Ooph & surgical report?

[Chelee]

A while ago I had an ooph so I wouldn't have to take Zoladex. Its been since April 5th, 07 that I had the surgery. Since then I've had my FSH & Estradiol checked several times. I am still reading in peri-meno range. I am still getting the Zoladex implants and my most recent results of last week was, FSH 2.5, and Estradiol 28. (This makes no sense?) My onc said she doesn't know what to do with me?

So I ran around and got my medical reports from my GYN and the hospital records. I was told several times by my GYN we would be removing BOTH ovaries, falliopian tubes and a cyst on one ovary. Both medical reports I dug up says "Operative Laparoscopic Bilateral Salpingo-oophorectomy".

I've read my GYN's office reports and the hospital/surgical report and no where does it mention that he removed my fallopian tubes? It mentions the ovaries several times...but that's it. The detailed surgical report SHOULD of mentioned the tubes I would think? Now I am wondering if he just removed my ovaries and not the tubes like we discussed? If that's the case could this be a reason I am still reading peri-meno on FSH and estradiol?

Chelee

[Jean]

Chelee,
Since your report states, bilateral salpingo -that means the overies and the tubes are removed. Does the body respond so soon after this surgery
with lower estrogen levels? Have you discussed this with your dr? You mention that your had an estradiol level of 28, a 10-20 /pg/mi estradiol
level is normal for a postmenopausal woman. You are not that high...
did your dr. think 28 was still too high? 28 should not be considered too high...plus your body may still be adjusting. I am sure there are others who know much more on this topic. Your FSH is low, but this test is far from foolproof, you may have to be tested yet again. I am no expert on this subject and know just enought to understand the basic points.
Since you had the surgery, and getting the shots, your body just may need additonal time to adjust hormone levels. Have you seen a specialist
such as an endocrinologist?

Hormone levels are tricky - and your body has been through so much.
Hopefully there will be an explanation to the FSH level.

Kind Regards,
Jean

[Chelee]

Hi Jean, I do know Bilateral Salpingo-ooph means the ovaries and tubes. But I can't help but think it would be mentioned in the surgical report? It is a very detailed report...nothing was left out it would seem? But nothing about tubes? I find that strange? I'm just grasping for straws here. I've been up to my 2nd opinion onc over this issue MONTHS ago. She talked to 3 doc's up there and they all agreed I needed to see an endocrinologist and have a battery of tests run. I've done that...everything checks out ok.

Its been SIX months since my ooph...even if it took a while for the estrogen to taper down...it certainly wouldn't take this long. All my doctors agree. But my onc just says she doesn't know what to do with me and sent me on my way. A month or so back my FSH was finally looking like it was going up...it made it to 13.5. But now AFTER my 2nd implant of zoladex its back down to 2.5. My estradiol was in a good range for a while...it was between 6 and 9...but now its climbed to 28 and still rising. (My onc likes my estradiol to be under 20...so do I at the bare minimum.) I've had no side affects of menopause at all? You would think I would after an ooph and two months of zoladex? I've had my FSH and estradiol ran five times now. So does anyone know if my tubes were NOT removed if this could cause enough estrogen to have my FSH and estradiol showing that I'm still peri-meno? I really need some help with this please. Thanks so much for your reply Jean. :)

Chelee

[Becky]

A salpingo oophorectomy means tubes and ovaries. If it did not say salpingo then you could question it.

At the lab (Quest) my onc uses, they say estradiol less than 32 pg/mi is postmenopausal. If we want a more detailed and absolute number, it is sent out (I did this before and then 6 weeks after getting my estring to ensure it did not affect my systemic level of estrogen).

I would say you are postmenopausal but you are using Zoladex so this may be the reason.

[Chelee]

Becky, My labs reference range number for estradiol is 27 or less. But regardless of that my concern is my estradiol was running between 6 & 9, which is good. :) Now its up to 28 & climbing as I mentioned. I figure my next lab will be even higher yet. (Even my onc said it should not be going up at this point.) I should be strongly meno-pausal after a ooph & zoladex?

What's your thoughts on my FSH? Its been staying really low...the lowest was my most recent results of 2.5. Reference range at my center for FSH to be menopausal would be between 23.0-116.3. How can I be menopausal if my FSH is 2.5 and my estradiol continues to climb? I'm sorry but I just don't get this? Thanks for trying to help me.

Chelee

[Becky]

Dear Chelee

Have your gyne or onc do an ultrasound of your uterus. Sometimes there can be benign tumors (of the endometrium) that are aromatase secretors - so much so that an AI cannot inhibit it so your adrenals and fat will produce estrogen. Make sure - this could be the culprit (or not). Just a thought.

Hugs to you

[Chelee]

Hi Becky, In this surgical report my GYN says due to my recent history of bc I wanted exploritory surgery. (This was never discussed?) I did tell him I was concerned about the mass that showed on PET/CT on my right ovary since I was DX with bc. But we never talked about exploratory surgery? However I was worried the mass might be cancer. So maybe that's why he words it that way.

So in the surgical report it says he looked at my uterus. The only thing I see that he mentioned is something about "Normal appearing uterus with small myomas noted". I need to look that up...first time I read that? Not sure what "myomas" means or is? Time to google. I'm still curious if he didn't remove the tubes if that could explain my FSH & estradiol issue? I could see about getting an "US"...but if he looked at my uterus during the procedure wouldn't that be good enough? (Seems I'm just an estrogen machine no matter what they do.)

Chelee

[Becky]

Sapingo means that the tubes were removed. In an oophorectomy, it would be unethical not to also remove the tubes. It would be an extremely rare occurance for a doctor to want to leave them behind.

[Chelee]

Becky, This was only my 2nd surgical report I've read so I just *assumed* since he mentioned slicing & dicing my ovaries...he would of mentioned removing the tubes to. (But that must go without saying.)

This GYN is new to me. He knew my bc history being her2 pos and he was ONLY going to go in and remove the right ovary with the cyst on it. I told him at that point I wanted both removed with my history. So since he was orignally *only* going to remove the ONE ovary...it worried me that he might of only took the two ovaries and not the tubes like we discussed? Especially when my onc and my 2nd opinion onc keep asking me if he removed everything like he said? (How would I know...I can only go by what he said and the surgical report.) I've had alot of things happen to me that shouldn't of since this started...no one would believe it. So it would not surprise me if he only took the ovaries. If it would happen to anyone...it WOULD be me. Thanks a million Becky.

Chelee