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Suggest Treatment For Utero-vaginal Prolapse
Question: Hi, I'm a 53 y/o white female, three pregnancies, 3 deliveries. All remarkable, except for now having 3 BEAUTIFUL children. For starters, my periods have never been a regular 28 day cycle. My entire life I only had 3-4/yr. ALL ob/gyn exams have always been normal. Over the last months, I've noticed some gynecological changes that are a little concerning. I began having trouble inserting a tampon when I did start my period. At some point, I decided to do my own "digital" exam, if you will. At first, I could only feel what I can describe as a "webbing" when inserting my finger vaginally. Now, just a few months later, I almost can't get a tampon in far enough for it to "stay in place". but more concerning is that when I once again do the same digital exam, I find that there is now, what feels like, a SMALL round/circular opening in toward the back of my vagina towards, but just before my cervix. I can't imagine why I would have scar tissue develop there for any reason, but especially so "suddenly". I have no pain or discomfort, no discharge, or anything else that I can think of that might be helpful for you. I know that I obviously need to go and have this evaluated, but I guess I'm just trying to mentally prepare myself and am wondering if it could/would be anything serious or do I need to be particularly concerned about it. I do have other health issues, (ie: undiagnosed lung disorder of 16 yrs. duration, but I don't see how they could be connected. I don't know if you can see my profile, but I did write up a bit on the lung issues in my profile area.) I do okay and putz through daily life, but it would really be nice to be able to say again that I felt like I was actually LIVING again. Overall, I have no real complaints. Even though I've been sick, I think I still feel like I live a life that is satisfying and gratifying, both to myself and to others. Not a bad legacy to leave, I guess, huh? :-) I can't imagine that the two situations could possibly be connected! But, I would really like to hear what your take on the gynecological aspect of this might be about. Thanks so much for your time and thoughts!
Brief Answer:
Probably Utero-Vaginal Prolapse
Detailed Answer:
Dear XXXXXXX
At the outset, I must compliment you for providing such an exhaustive detailed history. I appreciate the mention of your lung condition.
I believe due to the lung condition, you would be having some chronic cough too. This could be one of the precipitating cause of what you are feeling as a round structure with an opening in the vagina. This structure you are feeling inside the vagina is mostly the mouth of the uterus (cervix).
XXXXXXX I feel you are having prolapse of your genital organs in which the uterus slides in the vagina. Initially, it is the moth of the uterus (the cervix) that slides down in the vagina and then the whole uterus starts coming down.
Did you have any difficulty during your deliveries, particularly prolonged labour or too much straining or difficult delivery? These are the causes which are predisposing factors for the utero-vaginal prolapse.
This is not a life threatening condition, though an embarrassing and disturbing condition. If ignored it may lead to complete prolapse where the whole uterus may come out of the vagina. It may also lead to urinary and/or bowel problems. Please report to your Gynaecologist for confirmation of the disorder.
Considering your Obstetric history and age factor, I feel you would be a good and suitable candidate for surgical repair. Though prolapse can be repaired without removing the uterus, at this age when you have completed your childbearing function, removal of the uterus with the repair of the muscles should be most ideal for you. This is known as Mayo-Wards surgery.
However, you have to take your lung problem rather seriously to stop cough if any lest even after the surgery, there is probability of recurrence since chronic increased intra-abdominal pressure is one of a very important precipitating factor for Utero-Genital prolapse.
I would appreciate you uploading the reports after examination from the Gynaecologist for further evaluation and advice.
For any further or more information, I am always available for you, XXXXXXX
DR. Nishikant Shrotri
Probably Utero-Vaginal Prolapse
Detailed Answer:
Dear XXXXXXX
At the outset, I must compliment you for providing such an exhaustive detailed history. I appreciate the mention of your lung condition.
I believe due to the lung condition, you would be having some chronic cough too. This could be one of the precipitating cause of what you are feeling as a round structure with an opening in the vagina. This structure you are feeling inside the vagina is mostly the mouth of the uterus (cervix).
XXXXXXX I feel you are having prolapse of your genital organs in which the uterus slides in the vagina. Initially, it is the moth of the uterus (the cervix) that slides down in the vagina and then the whole uterus starts coming down.
Did you have any difficulty during your deliveries, particularly prolonged labour or too much straining or difficult delivery? These are the causes which are predisposing factors for the utero-vaginal prolapse.
