D&C surgery and pathology (It's all good!!!)

I was scheduled yesterday (Tuesday, October 17th) for the following procedures:  D&C, hysteroscopy and an ablation.  After my  ablation consult appointment with Dr. R last Thursday I went home and turned to Google for my new diagnosis of endometrial hyperplasia and I couldn't find one website what so ever that said ablation was the right thing to do.  I only went for that ablation consult because I was bleeding so much and I really wanted the bleeding to stop.  We felt by the time I got an appointment for the consult the biopsy results would be back and it was.  With the new diagnosis of hyperplasia this is a disqualification for an ablation surgery but I think this new doctor went along with it and scheduled it for me anyway because I was so frustrated by my bleeding.  Of course she also wanted to do the D&C and hysteroscopy and have the entire lining of the uterus biopsied to rule out anything else other than the hyperplasia but did not let me know that D&C usually stops the bleeding from hyperplasia once it is all scraped out anyway.  If you do an ablation then your uterus lining is damaged forever and cannot be biopsied in the future.  With hyperplasia you need to continue to monitor it.  The D&C is a treatment for hyperplasia in someone like me who cannot take progesterone to treat it.  There is a chance it can progress but most likely this D&C will take care of it and my lining will revert back to normal.  If by chance it progresses then we will know for sure that the Tamoxifen didn't cause it and it is more than likely my hormones did and I will have to have a hysterectomy.  However, if it reverts back to normal then we can assume that Tamoxifen caused this condition as it is one of the 3 side effects from taking this drug and there is nothing more to do and since I have been off of Tamoxifen for almost a year now I should have no more worries that this will happen again.

After my extensive research on hyperplasia and ablation I decided on Monday to call my doctor and let her know why I would not be doing the ablation surgery the next day.  She understood and apologized for not telling me more about why it was not a good idea but she is new and fresh out of school and she said where I came in just wanting my bleeding to stop and it was an ablation consult appointment she assumed I knew what I wanted and that I wanted the ablation.  She said because of me she will use this as a learning tool and question the next person who is diagnosed with hyperplasia and tell them the risks going forward with ablation and not being able to monitor the uterus.  After all hyperplasia is a pre-cancer and something to not be messed with and you want to be able to monitor the uterine lining.  I have learned to always do my research and in this case I am super glad I did.  The internet can be our friend and I made sure to only go to the reputable sites when I was doing my research.  I am glad that I found this information and that I didn't destroy my uterus with an ablation because if it progresses it can lead to cancer but you would have no signs or symptoms with an ablated uterus until it is too late.  In the future if I do get my periods back which I probably will now that my lining has been removed (the symptoms of hyperplasia is missed periods and heavy extensive bleeding) and since my hormone levels are normal then I may consider ablation in the future but that is after we have checked my uterus over and over for abnormal thickening.  For now I am anxious to see what my body is going to do.

I had my D&C surgery yesterday along with a hysteroscopy.  These procedures were performed in the hospital operating room and I was put under so that was nice that I didn't have to feel any of the pain or discomfort.  After that endometrial biopsy I was a little nervous that I would feel the same type of pain with this but so far so good.  I can feel that they did do something "down there" but it isn't that painful, I have a little bleeding but that is normal with this type of surgery and I have some minor cramping.  I only hope that as the day progresses they don't get worse.  I started with a cold yesterday but of course I didn't tell the hospital that because I did not want to delay this surgery.  I had been bleeding for 19 freaking days and I couldn't take any more!!!  Today I feel like crap from the cold but maybe that is good since it is overriding any pain I might be feeling from the D&C procedure. 

The tissue samples are sent to pathology and next Monday I have a followup appointment with Dr. R and we will go over the results.  If by chance the results aren't in then she will call me to reschedule my follow up until they come back.  I am feeling positive and hopeful that it won't show anything other than the hyperplasia and that going forward we will monitor my uterus until we are at a point that it looks good and further monitoring doesn't need to take place. 

***PATHOLOGY REPORT FOR D&C PROCEDURE ON 10/17/17:
Disordered proliferative phase endometrium and reparative changes.  The prior endometrial biopsy, is reviewed in conjunction with this biopsy, and residual endometrial hyperplasia is not observed.

This is the best news ever, no additional hyperplasia and no cancer!!!  It appears the in office endometrial biopsy just happened to grab the only hyperplasia that was there, what are the odds?  As for the rest of my endometrium, it was very disordered and the reason for my abnormal bleeding.  From here I am anxious to see if my cycles return because they should or at least my hormone level tests say they should.  If they don't then this might be a new ongoing problem with my body and this will happen again as my uterine lining thickens and doesn't shed.  If it happens again then I will for sure get a hysterectomy and have my uterus removed.

I know my hormone levels are back and that is not a good thing for a breast cancer survivor whose cancer was highly ER/PR positive but for me I love feeling this good again and I am enjoying every second of it and all without fear of the unknown.  I refuse to let fear get me down because these days are good in fact they are really, really good.  I feel so normal and that is a good thing.  I am living in the moment and soaking up these days that I feel are a gift and enjoying my quality of life.  Some may disagree and some may take drastic measures to keep the hormones from flowing through their bodies and I respect that.  I too once took Tamoxifen and I felt like crap the entire 1 year and 5 months I took it.  It wasn't for me and I as well as my doctor feel that this drug did cause these issues.  Should my endometrium continue to be normal then we will know for sure that Tamoxifen caused this issue with the lining growing out of control and thickening.  I had no choice but to get a D&C to clean it up or else I would have probably slowly bled to death because that is how I was feeling after 19 days of it with no signs of stopping.  Through this whole cancer journey I got every odd/ rare side effect possible so it isn't a surprise that I was one of the many who ended up with the uterine thickening and causing bleeding problems possibly from the Tamoxifen.