Covering health care can get depressing. Sickness, medical bills, insurance premiums, death. For that matter, reading about it can get depressing, too. As a modest antidote to all the downers, today CommonHealth is launching an occasional feature called Happy Endings, showcasing medical stories that went very right.
You know you’re in trouble when you get your MRI scans back and your doctor uses words like “huge” and “gigantic.”
“This is not getting off to a good start,” Sophia Watson recalls thinking.
An attorney who lives on Beacon Hill, Sophia had long been aware that she had fibroids, the benign tumors of the uterus that grow in more than half of all women, often causing pain and heavy menstrual bleeding. She had reason to suspect that hers were large; feelings of pressure, even a visible bulge in her lower abdomen when she was lying down. But it wasn’t an issue — until she had trouble getting pregnant at 35.
A previous doctor had played down the fibroids as a potential problem, but Sophia and her husband, David, decided to seek a second opinion at Massachusetts General Hospital. “The radiologist wrote that you have a giant fibroid,” the Mass. General doctor said, openly taken aback by the dramatic language. (Radiologists tend to be hard to impress.) He recommended removing the tumor with traditional surgery, involving a long incision across her abdomen, soon. The fibroid was so big, he said, that it could, in fact, be cancerous.
“I went from infertility to cancer in like four seconds,” Sophia said. “I was like, ‘Get it out, get it out, I don’t care what you do!’”
To the best of their knowledge, her fibroid was the largest that was ever removed using robotic surgery and followed by a spontaneous conception and a live birth. (Actually, two conceptions: Sophia is now pregnant again.)
David, a financial analyst, reacted differently. He follows the biotech industry, and knew from his own research about Intuitive Surgical, Inc., the company that makes the da Vinci robotic surgical system. He knew some hospitals were using it for uterine surgery. When he asked, the doctor said Mass. General did not, but Brigham & Women’s did. Could it be used on such a gigantic fibroid? The doctor did not know.
At the Brigham, Sophia and David met with Dr. Serene Srouji, who was about to go on maternity leave — a good omen, Sophia thought. Yes, Dr. Srouji said, looking at Sophia’s MRI; this is probably why you’re not getting pregnant.
Sophia felt a welcome wash of relief. At least now, her problem seemed fixable, even though she knew that “what was to follow was really intense surgery,” with all the usual risks of a major — though laparoscopic — operation under general anesthesia.
Dr. Antonio Gargiulo, Dr. Srouji’s partner and the director of robotic surgery at the Brigham’s Center for Infertility and Reproductive Surgery, agreed to operate. “It’s a very large fibroid,” he allowed, but “we can do it.”
Just how large was it? For the strong of stomach, the video of Sophia’s March, 2009 operation — with “giant myomectomy” in the title — is here. And below is an instructional video on the surgery, enlivened by music from Boston-area piano rocker Matthew Ebel. In summary: Sophia is a slight woman, and the fibroid was, yes, the size of a cantaloupe.
He may perform robotic surgery, but Dr. Antonio Gargiulo is the opposite of robotic in manner. He exudes Italian warmth: the rolling speech, the high enthusiasm, the easy humor. Even the attitude toward mothers: He told Sophia to warn her family members that when he met with them right after the surgery, he would address himself mainly to her mother. “I always look at the mother,” she recalls him saying, “because it’s the mother who’s struggling the most at the moment.” And indeed, Sophia said, her mother prayed non-stop all five hours of her operation. Continue reading