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Un-diagnosed but worried about symptoms & US results

Shan555
Posts: 10
Joined: Mar 2018
Hope it is ok I am posting here as I am undiagnosed. I am having a bit of anxiety as I am concerned I have cancer. I have been having symptoms for over a month+ (well since Sept. if you call tachycardia a symptom, but pelvic symptoms since Feb consistently.)
I just had a pelivic ultrasound and have been referred to a gynecologist as a polyp was found and due to my pain.
My symptoms are (fyi I am 46)-
-period has been coming a few days early which is new for me as I have always had a very regular cycle, and often times I have 2-5 days of spotting beforehand and I do have pretty heavy bleeding for a few days and bad cramping (was explained as age related)
-BAD lower pelvic, both sides, and lower back pain, which I thought were my ovaries but ovaries appeared normal on the ultrasound. I get shooting pains on both lower sides, it sometimes feels like my ureters on the left side (or ovaries like I said.) It also at times feels hot and like it's bleeding inside. 
-period like cramping even when I don't have my period
-nausea and acid reflux
-tachycardia & hot flashes
-stomach pain
-gas
-weird feeling like my lymph nodes are itching inside my lower back and pelvis
-blood found in urinalysis 
-frequent urination and thirst
-extreme fatigue
 
The main symptoms are the pain and fatigue, sometimes I cannot get out of bed. 
 
Anyways, I just received my ultrasound report and am concerned with the thickness of the lining and the polyp. I was about mid-cycle when this was done, is this normal thickness for a premenopausal woman? (I did have an ultrasound a few years back and the thickness was 10mm but I seem to recall I was due for my period any day then.)
Also what does it mean that prominent uterine vessels were seen?
 
I feel with this pain and fatigue that something is definitely going on and am worried. Am I to assume that a biopsy of some sort will want to be done on the polyp? Any help or advice would be greatly appreciated. How worried should I be? I currently have such bad cramping and pain and hot feeling inside, it feels like I have my period but I don't. Can a polyp cause this?
 
Here are the results.
 
COMPARISON: None.
 
TECHNIQUE: Transabdominal and transvaginal imaging was performed.
 
FINDINGS:
Uterus: Measures 8.1 x 4.3 x 4.9 cm. Prominent uterine vessels on the left.
 
Endometrium: Measures up to 1.1 cm in thickness. Ovoid mildly echogenic structure in the endometrial cavity with an apparent stalk and vascularity. This probably represents a polyp and measures 7 x 11 x 18 mm.
 
Right Ovary: Measures 3.1 x 2.1 x 2.3 cm and appears unremarkable
 
Right Ovary Blood Flow: Present.
 
Left Ovary: Measures 2.4 x 1.4 x 1.7 cm and appears unremarkable
 
Left Ovary Blood Flow: Present.
 
Free Fluid: no significant free fluid.
 
IMPRESSION
IMPRESSION: Probable endometrial 7 x 11 x 18 mm polyp. See above.
Michaelynn
Posts: 81
Joined: Apr 2010

Prominent uterine vessels can be a sign of pelvic congestion syndrome.  

It would explain some of the symptoms your having.  Just a thought.

NoTimeForCancer's picture
NoTimeForCancer
Posts: 2483
Joined: Mar 2013

Shan555, I'm sorry, I am not a doctor but would encourage a good, overall physical, as well as pushing for a few answers.  

Shan555
Posts: 10
Joined: Mar 2018

Thanks for the replies. I did have a complete physical about 5 months ago with all blood work and then testing done for the tachycardia/echocardiogram. Unfortunately, I have bad insurance and only get 3 office visits a year and my family doctor hasn't been of much help. Hopefully the appt. wth the gynecologist will give me some answers and help.

I had never heard of pelvic congestion syndrome, some of my symptoms do seem to fit, I will bring it up at the appt.

Thanks again for the replies.

