What to expect During
Uterine Fibroid Embolization Treatment?
The first step toward fibroid embolization begins with a consultation with Dr. Niedzwiecki,
an Interventional Radiologist (IR). Consultations take approximately one half-hour. In that time he will ask you
to describe your symptoms, any past and/or present treatment received, do a brief physical examination (which does
not include a pelvic exam), and describe the FE procedure to you. This is also your opportunity to ask any questions
you have in a non-hurried, one-on-one setting. As part of this consultation, you may be asked to have a MRI if
you have not already had one. When ever possible we schedule your MRI prior to your consult (oftentimes we can
coordinate these for the same day for your convenience). By having the MRI results at the time of your consultation,
Dr. Niedzwiecki can better assess if you are a candidate for FE. This allows you to leave your consult with all
the information you need about FE to make an informal decision.
Before the procedure
Several days before you procedure our Pre-admission Teaching and Testing (PATT) office will contact you to confirm
your appointment. On the day of your procedure you will be asked to arrive two hours early where upon you will
be taken to the Ambulatory Care Unit. Their nurses will start an IV, shave and prep the groin area, place a foley
catheter in the bladder, and start an intravenous antibiotic. From there, you will be transported to Special Procedures
in the Radiology Dept. where Dr. Niedzwiecki will perform your FE.
During the procedure
FE is performed in sterile conditions.  You will be made comfortable with intra-venous conscious sedation and a local anesthetic.
Dr. Niedzwiecki will make a very small incision, less than a ¼-inch, next to your groin area where he will
access the femoral artery. Guided by X-ray imaging, he will feed a small tube, called a catheter, through the femoral
artery to the uterine artery. Once in place he releases small plastic particles known as polyvinyl alcohol (PVA)
into the bloodstream. They will pool and block the blood flow to the fibroids, thus essentially "starving"
them. Since the fibroids are no longer being nourished they immediately begin to break down. Over time they will
shrink and/or be completely be reabsorbed into the body.
After the procedure
FE is a same-day surgery, or a  23-hour admit. Dr. Niedzwiecki prefers that his patients remain over night for observation and pain
management. In the first several hours following FE, most women experience marked cramping, some may also have
nausea and vomiting. These are well controlled with IV pain medication, which you will be able to self-administer
via Patient Controlled Anesthesia (PCA). Upon release, you will be sent home with prescriptions for the necessary
pain medications. Plan to take a week off. Though you have avoided major surgery, and the 6 to 8 week recovery
period that goes with it, you are still likely to experience several days of discomfort. It is important that you
not attempt to return to routine activities for about a week.
Some women later develop a low-grade fever; this is related to the destruction of the fibroids and is not an infection.
Some symptoms, such as menstrual bleeding and pain show immediate improvement following FE. It is important to
remember, however, that your fibroids took months, and more likely years, to develop, so it may take time to see
improvement from such symptoms as sciatic pain and mass effect (bloated appearance).
Follow-up
Dr. Niedzwiecki believes in close follow-up with his patients. You will be contacted in one week following your
FE to check on your progress. Thereafter, we will contact you at one month, three months, six months, one year,
and annually thereafter. At six months and one year post-FE Dr. Niedzwiecki requests that you receive additional
MRIs to be compared with your pre-FE images to evaluate fibroid shrinkage. Typically it is unnecessary to return
to our office as most, if not all, of your follow-up will be handled by telephone.
Be prepared
(advice from other women)
Have your prescriptions filled before returning home. While some would prefer to do this before arriving for their
procedure, all women are different. Since our patients don’t fit snugly between the pages of a textbook, it is
important that Dr. Niedzwiecki observe you following the FE to ascertain your individual needs before prescribing
any medications. Do, however, have a family member have these filled for you before you return home.
Bring boxer shorts with you. You will likely experience some tenderness at the incision site. The elasticized
leg bands of most undergarments may lie directly over this area causing more irritation. By wearing boxer shorts
you can avoid irritating your incision.
Have a heating pad available. Heat causes blood to pool at the applied area, and can ease some of the cramping
you may experience. However, it is recommended that you do not exceed one half-hour when applying heat to any area
as it becomes ineffective after a period of time.
If you do not have a heating pad, one can be easily made with a few readily available household items: Dampen a
thick, folded bath towel and microwave until very hot. Place the heated towel inside a large plastic bag. Wrap
with a second heavy bath towel. This homemade heating pad should maintain its heat for the recommended half-hour
application.
Bring you own pillow. Many are unable to sleep or rest comfortably when not in their own home. Bringing
you own pillow may help to ease that "displaced" feeling.
Have laxatives on hand. Some pain medications can cause constipation. So to avoid unnecessary discomfort,
you may wish to have laxatives on hand.
Where do I Call for a Consultation?
Please
Call us TODAY
at 727-791-7300 if you have any questions.
We're looking forward to helping you . |
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