What's wrong with my tummy?
March 29, 2006 2:59 PM Subscribe
My gynecologist recommended laparoscopy to diagnose my pelvic pain, but I'm not sure this is the way to go.
I've had intermittent pelvic pain in a very particular spot for the past couple of years. It only bothers me when I'm not on birth control. It's most painful during sex and in the week immediately after my period. A recent pelvic exam and ultrasound did not find cysts or anything out of the ordinary. My gynecologist says I have two options. I can either see a GI doctor, who will likely do some blood work and a colonoscopy to determine if this is a GI issue, or I can have diagnostic laparoscopy to determine if it's a gyno issue.
The timing of my symptoms and the birth control connection makes me think that this is not a GI issue. Although laparoscopy is a minor surgery, there are potential risks, and it's expensive (even though I have insurance). I would hate to go through with it to find out there's nothing gynecologically wrong with me. I'm wondering if there's anything other than endometriosis that would turn up in a laparoscopy. I'd also like to know if there are GI issues that could mimick gyno issues. Part of me wants to just get back on birth control and not worry about it. I don't know if I'd be putting myself at risk by doing this. And I don't know if I there are any diagnostic alternatives to laparoscopy.
I do have a follow-up appointment with the doctor, and I plan to ask these questions. However, she seems reluctant to tell me what to do. If you have any experience with these issues, I'd like to hear from you (especially if you can tell me how much diagnostic laparoscopy costs).
I've had intermittent pelvic pain in a very particular spot for the past couple of years. It only bothers me when I'm not on birth control. It's most painful during sex and in the week immediately after my period. A recent pelvic exam and ultrasound did not find cysts or anything out of the ordinary. My gynecologist says I have two options. I can either see a GI doctor, who will likely do some blood work and a colonoscopy to determine if this is a GI issue, or I can have diagnostic laparoscopy to determine if it's a gyno issue.
The timing of my symptoms and the birth control connection makes me think that this is not a GI issue. Although laparoscopy is a minor surgery, there are potential risks, and it's expensive (even though I have insurance). I would hate to go through with it to find out there's nothing gynecologically wrong with me. I'm wondering if there's anything other than endometriosis that would turn up in a laparoscopy. I'd also like to know if there are GI issues that could mimick gyno issues. Part of me wants to just get back on birth control and not worry about it. I don't know if I'd be putting myself at risk by doing this. And I don't know if I there are any diagnostic alternatives to laparoscopy.
I do have a follow-up appointment with the doctor, and I plan to ask these questions. However, she seems reluctant to tell me what to do. If you have any experience with these issues, I'd like to hear from you (especially if you can tell me how much diagnostic laparoscopy costs).
Response by poster: Yes, I've had an ultrasound (see above).
posted by lunalaguna at 3:51 PM on March 29, 2006
posted by lunalaguna at 3:51 PM on March 29, 2006
I had one and it went fine. But I live in Canada where health care is considered a human right and thus patients do not pay.
posted by acoutu at 4:49 PM on March 29, 2006
posted by acoutu at 4:49 PM on March 29, 2006
Laparoscopy is really the next best alternative after ultrasound. A CT Scan might help -- but it's best for bigger growths or IV stuff where contrast is helpful. It can't hurt either though. Also, if they need to biopsy something at least you're already being scoped.
Does she think it's fibroids? If so, you're probably going to need another surgery for that....or, the pills.
Also, was the ultrasound transvaginal or just pelvic? Transvaginal is, strictly speaking, the next "least invasive" step other than CT Scan.
posted by narebuc at 7:23 PM on March 29, 2006
Does she think it's fibroids? If so, you're probably going to need another surgery for that....or, the pills.
Also, was the ultrasound transvaginal or just pelvic? Transvaginal is, strictly speaking, the next "least invasive" step other than CT Scan.
posted by narebuc at 7:23 PM on March 29, 2006
My wife got scoped for fibroids, after I did some research and suggested to her aging doctor that a full abdominal slicing might not be the best idea. We got a second opinion. Recovery was much faster, but she was still hurting afterwards. I guess you could ask if they will go ahead and treat the fibroids at the same time, thus bypassing the need for a second procedure.
posted by craniac at 9:08 PM on March 29, 2006
posted by craniac at 9:08 PM on March 29, 2006
Response by poster: The ultrasound was transvaginal, which was seriously weird! The doctor did not say that she had any hunches, but she did mentioned fibroids and endometriosis.
posted by lunalaguna at 9:19 AM on March 30, 2006
posted by lunalaguna at 9:19 AM on March 30, 2006
Unless you've had changes in bowel habits (diarrhea, constipation), bloody stools, clay colored stools, abdominal distention/cramping/guarding, etc -- it's probably not a GI thing. Did she do a rectal exam and swipe some of what she got on a card to look for "occult" blood?
Your insurance should cover the laparascopy so I can't really understand why cost would deter you. As for its actual cost, you have to also understand that equipment and room have been largely paid for -- it's the drugs to knock you out, the doctor's services, and the hospital/laparoscopic suite time that are the bulk of the cost -- and that's mostly service based.
posted by narebuc at 10:03 AM on March 30, 2006
Your insurance should cover the laparascopy so I can't really understand why cost would deter you. As for its actual cost, you have to also understand that equipment and room have been largely paid for -- it's the drugs to knock you out, the doctor's services, and the hospital/laparoscopic suite time that are the bulk of the cost -- and that's mostly service based.
posted by narebuc at 10:03 AM on March 30, 2006
Response by poster: My insurance pays 80/20 of the total surgical and anesthetic cost. I have to pay an additional $100 for an outpatient procedure on top of the 20 percent, plus $30 for any follow-up appointments, plus any prescription costs. I assuming that because the procedure is done under general aesthesia, the total cost will be several thousand dollars. A $3,000 procedure would be at least $700 out of pocket for me. I can swing that, but I don't have it lying around.
posted by lunalaguna at 10:33 AM on March 30, 2006
posted by lunalaguna at 10:33 AM on March 30, 2006
I had similar problems, and I, too, had a transvaginal ultrasound (seriously weird is right!). Since the ultrasound didn't show anything out of the ordinary, the doctor spared me the laparascopy and put me on a three month-cycle birth control pill. The pain has virtually disappeared except for when I'm on my period, but that's only four times a year now, instead of 12.
posted by liet at 11:44 AM on March 30, 2006
posted by liet at 11:44 AM on March 30, 2006
Response by poster: Yeah, that's one of the big questions in my mind. Can I just go back on birth control? I mean, I know it stops the pain. I just don't know if I would be covering up something serious by doing that.
posted by lunalaguna at 12:00 PM on March 30, 2006
posted by lunalaguna at 12:00 PM on March 30, 2006
Have you sought out a second opinion? Talking with another gynecologist seems like a good idea.
posted by Carol Anne at 5:57 AM on March 31, 2006
posted by Carol Anne at 5:57 AM on March 31, 2006
This thread is closed to new comments.
posted by seawallrunner at 3:44 PM on March 29, 2006