Shan555
Posts: 10
Joined: Mar 2018

I hadn't googled but as I am stuck in bed in pain, it's hard not to do.

Found this which worries me, especially as I have so many symptoms- "Polyps larger than 1 cm are also more likely to be premalignant or malignant in nature." The study also mentioned that cancer is more likely in polyps in women who are symptomatic. 

Sorry to post and be freaking out, but I am worried as I haven't felt right in awhile and have a lot of symptoms.

To me it looks like I will need a biopsy, right? How is that done and is a regular gynecologist equipped to do it? I also read that a d&c can spread the cancer around if there is any, is that true? Want to make sure I get the correct and safest test done if it's needed.

 

Tamlen's picture
Tamlen
Posts: 189
Joined: Jan 2018

Shan555, it's so hard to resist the temptation to look online -- I did the same when I had an abnormal ultrasound result in December. But, as several ladies warned me, beware Dr. Google. There's reliable and useful information, and there's also a lot of outdated and downright wrong information.

I believe most gynecologists are equipped to do a biopsy themselves, either in the office (as mine did; it's uncomfortable but not horrible), or as part of a D&C procedure if they feel that's the better way to go (my gyn found the office biopsy to be a problem and I ended up getting a D&C, which was also a better experience than I anticipated).

There's a lot of waiting when something like this shows up, and it can be mentally and emotionally excruciating. I used the time to write lists of questions for my gyn, who patiently worked through them with me when we met.

Take good care of yourself in the coming days and weeks. We're all here and this forum is filled with wonderful, caring, giving women.

MrsBerry
Posts: 102
Joined: Dec 2017

I wish this board had a “like” button! Ditto to this, google with care. Sometimes too much information is just that- too much! 

Shan555
Posts: 10
Joined: Mar 2018

In looking at my ultrasousnd results, I am confused, how come it doesn't say anything about the bladder, fallopian tubes etc. Isn't a pelvic ultrasound also suppose to also look at those things? The results only mention the ovaries and uterus.

I do sometimes wonder if this is bladder or ureter related as what else is on the low left if ovaries looked fine? Maybe it's lymph nodes? I swear I felt a lump there but my Dr. said she didn't feel anything. 

I really feel like something is wrong and it wasn't seen on the ultrasound. The pain is on both lower sides, I can feel something is wrong, especially on the left side. It all started with a horrible wrenching pain on the low left and since then I have had daily pain with frequent urination and low back pain. The pain is only tolerable if I keep my bladder empty and am laying down.  I also get the pain on the lower right too and my whole lower abdomen feels heavy and swollen and crampy and my lower back is painful. I feel I need a CT or something to see more than the ultrasound did. Will gynecology be able to order one? I did have a reaction to iv contrast when young, can a CT without contrast still see enough?

Sorry to bother you all wih my crazy rambling, and feel free to ignore me, I just have no where else to vent about this and I am scared as I have never experienced pain and fatigue like this.

Tamlen's picture
Tamlen
Posts: 189
Joined: Jan 2018

How soon is your ultrasound follow-up appointment with your doctor? If it's not very soon, it might be time to be a strong advocate for yourself and call to tell them that you're in a lot of discomfort, unusually fatigued, would like to see the doctor sooner, and how can that be made to happen?

Shan555
Posts: 10
Joined: Mar 2018

I have a referral appt with a gynecologist in 2 days. I did call last week and mentioned what I was going through and was told to go to urgent care or the ER.

I have not been happy with my doctor at all, she does nothing besides refer to someone else, she has referred me to see a cardiologist, a gastroentrologist, urology and now gynecology, and she knows I only get 3 appts per calendar year so I cannot possibly go to see them all. As what is going on is most likely due to all one issue- who do I go to see, what is the right specialist? I obvioulsy need to find a better primary care Dr. as she is incapable of doing more than a basic yearly check-up.

