Goerwitz

[This story was originally sent to me as a personal note by Anne Woods. It is a tough, moving account of searing abdominal pain, botched diagnoses--and an eventual emergency surgery and recovery. Thanks go to Anne Woods for granting me permission to reproduce it here.]

Thank you for writing and posting your laparotomy story. It was well-written and struck chords with me.

I've never had any types of gynecological problems and considered myself "right as rain" and "born to breed" etc. That was right up until my endometrioma exploded last July 9. The frightening and disappointing part of it was that two doctors completely missed it and I was put in a dangerous situation.

I suppose looking back now there were signs. I relate to the dull thud you experienced. I also wondered why I was experiencing so much flatulence and diarrhea during my periods. At this point I'm sure those problems were caused by the endometriosis irritating my intestines.

One sign that I didn't ignore was the toe-curling pain that hit me one morning last June. I was getting up in the morning when the pain hit suddenly. It was unlike any pain I'd ever experienced--worse than any related to the birth of my two sons. It drove me right back down on the bed. I couldn't find a position that would relieve the pain. I curled up and just rolled around doing birth breathing to try and cut the pain. After 10-15 minutes of it I nearly called 911. It felt like a sword going up through my vagina and it hurt from there all the way up to my ribcage. After 20 minutes it subsided. But I stayed home from work and made an appointment to see my doctor.

I told the doctor that this was something new and scary. I told him "I trust that you will find out what it is and fix it." I was preparing for a business trip back-to-back with a vacation out of state and I didn't want trouble along the way. After a pelvic and rectal exam he pronounced that I was constipated. I didn't feel constipated. I didn't think that could be it. But he prescribed fiber supplements and told me to get in and have a flexible sigmoidoscopy and barium enema.

I quickly had those hideous little procedures done. The results were normal. So off to the midwest I flew with my jar of Citrucel in my suitcase. During my trip I did little activities that could have put me in a dangerous situation if the endometrioma had chosen to rupture. For example I paddled way out onto Lake Huron alone in a kayak. Flying across the country was risky enough! Fortunately though, nothing else happened until the last night of my vacation after I got home to San Diego.

It was around 11:00 p.m. and I was preparing for bed. Suddenly the pain struck again. I sat and then laid down. I pulled my knees up. I tried to straighten my legs again. I called for my husband but he couldn't hear me and I couldn't move. I picked up an alarm clock and threw it at the wall and then curled up into a ball on the floor.

He sat beside me hoping the pain would pass as it had in June. After 20 minutes of him watching me cry, pray and beg for relief we agreed it was time for the paramedics. When they arrived I couldn't even look up at them to answer their questions. I was talking to their shoes. By the time I was getting on the gurney I was ready to vomit from the pain. I ended up vomiting all the way to the hospital.

When we arrived at the emergency room the nurse looked me over and said to the paramedics, "I know what she has. She has a ruptured ovarian cyst and she's in such pain right now that she wants to die." I asked her how she could be so certain and she said she had one. Then she proceeded to tell me the exact tests that should be done to confirm it: a CT scan and a vaginal ultrasound. Her experience had concluded with a hysterectomy which she said made her feel like a new woman.

Then the doctor saw me. He asked me to rate my pain on a scale of 1 to 10. When I told him it was a 10 he ordered morhpine. The morphine didn't move me down from a 10 so I got repeated doses. He performed a pelvic exam and I heard him state "seems normal". After about 4 hours on the morphine the pain was masked enough for me to be able to straighten my legs and rest a bit. Then to my surprise at 4:30 a.m. the doctor came in and discharged me. I questioned the decision and he said there didn't appear to be anything acute or requiring surgery and if the pain increased (he'd gotten it down to a 7 with the morphine) I should call my regular doctor two days later on Monday. I asked him if he didn't want to do any tests: ultrasound or CT scan. He declined to do them.

The next morning I did call my doctor's office. I told the on-call doctor what the ER nurse had said. He agreed that there was something to investigate and asked me to come in right away. A CT scan was done upon my arrival. Then I laid on a gurney in the hallway of Radiation for an hour or so waiting for the ultrasound technician who had to be called in. That's when I noticed that I was burning a fever. The on-call doctor appeared and apologized for what I was going through. He said that based on the CT scan results he was calling in a gynecologist. Unfortunately the gynecologist was tied up with a birth so I waited.

When I finally got the sonogram the gynecologist said I needed emergency surgery. He thought I had a ruptured ovarian cyst but it could be cancer. So I had to be prepared for everything from losing my ovary to waking up with a total hysterectomy. I just told him to take whatever he needed to fix me and stop the pain. (I sounded tough but I was so scared.)

Like you, Amy, my specific request as they were wheeling me into the O.R. was for him to give me color photos of any "medical curiositities" he pulled out of me. When I awoke he handed me a polaroid of my left ovary which had grown to the size of an orange. It had relocated to an area above my uterus. It was filled with the endometrioma which had burst. He explained that the contents of the endometrioma were caustic to my internal organs so there was scarring to my intestines and my ureter had adhesed to the side wall of my abdomen. He cleaned all of that up and removed my left ovary and fallopian tube.

My recovery was similar to yours. But I marveled that two different doctors didn't do more to diagnose and react to this horrible situation.

Now, a year later, I'm feeling the dull thud again on the right side. I rushed in for a sonogram last week and sure enough, the doctor said there are "changes" to my ovary. I'm awaiting the results of the CA125 [cancer] test they did. I'm also scheduled for a second sonogram in four weeks. Like you, I don't like the idea of something growing for a month. I'm scared of going through that dangerous and painful experience again. So I'm doing everything I can to head it off early.

I've also spent the last year telling women my story whenever it's seemed appropriate. I would like more women to know to read their own bodies and take the initiative in demanding tests that should be done to keep them safe. Two doctors failed me. I'll never sit back and hope for the right tests to be done again. I'll insist on them.

Thanks again for your posted story.

Anne Woods
califwoods@yahoo.com

[Anne's story just goes to show that although physicians in this country are some of our best and brightest professionals, they are people nonetheless. They can and do make mistakes. On a side note: Since writing this, Anne has learned that the CA125 test results were normal, so there's apparently no cancer. At least she's out of that woods. --Amy]

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Amy and Richard Goerwitz
Amy@Goerwitz.com
Richard@Goerwitz.com