This is not a life threatening condition, though an embarrassing and disturbing condition. If ignored it may lead to complete prolapse where the whole uterus may come out of the vagina. It may also lead to urinary and/or bowel problems. Please report to your Gynaecologist for confirmation of the disorder.
Considering your Obstetric history and age factor, I feel you would be a good and suitable candidate for surgical repair. Though prolapse can be repaired without removing the uterus, at this age when you have completed your childbearing function, removal of the uterus with the repair of the muscles should be most ideal for you. This is known as Mayo-Wards surgery.
However, you have to take your lung problem rather seriously to stop cough if any lest even after the surgery, there is probability of recurrence since chronic increased intra-abdominal pressure is one of a very important precipitating factor for Utero-Genital prolapse.
I would appreciate you uploading the reports after examination from the Gynaecologist for further evaluation and advice.
For any further or more information, I am always available for you, XXXXXXX
DR. Nishikant Shrotri
Above answer was peer-reviewed by :
Dr. Sonia Raina
Wow! Thank you so much for your kind words! All three of my deliveries were quite unremarkable, in fact, they were quite quick! If I recall correctly the first labor & delivery was just under 9 hours, with each one being slightly shorter til the third and last being only ~6 hrs long. (I think I was one of the lucky ones!) I had all three of my children naturally, in fact, I never had more than a single shot of demerol for the labor pains. By the time I got to the 3rd one, I realized, I had NOTHING "left" to prove and decided to have an epidural, but alas, there was someone in line ahead of me, and my delivery hastened on to the point where I ended up not being able to have the epi. Oh well! She was a fine healthy strappin' baby girl to go with the first girl and boy, all of whom are now 31, 29, and 28!
As to my lung condition, I've been sick with this since Feb 2000. The only time I cough is when I have an exacerbation, which fortunately, over the last few years, hasn't been often. Over the 16 1/2 yrs I've had over 30 hospitalizations with the condition and have had to be intubated for respiratory failure and arrest on multiple occasions and have almost died from it at least twice. In fact, the most recent was in XXXXXXX I drove to the doctors office for a check up as I knew I wasn't at base line. I got 5 min out from his office and drove through an area where someone had been mowing grass. I'd never had a reaction to grass before, or at least certainly not to such a degree. I knew in seconds that things were fixing to go sideways in a VERY BIG and BAD way! Somehow I managed to get to his office before it got to the point I was unsafe to drive, but frankly, I was cutting it a little to close for comfort, for my taste! Hurting myself in such a situation is one thing, hurting someone else, is well . . . just unacceptable! After reaching his office within 45 min. I was in a rescue unit on the way to the hospital a mile up the road. I spent about two hours in the ED before being admitted to the MICU in critical condition in respiratory failure. Within 30 mins, I was intubated and on a ventolator for the next two days. I was admitted XXXXXXX 7th and discharged home on XXXXXXX 15. I had a post hospital check up on Fri. XXXXXXX 17th only to end up back in the ED on Sat. XXXXXXX 18 in the wee hours of the morning. More breathing treatments, send me home. The following Fri. I had another checkup with my doctor, to again only end up BACK in the ED late that night. More steroids, breathing treatments, and sent home. Then the following Sat, July 2, I was again, back in the ED. More breathing treatments, more steroids, and then admitted to ICU and narrowly missed being intubated again. I was then discharged home on Wed. July 6th. What upsets me about the whole thing is the way that I've been treated. I guess the short of it is that I've done EVERYTHING that I've been asked to do by doctors over the years, and have been as compliant a patient as I know how to be. Even up to and including following the advice of my doctor who's been with me for the entire 16 yrs. After about a yr of not being able to figure it out, even I realized that he would be remiss to NOT consider the possibility of a psych component, at least to some degree! So, since I had also developed some SEVERE chronic global pain, he asked me to start seeing a psychiatrist that he knew of with in the healthcare system that I utilize, that specialized in chronic pain (which by the way, I've been VERY careful to try to keep my healthcare centralized in an attempt to avoid having any questions about "doctor hopping" or attention seeking behavior accusations) I've been seeing the same psychiatrist for 15 years! The thought was that we could accomplish multiple things by doing this.
1) He could treat my pain - He has. Quite successfully
2) He could remove or verify the ? of a psych component - He has. Removed it that is.
3) He could monitor me for the development of depression, as many people with chronic health problems develop depression, especially in light of no diagnosis. - He's done that too. No depression.
