>----- Original Message -----
From: cathy:- <anonymous@medispecialty.com>
To: Multiple recipients of list ADHESIONS <adhesions@mail.medispecialty.com>
Sent: Wednesday, January 09, 2002 6:19 PM
Subject: Re: First time poster - Hello and Questions
> Welcome, Kim -- unfortunately it sounds like you are in the right place!
> It also sounds like your doctors have told you some very false and/or
> misleading things..
>
> First of all, there are 2 kinds of adhesions that form in the abdomen,
> endo adhesions and fibrous adhesions. Nobody really knows what causes
> endo, but the current theory is that there is some mistake in fetal
> development where some of the cells that are supposed to be inside the
> uterus, and whose job it is to grow endometrial tissue, somehow end up
> getting placed outside the uterus. (Almost like if you got a few stray
> kidney cells in your knee or something.) When you reach puberty these
> colonies of out-of-place cells bleed and cause irritation to the
> surrounding tissues. Then there are fibrous adhesions. These are the
> body's natural response to some sort of injury. A pelvic injury could
> be from an infection, or from a massive blow to the abdomen (think car
> crash), or from surgery, or, in fact, from endometriosis. So yes, it is
> possible to have BOTH endometriosis AND fibrous adhesions. The only way
> to say definitively that you do have endo is if they send suspicious
> tissue to the lab and it truly is endo. You can't actually say
> definitely that you don't have it, though. It's possible that you have
> it and they just didn't find it. How confident you can be of their
> negative finding on the endo really depends on the surgeon's skill.
>
> Most fibrous adhesions are caused by surgery. The only way to detach an
> adhesion is to do surgery on it -- in other words to cut it. But doing
> surgery on it causes a new adhesion to form where you did the surgery.
> Plus a couple of brand-new adhesions on the path that they used to cut
> down to the spot. If you are familiar with greek mythology, think of
> the hydra. This is the mythical beast where if you cut off one head
> then 2 more heads would grow back in its place. So we come to the
> misleading part of what your doctors told you. Yes, the moment that
> they pulled the instruments out of your belly and started sewing you up,
> you had about 2/3 of the adhesions that you started the surgery with.
> But the part your docs obviously didn't tell you -- by the time they
> wheeled you out of the operating room and down the hall to the recovery
> room you were already sprouting dozens if not hundreds of more
> adhesions. The general opinion here is that there are 4 surgeons in the
> entire world who are capable of doing an adhesion operation and that
> causes fewer adhesions than it cures. And it sounds like the surgeon
> who told you the part obut the "other 2/3" couldn't have been one of
> those 4...
>
> Adhesions can certainly cause all sorts of gyne problems including
> infertility. They can pinch your tubes shut so that a fertilized egg
> can't make it down. They can totally encapsulate an ovary so that no
> eggs can escape to get fertilized. In fact they "typical" in-vitro
> fertilization case is a woman with scar tissue. The particular
> technique with in vitro is they use a needle to get an egg out,
> fertilize it in a test tube or petri dish ("in vitro" is latin for "in
> glass") and then deposit the fertilized egg into the uterus. This is an
> effective way to bypass the scar tissue. But that is actually a last
> resort -- what they do first is to try to clear the scar tissue via
> laproscopic microsurgery. I think that Dr Reich ( http://www.adlap.com
> ) (he's one of the 4. The best of them, probably.) has had pretty good
> success rates with clearing scar tissue well enough so that women can
> get pregnant without needing IVF.
>
> I don't know what your financial/insurance situation is, but I think it
> would be reasonable at this point to call Dr. Reich and at least get a
> phone consultation and figure out what your options are. You are
> absolutely right to worry that your fertility could be ticking away, and
> to figure out what your options are earlier rather than later...
>
> At Wed, 9 Jan 2002, Kim wrote:
> >
> >Hi everyone. A few years ago, I had a diagnostic laparoscopy. I
> >thought I had endometriosis, and my doctors agreed. (Don't get me
> >started on them missing the diagnosis completely and just putting me on
> >birth control pills.) After the surgery, I was told that I had
> >adhesions, not endo, and was told that most likely the adhesions were
> >from a fallopian tube infection a few years back. Now, I'm only 21 now
> >and had no surgeries before this, so the adhesions aren't a result of a
> >surgery. They figure they formed when I was about 16 (when the pain
> >started). My surgery, at 18 or 19, only reduced my pain a little, since
> >they could only remove about 1/3 of my adhesions because they're on a
> >whole lot of parts on my left side (tube, bowels, etc.). After I have
> >children, I'm told to have laser surgery to remove the other 2/3. My
> >questions are: Are there any infertility statitics available on
> >adhesions? And does my risk of infertility rise considerably as I age? I
> >don't want to wait too long before I have children, anyway, because I'm
> >dying to get the other 2/3 removed. Also, should I get a second opinion
> >on whether the adhesions can be removed now? Thanks, and I look forward
> >to reading and posting here. Kim
>
> --
> cathy :-)
>