I'm in a "catch 22"

sharrywine · #1 (**permalink**) 10-01-2008, 01:26 PM

Hello,
I find myself in a "catch 22". I have large fibroids that cause heavy bleeding during my monthly. My hgb count drops considerably each month. I take iron tablets but it's never enough to recupe the amount lost, then my next monthly comes and my levels drop even more. I have had this battle for years and I am losing as the fibroid grows and causes more trouble. I have a surgeon who will do a hysterectomy. He took me off the "pill" because it can cause a stroke. I do not smoke or drink. Then I had to have a Lupron shot. Found out that after 2 shots (1 each month) my blood pressure has been high, spikes and is unstable. My hemoglobin and iron levels have now raised after 2 months and a few iron iv infusions. I showed up for surgery on the date scheduled and my bp was so unstable that my Dr decided against surgery. Now, after seeing a cardiologist (and being put on bp meds which isn't helping that much, as bp is still high) and my primary Dr that the Lupron is the culprit. Next week, I need another Lupron shot or risk beginning my cycle which will again drop my hemoglobin and iron level again and I'll be right back in the same situation I was in with such low levels. Any suggestions? Thank you very much.

jgrossberg · #2 (**permalink**) 10-05-2008, 03:28 AM

How low do your levels drop? How long has it normally taken for them to recover?

sharrywine · #3 (**permalink**) 10-05-2008, 09:11 AM

Thank you for responding. My levels drop due to my monthly cycle. My hemoglobin can drop by 2 or more and iron can be completely depleted. After my iron iv infusions I was at 20. My bleeding is significant. I have to decide on what to do soon as my Lupron shot will be due this week. It's either take the Lupron and try to deal with my wild BP or not take the Lupron and risk another significant blood loss. Right now my Hemoglobin is at 14 (perfect for surgery my Dr says). He doesn't want it to drop any, I don't either. But I don't like the wild BP & heart palpitations either (my surgeon doesn't believe it's the Lupron doing this because it's so rare- he's the one who prescribed it). The Procardia (30mg) the cardiologist I briefly saw gave me, does seem to help. But there are times when my BP is still high even with the medication. If I don't take the Lupron for October then my cycle will start and probably be light according to all that I've read about it. But November may not be so kind. That is why I'm considering taking 1 more Lupron shot, which my family is completely against. I don't know what to do. Thank you for any help you may be able to provide.

sharrywine · #4 (**permalink**) 10-05-2008, 09:17 AM

I forgot to say that in 8 years I've probably never been normal regarding my iron and hemoglobin levels. I have a period and then drop by 2 or so points then work all month long with those nasty black iron tablets (my stomach can barely tolerate 2 a day) to try to build it back up and then I'm hit with another period and the cycle goes on and on. I can never build it back up to normal. I have functioned on levels as low as 6 or 7. Been on the pill many times to help regulate, but I've still bled profusely with that. It's a 2 steps forward 1 step back fight that I've dealt with for too long now, thus the need for a hysterectomy. Thanks again!

drgapay · #5 (**permalink**) 10-05-2008, 10:35 AM

Dear Sharrywire,

Literature says Lupron (leuprolide) may increase BP. I would like to know if you had BP rises before taking Lupron, or you have a family history of hypertension.
Now that you are seeing a cardiologist, you need to suggest to him that you might need more than one anti-hypertensive drug. In our setting here in the Philippine countryside where I work, many times I get a patient for anesthesia similar to your case. The internist/cardiologist gives more than one anti-hypertensive drug and we go in to do hysterectomy. We have lots of drugs for hypertension available in the market. Many times too, I get patients with large fibroids and even with a Hb of 10 gms, when BP and cardiac status are optimized we go in before the next menses come along. We don't have the luxury of sophisticated machines and gadgets. All we have is a good simple electrocautery machine. All we need is a meticulous surgeon and competent assistants who will try to catch every "red blood cell " that pops out of the vessel.

sharrywine · #6 (**permalink**) 10-05-2008, 07:34 PM

Thank you for your response. My BP was fine 3 months ago when I went to the Dr for a sinus infection. After my 2nd monthly Lupron shot, I felt my heart pounding for no apparent reason and knew something was very wrong. My mother is on BP meds. Could this be coincidence that I may now need this and the Lupron may not have anything to do with it? I am scared to take my shot due this week. The cardiologist I saw was a 1 time deal. There isn't a cardiologist monitoring me, just my primary Dr and my surgeon. My surgery was to be performed at a bloodless center hospital out of town (1 hour away) where I saw the cardiologist that day. Perhaps I should get a cardiologist here where I live? For now, I have to decide ... either take my next shot of Lupron this week... or not?
Thank you again. How I would love to see the Philippine countryside!!!

drgapay · #7 (**permalink**) 10-06-2008, 08:10 AM

Palpitation is also one of the side effects of Lupron listed in the drug literature. Probably, racial differences may occur; this afternoon I asked my obstetrician if her patients given this drug has had such effects and she said none. Your BP rises may be due to the drug if your BP was previously normal. You may have to monitor your BP more frequently and see your cardiologist or internist regularly so your BP could be controlled before your next monthly flow, then you can undergo hysterectomy.

Yes, you are most welcome in the Philippines!

Regards,

sharrywine · #8 (**permalink**) 10-08-2008, 12:44 PM

Thanks for your information. I appreciate it. I will monitor my BP more closely as I take my 3rd shot. I don't know what else to do except take the shot. I cannot have a monthly cycle begin. It's probably the lesser of all the evils! Thanks again.

katemanilli · #9 (**permalink**) 10-08-2008, 01:08 PM

I, too, had heavy bleeding. As a birth attendant, I can safely say that I was hemorraging. I read about a procedure called uterine eblation which destroys the lining without necessitating the removal of the organ. It effectively stops your periods.
I also used microcurrent, which reduced the bleeding almost immediately.
Also, be sure you are using an effective form of iron supplementation. I found in childbirth that doctors often prescribe ferrous sulphate. However, as you will read in the link below, the upper limit on the NIH site is 45 mg/da. MedlinePlus Herbs and Supplements: Iron Higher levels CAUSE anemia by destroying so many other nutrients.
There is a good link today on a fermented yeast supplement called EpiCor, which builds health along with your iron levels. Cheapest source I've found is Puritan's Pride Vitamins: Discount Vitamins and Herbal Supplements. Any POWDERED seaweed supplement such as chlorella, spirulina, blue-green algae would work quickly and help on all levels. I mixed mine with tomato juice and thought "salad" while drinking. The good thing about fibroids is that when menopause happens, they shink and cease to be a problem, so if you can wait it out, you will win like I did. Success in your efforts!

sharrywine · #10 (**permalink**) 10-08-2008, 02:34 PM

Thanks for your advice and response. My friend had embolization. Not good. She's in pain and it may not have worked and she may have to have a hysterectomy anyway.
The Hospital Bloodless Center ordered Venofer IV iron infusions. I had 3.
I am 47 years old. Menopause is nowhere in sight. My monthly cycle is extreme and interrupts my life terribly for several days. As much as I hate to have surgery, I am settled in my mind to go ahead with it. It's the Lupron I wish I didn't have to take. I am scared of the side effects regarding my heart, blood pressure etc... Thanks again.

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I'm in a "catch 22"

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