4) AND MOST IMPORTANTLY - Seeing him on a regular basis was supposed to establish a longevity record of SOLID PSYCHIATRIC STABILITY! And ALTHOUGH HE'S DONE THAT AS WELL, it has remained a useless endeavor!
EVERY SINGLE ADMISSION, save this last one last week I have been subjected to yet ANOTHER psych eval! This time . . . I REFUSED! They always take his contact information, lie and say that they've talked to him, and then I find out that in fact, NO ONE has even ATTEMPTED to contact him!
I'm SO frustrated because NO ONE, except the two doctors that I've been with over the last 16 & 15 yrs believes me. EVERYONE thinks that this is COMPLETELY psych related . . . through and through! I simply cannot wrap my head around why it is that just because they can't figure it out, it HAS to be something, and since they can find no "biological" basis for it, then it HAS to be psychiatric! Both of my doctors assure me that this is TOTALLY medically related! Frankly, my psychiatrist has been practicing for 47 YEARS! 15 of them with ME! I find it HIGHLY UNLIKELY that he would have somehow missed a psychosomatic, psychogenic, conversion disorder, or a psycho ANYTHING after 15 YEARS! I feel like I have NO where to go to be properly treated when I have a problem! Although I do NOT feel like I'm in any danger of dying any time soon, I'm still left with the general feeling of when I go into respiratory failure, I can choose to sit at home and die, or I can pick a hospital and go lay in one of their beds and die. I know that sounds a tad bit over dramatic, but truly, if I can't get them off of this psych train, they WILL STOP treating this medically in the appropriate way. I've already developed diastolic heart failure (not sure why), but my concern is that every time I go in, the seem to wait longer and longer to intubate me. I mean, I have NO DESIRE to BE intubated, unless it's medically necessary, but they seem to wait even longer than that. I didn't realize how bad it had effected me until the hospitalization in XXXXXXX The ED doctor asked me if I wanted him to intubate me. Now, understand, I was LONG PAST being able to talk and was reduced to trying to write notes. And at that point, I KNEW I was in respiratory failure, as I was getting confused and having trouble keeping coherent thoughts, but I'll never forget the feeling of being AFRAID to answer the question because it MIGHT be a "trick" question! NO ONE should be in that position! NO ONE! So I wrote to him that, "NO! No one in their RIGHT MIND WANTS to be intubated! But that said, YES! PLEASE!!! DO IT! I HAVE NOTHING LEFT TO GIVE!" I literally just wanted to STOP breathing for just a little while so that I could have a break from breathing, then I would have been HAPPY to have resumed my breathing "duties"! Yeah, it doesn't work that way, I know. . . But, he STILL OPTED TO NOT intubate me! Instead, he WAITED and sent me to the MICU and let THEM make the decision! By then, another 45-90 had past, with my systolic blood pressure soaring up to close to 260! They're going to CAUSE me to develop UNSTABLE CHF or even worse pulmonary hypertension! Neither of which, I'm too willing to accept lying down! The bottom line is that I seemingly test negative for everything. COPD, Vocal Cord Dysfunction, maybe a little asthma, maybe. . . no muscular dystrophy, no multiple sclerosis, no myasthenia gravis, and no anything else that anyone can think of! A few say that it's ILD (interstitial lung disease), but as there's minimally over 130 diagnosis' that fit under that umbrella, we haven't had any success there either. I simply can't understand why it is that if doctors can't find a satisfactory biological basis for an illness, why it MUST BE psychiatrically based! We discover NEW DISEASES ALL THE TIME! I make NO CLAIMS as to what it is. I just know that I'm on 6L of O2 at rest and 8-10L on exertion and a boat load of other medications that I can't afford, and yeah, it's supposed to all be in my head!
So, anyway, that's my story, and I'm stickin' too it! ;-) I GREATLY appreciate your time and your understanding! I had actually thought that there was a better than good probability of a uterine prolapse, so it's good to hear that's what you think. Somehow, it makes it a little less nerve wracking with everything else going on to go in and have it checkout knowing that someone else, an actual doctor agrees with my thought processes. 'Cause if they tried to tell me that this one was all in my head too, I think they might just push me on over the edge. Everybody tells me that I've got to be the strongest person that they've ever known, but hey! We ALLLLLL have our limits!
