By Evan Koch
Omonike Adewole’s swollen midsection dominated nearly every aspect of her life for more than a decade.
The large bump, often mistaken as a pregnancy, impacted Omonike’s energy level, self-esteem, mobility, sleep patterns and much more.
During the day, Omonike worked through pain and exhaustion to put her four children through college. The 48-year-old smiled and shrugged off jokes from coworkers about her “due date.” The tears came at night from the embarrassment, frustration and helplessness she felt.
“I was always ashamed, always crying,” Omonike said.
Omonike suffered from a condition called uterine fibroids, non-cancerous growths found in and on the uterus that resulted in massive swelling, bleeding and the 12 years of emotional and physical hardship.
She knew she needed help, but she was concerned about committing to a serious medical intervention.
“There was a lot of stress,” Omonike said. “I wasn’t sure how I could take the time to have the surgery because I have to support my family. I am the head of the household and I couldn’t afford to miss work. I was scared, too.”
A routine well visit to her family physician proved to be the tipping point.
Omonike was told she was in danger of developing life-threatening complications from the fibroids. She was referred to Bao Quoc “Core” La, MD, an OB/GYN affiliated with Women’s Memorial City at Memorial Hermann Memorial City Medical Center.
Understanding uterine fibroids
The exact cause of uterine fibroids is unknown, though there is evidence that genetics, hormone levels and an increase in certain cellular material are potential factors in their development.
Uterine fibroids are common, but many go unnoticed because they are so small. They can become increasingly problematic depending on their size and location.
In Omonike’s case, the swelling affected her appetite, causing her to feel bloated. Her enlarged uterus pressed on her bladder, resulting in frequent trips to the restroom. The social stress, physical pain, pressure and heavy menstrual bleeding Omonike experienced for months at a time was compounded by anemia.
Dr. La was especially concerned that the extreme size of Omonike’s fibroids was putting her life in danger.
“When the uterus gets to that size, it has the potential to lay on larger blood vessels like the vena cavae, two large veins that return blood to the heart,” Dr. La said. “That can lead to blood clots, which can be life-threatening.”
Allaying fear and addressing the issue
Medication and advanced ultrasound and embolization have been effective in treating uterine fibroids and sparing the uterus. But the size of Omonike’s uterus, number of uterine fibroids and potential for much more serious complications necessitated surgery. The average uterus is about the size of a pear and weighs a little more than 5 ounces. The uterine fibroids had enlarged Omonike’s uterus to 17 times that—5 pounds, 7 ounces.
Omonike dreaded the thought of surgery, spending days or weeks in the hospital recovering from a large surgical incision that was sure to scar.
“I told Dr. La that I was scared and didn’t want to die,” Omonike said. “Dr. La said he would take care of this and that I would be fine.”
Dr. La presented Omonike with a minimally invasive laparoscopic procedure as an option. Omonike’s uterine fibroids would be removed through small incisions in her abdomen and she would also be able to leave the hospital the same day of the procedure.
One large removal through two small holes
A few years ago, Omonike likely would have undergone a surgical incision from the pubic bone to mid-abdomen called a laparotomy to remove the uterine fibroids. But advancements in equipment, technology and surgical expertise have made viable options for patients, minimally invasive procedures that can reduce recovery time and risk of pain, bleeding and infection.
“A laparotomy would have taken so much longer to heal and there was higher risk of pain, infection and the wound re-opening compared to a minimally invasive laparoscopic procedure,” Dr. La said. “A laparotomy is an easier surgery to perform, but it is not nearly as convenient for the patient.”
Instead, Dr. La made two small incisions in Omonike’s abdomen and maneuvered instruments to remove the uterine fibroids in pieces through the small opening in the belly button.
The procedure took five hours and Omonike was able to return home that day.
Returning to work and life refreshed
Because of the physical requirements of Omonike’s job as a nurse assistant, Dr. La recommended she rest for six weeks before returning to work to allow her body to completely heal. But she immediately noticed at home that she was able to move around much easier than before.
There was a noticeable difference when Omonike returned to work. She could bend over to pick up items with ease and provide more support to her patients.
“I like helping people,” Omonike said. “When I have to pick things up or help someone, my back pain is gone.”
Omonike sleeps better now. For the first time in years she is able to wear clothes that fit her. Her mobility has increased and she is losing excess weight caused by the uterine fibroids.
“I put my faith in God and my trust in Dr. La,” Omonike said. “I am so happy now.”
For more information about Women’s Services at Memorial Hermann, visit https://womens.memorialhermann.org/ or call 713-222-CARE (2273).