UTERINE FIBROIDS

Fibroids are muscular tumors that grow in or on the wall of the uterus (womb). Fibroids are almost always benign (not cancerous). Fibroids can grow as a single tumor, or there can be many of them in the uterus. They can be as small as an apple seed or as big as a grapefruit. In unusual cases they can become very large. About 20 percent to 80 percent of women develop fibroids by the time they reach age 50. Fibroids are most common in women in their 40s and early 50s. Not all women with fibroids have symptoms. Women who do have symptoms often find fibroids very difficult to live with. Some have pain and heavy menstrual bleeding. Fibroids also can put pressure on the bladder, causing frequent urination, or the rectum, causing rectal pressure. Should the fibroids get very large, they can cause the abdomen (stomach area) to enlarge, making a woman look pregnant.

Uterine Fibroid Symptoms

Most fibroids do not cause any symptoms, but some women with fibroids may experience the following:

 

  • Heavy bleeding (which can be heavy enough to cause anemia) or painful periods

  • Feeling of fullness in the pelvic area (lower stomach area)

  • Enlargement of the lower abdomen

  • Frequent urination

  • Pain during sex

  • Lower back pain

  • Complications during pregnancy and labor, including a six-time greater risk of cesarean section

  • Reproductive problems, such as infertility, which is very rare

 

What causes fibroids? No one knows for sure what causes fibroids. Researchers think that more than one factor could play a role. These factors could be:

  • Hormonal (affected by estrogen and progesterone levels)

  • Genetic (runs in families)

Because no one knows for sure what causes fibroids, we also don't know what causes them to grow or shrink. We do know that they are under hormonal control — both estrogen and progesterone. They grow rapidly during pregnancy, when hormone levels are high, and stop growing or shrink once a woman reaches menopause.

 

There are factors that can increase a woman's risk of developing fibroids. Fibroids become more common as women age, especially during the 30s and 40s through menopause. After menopause, fibroids usually shrink. Having a family member with fibroids increases your risk. If a woman's mother had fibroids, her risk of having them is about three times higher than average. African-American women are more likely to develop fibroids than white women. Women who are overweight are at higher risk for fibroids. For very heavy women, the risk is two to three times greater than average. Eating a lot of red meat (e.g., beef) and ham is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.

 

How are Fibroids Treated? Traditionally, patients with mild symptoms may be treated with medications that address pain or iron supplements to address anemia. Low dose birth control medications and/or progesterone injections can also be prescribed since they do not cause fibroids to grow and help control heavy bleeding.

 

Hysterectomy (surgical removal of the uterus) and Myomectomy (surgical removal of the fibroids) were the only options available to patients with moderate to severe fibroid symptoms. Now, a safe, non-surgical cure called Fibroid Embolization is changing lives.

 

What is Fibroid Embolization? Uterine fibroid embolization is a procedure to shrink fibroids in the uterus. It does not use major surgery, so recovery is faster. It can be performed on an outpatient basis so no hospital stay is required.

 

Uterine fibroid embolization shrinks fibroids by blocking off their blood supply. The doctor injects very small blood clotting particles into the arteries that supply the fibroids. The particles stick to the vessel wall. This causes a clot to develop that blocks off the blood supply. Once the blood supply is gone, the fibroids shrink. Your symptoms usually ease or go away over time.

Venous Reflux Disease and Varicose Veins

 

Health leg veins contain valves that open and close to assist with the return of blood to the heart. Venous Reflux Disease develops when these valves become dysfunctional and allow retrograde blood flow caused by incomplete valve closure. Venous Reflux Disease is progressive – symptoms can worsen over time if left untreated.

 

What are the symptoms of Venous Reflux Disease?

Varicose veins

Restless legs

Heaviness and fatigue

Leg or ankle swelling

Pain, aching or cramping

Skin changes

 

How is Venous Reflux diagnosed? Diagnosing venous reflux disease begins with a medical history and physical examination. During the physical exam, our vascular specialists will carefully examine your legs. An Ankle Brachial Index (ABI) may be ordered. An ABI, is a simple test that compares the blood pressure in your ankle with the blood pressure in your wrist. A test called a venous or duplex ultrasound may be performed to examine the blood circulation in your legs.

 

How is Venous Reflux Disease Treated? Endvenous Ablation is a minimally invasive procedure that treats varicose veins and their underlying cause, venous reflux, with little or no pain and is performed on an outpatient basis using a local anesthetic. Patients who undergo this procedure typically resume normal activity within a day.

 

Varithena is an FDA approved micro-foam medication used to treat varicose veins. Varithena is injected into damaged veins under the guidance of ultrasound technology, where the foam expands to collapse and seal the faulty vessels so that blood flow can be rerouted to nearby healthy functioning veins.

What is PAD (Peripheral Arterial Disease)? Also known as PVD (Peripheral Vascular Disease)

 

Do you have trouble walking because of pain in your legs? It might not be old age, it could be PAD. Peripheral Arterial Disease or PAD, affects up to 12 million Americans, but many do not even know they have the disease. PAD occurs when arteries in the legs become clogged with fatty deposits called plaque. If left untreated, PAD may lead to poor quality of life, heart attack, stroke or even amputation of your limb(s).

 

The most common signs of PAD include one or more of these problems:

1. Cramps, tiredness, or pain in your legs, thighs or buttocks that occurs when you walk but goes away when you rest 

2. Foot or toe pain at rest that often disturbs your sleep

3. Skin wounds or ulcers on your feet or toes that are slow to heal (or that do not heal for 8-12 weeks)

 

Risk factors for PAD:

·Smoking or a history of smoking

·High Cholesterol

·High Blood Pressure

·Obesity (Body Mass Index over 30)

·Diabetes or uncontrolled high blood sugar

·A Family History of PAD

·Over the age of 50

 

How is PAD diagnosed?

Diagnosing PAD begins with a medical history and a physical exam. Our Vascular Specialists use a simple test called the ABI (Ankle Brachial Index). After that, other tests may be done, including:

  • Doppler and Duplex Ultrasound Imaging

  • CT Angiogram

  • Catheter-based Angiogram

 

How is PAD Treated?

Most people with PAD are treated with lifestyle changes, medicines or both. In some instances, treatment may require non-surgical, minimally invasive procedures

 

Lifestyle changes that lower your risk include:

  • Stop Smoking

  • Controlling Blood Pressure

  • Controlling Diabetes

  • Physical Activity or Exercise

  • A low-fat, low cholesterol diet

  • Use of compression stockings

 

PAD may require medications, including:

  • Medicines to help improve walking distance

  • Statins to lower blood cholesterol

  • Anti-platelet agents to keep the blood platelets from sticking together and triggering a blood clot.

Angioplasty is a non-surgical procedure that widens narrowed or blocked arteries. A catheter with a deflated balloon on its tip is passed into the narrowed artery segment. Then the balloon is inflated. This pushes open the narrowed segment. Often a stent—a wire mesh tube—is placed in the narrowed artery with a catheter. The stent expands and locks open, keeping the diseased artery open.  

Atherectomy is a minimally invasive procedure to remove plaque from an artery (blood vessel). In an atherectomy, the plaque is shaved or vaporized away with tiny rotating blades or a laser on the end of a catheter (a thin, flexible tube). This procedure is used to treat peripheral artery disease and coronary artery disease.

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