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Diabetic, BP, bleeding with big clots. What are treatment options?

Hi, doctor, my aunt is having periods since last 8 yrs and it never stopped sometimes more bleeding sometimes less doctors in our city suggested to have hysterectomy as fabroids were also present in the uteris. She is a diebetes patient since last 12 yrs and few months back was treated for diebetic foot and hence she was asked to wait until the foot is completely cured to have hysterectomy. Now there is lot of bleeding with big clots again she is also suffering from BP. She is 55 yrs. old please suggest weather it is advised to go for hysterectomy?
Asked On : Fri, 12 Apr 2013
Answers:  3 Views:  26
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Internal Medicine Specialist 's  Response
according to your data it seems she requires hysterectomy...continous bleed from fibroids can cause anemia and cause heart strain..she has hypertension too....diabetic foot is a common feature but do check for kidney function and hypothyroidism ...causes bleeding from a complication of diabetes
take care
Answered: Fri, 12 Apr 2013
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Internal Medicine Specialist Dr. Akhilesh Dubey's  Response

Welcome to HCM,

After going through history in details,she is Hypertensive,Diabetic, and due to fibroids having blood loss due to irregular period called (DUB).

She must visit Gynecologist and after examination and Ultrasonography if it is possible to get some more time by giving medical treatment in the form of hormone (Progestin).
She should be examined and managed by internal medicine specialist properly .

She should be checked for CBC,FBS,PPBS.,her cardiac status by EKG and 2 D Echocardiography.

If her Hemoglobin is low due to blood loss may need to be replenished with transfusion of blood and if it necessary to go for surgery then Hysterectomy can be done with understanding of little more risk.

In the mean time she should continue antidiabetic therapy and keep her BP under control.

I presume that her diabetic foot is improving.

Please take care.

Good Luck.

Answered: Fri, 12 Apr 2013
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General & Family Physician Dr. Pavan Kumar Gupta's  Response
Since there is lot of bleeding and since it can't be controlled medically,the only option is hysterectomy.
Since she is diabetic and hypertensive,hysterectomy can be done only after proper control of blood sugar and hypertension.
The surgery for diabetic foot done few months back is not a hinderence for hysterectomy.
She should be properly evaluated and if found fit,then hysterectomy can be undertaken.
Proper clearance from cardiologist and diabetologist is important before the surgery.
Answered: Fri, 12 Apr 2013
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