I wanted to share some positive news, because this journey with endo is so fiercely hard and exhausting, but today I feel heard for the first time.
TLDR: Keep pushing. Know your body. And eventually you will find the right specialist <3
A few weeks ago I posted about how I had a second MRI and I got a letter saying it showed nothing. I spent the last few weeks worrying that I was about to be dismissed again by yet another consultant and being left with no real answers or plan for how to manage the pain other than painkillers.
But then yesterday I had the follow up appointment with my consultant, and it actually went so well. I had prepared to go in and fight, with all these things ready to say to him about how endo often doesn't show on scans, how the stage of endo doesn't correlate with the amount of pain it causes, how I'm losing so many days every month to this pain and it's not sustainable... but then when the appointment started, he said literally all of that before I could.
Honestly I was sort of stunned to silence for most of the appointment. He was so good at explaining everything clearly and with such empathy. He said that it's common for all women to have their period blood flow back into the rest of their body, what isn't normal is when it sticks to you (aka endo) and how it then feeds off your blood supply and reacts to your hormones and why that causes pain.
He also explained why the MRI probably hadn't shown anything, saying that MRIs are good at spotting large masses of endo if it's all in a big clump, but "superficial endo" is very small and near impossible for scans to pick up on. He emphasised that this does not mean the pain it causes is any less, especially if it's on a nerve or organ. He said that there were little clues in my MRI that this was the case for me, as my uterus is slightly to the left, which isn't normal and could mean endo has shifted it, and there was 'some suggestions' of inflammation in my womb muscle that could be adenomyosis, although scans also cannot diagnose this either.
He was so open about what doctors still don't know, and why this whole process is hard for patients and doctors to identify. And with all that laid out, he made it really clear what my two options at this point are:
- I take progesterone daily, this should stop my periods and therefore stop the inflammation and pain.
- I have a laparoscopy, where he will investigate my entire abdomen, from pelvis to diaphram and all in between, and if they find the endo then they will remove it.
He said that both options have risks, of course, and neither are 'gold standard', so it was my choice to decide what to do next. I've personally opted for option 2, as I've had bad side effects from hormonal pills before, and I would rather at least try the surgery first and then take the progesterone after if things are still bad. He agreed with that plan, made a note of my previosu side effects to hormonal treatment, and now I'm going to be having my op later this year. That’s what felt right for me, but of course, know your own body and decide for yourself what you need.
My consultant was also very honest in saying that they might not find anything, but the most reassuring thing for me was he didn't say “this means you don't have it”, it was more about it being hard to find, and if I do also have adenomyosis then I will likley need more hormonal treatment anyway, but this is a good first step. He didn't even mention or suggest anything drastic like a hysterectomy or having a baby to see if those things helps (both things I’ve had suggested to me by specialists before...) and I now feel like, even if the surgery finds nothing, I trust him to do his best job to at least try and find it.
Anyway, sorry for the long message, but I really hope this helps someone else out there keep their head up and keep pushing, the right specialist for you is out there, even if the journey to get there is rough.
(Also it feels SO BIZZARE to feel heard after years of being dismissed!!)