Again - I thank you! ~ Kindest Regards
As to my lung condition, I've been sick with this since Feb 2000. The only time I cough is when I have an exacerbation, which fortunately, over the last few years, hasn't been often. Over the 16 1/2 yrs I've had over 30 hospitalizations with the condition and have had to be intubated for respiratory failure and arrest on multiple occasions and have almost died from it at least twice. In fact, the most recent was in XXXXXXX I drove to the doctors office for a check up as I knew I wasn't at base line. I got 5 min out from his office and drove through an area where someone had been mowing grass. I'd never had a reaction to grass before, or at least certainly not to such a degree. I knew in seconds that things were fixing to go sideways in a VERY BIG and BAD way! Somehow I managed to get to his office before it got to the point I was unsafe to drive, but frankly, I was cutting it a little to close for comfort, for my taste! Hurting myself in such a situation is one thing, hurting someone else, is well . . . just unacceptable! After reaching his office within 45 min. I was in a rescue unit on the way to the hospital a mile up the road. I spent about two hours in the ED before being admitted to the MICU in critical condition in respiratory failure. Within 30 mins, I was intubated and on a ventolator for the next two days. I was admitted XXXXXXX 7th and discharged home on XXXXXXX 15. I had a post hospital check up on Fri. XXXXXXX 17th only to end up back in the ED on Sat. XXXXXXX 18 in the wee hours of the morning. More breathing treatments, send me home. The following Fri. I had another checkup with my doctor, to again only end up BACK in the ED late that night. More steroids, breathing treatments, and sent home. Then the following Sat, July 2, I was again, back in the ED. More breathing treatments, more steroids, and then admitted to ICU and narrowly missed being intubated again. I was then discharged home on Wed. July 6th. What upsets me about the whole thing is the way that I've been treated. I guess the short of it is that I've done EVERYTHING that I've been asked to do by doctors over the years, and have been as compliant a patient as I know how to be. Even up to and including following the advice of my doctor who's been with me for the entire 16 yrs. After about a yr of not being able to figure it out, even I realized that he would be remiss to NOT consider the possibility of a psych component, at least to some degree! So, since I had also developed some SEVERE chronic global pain, he asked me to start seeing a psychiatrist that he knew of with in the healthcare system that I utilize, that specialized in chronic pain (which by the way, I've been VERY careful to try to keep my healthcare centralized in an attempt to avoid having any questions about "doctor hopping" or attention seeking behavior accusations) I've been seeing the same psychiatrist for 15 years! The thought was that we could accomplish multiple things by doing this.
1) He could treat my pain - He has. Quite successfully
2) He could remove or verify the ? of a psych component - He has. Removed it that is.
3) He could monitor me for the development of depression, as many people with chronic health problems develop depression, especially in light of no diagnosis. - He's done that too. No depression.
4) AND MOST IMPORTANTLY - Seeing him on a regular basis was supposed to establish a longevity record of SOLID PSYCHIATRIC STABILITY! And ALTHOUGH HE'S DONE THAT AS WELL, it has remained a useless endeavor!
EVERY SINGLE ADMISSION, save this last one last week I have been subjected to yet ANOTHER psych eval! This time . . . I REFUSED! They always take his contact information, lie and say that they've talked to him, and then I find out that in fact, NO ONE has even ATTEMPTED to contact him!