I went to urgent care in October for tachycardia and had a urinalysis done, I just found out last week that blood and bacteria was found in that test! That was 5 months ago! I was not told and it was not mentioned to me at all. I had to ask for a retest urinalysis and when that also came back with microscopic blood my doctor said well maybe that is just normal for you. WHAT? I am having symptoms along with these findings and that is normal? I am frustrated and worried that it has now been so long. 

I have just been googling local mri options that can be done quickly and cheaply out of pocket as I am done with sitting around and waiting and having my doctors do nothing. I found a place that does mri's for $600 and may just go ahead and do that for piece of mind. Can an mri see things as well as a ct? As I am allergic to the contrast dye in the ct, I was thinking an mri might be the way to go for me. 

I'll see what happens at gyno appt and maybe I'll actually get a doctor that can help me.

Does anyone know if the bladder is looked at during a pelvic ultrasound, and if so, why was it not mentioned in the report? 

Thanks for listening to me vent and like I said before sorry to post before diagnosis and to be a bother.

MugsBugs
Posts: 100
Joined: Jan 2018

This is maddening that you are going through this!  i don’t knowmif they look at the bladder during the ultrasound. I imagine they do because when I had mine I had to have a full bladder for external ultrasound, then empty for internal. Bladder wasn’t mentioned in mine.    I find it terrible that they found bacteria 6 months ago and didn’t address this issue.  Kidney stones can cause blood in the urine.

Good luck!

pinky104
Posts: 574
Joined: Feb 2013

I've had uterine polyps twice.  Also, I had cervical polyps six times.  The first uterine polyp and the six cervical polyps were benign.  Ten years after I had the first one removed with a hysteroscopy and D&C, I got the malignant one.  I was found to have stage IV UPSC (uterine papillary serous carcinoma).  I'd had heavy bleeding with my periods since the age of 14 (my period started at 12) and bad cramps from 14 onward.   I think it got a little worse around menopause at 51.  The cramping just before menopause started two or three days before my period did.  My cancer was found at 61.  I had a recurrence 7 years after the first surgery.  Both times I had cancer, I got wicked hot flashes.  I hadn't had any when I became menopausal.  I had one little zing of pain in my left side once a day every day, but none on the right.  The cancer had spread to both ovaries.  My GYN/onc thought I had ovarian cancer, but the tumor board at the hospital thought it had started in the uterus. 

I didn't have nausea, but did have reflux.  Being put on 40 mg. of Omeprazole has pretty much taken that away.  I had tachycardia at one point in my life, but it turned out to be from hyperthyroidism.  I got treated for that.  I used to be fatigued a lot and had to go back to bed after breakfast.  I couldn't do it on work days, but it always seemed worse on the weekends.  It turned out to be that I was eating high carb foods on the weekends.  Once I cut out all the simple carbs (ones that burn off quickly and leave you tired and hungry), most of my fatigue was gone.

Some doctors do a biopsy, but there is a chance that they might not get the right spot when they do that.  I had a D&C and the pathology report from that found my cancer.  My polyp was a little over 5 cm., so yours is much smaller than mine was.  Then I had a CT scan, which showed my cancer was in my uterus, both ovaries, the omentum (fatty layer in the abdomen), and the small intestine.

You definitely sound like you have a UTI.  Your doctor should have given you an antibiotic.  Go somewhere else if your doctor won't give you one.  UTI's can eventually get into the blood and cause worse infections.  Maybe that's what's causing all your fatigue.  It would certainly cause pain.  Maybe you felt swelling of a lymph node from the infection.  The polyp might or might not mean cancer.  If it's cancer, it could spread to a lymph node. Oh, another thing that can happen is that a UTI can spread to your kidneys and cause an infection there called pyeloneprhitis.  That can cause pain in your back, but it would probably be higher than where you describe yours to be.  I had it once, and I was pretty sick. 

