Re: what to say

From: cathy:- (anonymous@medispecialty.com)
Fri Feb 15 14:12:55 2002


At Fri, 15 Feb 2002, Em wrote: >
>Okay, I have a few questions for you wonderful individuals who
>continually post their love, support, and in my opinion "expert"
>advice.
>
>#4-What else would you call a book on vagina ovarian adhesions? Hey, I
>know, the patients guidebook to a life of living hell from adhesions, no
>wait it's in your head!
>

I kinda like "A Kick In the Nuts" myself. Or if you're willing to go a bit longer, how about, "Even If You Have Two X Chromasomes, You, Too, Can Experience a Kick In the Nuts"

>#3-Should I seriously be considering long term meds vs. adhesiolysis?
>When is enough enough? I know the ramifications, but I need to hear it
>again, and again.
>

The most important message I've gotten from reading this board (and also from a book I read years ago about PMS where the author had adhesion problems) is that when you have adhesions you a two choices. Choice A is to be in constant pain, and Choice B is to be in constant pain AND have surgery, too.

>#2-What to do when the doctor who has been managing your pain meds dumps
>you?
>I realize that a pain clinic is my best bet, but it takes forever to get
>in, any advice? Call them up and inform them I have a gun to my head?

Call a lawyer. Seriously. Call one of those lawyers who advertises on daytime TV trolling for accident and malpractice victims. Especially if this doctor is the same one who recommended ANY surgery, necessary or unnecessary, that made your pain worse. Especially if this doctor did not give you a full and accurate picture of the true probability of adhesions forming (or re-forming) before you had the surgery. If this is not the surgeon, sue the surgeon, too. You'll find out that the surgeon used less than absolutely impeccable surgical techniques because so few surgeons do. And as part of your lawsuit, demand adequate pain relief for the rest of your life, and that THEY pay for it. (This actually gives protection to the doctor. When the jackbooted thugs from the DEA and FBI show up in the doctor's office to demand an explanation for why the doctor is giving you an adequate dosage of pain pills, the doc can pull out the court order that says that he has to.)

>#1-I have found such conflicting information on this one, when, and how
>long does it take adhesions to reform after adhesiolysis?

There are some really good technical explanations of adhesion formation that you can find if you go to the main page of http://www.adhesions.org Another really good use of a couple of hours is to go to http://www.google.com and type "pelvic adhesions" in as the search phrase. All sorts of really good technical articles will come up. The short answer to your question is that as soon a the scalpel cuts into your tissues the chemicals that form the adhesions are released from the cut-open cells. As soon as a dray sponge is rubbed over the tissues, again, out come those adhesion-causing chemicals. As soon as the blood from the cut hits tissue, that tissue starts releasing the chemicals that form the adhesions. And it's not just the blood from the cutting -- it's the blood from a burst tube, or the blood, puss, goop from a ruptured ovarian cyst or ruptured appendix. The chemicals that cause scarring come from inside your own cells, and you get adhesions when something causes those cells to release those chemicals. The purpose of those chemicals are to save your life if you have appendicitis, or a burst ovarian cyst, or a PID, by "walling up" the infection it keeps the infection from killing you. Suppose you have a best friend who does not form adhesions. Both of you get appendicitis at 12 years old. In the 20th and 21st century, you both have appendectomies, and you have lifetime problems and she doesn't. But in evolutionary terms, think about humankind before the invention of surgery. Two 12-year-olds get appendicitis. The one who doesn't form adhesions dies from the peritonitis when her appendix bursts. The one who forms adhesions survives, although in pain, and bears children and passes on her adhesion-forming genes. Before surgery, being an adhesion-former was a form of genetic superiority!

So the adhesions start to form at the instant the "pelvic insult" happens (usually surgery, but also it could be an infection or trauma like a car accident or gunshot wound.) The structure of the adhesion typically stops forming by a week or so after the pelvic insult stops. The next part of the process depends on your genetic makeup. Your body could break down the adhesions and reabsorb them into the body. If this was in the million years before surgery, this would be the point that the infection would come out of the collapsing adhesion and kill you. Or the adhesion could just sit there soft and pliable and never cause you any problems at all. Or your body could start adding collegen to the "scaffolding" of the adhesions, and they get fibrous and tough, and they no longer stretch. All of us meat eaters are familiar with collegen -- we call it "gristle" when it's in a piece of meat and it is tough and unchewable.

So the answer to "how long for new adhesions?" the answer is zero time. As for the question "how long until the adhesions are a problem?" the answer is "it depends." It depends upon exactly what each end of each adhesion is stuck to. It depends how fast your body "tightens up" the adhesions with collegen. For some people it means they get a year or two of partial relief or even full relief. For others the pain starts as soon as the anesthesia from the surgery wears off.

(I started my period today and I'm crampy and crabby. That must be why I think that adhesionFormer=geneticallySuperior comment strikes me as funny. Also for some reason I really like this Q&A:

Q: How long can I expect to have relief from adhesion pain after an adhesiolysis?

A: If you can arrange to get run over by a bus while leaving the hospital, then you will have had relief that lasted "the rest of your life!" )

--
cathy :-)

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