goes and remember to ask your doctor to advise you of what will be done next. Don't accept let's-wait-and-see advice. It sounds like something is going on with your reproductive system so ask your doctor to talk with you about what steps need to be taken next. Make sure you book a follow-up before leaving the office and make any appointments for testing as soon as you can.

We wish you the best and look forward to hearing how your appointment went!


March 25, 2013 - 12:48pm
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