Geek’s 2007 SIR Abstract Report 2: Post-Embolization Syndrome: Leukocytosis after Uterine Artery Embolization

This is the second in my series of geeky reports on the abstracts and posters presented at the Society of Interventional Radiology’s 32nd annual Scientific Meeting held March 1 – March 6, 2007.

Post-Embolization Syndrome: Leukocytosis after Uterine Artery Embolization

Authors:
S. Ganguli, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA · S. Faintuch · D.J. Rabkin · E.V. Lang

Purpose:
The authors wanted to determine the incidence and magnitude of leukocytosis after Uterine Artery Embolization as a component of post-embolization syndrome.

Materials:
This was a retrospective study of UAE patients who had the procedure between 2002 and 2006 at the institution of the authors. Medical records were reviewed for any evidence of infection within a week after UAE. Leukocytosis was defined as a WBC > 11,000.

Results and Conclusions:
78 patients were included in the study. There was a significant increase in WBC after UAE. Some degree of WBC increase was seen in 86% of patients. New onset of leukocytosis following UAE was observed in 21% (16/78) of patients. All patients had follow-up appointments 7 days after UAE with no evidence of infection. Three patients were readmitted on post-procedure day 4 for pain control.

The authors demonstrated that leukocytosis presents within 24 hours post-procedure in a signficant number of patients undergoing elective UAE.

Interventional radiologists and other clinicians involved in the care of these patients should expect such changes and not be alarmed for early infectious complications.

What’s the significance?

That last sentence I quoted clearly points to the importance of this study. I guess my graduate level Cell Biology classes ended up helping me out in terms of my own health. I remember studying the processes of inflammation and cell death so I knew what was involved.

Doctors must be willing to explain the implications and patients must be willing to listen and ask questions to reach an adequate level of understanding about any procedure. Ladies, you really do need to be inquisitive. Proper communication is an essential factor in good health care.

To view the abstract as it was presented at the meeting, visit this Abstract Presentation page and click Uterine Fibroid: Outcomes. There you will find a list of several abstracts including this one.

For more information:
Wikipedia entry for Leukocytosis (also, check margination and diapedesis)

Wikipedia entry for Inflammation

Let’s hear your questions or thoughts on this abstract –
Post-Embolization Syndrome: Leukocytosis after Uterine Artery Embolization.

——————–

Related Posts:
How are you feeling after your Uterine Fibroid Embolization?
Geek’s 2007 SIR Abstract Report: Comparison of Partial to Complete Uterine Fibroid Embolization

Advertisements

7 Responses to “Geek’s 2007 SIR Abstract Report 2: Post-Embolization Syndrome: Leukocytosis after Uterine Artery Embolization”

  1. Aly Fibroids Says:

    See? There’s that Bell Curve I was on. 21% is low, but I was on it in a big way! AND, Geek, have you actually counted how many posts we get from women that had mild or no adverse reactions/experiences after the UFE as opposed to those of us who did or are experiencing some really wild and surprising things? That in itself is interesting to me. Is it because most women don’t post if they are feeling well after the UFE? We need both types to post!

  2. EclecticGeek Says:

    Hey Aly!

    That’s why I rewrote my original entry to say women with good UFE experiences probably won’t post. Why would they? They had the normal 7-10 day recovery and have gone on with their lives. I had the 7-10 day recovery and am now going on with my life. The ones with positive experiences who happened to come here probably took one look at that page and decided to leave. Why would they feel comfortable enough to post there? I didn’t feel comfortable posting there and this is my blog! 😀

    I find it amazing that the IR initially turned down my case for UFE until I had two very small fibroids resected but it seems as though the cases of others were taken lock, stock, and barrel. It’s not just fibroid size. It’s also location and number. For me, it was location. The IR looked at my images and could tell which fibroids would possibly cause problems post-procedure. Those were the two that were resected. That’s why I had a great recovery. No magic. No voodoo. He is an experienced, knowledgeable doctor. Not to say that others are not but Batman really knows his stuff. I say this over and over and over. I grow tired of posting about my positive experience only to have people disregard it. People will believe what they want to believe even if statistics definitively prove them wrong.

    Aly, you are one of the few UFE ladies who actually understands what I’m trying to do here. You get the bell curve, you wander around the site, and you want to learn the science behind this. I will continue to post geeky things but I had to discontinue the UFE support page. I don’t understand why all the other pages of my blog remain balanced (even Lupron and hysterectomy pages). All but the UFE page.

    Perhaps I’ll write another UFE support page in the future. I’ve always wanted to hear all experiences (the good, the bad, and the ugly) but not at the expense of women who would disregard this procedure based on something they read on my blog.

