Myoma Uterine Fibroids What is Myoma, Causes, Symptoms and Treatment for Myoma
A fibroid is a benign tumor that mainly consists have muscular tissue and usually grows inside the uterus. Fibroids are also called myomas. Its size ranges widely, from a small tumor the size of a pea to a large tumor almost the size of the uterus. Myomas are classified into three types, depending on the location where they are found. The intramural myoma, a fibroid that grows in the muscular wall of the uterus. This subserosal myoma, a fibroid located just beneath the outside mucosal covering of the uterus. Here the fibroid projects to the.
Outside and occasionally remains connected with the uterus only through a small stalk. The submucosal myoma, a tumor that grows beneath the surface of the uterus lining. Therefore, this type of fibroids can grow into the uterine cavity. The actual causes have development of a fibroid are still unclear. However, it has been documented that fibroids are associated with high levels of estrogen, the female sex hormone. Fibroids can only developed during reproductive years of women. Following menopause, the production of estrogen decreases which will usually cause fibroids to shrink or disappear.
Myomas are more common in nonpregnant and infertile women. In general, fibroids are asymptomatic or associated with just a few complaints if any complaints. If any complaints occur, then the location, size and type of the fibroid are the major factors. Fibroids can affect nearby structures. They can cause compression of the bladder, which may lead to urinary complaints, or may obstruct the intestine, which may result in constipation. Other complaints can be backaches, abdominal problems, menstrual flow disturbances. Fibroids can impede normal childbirth, which may require caesarean delivery. Fibroids relatively more often lead to miscarriages.
Whenever fibroids cause symptoms, they need to be removed or shrinked. Medications sometimes cause fibroid to shrink by blocking the production and secretion of estrogen. In other cases, surgery may be required to remove the fibroid. The type of surgery depends on the location of the fibroid. Sometimes it's possible to remove the fibroid with the help of the tube entered through the vagina and the procedure is called hysteroscopic myomectomy. In other cases, surgery through the abdominal wall may be necessary. In the case of a large fibroid, hysterectomy may be the only solution.
Endometriosis, Uterine Fibroids, and Estrogen Dominance
Now, when we have a stage called estrogen dominance estrogen proliferates tissue when it's dominant. Estrogen within itself is very good. I helps us with our brain tissue, our memory. It helps us to think clearly, prevents foggy brain and all this other stuff. Estrogen in itself is very goodit's not bad. But when you have an estrogen dominance situation where the estrogen is very dominant over the progesterone, you're going to have all these symptoms and you're going to have a proliferation of tissue. For instance, if a woman comes in with cysts on her ovaries or cysts in her breasts.
Or she has fibroids on the inner uterine lining, or she has endometriosis these are all tissues that are being proliferated. They are increasing because she's got too much estrogen in her. Thus, we have a lot of increase in the amounts of hysterectomies because women are getting large fibroids and they're bleeding heavy, heavy, heavy, so they have anemia. I went through this myself, personally, in my forties. I had a lot of estrogen dominance but back then we didn't know exactly what to do. And so, I ended up having a hysterectomy because every time.
ICD10 Coding Annual Physical with Chronic Conditions
Laureen Q Annual Physical ICD10 question, if a patient is in for an annual physical and has chronic conditions like diabetes mellitus or hypertension, would you use Z00.01 Alicia Chandra knows this one. Chandra A Z00.01 is annual preventive or adult preventive examination with abnormal findings. As we talked about earlier, abnormal findings means we found something during that exam that we didn't already know that the patient had. Chronic conditions would be things we already knew the patient had. The thing that I go back to with that and then determining whether we knew it ahead.
Of time, look at some of your documentation guidelines. If you really want to think about it, I'm going to cite inpatient for a minute, but if you look at your Present on Admission Guidelines, they tell you any chronic condition that patient had before they were admitted are considered present on admission. It's kind of the same thought, they come in and do a preventive exam, we knew they had hypertension, we knew they had diabetes, we knew they had whatever. Even if we write them a script to refill those meds, it's not that we found something abnormal.
