Questions to Ask Your OB-GYN About UFE

If you’ve been diagnosed with uterine fibroids and are tired of the pain and heavy bleeding you’re experiencing, it’s time to take action.

With many treatment options available, it’s important to find the right one for you. Uterine Fibroid Embolization (UFE), a minimally invasive, nonsurgical procedure that blocks off the blood supply to the fibroids, is one option. While UFE may be right for you, it is first a good idea to talk with your OB-GYN. He or she can be a very useful resource in diagnosing your fibroids and guiding you to the best course of treatment.

Make an appointment with your OB-GYN to discuss whether you might be a candidate for UFE. The questions below will help you better understand the fibroid treatment options available.

Questions about fibroid treatments:
• How do you typically treat symptomatic fibroids? What are the risks and benefits of each of these treatments?
• What are the surgical, and less-invasive, options for treating my fibroids?
• What are the advantages, risks, and benefits of each of the fibroid treatments?
• Have all of the necessary diagnostic tests been performed? Trans-vaginal ultrasound or MRI? Endometrial biopsy? Blood tests? Why or why not?
• If I want to retain my uterus, what alternatives to hysterectomy are available?

Questions about more invasive surgical options:
• Do I need to have surgery? Will my ovaries be removed? If so, why? Will my cervix be removed? If so, why?
• What are the risks associated with surgery?
• Will I experience earlier menopause? Can the symptoms of menopause be treated?
• What are the risks and benefits of treatment for the symptoms of menopause?
• What are the limitations of surgery?
• Will surgery cure my uterine fibroid tumors?

Questions about UFE:
• Do you refer patients for UFE? If not, why?
• How many patients have you referred for UFE, and how many have chosen UFE to treat their fibroids?
• Will you refer me to an interventional radiologist for a consultation?

If your OB-GYN determines that you are a good candidate for UFE, ask for a referral to a specialist. The interventional radiologists at Indiana Fibroid Center are some of the most experienced in the Midwest at UFE, and we would be happy to speak with you about your specific symptoms and treatment plan.

Running and Back Pain

In recent years, running has seen a huge spike in popularity. More and more athletes are participating in half and full marathons, as well as “fun” running events—where runners are doused with colorful powders, run through muddy obstacle courses, or have to outrun “zombies.” Besides the “fun” element added to running in recent years, running remains popular due to its affordability and accessibility. All you really need is a good pair of running shoes and a road (or treadmill!).

Although running is an easy and excellent form of aerobic exercise, it can be a source of back pain for many athletes. The repetitive jarring of the spine from the up-and-down motion, combined with a hard running surface, can worsen a current or emerging back problem.

How Can Running Cause Back Pain, and What Can I Do to Avoid it?

By knowing what can cause back pain while running and improving your technique, you can help decrease your chances of experiencing painful symptoms.

The Problem: Force and jarring.

Joints and discs are jarred and compressed by the force of the body leaving the ground and landing on every stride when running or jogging. Running on hard surfaces, such as concrete or asphalt, can be especially jarring to the back.

The Solution: Use proper form and vary your training ground.

Use form that reduces the up-and-down stride motion and focuses on forward motion while running; this means leading with the chest, keeping the head tall and balanced over the chest. Grass, trails, padded tracks, and treadmills soften the force of impact and also produce stronger legs. Because your feet sink into soft surfaces, your body works harder to push off than when running on concrete. Try to maintain a flat running course, as leaning forward to climb a tall hill can put pressure on the back, and avoid slanted sidewalks and road shoulders, as running on an uneven surface can also cause damage.

The Problem: Weak core and leg muscles.

The back muscles have to work to keep the body upright and in good posture during the run. Weak abdominal muscles don’t support the back well, thus straining the hip muscles and putting tension on the lower back. Also, as you run, your gluteals and hamstrings don’t get worked as hard as your hip flexors or quadriceps. This imbalance can put extra pressure on your back to make up for weaker leg muscles.

The Solution: Build strong abs, glutes, and hamstrings.

Do specific exercises to target weaker muscles. Cross training can also give you a break from running—and possible back pain—by working other muscle groups and avoiding repetitive overuse. Also be sure to stretch your muscles completely before beginning each run to avoid additional injury from tight muscles.

The Problem: Bad feet.

Flat feet, fallen arches, and weakness in the feet can also be to blame for back pain. The arch absorbs shock and takes the weight and pressure from each foot strike. If the arch has fallen, it sends a ripple effect up the back, causing undue stress and possible injury.

The Solution: Wear proper running shoes.

Visit a specialty running store to be fitted with shoes for your foot type. Employees can assess your running technique and recommend the right shoes or insoles, if needed, for your technique and training goals.

Running can cause back pain that ranges from a dull and achy back to decreased flexibility and mobility to injured discs and fractures. While some injuries can be treated at home, others may require a doctor’s care. If you have followed the above suggestions and still suffer from chronic back pain, it’s time to give us a call.

Surgery vs. Laser Treatment for Varicose Veins

In recent past, if a patient suffered from painful and unsightly varicose veins, a doctor would typically recommend vein ligation and stripping—a surgical procedure that removes the veins from the legs or thighs.

Ligation refers to the surgical tying off of the greater saphenous vein in the leg, while stripping refers to the removal of this vein through incisions in the groin area or behind the knee. Tying and removal of the vein are done to reduce the pressure of blood flowing backward through this large vein into the smaller veins that feed into it.

Varicose vein stripping is often done under general anesthesia, and although it is a safe and low-risk procedure, there are always possible side effects, including allergic reaction to the anesthesia, infection at the incision sites, heavy bleeding, blood clots, bruising or scarring, and nerve injury.

Stripping and ligation surgery typically takes 60-90 minutes, although more complicated cases may go longer. However, it is usually an outpatient surgery, so patients can go home the same day. Recovery typically takes two to four weeks, but actual recovery time will vary depending on the number and location of the veins that were removed.

For more than a decade, though, surgical vein ligation and stripping have been performed less frequently because of newer, less-invasive, forms of treatment.

One of these treatments is known as Endovenous Laser Therapy (EVLT). EVLT uses ultrasound to guide an optical fiber into the vein. A highly concentrated laser beam heats the walls of the veins and reduces them, causing unhealthy veins to contract and close up.

The patient is conscious (but given the option of oral or intravenous conscious sedation for relaxation), and the leg is numbed using local anesthesia. Laser accuracy allows the doctor to treat the vein without affecting surrounding tissue, and when the vein is closed, it is slowly absorbed into the surrounding soft tissue. Other healthy veins in the legs then take over and blood flow returns to normal.

EVLT is remarkably safe, but as always with any medical procedure, there are risks involved, including skin burns, nerve injury, and blood clots. The procedure also boasts a remarkable 98 percent success rate.

The procedure is typically done within an hour, and patients go home the same day. In studies, patients have reported a faster recovery time than with vein stripping, and EVLT can also be less expensive than stripping and ligation, depending on the number of veins treated.

Although both forms of treatment can be highly successful and have minimal side effects, EVLT is generally a faster and less painful approach, can be less expensive, does not involve general anesthesia, and can have a faster recovery time than vein stripping and ligation surgery. Talking with your doctor can help you decide which procedure is right for you.