    Thanks for your continued support!

  3. Aly Fibroids Says:

    Eclectic: I must apologize if my experience led to the removal of the UFE post. That was never my intention. I knew once my course of watching and waiting was no longer viable and it came to the point of having to deal directly with my fibroids, that all my treatment choices involved degrees of risk. Based upon the published medical reports, I chose the UFE because of the lower degrees of risk and the bell curve information.

    I am mortified to think that my own experience would dictate a woman’s choice on how to deal with her own physical health. I tend to gather all sorts of information and rely upon my own mind, body and spirit in order to proceed with what’s best for me. (There’s that different drummer I march to).

    In any event, thank you for the past seven months of helping me through my situation.

  4. EclecticGeek Says:

    Hi Aly,

    You owe me no apology. Actually, through your help and a few others, I thought the page was finally making a turn for the better. Your comments about how the procedure helped even though the recovery was long for you were great. Someone else (who is struggling now post-UFE) kept taking the time to write extremely balanced comments. Still a third who was having a rough time previously came back to shout that it was worth it. That’s what I wanted to see on that page. I wanted everyone to feel comfortable enough to post so we could have a great discussion. Those with longer recoveries could compare cases to those with shorter recoveries.

    There are many factors. Size, yes, but also location and number (me being a broken record, again). There’s also type of embolization. The first abstract I talked about compared partial UFE to complete UFE. Partial is thought to lead to fewer complications. Lots to consider.

    I thought by being a geek and talking about geeky stuff, I would attract other geeks. I’ve managed to do that but the site also attracts others. I have a pretty broad definition of geek. As long as someone is seeking knowledge and trying to understand, I consider them a geek and I attempt to help. I realize the science can be overwhelming when all anyone wants to do is feel better but that’s why I started the site. I will present the science to those who will listen and want to discuss it.

    There are some who don’t want that and will never want that. They just do not care one iota about the science behind fibroids nor wish to have any type of in-depth discussion about any topic whether it involves the mind, body, or spirit. I cannot help them. There are some who make medical decisions based just upon things they read off of the Internet from people who are not doctors or feel they can treat themselves. I cannot help them. There are some who wish to criticize doctors and think I will allow them to use my site to disrespect those trying to assist women dealing with this health issue. I cannot help them. There are some who are mentally and spiritually unprepared for life in general let alone life + fibroids. I cannot help them. There are some women with fibroids that I will never be able to help no matter how hard I try. That’s why I have to think about every woman with fibroids and do what’s best for the family as a whole.

    I am not a psychiatrist or spiritual guru or doctor. I am an inquisitive geek who keeps asking questions until I get answers. I will continue to talk about the science because that’s what I do.

    I’m still pondering over UFE support. Perhaps, I’ll start a new page or maybe I’ll open the previous one again but add editorial notes to comments along the way so everyone can see the big picture. Option two sounds like a good possibility but I’ll give it some more thought.

    Thank you for visiting and commenting over the past seven months. I’m happy I was able to be of help. Please know that what you posted was a help to others. That’s what is so disappointing to me. Some of the comments were great. I’m sure I’ll be able to come up with a solution to get things back on track.

    I hope you will continue to visit and comment and keep me updated on your “incredible shrinking uterus” (I like that name.)! 😀

  5. Cathy Says:

    Hi Eclectic and Aly,

    I was sorry to see that you discontinued your UFE support page because that’s where I found the information I was looking for. However, I do understand your reasons for doing so. I really hope though, Eclectic, that you could find a way to continue your page on post UFE. I personally think the disproportionate number of women posting bad experiences is simply because of the way UFE is presented to those about to go through the procedure. We are told that it’s easy and that you heal so quickly that those of us (the small numbers that aren’t represented practically at all) who don’t fit into the majority have no place to find info. I guess you could say that “easy” is presented as the default so that when UFE works “easily”, it’s just taken for granted. That’s why successful cases don’t usually post. It’s like individuals getting a cold and then treatment for a cold. People normally recover quickly from colds and so you would probably not see people posting about positive recoveries on getting well after taking a cold medicine. I know that this perhaps overly simplifying my explanation for disproportionate post UFE comments, but it may help explain this phenomenon.