I don't know what the thickness of the uterine lining should be at your stage in life.  I've heard that if you have cancer, more blood vessels can develop to feed the cancer. I'm not sure if the mention of prominent blood vessels in your report might have anything to do with this fact or not.  Maybe it is the pelvic congestion syndrome that was mentioned earlier.  I don't think detail is shown in an MRI as well as in a CT when it comes to cancer.  Maybe you can have a CT without the contrast medium.  They are sometimes done that way, but the results won't be as clear. Frequent urination is a UTI symptom, as is pain and burning upon urination.  Frequent thirst can also be a symptom of diabetes.  Possibly the dry winter air might also cause this.  Who knows? 

I wish you luck with all this.  I hope your polyp turns out to be benign. It's certainly very small.  If you do get diagnosed with a UTI and you find yourself getting them frequently, my urologist recommends taking two grams of D-Mannose daily, which helps some people get rid of the bacteria that causes them.  The D-Mannose attaches itself to the bacteria in the body and carries it out of the body thru the urethra.  It hasn't worked well for me, but it does for others.  It's an over-the-counter med that can be bought over the Internet, GNC stores, etc.  Sometimes it comes in combination with cranberry, which is also good for the bladder.  Some of the Internet ads are misleading as to the dose, so make sure you take the correct number of pills each day.  It also comes in powder and gel capsules if you prefer those.

I hope this helps. I'm glad your appointment is coming up soon.

Shan555
Posts: 10
Joined: Mar 2018

Thank you for all the replies!

Had the gyno appt, the Dr. felt confident the polyp will be benign but you never know until it's biopsied. She said the lining thickness is normal for my age and she said she didn't know why the report said prominant veins but it means nothing to her, which kind of concerns me..as she did mention hemoraging as a comlication of surgery, what if the veins are larger than normal and she has just never dealt with that before or knows nothing about it? I unfortunately forgot to ask about pelvic congestion syndrome as she was sort of rushed. 

I am having surgery to remove the polyp in a month or so. It's on the borderline for size for doing in office so she recommended general anethesia in hospital which I don't like so I did ask to not do general anethesia. We are going to start out with light sedation and numbing the cervix and will have an anethesiologist there in case it gets too painful or takes too long. She was concerned about the blood in my urine and couldn't believe my doctor had done nothing about it so I am to see a urologist. Can't get in for a wekk and a half and am in a lot of pain and can't wait to finally figure this out and feel good.

The whole surgery thing makes me nervous, especially if I have to have general anethesia, but first I have to figure out what is causing all this painb fullness, nausea  and frequent urination as she didn't feel the polyp would be causing any of that. On to more doctors and hopefully I can wait until the urology appt, I am in such pain that I may not be able to.

I thank you for all the help.

LisaPizza's picture
LisaPizza
Posts: 166
Joined: Feb 2018

I had a large polyp removed as outpatient surgery (during my D&C). They didn't use actual general anesthesia, but whatever they used ... I don't remember a thing after wheeling over to the OR. You should be fine!

EZLiving66's picture
EZLiving66
Posts: 1285
Joined: Oct 2015

If it makes you feel any better at all, I have blood in my urine all the time - even when I was a kid.  In my 30s, I finally went in to see a urologist and he told me my "plumbing" was hooked up a little different.  It was nothing to worry about and if I ever had problems with anemia, a minor surgery could fix it. So, here I am at 65 and just had a UTI. My doctor said she found a small amount of blood along with bacteria.  I told her not to worry about the blood.  Every time I've been tested, that small amount of blood is there.

I hope you get some answers soon!!

Love,

Eldri

HorseLvr's picture
HorseLvr
Posts: 102
Joined: Nov 2017

Have you been tested for diabetes? You mentioned excessive thirst and urination, which are classic signs. I know that wouldn't explain the rest of your symptoms but I wonder if there are multiple causes?

I hope you get it figured out soon. It's no fun being so uncomfortable. 

Shan555
Posts: 10
Joined: Mar 2018

I was tested for diabetes. I think I just get so thirsty because I am peeing so much. Hope they can figure it out at the urologist.

I wouldn't worry so much about the microscopic blood in the urine as I have had it before, it is just I am feeling so bad now and symptomatic, so it has me more worried.

I shouldn't have googled the polyp removal procedure either as now I am thinking about that. yish. I didn't have much choice though as the Dr. didn't explain any of the procedure to me beyond me saying I don't want general anesthesia and discussing that. I actually wasn't very comfortable with her as she seemed rushed and spent no time and assumed I knew everything, which I don't. She asked "You want me to burn the lining?" What? What is that and why would I want it? She also asked if I wanted an iud placed which I found kinda odd at my age and then she seemed annoyed when I said no. She barely addressed my concerns with all my symptoms and how bad I feel. Told me things like she wants to do it in the hospital so she doesn't have to call an ambulance if things go wrong. WHAT? How often do things go wrong? Her pre-op exam was just listening to my heart and lungs. Makes me more nervous. I am almost wishing I didn't have the ultrasound and find this thing. What I thought was going to be a quick procedure in office with a local is now 4-6 hrs at the hospital and possible anethesia or sedation.

Also now I don't know what to do, put off the polyp removal as I feel so bad and go to the urologist and gastroenterologist to try to figure out what is going on as I don't know if I can go through that now with how I feel. Or do I do the removal and biopsy asap in case it isn't benign and what if that is what's causing all this? It's so hard to know. I feel so bad though that I don't know how much more I can do. I'd hate to go through the removal and wake up and still have all these sympotms I have to deal with in addition to the pain and sedation from that and no solution, I don't have the energy for it. I also don't know if going through sedation etc with the nausea and frequent urination is a good idea, I don't think I can do it.

I have a question, as the polyp has vascularity, how do they stop the bleeding once it's cut off, esp as mine is large? I still don't really get what is involved and guess I will call and speak to the Dr. as now I am not comfortable with it being done as I have had hardly any info from her regarding the procedure. 

Anyways, thank you all for taking the time to reply, I appreciate it.  

 

HorseLvr's picture
HorseLvr
Posts: 102
Joined: Nov 2017

Is it possible to get another doctor? You sound very uncomfortable with yours (and I can see why). Doctors should always take the time to answer your questions. 

Regarding sedation, speak to an anesthesiologist and make sure you tell him/her about the nausea and frequent urination. I know that it's a huge problem if a patient vomits while under anesthesia, I imagine sedation would be the same. Maybe they can give you an anti emetic like gravol before the procedure. 

pinky104
Posts: 574
Joined: Feb 2013

I would go ahead with the procedure just in case it isn't benign.  My guess is that they would stop the bleeding once the polyp is removed by cauterizing the spot.  That is where they burn the spot a little to stop the bleeding.  It's a quick procedure.  I'm not sure what the other burning the doctor was talking about was. 

Although the bleeding might not be serious, as some of the other women on here have written, it also could be. I worked in a hospital office with a woman who smoked a lot and developed lung cancer.  A surgeon removed her lung cancer and had a catheter put into her urethra for the procedure.  She had bleeding from her urethra afterwards and was still bleeding a whole year later.  In the meantime, she kept testing herself with test strips (we worked in an ER) for urinary tract infections as she had heard that catheters could cause them.  She had a little blood pm the strip each time but an insignificant amount of bacteria.  Finally, she mentioned the bleeding to her doctor.  To make a long story short, she had bladder cancer, and she had waited too long. She survived a couple more years after that even though the cancer had advanced pretty far.  I pray this isn't the case for you.  I don't want to scare you and hope it's something simpler than this.  Get yourself checked as the earlier you do, the better off you should be. 