During this exam. It's simply that we gave them a script for their chronic conditions. Laureen Very good. Alicia If it is a new condition, they'll document that they'll be doing counseling on they're sending them to the diabetes nurse and getting counseling on nutrition that this is a new finding but Chandra And then in that case, then they also have to make sure that anytime they use the code that says they did a preventive with an abnormal finding they need an additional code to identify what that abnormal finding is. That's typically where they're going.
Fibro Cystic Breast Lump Disappears
Hi, I'm Teresa and I'm from Illinois. And, um, I came to see Dr. Lubecki because, um, of nuh.num a number of things. But, um, one of the benefits that I've received was that I have fibrocystic breasts, and, um, had a mammogram three years ago and there's a spot that they said we needed to watch. I had several cysts aspirated at the time, but that one would not aspirate. And over the three years it's been growing. And, um, I could tell after laser treatments, uh, a change in my breasts. If you've ever nursed.
I would say it was similar to a letdown feeling. So, I could tell that something was changing. And, um, I checked for the lump and it was smaller after three treatments. And, I told my family that I was here with, you know, it was smaller and texted people. And, um, after the next treatment, the fourth treatment, it was completely gone. And, it was probably the size of a marble. And, after four treatments its gone! So if you suffer from fibrocystic breasts, um, and you have to have them drained or if.
da Vinci robotic gynecologic surgery for fibroids
Ashley Two of my aunts had fibroids and they just took out their uterus. So they don't have any children. Dr. Saffer Ashley has very large fibroids. It's not a cancer. So it's just an abnormal growth that just keeps on growing. If Ashley one day wants to get pregnant the only real option is removing the fibroids but not removing the uterus. Nurse You'll get prepped and ready to go to surgery. Dr. Saffer She's 20 and it's very unusual to see fibroids this big, early on in life. Louella I'm Louella. I'm Ashley's mom.
Nurse Her mom Okay. Ashley I'm Alexis, her sister. Nurse Okay very good. Dr. Saffer This is a da Vinci SI System. The first component is the arms of the robot maneuver very similarly to a human hand with perfect wrist movements. The second component is the actual surgical console. This manipulates the instruments on the robotic arms. When I put my head where the headpiece is, I'm immersed in a 3D field, of fantastic resolution. Fibroids can start to twist on themselves. And that can cause excruciating pain. Ashley It feels like something is like eating me from the inside out. My stomach rises up.
And it stiffens. I'm going to kill you. Dr. Saffer There are ways of removing fibroids, the conventional way is where you make a large incision and take them out. How you doing Nurse Hello. How are you Dr. Saffer With Ashley's surgery there's no way we could do this minimally invasively if it wasn't for the robotic system. I'm going to go through a couple of things, as to what's going to happen this morning. We'll make little incisions in your tummy, and if we can safely take the fibroids out robotically, then that's what we'll do.
Ashley Mmhmm. Okay. Male I'll kind of hold your hand while things are happening. Ashley Yeah. Colleen What seems very routine to us on a daytoday basis is not routine to our patients. They're in a world that's unfamiliar to them. Nurse Just kind of nervous Ashley Yeah. Nurse That's alright. Colleen We understand their fear. We're here to alleviate those fears. Nurse Even nurses get nervous. I had surgery a couple months ago, they kept saying are you nervous No, no, no, no, no, no. But when it got right down to the point it was yes,.
I was nervous. Colleen All of us just as human beings want to know what to expect. Nurse Hugs and smooches and see you later. You're in great hands. Dr. Saffer It's the only robotic system that's dedicated to women's surgery in San Diego County. Nurse Did you meet Sophia the robot Dr. Saffer She'll be out of the hospital the next day. Recovery instead of being six weeks, tends to be 10 days. We attach the robotic arms to the patient. And then I'm right next to her, at the console during the surgery.
Nurse Wow. Dr. Saffer The last thing that you need to do is to get that fibroid tissue out of the abdomen. And we use something called a morcelator. It is sucking the fibroid out. You take it out through a small incision in the abdomen. And close up the middle incisions and we're done. The biggest hole is this one, and it's about a centimeter. How you doing Everything went very, very well. Louella Uhhuh. Dr. Saffer The good news is we did it all robotically, as we planned. She has a beautiful.