    Thus, it is easy that this page gets “unbalanced” simply because “unusual” cases who had no places to find information, are so relieved to find your page, that they “unload” their “suffering” or bad experiences on this only existing page (that I know of). For me, that was what happened. My initial long ranting was like a person, suffering from side effects she could not understand (no one warned me previously about possible unusual side effects nor could I find anything else about my rare, unusual situation). It was a relief to find out on your site, that these unusual complications though rare is “normal” for my unusual condition. I finally understood through Aly’s unusual “case study” what was happening to myself so that I could finally put things in perspective. That was when I was finally able to get past my initial ranting and put things in perspective and write more balanced comments about my extreme and rare condition. And all factors put into perspective, I would highly recommend this procedure to other women, even with my extremely unusual prolonged post-UFE recovery period (which all considered, would still be 10 times easier than surgery!).

    Eclectic,

    I felt really bad that this page got removed, but to take it off entirely is not very balanced either.

    Unfortunately, it is true that some women do not explore all options and try to see all sides before deciding for or against UFE or any type of treatment. I hope that my comments did not scare everyone away. I was shocked with how my body was responding from the treatment because I had not found any information anywhere about possible side effects for extreme cases like mine. It was really thanks to women like Aly that I found my answers to what was going on and still inspite of my difficulty, I would recommend UFE, knowing that my extreme case of long recovery is very rare and that it is more my own problem in not seeking treatment earlier rather that UFE itself which is an amazing treatment and which more women should benefit from.

    A possible suggestion on how to keep the site balanced: (if it is technically possible) perhaps on the “leave a reply” part on post UFE experiences, a warning should be stated for those that write that they remember that they should be responsible for their comments. In other words, that although for ANY fibroid treatment, there are possible side effects, risks, and varying times of recovery and individual difficulties, that women remember to write their comments in keeping things in perspective after reading through ALL the different points of view and experiences before posting or deciding on treatment. There should be a reminder too, to women that they know that others could end up not getting necessary treatment due to unbalanced portrayal of their own experiences in relation to the greater picture of what UFE has to positively offer. Women should be warned to write both the positive and negative factors of their experience with the consequences of their comments in mind for those needing treatment.

    Eclectic, I spoke to my doctors about your page and my personal doctor too thought it would be a shame to remove such a page. Your page could even educate radiologists and post UFE follow-up doctors about unusual extreme conditions that most don’t seem to even know exist. (I am thinking of Aly’s comments about her radiologist and I believe mine too who honestly have ONLY seemed to know about “easy”, 7-12 day recovery cases because that’s all I have been able to find on the internet.) Doctors should warn women about unusual cases so that they don’t “create” this imbalance right from the outset in patients only expecting short easy recoveries though this be the great majority. I find that UFE pretreatment info in comparison to more invasive techniques is overly skewed towards easy recovery. Even if I had known the extremely low cases of unusually long recoveries, I would still have chosen UFE over other more invasive techniques. The difference is that I would not have been so scared and found myself ranting on your site due to my own relief at finding out that my post UFE symptoms were normal. If I had known ahead of time what to expect in an unusual long recovery case, my comments would have been more balanced right from the start.

    Eclectic, I would have remained extremely scared if I had not found your post UFE page. It helped me through a difficult initial period and like Aly, with time, I would have encouraged and given more and more positive comments to other women going through or thinking about having the procedure. Like Aly, your page got me through the roughest moments and I am sad that unusual cases like mine would have no place to go now nor will doctors and radiologist be able to find out about unusual cases like mine so that they can present more balanced info to possible UFE candidates. The way I see it, is that if my case were presented as one of the “worser” case scenarios, it would still seem a better and “safer” calculation and choice for me, and I would still have chosen it. As a “worse” case scenario, it’s still not worse that the “worse” case scenarios of other treatments.

    Eclectic, I really do hope that you reinstate your post UFE page with the new comments/reply warnings so that everyone can benefit from UFE and post UFE info.

    Aly, I don’t know if you check in anymore. But personally, in my case, I am committed to trying to help other women along and encourage them about getting treatment and especially UFE treatment in a future reinstatement and continuation of the UFE page.

    Eclectic, me and probably others too, having seen a comment/reply warning would probably make this a more balanced page and try to encourage women to take action on getting good treatment like UFE that they need.

    Sincerely,

    Cathy

    P.S. If this page does get reinstated, I will add too that my fibroid definitely has shrinked dramatically!

  6. Sonia Says:

    Hi Eclectic and Aly,

    Oh goodness. I had no idea you have removed all of the UFE support documentation. I just logged in to check the posts against my own one-month post UFE symptoms and they are gone! That’s very unfortunate for those of us that need it. It’s not only educational but calming in the sense that I can validate or debunk certain symptoms I’m having. Well, that’s too bad.

    I’m glad I had the surgery, because I feel much better overall.

    Sonia

  7. marion Says:

    imdue to go tomorro for uae terrified


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: