The refusal: now what?
Last November, the American Association of Gynecologic Laparoscopists (now known as the AAGL), of which Singh and a growing number of Canadian gynecologists are members, issued a statement at its global congress in Las Vegas saying that training gynecologists in minimally invasive procedures is the key to increasing patient access. When contacted, the Society of Obstetricians and Gynaecologists of Canada declined comment on its position on minimally invasive surgery.
Not taking no for an answer
Armed with this information, I was anxious to get a referral from my original gynecologist for the surgery. I was shocked when he refused to give me one. Lise Cloutier-Steele, Ottawa author of Misinformed Consent: Women's Stories about Unnecessary Hysterectomy, says many gynecologists in Canada are either unaware of the latest alternatives to hysterectomy, unwilling to refer their patients to subspecialists such as Singh, or reluctant to disrupt their practices or extend their already long waiting lists to upgrade their skills. The solution, she says, lies in women refusing to take no for an answer.
"This is 2009; there are a number of things you can explore before you surrender your organs," states Cloutier-Steele. "In this day and age, you cannot just take a doctor at his word. Find out what kind of skill he has. Ask if he can perform a myomectomy [removal of the fibroids only] instead of a hysterectomy. If not, the doctor will usually prescribe only the surgery he is comfortable doing, and a lot of women are not cognizant of this fact. Women have to do their homework."
I did mine: I got a referral from my family doctor, and almost a year to the day my sister died, Singh performed two of the most high-tech alternatives to hysterectomy available in the world today — a hysteroscopic myomectomy to cut out the largest of my fibroids, and a hysteroscopic endometrial ablation to burn the lining of my endometrium.
The surgery
Both procedures were done by inserting an eight-millimetre scope in the opening of my vagina, through my cervix and into the cavity of my uterus. A tiny camera on the end of the scope projected a live picture onto two plasma screens above the operating table to show Singh exactly where to attack the fibroids and burn the lining of my endometrium. Talk about hand-eye coordination. The whole thing took about 90 minutes.
A few hours later, recovering from general anesthetic (which I chose; I could have had a local), I was up and around — no pain, no painkillers, no incisions, no stitches and all my reproductive organs intact. I plunked myself down in the passenger seat of my car when Gaston came to pick me up, his jaw dropping from the shock over how well I was doing. I was back at work within 10 days and, like my friend Louise, I have never felt better.
For more information about minimally-invasive alternatives to a hysterectomy, see Me oh myomectomy and Fibroid FAQ.
This article originally appeared in the September 2009 issue of More
