After seeking help for intense pelvic pain from fibroids, Dr. LaNail Plummer was told her health was not essential. Due to the COVID-19 pandemic, her surgery was delayed by four to six months. Knowing she couldn’t endure six more months of pain, LaNail sought a second opinion from CIGC.  

In a Facebook Live discussion, LaNail joined CIGC Director of Education and Community Outreach Nilofar Kazi to emphasize the importance of not delaying life-changing surgery — even during a global pandemic — and to share her journey to a life free from fibroids. 

Watch the recorded discussion here.

 

A Family History of GYN Conditions 

By the time she was 7, LaNail knew complex GYN conditions were likely in her future. She had aunts with fibroids, cousins with fertility issues and she helped her mother through her hysterectomy recovery. Her family’s health issues were readily discussed throughout her childhood and she knew her fertility options would become more limited as she got older. 

At 23, she decided to have her first child and at 26 she conceived her second. Most of her female cousins had become infertile by their mid-20s, so she made sure she was able to have her children before her health got in the way.  

A Necessary Surgery Delayed Due to COVID-19 

About four years ago, LaNail began to feel some pelvic pain. Her wife, Maegan, suggested she get checked, and an ultrasound confirmed she had fibroids. At first, she tried to manage her symptoms with reiki, an alternative healing technique that uses energy through touch to activate the body’s natural healing processes. While LaNail said the reiki sessions may have helped a few of her fibroids, subsequent scans still showed new fibroids and, when the pain returned after a few years and her lower belly began to protrude, she knew the situation was serious enough to start looking into surgical options. 

In May of this year, LaNail’s primary care physician referred her to a surgical clinic in Annapolis, Maryland. The experience was not at all what she expected. During her ultrasound to check on her fibroids, LaNail said the technician was making worried sounds but refused to tell her what she was seeing. She told LaNail she had to wait for her follow-up appointment with the surgeon. 

Due to the COVID-19 pandemic, LaNail’s follow-up appointment needed to happen virtually. Over a telemedicine appointment, the surgeon in Annapolis delivered the news: LaNail was told she not only had fibroids, but one was as large as the size of a typical uterus and she would need a full open hysterectomy to remove them. She also had precancerous cells on her cervix that would likely develop into cancer within the next few years. The surgeon never discussed other options, including a partial hysterectomy, and did not seem to fully grasp the severity of receiving this news virtually. As a mental health professional, LaNail felt the implications of the surgeon’s recommendation keenly. 

“Because I’m a mental health therapist, I’m constantly aware of my own mental health, my own awareness, where my emotions are, where my cognitions are,” LaNail said.

“But it definitely made me think of how many women they are delivering this type of news to virtually. Who is home by themself, already dealing with isolation? Already dealing with maybe some family issues or relational issues? Already dealing with being in the midst of COVID and all the implications of that?” 

LaNail also felt the surgeon in Annapolis was not willing to engage in discussion or answer any of her questions. She wanted to know what this medical professional thought about the higher prevalence of fibroids in the African American community. She wanted to discuss alternative options to a full hysterectomy. She wanted to know what the surgeon’s rate of success was for hysterectomies. The surgeon never asked her what her expectations were or if she was finished having children. 

“I’m a mother, I’m a wife and I have obligations,” LaNail said.

“I’m a Black woman and my people have had a history of bad health care issues like being experimented on. I wanted to have a conversation with the person who was going to be removing something from my body. She just wasn’t open or equipped to do that.” 

After determining the need for surgery, the surgeon said LaNail’s hysterectomy was not classified as an essential surgery and needed to be pushed 4-6 months because of the pandemic. Without offering any type of pain relief or other solutions in the meantime, LaNail was expected to wait until November 2020 to undergo the surgery. It was time for a second opinion. 

A CIGC Love Story 

Many women don’t end up seeking a second opinion because they trust their OBGYN to give them the best option for their health. LaNail had a bad experience with her first surgeon that pushed her to find another option, but not everyone will experience that push.  