I'm SO frustrated because NO ONE, except the two doctors that I've been with over the last 16 & 15 yrs believes me. EVERYONE thinks that this is COMPLETELY psych related . . . through and through! I simply cannot wrap my head around why it is that just because they can't figure it out, it HAS to be something, and since they can find no "biological" basis for it, then it HAS to be psychiatric! Both of my doctors assure me that this is TOTALLY medically related! Frankly, my psychiatrist has been practicing for 47 YEARS! 15 of them with ME! I find it HIGHLY UNLIKELY that he would have somehow missed a psychosomatic, psychogenic, conversion disorder, or a psycho ANYTHING after 15 YEARS! I feel like I have NO where to go to be properly treated when I have a problem! Although I do NOT feel like I'm in any danger of dying any time soon, I'm still left with the general feeling of when I go into respiratory failure, I can choose to sit at home and die, or I can pick a hospital and go lay in one of their beds and die. I know that sounds a tad bit over dramatic, but truly, if I can't get them off of this psych train, they WILL STOP treating this medically in the appropriate way. I've already developed diastolic heart failure (not sure why), but my concern is that every time I go in, the seem to wait longer and longer to intubate me. I mean, I have NO DESIRE to BE intubated, unless it's medically necessary, but they seem to wait even longer than that. I didn't realize how bad it had effected me until the hospitalization in XXXXXXX The ED doctor asked me if I wanted him to intubate me. Now, understand, I was LONG PAST being able to talk and was reduced to trying to write notes. And at that point, I KNEW I was in respiratory failure, as I was getting confused and having trouble keeping coherent thoughts, but I'll never forget the feeling of being AFRAID to answer the question because it MIGHT be a "trick" question! NO ONE should be in that position! NO ONE! So I wrote to him that, "NO! No one in their RIGHT MIND WANTS to be intubated! But that said, YES! PLEASE!!! DO IT! I HAVE NOTHING LEFT TO GIVE!" I literally just wanted to STOP breathing for just a little while so that I could have a break from breathing, then I would have been HAPPY to have resumed my breathing "duties"! Yeah, it doesn't work that way, I know. . . But, he STILL OPTED TO NOT intubate me! Instead, he WAITED and sent me to the MICU and let THEM make the decision! By then, another 45-90 had past, with my systolic blood pressure soaring up to close to 260! They're going to CAUSE me to develop UNSTABLE CHF or even worse pulmonary hypertension! Neither of which, I'm too willing to accept lying down! The bottom line is that I seemingly test negative for everything. COPD, Vocal Cord Dysfunction, maybe a little asthma, maybe. . . no muscular dystrophy, no multiple sclerosis, no myasthenia gravis, and no anything else that anyone can think of! A few say that it's ILD (interstitial lung disease), but as there's minimally over 130 diagnosis' that fit under that umbrella, we haven't had any success there either. I simply can't understand why it is that if doctors can't find a satisfactory biological basis for an illness, why it MUST BE psychiatrically based! We discover NEW DISEASES ALL THE TIME! I make NO CLAIMS as to what it is. I just know that I'm on 6L of O2 at rest and 8-10L on exertion and a boat load of other medications that I can't afford, and yeah, it's supposed to all be in my head!
So, anyway, that's my story, and I'm stickin' too it! ;-) I GREATLY appreciate your time and your understanding! I had actually thought that there was a better than good probability of a uterine prolapse, so it's good to hear that's what you think. Somehow, it makes it a little less nerve wracking with everything else going on to go in and have it checkout knowing that someone else, an actual doctor agrees with my thought processes. 'Cause if they tried to tell me that this one was all in my head too, I think they might just push me on over the edge. Everybody tells me that I've got to be the strongest person that they've ever known, but hey! We ALLLLLL have our limits!
Again - I thank you! ~ Kindest Regards
Brief Answer:
Please get the diagnosis of Prolapse confirmed from a Gynaecologist
Detailed Answer:
Dear XXXXXXX
I indeed empathize your feelings about your physicians which are but natural since you are not satisfied with the treatment and your aghast experiences about respiratory problem do go on bothering you. I do understand your disgustion.
Well, your deliveries do not seem to be the underlying cause of your prolapse. Could be some other reason due to which your pelvic diaphragm muscles have been weakened, ultimately resulting into the genital prolapse. The respiratory problem with chronic increased abdominal pressure seems to be the precipitating factor for the prolapse.
I do empathize your feelings towards doctors and now developed disbelief towards the medical fraternity. However, this is a different problem, entirely from different fraternity and system. Moreover, when a person like me can diagnose your prolapse on history and your own findings, without even examining you; the Gynaecologist will definitely diagnose this physical ailment on clinical examination. Please get read of the skepicism about the medical profession from your mind and consult your Gynaecologist.
Considering your Cardio-vascular problem, may be your Gynaecologist might opt to treat you by vaginal pessaries rather than surgical treatment. Your prolapse appears to be grade I or Grade II. So you can pull on with pessary management for few years.
Please avoid lifting weights, straining during bowel movements, coughing, etc. which will increase the intra-abdominal pressure.
Please consult the Gynaecologist and upload his findings, remarks and suggestions with all the investigations for my review. Then I can advise you further on confirmation of the diagnosis.
Please feel free to ask me any more information at any time, XXXXXXX You may please post good review about me with 5 stars rating since you seem to convinced by my diagnosis and advice.
Dr. Nishikant Shrotri
Please get the diagnosis of Prolapse confirmed from a Gynaecologist
Detailed Answer:
Dear XXXXXXX
I indeed empathize your feelings about your physicians which are but natural since you are not satisfied with the treatment and your aghast experiences about respiratory problem do go on bothering you. I do understand your disgustion.
