Voices from Yale-New Haven: In a Year - Yale-New Haven Hospital




	The gift of life I am a 29-year-old woman who, about five years ago, was diagnosed with a very small benign fibroid in the broad ligament of my uterus, and until November 1999, there was nothing remarkable about it. Suddenly, within a six-month period, it grew from six to nine centimeters. During this period of growth, my then fiancé, Dr. Douglas Curtiss, was contemplating going back to his roots, Yale-New Haven Hospital, where he had done his residency in pediatrics. After making the decision to leave Stamford and move back to New Haven, we immediately started searching for an OB/GYN since we were eager to start a family. Without a doubt, we asked the greatest doctors at Yale for the best OB/GYN available in the area. As a result, we ended up at County Obstetrics and Gynecology Group, P.C., in the hands of wonderful and exceptional physicians like Dr. David Lima, Dr. Norman A. Ravsky, Dr. Scott E. Casper and Dr. Howard Simon, to name just a few. We had been somewhat informed before moving here of some of the risks of becoming pregnant with the fibroid and of having a myomectomy, which included having a hysterectomy. Consequently, with the information given to us at that time, we concluded that the best choice was to leave the fibroid alone and try to conceive. So, after getting married in September of 2000, we conceived in October that same year. After only four to five weeks, I started having excruciating abdominal pain. At that point, I went for my first visit to County OB/GYN, where I saw Dr. Ravsky. Even at that early stage, the HCG levels were elevated, although the ultrasound could not detect any fetal point (i.e. no signs of a baby.) The most remarkable finding that day was my unreachable cervix. From that point, I went back and forth to the Yale Prenatal Unit for Level II ultrasounds, and yet not only was there no presence of a fetal point, but it was hard to locate my uterus. By then my fibroid had grown to 15 centimeters and my cervix was extremely elongated. For weeks and weeks the HCG's continued to elevate with no sign of a fetal point. We finally had to face the music; this was not a normal pregnancy, and we had to do something about it. At this point, I was seeing Dr. Ravsky, Dr. Simon and Dr. Lima, getting Level II ultrasounds and HCG levels on a regular basis. After much research and phone calls to specialists, Dr. Lima initiated the use of methotrexate. Since the enormous fibroid was blocking the entrance to my uterus, making it impossible to do a D and C, we tried two more injections with the hopes that a miscarriage would take place naturally. Well, since my physical being is as stubborn and determined as my emotional and spiritual part, there was no way it would let go of this pregnancy. (I even went downhill skiing in the Laurentians.) So Dr. Lima, with his knowledge and expertise, orchestrated a team of experts, including Dr. Ayden Arici, the reproductive endocrinologist from Yale, to remove this unviable pregnancy. Just before the surgery, I got a MRI done. Well, it was so impressive that Dr. Lima would not let it out of his sight and whoever reviewed it was amazed! In brief, my cervix was fifteen centimeters long, my uterus was above my belly button, and the fibroid occupied most of my lower abdominal cavity. (What a view!) So, on February 2nd, 2001, they performed miracle number one, the removal of the suspected, and now, confirmed molar pregnancy! Not only was I just 28 years old with a large fibroid, but also I got a bonus molar pregnancy. How lucky can someone get! After the confirmation of the molar pregnancy, I was referred to the world renowned "Dr. Ernest Kohorn" from Yale who took very good care of me for months. Dr. Kohorn and Dr. Lima were on my trail making sure I got my HCG's done on time every week and done at Yale of course, since that's where the most accurate HCG's levels are done. I was also on Lupron for five months to shrink this monster fibroid for the upcoming myomectomy. In June 2001, it was official. Dr. Lima, Dr. Arici and Dr. Kohorn all agreed. It was time for miracle number two. On July 12th at Yale again, the "challenging" myomectomy was performed with astonishing success! I am now a new woman. Thanks to my wonderful husband who spent countless hours at my side through the painful and difficult days and especially night times of this past year. I am so grateful he decided to come back to Yale because we ended up with the best care you gave me. I look forward to seeing you next year with a "real" pregnancy! Finally, my case was so rare and complex that it has been accepted for publication in one of the OB-GYN journals, and it will be written by the "marvelous" Dr. Lima. Forever grateful, Lucie and Douglas Curtiss

The gift of life