In 2017, CIGC researchers conducted a study to explore why 45% of women are electing to have open hysterectomies when there are many laparoscopic options out there, said Nilofar Kazi, CIGC’s director of education and community outreach. The data showed 38% of survey respondents underwent an open hysterectomy. Of those women, 63% indicated the type of surgery “didn’t matter” or they didn’t know about other surgical options. Almost half said they were not offered any alternatives to open hysterectomy and approximately 80% of all respondents did not feel the need to seek a second opinion. 

“In order to provide patients with the highest quality of care, it is imperative for OBGYN surgeons to offer patients all treatment options, including referral to GYN surgical specialists when appropriate,” Kazi said. “If you’re not trained to do laparoscopic minimally invasive surgery, refer your patient to your colleague who is trained. You’re working together in this.” 

LaNail’s first doctor did not refer her to a specialist, but one of LaNail’s friends had recently had a wonderful surgery experience at The Center for Innovative GYN Care and recommended Dr. Natalya Danilyants. CIGC is an ambulatory surgery center and is not attached to a hospital. Because the center is freestanding, it’s not subject to the same delay and backlog of surgeries that hospitals are needing to impose during the COVID-19 pandemic. CIGC does not treat COVID-19 patients and all medical staff and surgery patients are required to undergo screening for COVID-19 symptoms. Because CIGC is an outpatient facility, there’s no overnight stay and patients can go home directly after their surgery. 

These safety characteristics combined with the center’s minimally invasive techniques seemed almost too good to be true, but LaNail knew she owed it to herself to find out if having her surgery at CIGC was a possibility for her. She called CIGC’s patient care team the next day. 

“This is my love story,” LaNail said. “From the moment I called [CIGC], I experienced peace.” 

Within a week of that first phone call, LaNail went in for a consultation with Dr. Danilyants, who went over every available option, starting from only removing the largest fibroid to doing a partial hysterectomy and leaving the ovaries and finally to performing the full hysterectomy. Rather than the open hysterectomy discussed with her previous surgeon in Annapolis, every option Dr. Danilyants discussed with LaNail was laparoscopic. 

“Dr. D spoke to me like a human being,” LaNail said. “It was the first time in my almost 40 years where my doctor did not rush to get information. It did not feel like a checklist. It felt like a conversation. And then she told me that she could help.” 

After considering all her options, LaNail decided on a partial hysterectomy to take out her uterus and fallopian tubes while leaving her ovaries intact so she could avoid going into menopause at 39. She also opted to have her cervix removed to eliminate the possibility of cancer. Dr. Danilyants told her the surgery could be scheduled in three weeks. 

“So one doctor is telling me four to six months and another doctor is telling me three weeks,” LaNail said. “I almost cried in that room. I knew in three weeks I wasn’t going to have that same pain. I wasn’t going to have the same discomfort or the same worries and anxieties.” 

Just three weeks later, the surgery went off without a hitch. Dr. Danilyants performed the partial hysterectomy laparoscopically through two small incisions. LaNail’s wife was updated throughout the entire process and LaNail went home to recover that day. 

A Need for a Second Opinion 

During LaNail’s follow-up appointment after surgery, Dr. Danilyants told her she successfully removed her uterus along with 20 fibroids. She also found stage 2 endometriosis, which could have been causing a significant amount of the pelvic pain LaNail was experiencing. Once again, Dr. Danilyants answered all LaNail’s questions, including concerns for how to prevent her 16-year-old daughter from suffering the same pain later in life.  

“Dr. D made us feel so comfortable and she cared about us as a family,” LaNail said. “Not just me and the uterus she removed, but she cared about the implications for the future as well. I love her.” 

Many women who need a hysterectomy or another complex GYN surgery may not know there are laparoscopic options or alternatives to open surgery out there. Knowing the range of options that are possible can help you make the best decision for your health and your body.  

“Always go for a second opinion,” LaNail said. “There’s been so much innovation in the health care industry. The old way surgeries were done is not necessarily the way they’re done now. The way your mother or grandmother recovered is not necessarily going to have to be the way you recover because there are far more options now.” 

Know your options. Seek a second opinion today. 

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