Well, your deliveries do not seem to be the underlying cause of your prolapse. Could be some other reason due to which your pelvic diaphragm muscles have been weakened, ultimately resulting into the genital prolapse. The respiratory problem with chronic increased abdominal pressure seems to be the precipitating factor for the prolapse.
I do empathize your feelings towards doctors and now developed disbelief towards the medical fraternity. However, this is a different problem, entirely from different fraternity and system. Moreover, when a person like me can diagnose your prolapse on history and your own findings, without even examining you; the Gynaecologist will definitely diagnose this physical ailment on clinical examination. Please get read of the skepicism about the medical profession from your mind and consult your Gynaecologist.
Considering your Cardio-vascular problem, may be your Gynaecologist might opt to treat you by vaginal pessaries rather than surgical treatment. Your prolapse appears to be grade I or Grade II. So you can pull on with pessary management for few years.
Please avoid lifting weights, straining during bowel movements, coughing, etc. which will increase the intra-abdominal pressure.
Please consult the Gynaecologist and upload his findings, remarks and suggestions with all the investigations for my review. Then I can advise you further on confirmation of the diagnosis.
Please feel free to ask me any more information at any time, XXXXXXX You may please post good review about me with 5 stars rating since you seem to convinced by my diagnosis and advice.
Dr. Nishikant Shrotri
Above answer was peer-reviewed by :
Dr. Raju A.T
OH! My dear Dr. Shrotri! My HUMBLEST APOLOGIES!!! In NO WAY did I mean for my comments to apply to the ENTIRE medical establishment! Although I CERTAINLY see how one would have thought that was what I was saying! NO. I have the UTMOST respect for the medical community on the whole! In fact, I was part of it for many years, in various different capacities. I was merely referring to those involved with my cardio-pulmonary care! I absolutely SHOULD have made that clear! Again, my apologies!
But YES! I will be making the appointment as soon as possible, their schedule depending, as mine's pretty open these days! ;-) Again, I thank you for your assistance and your advice! You are a very kind, gentle, and may I say, wise sounding man. I feel fortunate to have gotten you here to discuss my issues with! And yes, you can be ASSURED of getting a 5 star rating! I couldn't have asked for any better council than I have received from you! Hopefully, I will soon have some news to share with you.
I see that this discussion will close out automatically within 2 -3 days. This is the first time that I have used this site, but based on your comments, I assume it should be fairly obvious as to how I can follow up with you when the appropriate time comes.
I very much look forward to a future interaction with you!
Kindest Regards,
xxxxxx
But YES! I will be making the appointment as soon as possible, their schedule depending, as mine's pretty open these days! ;-) Again, I thank you for your assistance and your advice! You are a very kind, gentle, and may I say, wise sounding man. I feel fortunate to have gotten you here to discuss my issues with! And yes, you can be ASSURED of getting a 5 star rating! I couldn't have asked for any better council than I have received from you! Hopefully, I will soon have some news to share with you.
I see that this discussion will close out automatically within 2 -3 days. This is the first time that I have used this site, but based on your comments, I assume it should be fairly obvious as to how I can follow up with you when the appropriate time comes.
I very much look forward to a future interaction with you!
Kindest Regards,
xxxxxx
Brief Answer:
Now you are my good friend. Pleae get well soon.
Detailed Answer:
My Dear XXXXXXX
I am indeed happy to note that you will be making your appointment with the Gynaecologist soon. I shall be very much keen to know his findings, diagnosis and the advice.
There is no necessity to apologize. With such experiences, it is but natural for any one to have bitter feelings about the health care providers.
The discussions closes only when you close it from your side or you do not answer for few days - I suppose 3-10 days. However, you are most welcome to continue it since you seem to have achieved quite a satisfaction from it. Even after closure of this discussion, you can reopen it any time and any number of times. Moreover, you may ask this forum to reach me your emails. Also, you may visit my website anytime. If you visit XXXXXXX any time, I shall be more than happy to meet you. I do not know how to be in contact with you. I am visiting US by the end of this month. May be Health Care Magic can help us.
I am indeed thankful to you for your expressions in your review about me. However, I would have appreciated you rating me with 5 stars which I feel you have missed.
For any more discussion, I am always available to you, XXXXXXX I too sincerely hope to meet you in nearest future.
Dr. Nishikant Shrotri
Now you are my good friend. Pleae get well soon.
