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Suggest Treatment For Postmenopausal Bleeding
Question: I started with postmenopausal bleeding two yrs. ago, long story short, I am now at a urogyn who is doing a hysterectomy, pelvic prolapse and bladder. Had numerous biops. ultrasounds vaginally, d&C and evidently no gyn thought I needed a hysto. bad mistake, ANYWAY, during the surgery I am most concerned about aspiration pneumonia bc I have had it five times, during colonoscopy, endoscopes, etc. MY QUESTION is who do I contact, meaning what Dr. to discuss the pneumonia with. My mother died from aspiration pneu. and a friend at work just had a hysto. and died from aspiration. Do I die from uterine cancer which I am so scared this is or do I die from aspiration pneumonia. I am scared to death, bc I know of just being put out for 15 mins. for colonoscopy how sick I always got from pneumonia and now they say this operation will be 3 hrs.
Brief Answer:
Additional precautions to prevent aspiration should be taken as follows
Detailed Answer:
Hello and Welcome
I appreciate your concern
Based on your history and age, a hysterectomy is required as the risk of an indeterminate uterine cancer at this age is more and the benefits outweigh the risks in terms of its removal as endometrial carcinoma is most common above 65 years of age.
Every surgery poses some risks, however your specific concern can be addressed by taking a few precautions.
1) PPIs, Antibiotics and Anti emetics started pre operatively 2 days before.
2) You should strictly observe the NBM ( Nil By Mouth ) time frame advised by your doctor and abstain from spicy food or huge meals in the week up to the operation
3) You should get vaccinated for Pneumococcal pneumonia ( Synflorix or prevenar )and Influenza ( annual flu shot ), as that will prevent superimposed infections also causing pneumonia.
4) Recent studies found that treatment of patients with gastrostomy tubes with mosapride citrate (a gastroprokinetic agent) was associated with a lower risk of aspiration pneumonia in comparison to both placebo and proton pump inhibitors.
In short , I would advise in favor of the surgery if the above precautions are observed. You may discuss these options with your doctor and then come to a final conclusion.
Let me know if you have any query
wishing you best of health
thanks
Additional precautions to prevent aspiration should be taken as follows
Detailed Answer:
Hello and Welcome
I appreciate your concern
Based on your history and age, a hysterectomy is required as the risk of an indeterminate uterine cancer at this age is more and the benefits outweigh the risks in terms of its removal as endometrial carcinoma is most common above 65 years of age.
Every surgery poses some risks, however your specific concern can be addressed by taking a few precautions.
1) PPIs, Antibiotics and Anti emetics started pre operatively 2 days before.
2) You should strictly observe the NBM ( Nil By Mouth ) time frame advised by your doctor and abstain from spicy food or huge meals in the week up to the operation
3) You should get vaccinated for Pneumococcal pneumonia ( Synflorix or prevenar )and Influenza ( annual flu shot ), as that will prevent superimposed infections also causing pneumonia.
4) Recent studies found that treatment of patients with gastrostomy tubes with mosapride citrate (a gastroprokinetic agent) was associated with a lower risk of aspiration pneumonia in comparison to both placebo and proton pump inhibitors.
In short , I would advise in favor of the surgery if the above precautions are observed. You may discuss these options with your doctor and then come to a final conclusion.
Let me know if you have any query
wishing you best of health
thanks
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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