Shan555
Posts: 10
Joined: Mar 2018

I am finally having the polyp removed and a D&C on Monday and I am very nervous esp as it's been more than a month since the polyp was found. I did go get a second opinion as I did not care for the first Dr. I went to and I am glad I did but worried that it did put off the procedure. My Dr. also wanted me to have my bladder looked at first due to the blood found in my urine and the bladder pain I was having so I had to have a cystocopy and a CT and then she wanted to wait until day 6-10 of my cycle to do the procedure. I have been in daily pain this whole time and am scared of what they will find.

My newest gyno mentioned endometriosis as a possible cause of a lot of my issues so I am hoping for that and not something more serious. She also said, unlike the first Dr. that seeing the prominent uterine vessels on ultrasound could mean pelvic congestion syndrome and could be causing me pain and that usually these vessels aren't seen on ultrasound so if they see them, it's something. 

The urologist thinks I may have interstitial cystitis also. I worry that instead of these 3 different diagnosis's, that it's one bad thing causing it all. I am tired of the daily pain and want to be done with this and feel good as I have been in daily pain since the end of Feb. Thankfully the bladder issues have gotten better but I still have 24/7 pelvic pain and a pain on my left side that worries me as I feel as if something is in there that shouldn't be. I also have itching in my pelvic lymph nodes and nausea. I am ready to be done and figure out what this is, who knew getting a diagnosis would be so hard. I have been to 6 Dr.s and have had multiple tests and still no solution and one Dr. keeps passing me off to another. But I am nervous to find out too, if this is something bad. I don't know if I can do that as I am exhausted from this already.

I am very nervous about the procedure also. My veins are hard to find so I am not looking forward to having them try to place an IV and then I worry about the procedure itself and the outcome.

How painful is this prcedure? How long does it usually take to get the biopsy results?

Thanks for listening!

Shan555
Posts: 10
Joined: Mar 2018

Is this procedure usually done with general anesthesia? When I talked to my Dr about it I expressed that I did not want general anesthesia and she said it wouldn't be, that it would be sedation but the surgery center just called and said it was ordered with general anesthesia. I do not want that. Are most done with ga? I am fine with pain but do not want to go under. Now I'm really nervous. I am not doing general anesthesia.

I also was just reading this http://www.hystersisters.com/vb2/showthread.php?t=362049

and am now concerned with having a d&c done. Why would I need that done? Can't the polyp just be biopsied? I have not had any abnormal bleeding beyond spotting a few days before my period. Should I do the d&c? I guess I don't get why it would be done. 

LisaPizza's picture
LisaPizza
Posts: 166
Joined: Feb 2018

I had a D&C and polypectomy. I 5dad sedation but not general anesthesia. That said, it was some good sedation ... I don't remember a thing after wheeling to to OR.

deanna14
Posts: 743
Joined: Oct 2008

I believe that D&C’s are always done under general anesthesia. My stage III uterine Cancer was diagnoses by having a D&C and hysteroscope. It’s really a simple and short procedure. You won’t be under general very long and it is the safest way to do it. Is there a particular reason you don’t want general?

Shan555
Posts: 10
Joined: Mar 2018

I guess I don't get why a d&c is needed. The Dr said the polyp is pretty big so why can't she just test that? Why would I need a d&c too? 

The reason I don't want general anesthesia is that I don't think it's needed, it carries extra risk and takes longer to recover. 

Thanks for the replies.

LisaPizza's picture
LisaPizza
Posts: 166
Joined: Feb 2018

The polyp can be benign and you can still have cancer on the remaining endometrium. The cancer can just be in certain spots, and not necessarily all over.

But they can definitely do it without general, because I did.

Soup52's picture
Soup52
Posts: 868
Joined: Jan 2016

Having a d+c would give you a clearer picture of what is going on. Personally I didn’t have any big recovery period. Maybe others will chime in with their experience.

Tamlen's picture
Tamlen
Posts: 189
Joined: Jan 2018

They gave me propofol for sedation and I went home and resumed my day a few hours later. It was a pretty simple procedure.

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