My husband and I decided when we got married in May 2012 that after a year of marriage, we would begin trying to have a baby. When May 2013 finally arrived, we began making the necessary preparations for conception. This, for me, included making sure that I was in good health. I began taking prenatal vitamins and scheduled an appointment to do my annual cervical smear to check for cervical cancer. At the appointment in June 2013, I told my doctor about the small lump that I had been feeling for 3 months, located on the lower left side of my pelvis. I told her that I would like for this to be investigated, and she ordered an ultrasound for me.
You see, around March 2013, I had started noticing a small lump on the lower left side of my pelvis, which was usually more obvious when I was lying down flat on the bed. The lump caused no pain and was not sore, but I worried that it was some sort of cancer. Out of fear, I chose to believe that it may be a benign ovarian cyst and I decided to delay going to the doctor to investigate it until my next cervical smear appointment.
When I attended the ultrasound appointment on 4th July 2013, the technician had a very concerned look on her face as she was performing the scan, and so I asked her what she was seeing. She informed me that I had not one, but several fibroids located in various parts of my uterus. I was in shock! At a follow-up appointment with my GP a few days later, she reiterated what the technician had found. I had about 4-5 fibroids in my uterus, with the largest two measuring about 7cm in diameter. The bulge that I had been feeling on the lower left side of my belly was indeed one of these large fibroids. She indicated that although I had large fibroids which may cause me to have fertility issues, my uterine wall was “unremarkable” and therefore I am still likely to be able to conceive with the fibroids. These last words were comforting. She referred me to a gynaecologist for follow-up.
For many days, I remained in shock about my fibroid diagnosis, I worried about whether I could have kids, and I spent many hours online reading about fibroids and remedies. My shock came as a result of believing all along that I was in great gynaecologic health. You see, I have always been a health-conscious person who ate very healthily and did my pap smears annually. In addition, In the USA (from where I moved the previous year),it was routine for doctors to do a pelvic exam when doing a cervical smear, and this involved using their hands to check for any changes in size and shape of reproductive organs. Abnormal growths can often be detected this way initially. I wondered why my fibroids hadn’t been detected in these annual pelvic exams. Surely, the fibroids did not appear within less than a year, I thought. In addition, I had not experienced any of the symptoms often associated with fibroids including heavy periods and pelvic and low back pain.
When I visited the gynaecologist at the end of July 2013, she informed me of options available to me for dealing with the fibroids, including removing them surgically prior to trying to conceive. Based on my medical history and the diagnostic ultrasound results, the gynaecologist advised me that the best course of action would be to try to conceive with fibroids intact, and then revisiting the idea of having surgery to remove the fibroids if I did not get pregnant after six months of trying. The concern was that removing the fibroids surgically may pose more of an infertility risk than the fibroids themselves, as the surgery is in effect a major operation to the uterus. I agreed with this approach wholeheartedly as I did not want the risks associated with surgery.
Much to my pleasant surprise, just one month later, in August 2013, I became pregnant (a positive pregnancy test in September 2013 revealed this)! When I got pregnant, I was informed of possible risks that fibroids could pose to my pregnancy, including bleeding, severe pain caused by the fibroids, a higher chance of miscarriage, restriction of the baby’s growth, and increased risk of premature labour. In addition, I was informed that the fibroids would likely grow in size due to pregnancy hormones. Luckily, my pregnancy progressed very smoothly with the exception of the fibroids growing slightly in size and one episode of severe fibroids-related pain at 14 weeks gestation which lasted for two weeks and which was managed with painkillers. In May 2013, I delivered healthy twin boys!
In the end, I am glad that I chose not to remove the fibroids immediately. I am now going to continue monitoring the growth and symptoms of the fibroids over the next few months and years, and will decide at a later time whether to remove them or leave them alone. I am likely to leave them alone as long as they continue to give me no symptoms, mainly because fibroids tend to regrow, and the risk of this occurring is much greater in Blacks. I learned a great deal about fibroids only after my diagnosis. I wish I had known more before. Sadly, I had not paid much attention to the disease before despite the fact that an older sister suffered with it. I had not realized how prevalent the disease was and did not realize that it affects Black women more than women of other racial/ethnic groups. I wish more women would talk about it, and I am now committed to speaking up as much as possible to raise awareness. I would advise other women to become more educated about fibroids and to learn whether they have a family history of it. Where there is known family history, a woman can then be more empowered to recognize symptoms and to make a decision about when to have children (if she desires to do so), as fibroids tend to develop in later years so delaying conception may not be wise for some. Fortunately, fibroids are not life-threatening and it is possible to conceive and have a healthy baby with it.
Pictured, Dr. Wheatley at 35 weeks pregnant.
Nkemdiri Wheatley is a public health researcher whose work has focused mainly on understanding the social and behavioural factors that lead to health conditions such as cancer, obesity and sexually transmitted infections. She is also interested in racial and socioeconomic inequalities in health outcomes, and has participated in developing and evaluating community-based health programmes meant to address these issues.