Resolve To Know Your “Story”

by Darline Turner Lee, Physician Assistant, ACSM Exercise Specialist

Article Last Reviewed: Sept. 9, 2006

As this article goes to press, I am having a myomectomy. I have uterine fibroids and I am unlikely to successfully carry a pregnancy to term without their removal. I had a miscarriage and it is a devastating experience I don’t want to repeat. After doing some research, I am following the advice of my physicians and having the tumors removed. But this article is not about my fibroids. It is about health—knowing one’s health history and the history of one’s family members. It is also about taking steps to prevent ill health; to slow the propagation and lessen the severity of illnesses that are present in one’s family .

To my knowledge, there is not much that I could have done to prevent my uterine fibroids from developing. My maternal great grandmother died from uterine cancer. While fibroids are not known to become cancerous, she had been told when she had my grandmother that there was something “suspicious” and to come back for evaluation. She never went back. That was September of 1923. She died in 1972 with such extensive metastasis that nothing could be done for her. Did her fibroids become cancerous? Current medical literature states that fibroids only become cancerous 0.1% of the time. In my great grandmother’s case, we will never know the cause of her cancer or if it could have been treated. She never went back to the doctor after my grandmother was born except for her final diagnosis some 50
Years later. My mother had uterine fibroids and elected to have a hysterectomy at age 52 for relief of symptoms. I have 2 older sisters and the younger of the two also has fibroids. Neither my grandmother nor my eldest sister was afflicted.

What can one do in this situation? It seems genetically random without an identifiable pattern. Is there something that I could have done to prevent these growths? Again, current medical knowledge is unable to identify specific causes of uterine fibroids. However, a few facts are known. Anywhere from 40-80% of all women will have uterine fibroids detected on routine exam. Of that number, 25% of Caucasian women and as many as 60% of African American women will experience symptoms of discomfort and bleeding severe enough to warrant intervention. (I am an African American female.) Traditional Oriental Medicine advocates a diet high in fruits, vegetables and grains and avoidance of red meat, animal proteins, dairy, refined sugar and caffeine. There are also herbal preparations that have been used to relieve symptoms and in some cases reduce the size of the tumors. Holistic practitioners believe that a woman’s stress level plays a major role in the exacerbation of symptoms. Women with fibroids are encouraged to engage in stress management techniques such as yoga, Tai Chi, bodywork and regular physical exercise.

Treatment ranges from conservative watch and wait to surgical removal, with combinations of therapies in between. I strongly advocate establishing a solid relationship with a healthcare provider who has extensive experience in diagnosing and treating uterine fibroids. He/She should work with you to find the optimum treatment plan for your situation. You should be able to talk with this person, consult with him/her and have all of your questions answered without fear or intimidation.

Despite my situation, I still consider myself blessed. I have a really good healthcare team and I feel well advised and comfortable with my treatment plan. I am in very good health, follow a near vegetarian diet (I eat fish and some chicken, little dairy and supplement with a multivitamin and calcium) and exercise regularly. I have regular physical exams and when there is an abnormality, it is quickly detected and treated.

This year, rather than make a lot of resolutions, I resolve to keep one commitment—to keep myself as healthy as possible. It is time to move away from the superfluous; i.e. trying to regain the shape and appearance I had in my 20’s. I want to be healthy, to feel good and to be able to do the activities that give me joy and a sense of contribution. Everyone is going to grow old. The question we all have to ask ourselves is “How am I going to live in those golden years?” Do you want to be robust, agile and independent? Or are you content to let life happen to you, eating randomly, behaving recklessly, not exercising and not taking any responsibility for your future?

I hope to live up to the very last moments of my life. Proper diet and exercise will be critical in order for me to reach my goal. The rest of my family history is remarkable for diabetes in two of four grandparents (my maternal grandmother and paternal grandfather, both sides contribute here!), heart disease, hypertension and strokes. I have observed my relatives who watch their weight, exercise, remain active and have regular preventive care live into the 80’s. Those that tend to be overweight, sedentary, and engage in risky behaviors (smoking, drinking, etc.) die in the 60’s and 70’s (or sooner). I don’t know the exact number of my days. For those I am given, I intend to live them fully, functioning as intact as possible. I can’t change my genes but I can do the best with what I’ve been given.