The Drs IV League: Heavy Uterine Bleeding & Knee Pain
The Doctors gathered some of the top doctors and surgeons to tackle issues in medicine in their segment called IV League. For this episode, the doctors worked together on a case involving Joan, a 44-year-old single mother of three who works as an immigration attorney. She’s had chronic severe bleeding from her uterus, causing dizziness. She said she has periods that will last two or three months and the condition has gotten worse in the last year, to the point where she even fainted in court. She’s become severely anemic and has fallen multiple times, resulting in a torn patellar tendon and knee damage.
Dr Thais Aliabadi and Dr Derek Dee were called in to look at Joan’s case. They shared that Joan’s hemoglobin is 9, which is pretty low because normal hemoglobin for her age is around 12. Dr Aliabadi shared that she’s lost about a third of her red blood cells. Dr Kerry Assil said the hemorrhaging needs to stop now, or else it could become life-threatening. She was scheduled for surgery, but then two days before the surgery she fell and dislocated her knee.
She has a dislocated kneecap with a partially torn patellar tendon. The ligament that holds the patella stable needs to be repaired, as well as the patellar tendon. Dr Aliabadi explained that she’s going to do endometrial ablation which basically removes the lining of the uterus to stop the bleeding immediately. Both procedures cannot be done at the same time because of her anemia. They have to get her blood levels back up before they can repair her knee.
The Doctors: Surgery To Fix Heavy Uterine Bleeding
The procedure that Joan was undergoing for her uterus is called hydrothermal ablation, which is the removal of the inner lining of the uterus. Her hemoglobin was at an 8, and if she dropped below a 7 they would have to consider a blood transfusion. About two weeks after undergoing the ablation, Joan then returned to the hospital with a higher hemoglobin level, in order to have her knee repaired. Dr Dee even showed a piece of her knee cap that had broken off when she dislocated it.
The Drs TV: What Is Hydrothermal Ablation?
As Dr Travis Stork said, Joan’s case is a perfect example of how important teamwork is in medicine. Dr Aliabadi explained that she evaluated the lining of the uterus and then did a scraping to remove the polyps that covered the lining. After removing the polyps, she did the ablation by dilating the cervix and entering the device into the uterine cavity and filling it with saline. At the onset of ablation, the fluid is heated to 80 degrees Celsius and the fluid circulates for 10 minutes, removing the inner lining of the uterus, called the endometrium. She said 53% of patients completely stop bleeding after the procedure and of the ones that continue bleeding, 94% go back to having normal or lighter cycles.
The Doctors: Patella Dislocation Repair
Dr Dee explained that the kneecap is a very unstable part of the knee, and there’s a ligament that allows for lateral movement of the kneecap. When she dislocated it, that tendon tore, so they reconstructed it with a graft from a tissue bank. When she dislocated it, the cartilage underneath the kneecap was damaged, so they were able to use a graft of minced up cartilage to heal that area.
Joan joined The Doctors via PolyCom and shared that she stopped bleeding the day after surgery and feel great. She said her quality of life has greatly improved. She can also walk with a walker, although she’s not able to drive yet. She said she’s on her way to recovery and is happy with the results.