At first Geiger refused it because she was afraid of the general anesthesia. But two years later, her situation had worsened; her bleeding was interfering with her training for a half Ironman triathlon. "The swim portion was in the ocean, and I was warned that sharks might be attracted to the bleeding," she says. She did complete the race, and doing so gave her the confidence to handle the anesthesia.
The outpatient procedure is done laparoscopically, using a special needle that is inserted through the skin and guided into each fibroid with the aid of ultrasound imaging. "Heat is generated in a predictable and controlled area, destroying the fibroid but leaving the surrounding tissue intact," Lee says. You’re left with two small abdominal incisions and one or two small needle punctures. After the surgery, you may need to take pain medication for a day or two to ease uterine cramps and/or pain from the incisions. Geiger scheduled her surgery on a Friday; she was back at work the following Tuesday.
Three months after Geiger’s procedure, her periods were normal, her uterus had shrunk by 60 percent, and she had no more pain. She’s training for her next triathlon, and, she says, "I can now wear tight pants without covering up the waistband. It’s the best thing I’ve ever done. I’m sorry I didn’t do it sooner."
Her only other regret: Insurance covered only the cost of the laparoscopy. Although the FDA has approved the technique, known as radiofrequency ablation, for treatment of soft-tissue tumors (which fibroids technically are), it’s considered investigational and thus is not currently fully covered. The total cost may be as much as $10,000; the out-of-pocket cost for insured patients is $5,000 to $7,000. Lee is now enrolling patients in a clinical trial, which is scheduled to begin in mid-2007, and says that full FDA approval will have to wait for the results. Lee notes that the first patient who attempted to get pregnant after the Halt procedure was able to conceive three months later and went on to deliver a healthy full-term baby.
Fibroid Surgery & Removing the Uterine Lining
The Fix: Removing individual fibroids surgically
The Deciding Factor: "Cost was a concern."
The Woman: Lisa Deeds, 45
When she was 41, Deeds, a massage therapist, went to a nurse practitioner at Planned Parenthood for an exam. The diagnosis: a grapefruit-size fibroid. Since Deeds wasn’t experiencing much heavy bleeding at the time, she decided to forgo immediate treatment and went online to research her options. She was accepted into a clinical trial of MRI-guided ultrasound. But after several hours of lying on her stomach inside the MRI tube, her back began to hurt, and she bailed on the procedure. Six months later, during a follow-up exam, she learned that the fibroid had grown.
By that time, Deeds’s periods had lengthened to nine days, she had to urinate every two hours, her back ached, she had numbness in one leg (from a fibroid pressing on the sciatic nerve), and she couldn’t sleep. "I needed my life back," she says. She chose a myomectomy, a procedure her insurance covered. During surgery, her ob-gyn discovered that one fibroid had grown to the size of a cantaloupe. While her doctor warned her that she would likely have fibroids again in five to seven years, she will probably be symptom-free until her hormone levels change dramatically. Deeds recovered quickly — she felt better after two weeks, rather than the estimated six. "I’m hoping to make it to menopause, when the fibroids will shrink," she says. She’s glad to have kept her uterus: "My mother went into a deep depression after her hysterectomy. I didn’t want that to happen to me."
The Fix: Removing the uterine lining
The Deciding Factor: "I was almost hemorrhaging."
The Woman: Ilene Silver, 53