Detailed Answer:
My Dear XXXXXXX
I am indeed happy to note that you will be making your appointment with the Gynaecologist soon. I shall be very much keen to know his findings, diagnosis and the advice.
There is no necessity to apologize. With such experiences, it is but natural for any one to have bitter feelings about the health care providers.
The discussions closes only when you close it from your side or you do not answer for few days - I suppose 3-10 days. However, you are most welcome to continue it since you seem to have achieved quite a satisfaction from it. Even after closure of this discussion, you can reopen it any time and any number of times. Moreover, you may ask this forum to reach me your emails. Also, you may visit my website anytime. If you visit XXXXXXX any time, I shall be more than happy to meet you. I do not know how to be in contact with you. I am visiting US by the end of this month. May be Health Care Magic can help us.
I am indeed thankful to you for your expressions in your review about me. However, I would have appreciated you rating me with 5 stars which I feel you have missed.
For any more discussion, I am always available to you, XXXXXXX I too sincerely hope to meet you in nearest future.
Dr. Nishikant Shrotri
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
Oh, you are SO sweet! I live in XXXXXXX NC. Sadly, probably not an area that you will be close to! Even sadder, it is highly unlikely that I will ever have the chance to come to your wonderful country! Something that I have always thought would be a blessed opportunity! XXXXXXX is one of a couple of places that I've always wanted to visit! The sights, the smells, and best of all . . . the people! I've meet SEVERAL people from XXXXXXX over the years, and they have ALWAYS been such a delight! So warm, caring, and best of all they all walk in such a natural and honest humility. Something not seen here in the USA very often. Don't get me wrong, I love my country! But I also so enjoy getting to meet people from other places! I guess it runs in the blood! My oldest daughter (31) has her degree in Anthropology, and is currently seeking her way to a masters in biologic/forensic Anthropology. Her goal is to work for the US government to help identify and return the remains of unaccounted soldiers from previous war conflicts and they are found. Most Americans don't realize that there are over 85,000 (last I heard a figure) that are still missing and unaccounted for as far back as WWII. Her desire is to give them back their identity, their families, and a proper recognition and burial. For a young woman who is herself quite handicap, she is really a go getter. She has SEVERE idiopathic scoliosis with 2 curvatures in opposing directions. leaving her spine literally shaped like a letter "S". She's had 4 back surgeries to place rods in her back, unfortunately, the first surgery, in July 1998, at age 13, paralyzed her at T-12. She lost EVERYTHING! They said she'd never walk again. I told the doctors that I/we believed in a God bigger than that, and that she WOULD walk out of the hospital. They of course didn't believe me and thought I was in denial, even after I explained that I felt that God had shown me her surgical outcome months before she even had the surgery. The day they discharged her from the hospital, it was 5 days shy of being exactly 3 months from the date of the surgery. They wheeled her to the front door, handed her a walker, and she walked out the door to the car! She used the wheelchair for the next 2 years while doing physical therapy to build her muscles back up but in XXXXXXX 2000 she put the chair away and began walking with a XXXXXXX She's NEVER looked back! My other two children are in my mind remarkable as well. (I would hope they would be! :P) My middle one, my son (29) is in law enforcement and my youngest girl (28) is in healthcare. They are all three kind, loving people who care deeply about those around them. It's a very warm and satisfying notion to sit back and watch your children blossom into the very people that you worked so hard to help shape and mold them into, and to know that they, for the most part, made good decisions! Whew!
NOW! . . . as to your comment, "I am indeed thankful to you for your expressions in your review about me. However, I would have appreciated you rating me with 5 stars which I feel you have missed." You are ABSOLUTELY correct! I could NOT find where to leave your five stars! I looked, but didn't see anything. At the bottom of the page there was a place to give the WEBSITE 5 stars (which I did do, just in case it transferred over to you, but alas, it doesn't appear to work that way. . .) So, I notice above that there is a "blue button" for me to click on that says, "Close Discussion & Review Doctor". But as soon as I hit submit for this current comment, it will disappear, just like it did for the previous comments. I wondered if that might be where I would find your star rating area. As I hit the submit button this time, to send you this comment, the "Close Discussion & Review Doctor" button will again disappear. But, if you can send me a brief reply instructing me on the proper steps, I will GLADLY award you ALL 5 stars (and more if they had them), that you SO RICHLY deserve! Oh, and as to how you can reach me, xxxxxxxxcorner at yahoo dot com hopefully written in such a way, it won't get caught and removed. You should know that you have given me a great peace over this situation. I was, admittedly, rather worried about what I would find out when I went in, but you've taken that away. I've dealt with SO much over the years, it just almost felt like the straw that could break the camels back, so to speak. But because of you, I KNOW that this too, I CAN & WILL handle. Just another day. Just another "thing". So to speak! Point is, I know I can do it now. Without having to carry the burden of extra stress. I can go in clear headed, knowing what I'm likely dealing with, making it much easier to hear, understand, and make the proper decisions that I need to make for ME! Your quite, soft wisdom is quite the gift! And I'm VERY grateful for you and too you!