Breast Cancer Why Early Detection Matters
In terms of the early detection of breast cancer, it's such an important issue because if a woman will get a breast cancer she should be diagnosed very early, because an early detection is going to be a factor in terms of how big the tumor is, and what the treatment is for that woman. Now early detection that we know of right now is mammography. And there is a lot of research in not only looking at what are the advantages of having mammography early or late but mammography in women with family history of breast cancer. When do they.
Breast Biopsy Incisional Surgery PreOp Patient Engagement and Education
Your doctor has recommended that you undergo a breast biopsy procedure or lumpectomy. In your case, you have lump or thickening in your breast. It was felt by you or your doctor during a routine breast exam or discovered following a mammogram. Let's take a moment to look at the reasons why lumps form in breast tissue. The breast is made of layers of skin, fat and breast tissue all of which overlay the pectoralis muscle. Breast tissue itself is made up of a network of tinymilk carrying ducts and there are three ways in which a lump can form among them.
Most women experience periodic changes to their breasts. Cysts are some of the most common kinds of tissues that can grow large enough to be felt and to cause tenderness. Cysts often grow and then shrink without any medical intervention. A second kind of lump is caused by changes in breast tissue triggered by the growth of a cyst. Even after the cyst itself has gone away, it can leave fibrous tissue behind. This scar tissue can often be large enough to be felt. The third kind of growth is a tumor. Tumors can be either benign or cancerous and it is.
Concern about this type of growth that has lead your doctor to recommend breast biopsy. Sometimes you will have breast changes that can not be felt by physical examination alone but may be seen on a mammogram. In order to learn more about the nature of the lump in your breast your doctor would like to surgically remove it. Most likely, you're feeling some anxiety about this procedure, which is perfectly understandable. You should realize that it's natural to feel apprehensive about any kind of biopsy. In some cases, a woman will choose not to have a biopsy simply out of fear.
But ignoring a lump in your breast won't make it go away. If you're feeling anxious, try to remember that the purpose of a biopsy is simply to find out what is going on in your body so that if you do have a problem, it can be diagnosed and treated as quickly as possible. If you should decide not to allow your doctor to perform the biopsy, you'll be leaving yourself at risk for medical problems. If the suspicious tissue in your breast is benign, most likely you'll suffer few if any.
Complications. However, if it is cancerous, and it is allowed to grow unchecked you might be putting your own life at risk. The bottom line trust that your doctor is recommending this procedure for your benefit and above all don't be afraid to ask questions raised by this tutorial and to talk openly about your concerns. On the day of your operation, you will be asked to put on a surgical gown. You may receive a sedative by mouth and an intravenous line may be put in. You will then be transferred.
To an operating table. Your doctor will scrub thoroughly and will apply an antiseptic solution to the skin around the area where the incision will be made. Then, the doctor will place a sterile drape or towels around the operative site and will inject a local anesthetic. This will sting a bit, but your breast will quickly begin to feel numb. Usually, the surgeon will inject more than one spot in order to make sure that the entire area is thoroughly numb. After allowing a few minutes for the anesthetic to take effect, the surgeon will make a small.
Incision. Once the incision has been made, your doctor will begin looking for the lump that is to be removed. You will feel some pressure or even slight tugging or pulling but you should not feel any sharp pain. If you do begin to feel pain, you should tell the doctor and you will be given more anesthetic. Once the lump is removed, the doctor will close the skin over the incision as neatly and as cosmetically as they are able. Finally, a sterile dressing is applied. Your specimen will be sent immediately to a lab for microscopic analysis. Your doctor.
PMS and Estrogen Dominance
We are starting to get more and more women that are bringing their daughters now. It's so good to seeit's preventive medicine. The first thing the mother says is, They're terrible around their PMS symptoms, and their breasts are hurting them, and they're very irritable and it's just very difficult to be around my young girl at this time. So they bring them in and we do a salivary hormone test, check their estrogen, progesterone, testosterone, and DHEA, because we also want to rule out stuff like PCOS and such as this.
But we, uh this is an indication that most of the time we see a low progesterone and what we do is we either give them botanicals or we give them a little bit of progesterone cream and it works wonders. I much prefer to use bioidentical estrogen and progesterone when I have to and I don't use the synthetic. So all that said, the estrogen dominance is big in the United States. The girls are coming inmothers bringing the girls in so we can check that at an earlier age, it's great to see that, it's a preventative, less girls on.
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