Will I recover completely after abdominal hysterectomy with a history of cancer, asthma and osteoporosis due to my low weight?
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Hello, I am scheduled for an abdominal hysterectomy this coming April. I have suffered with constant vaginal bleeding for over three years (I have not entered menopause, although I am 53). A uterine ablation was done in April 2013 without success and the bleeding resumed immediately following the procedure. We have tried provera without success. My wbc count and hemoglobin are dropping so I have made the decision to have a hysterectomy. My questions are this: (1) I am underweight and am hypersensitive to all medication. I have a history of cancer (thryoid), severe asthma and MVP. Will this put me at a higher risk of making a full recovery? (2) I have osteoporosis due to my low weight but have received conflicting opinions as to whether or not I should go on HRT. I look forward to your response.
Posted Sat, 18 Jan 2014 in Women's Health
Answered by Dr. Aarti Abraham 56 minutes later
Brief Answer: INCREASED OPERATIVE RISK, HRT WILL HELP. Detailed Answer: Hello Thanks for writing to us with your health concern. I assume a thorough workup has been done to ascertain the cause of the constant vaginal bleeding. In the absence of any identifiable pathology ( fibroid, endometrial hyperplasia, adenomyosis ) - the condition is termed as DUB ( dysfunctional uterine bleeding ) also called AUB ( abnormal uterine bleeding ). Since it has proven to be refractory in your case to medication as well as ablation , it is now almost inevitable that you should be undergoing a hysterectomy. Since that is a given, to answer your specific questions now - 1. Yes, you are a high risk candidate. Compared to other patients without the co morbidities you mention, you are at a higher risk of per operative and post operative complications. Specifically severe asthma is the most alarming condition. Past history of thyroid cancer is not of much concern, as it would already be fully treated. MVP too is considered relatively benign. Regarding your asthma, and being underweight as well as hypersensitive to all medications, once you inform your surgeon of these conditions, due care would be taken in advance to minimize the risks. Pre operative assessment by the anesthetist would involve eliciting a detailed history and tailoring your surgery and peri operative period to eliminate the risks posed by your condition. You should not be worrying about it, as women with many more severe medical conditions do go on to have successful surgeries. 2. Regarding osteoporosis, yes, HRT is considered beneficial for women who have osteoporosis. I hope the following links will reassure you - http://www.sign.ac.uk/guidelines/fulltext/71/section5.html WWW.WWWW.WW These are in medical terminology but the gist will convince you that HRT if taken early enough and for atleast 3 - 5 years, will have a positive impact on osteporosis. Of course, the risks vs. benefits should be weighed and your doctor would definitely do that. So go ahead for the hysterectomy with all facts in place, but with a positive mindset. Wishing you loads of luck and good health. Take care. I would be happy to address any follow up queries.