Well, as it's approaching 2:30am here. . . I suppose I should close this down for the moment. Till the next time!
Kindest Regards,
xxxxxxx
NOW! . . . as to your comment, "I am indeed thankful to you for your expressions in your review about me. However, I would have appreciated you rating me with 5 stars which I feel you have missed." You are ABSOLUTELY correct! I could NOT find where to leave your five stars! I looked, but didn't see anything. At the bottom of the page there was a place to give the WEBSITE 5 stars (which I did do, just in case it transferred over to you, but alas, it doesn't appear to work that way. . .) So, I notice above that there is a "blue button" for me to click on that says, "Close Discussion & Review Doctor". But as soon as I hit submit for this current comment, it will disappear, just like it did for the previous comments. I wondered if that might be where I would find your star rating area. As I hit the submit button this time, to send you this comment, the "Close Discussion & Review Doctor" button will again disappear. But, if you can send me a brief reply instructing me on the proper steps, I will GLADLY award you ALL 5 stars (and more if they had them), that you SO RICHLY deserve! Oh, and as to how you can reach me, xxxxxxxxcorner at yahoo dot com hopefully written in such a way, it won't get caught and removed. You should know that you have given me a great peace over this situation. I was, admittedly, rather worried about what I would find out when I went in, but you've taken that away. I've dealt with SO much over the years, it just almost felt like the straw that could break the camels back, so to speak. But because of you, I KNOW that this too, I CAN & WILL handle. Just another day. Just another "thing". So to speak! Point is, I know I can do it now. Without having to carry the burden of extra stress. I can go in clear headed, knowing what I'm likely dealing with, making it much easier to hear, understand, and make the proper decisions that I need to make for ME! Your quite, soft wisdom is quite the gift! And I'm VERY grateful for you and too you!
Well, as it's approaching 2:30am here. . . I suppose I should close this down for the moment. Till the next time!
Kindest Regards,
xxxxxxx
Brief Answer:
God bless your family!
Detailed Answer:
My Dear XXXXXXX
I am impressed!
Your elder daughter's story is not only surprising, it is encouraging to the rest of the world also. Her determination to serve the missing soldiers of the country is astonishing. I feel proud of her. You and your whole family has tremendously great will power and God's blessings!
Well, frankly I am not aware how my patients from HCM forum rate me; however, more than 90% have rated me 5 stars. Hence, I requested you knowing your satisfaction. The button must be in the screen from where you submit the answer. We do not have access to that screen. Otherwise, you may enquire with customer care of HCM. Our answers are always moderated. So am sure, the moderator who is reading this answer will guide you about rating the doctor.
I will contact you at xxxxxxxxcorner. I will be in XXXXXXX by the end of this month.
Can you give me some information about Cheney Wildlife Park?
I do appreciate you on computer at 2:30 I the morning!
Please keep me informed about the management of your prolapse.
Dr. Nishikant Shrotri
God bless your family!
Detailed Answer:
My Dear XXXXXXX
I am impressed!
Your elder daughter's story is not only surprising, it is encouraging to the rest of the world also. Her determination to serve the missing soldiers of the country is astonishing. I feel proud of her. You and your whole family has tremendously great will power and God's blessings!
Well, frankly I am not aware how my patients from HCM forum rate me; however, more than 90% have rated me 5 stars. Hence, I requested you knowing your satisfaction. The button must be in the screen from where you submit the answer. We do not have access to that screen. Otherwise, you may enquire with customer care of HCM. Our answers are always moderated. So am sure, the moderator who is reading this answer will guide you about rating the doctor.
I will contact you at xxxxxxxxcorner. I will be in XXXXXXX by the end of this month.
Can you give me some information about Cheney Wildlife Park?
I do appreciate you on computer at 2:30 I the morning!
Please keep me informed about the management of your prolapse.
Dr. Nishikant Shrotri
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
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