Josea Browne was in her early 20s when she was first diagnosed with degenerating fibroids. A diagnosis which came as a complete surprise to her because Josea had never experienced any of the symptoms associated with this condition. Initially, it seemed manageable, and throughout the years, her physician diligently monitored their growth. Still, it wasn’t until a fall during the pandemic, almost twenty years later, that the true impact that the fibroids were having on her overall health was revealed.

Degenerative fibroids are non-cancerous tumors that grow in or on the uterus’ muscular walls and can cause several symptoms, including abnormal or heavy periods, frequent urination, severe cramping during periods, excessive fatigue, and abdominal swelling.  Apart from an extended abdomen, Josea’s fibroids grew for two decades without causing any of those issues. However, during that time, she would come to experience another severe health issue: deep vein thrombosis. This factor prompted her doctor to monitor the fibroids instead of taking the traditional surgical approach to remove them.

Josea’s health took a critical turn during the pandemic while tending to her garden. An allergic reaction to a tomato vine led to a fall, unveiling the true extent of her fibroid-related issues. Initially attributing the pain she experienced to muscular swelling from the fall, Josea soon discovered that her blood started to clot again and was placed on blood thinners to manage the dangerous condition. Taking the medication led to an exacerbation in the growth of her fibroids. “Once I went back on the blood thinners, I could literally show you photographs of what I looked like at that time, and you could see that as soon as I went back on the medication, my fibroids got big. My doctor said that when they measured them out when I got to see her after the pandemic, I looked like I was seven months pregnant.” Despite not experiencing significant pain, the pressure on her internal organs was undeniable, significantly impacting her daily life. “I didn’t have the traditional symptoms of fibroids….I didn’t feel anything. What started to happen was I couldn’t eat a lot, I couldn’t do anything because there were so many that they were pushed up in my chest.”

With the help of her doctor, Josea explored a variety of options, including seeking treatment at a fibroid clinic in Trinidad, but her fibroids’ size ruled out the outpatient procedure available there. The return of the blood clots also ruled out the traditional approach of a myomectomy because they could not determine why the clots had returned. Jose soon learned about Dr Joycelyn Brookes, an interventional radiologist renowned for his expertise in fibroid management out of the U.K. who has practising privileges at Bayview Hospital and comes to Barbados throughout the year. Dr. Brookes introduced Josea to uterine artery embolisation (UAE), a minimally invasive procedure offering hope where traditional surgical methods posed risks. UAE involves injecting small particles into the blood vessels supplying the fibroid, effectively cutting off its blood supply and causing it to shrink.

“I had the consultation on the phone with Dr. Brookes before he came, and I felt very comfortable with him. I liked the fact that this is something that he does every single day, and I especially liked that he was operating out of Bayview.”  Before the procedure, Josea had to have a pelvic MRI and an abdominal MRI because of where the fibroids were positioned. “They had to scan from my breast bone down to my pelvis. Because of the size of the fibroids, they pushed everything up. There were so many and so big that they pushed all of my internal organs up. So, all of my major organs were sitting in my chest, and there was a fibroid on the other side of my heart…they were everywhere, and they were massive. And again, I had no pain; the only thing was that I couldn’t lie on my stomach or bend down to tie my shoes because there was this thing obstruction, but I had no physical pain.”

The procedure went seamlessly. “It was easy….I went under general anaesthesia, and I just remember waking up after. I had no scarring; I can’t even tell you where he made the entry to my upper thigh; I didn’t even have a Band-Aid on it. Whatever needle they use is very thin; it’s not like a laparoscopic surgery procedure where you have a scar and can see where they went; it’s nothing like that. I never felt pain. I had slight discomfort at times but slept through the next 24 hours and went home the day after.”

Josea was extremely pleased with the results. “I felt when the fibroids in my chest dropped. One day, my stomach was high, and the next day, it was low.” With the blood supply being cut off to the fibroids, they could no longer grow. “Because I’ve had fibroids for such a long time, Dr Brookes explained that this is not a 100% procedure; he estimated that 80% would go, but because of how old and big mine were, there are some that would have tapped into a backup supply of blood, and that even though the main supply was cut off the expectation was that there would be a few left behind. So the expectations set from the beginning were very clear, and for me, the biggest thing was not having to undergo major surgery because I am at high risk of having blood clots.”  Josea was on bed rest for two weeks without any issues. Over the following months, Josea had very heavy menstrual cycles because the fibroids were passing out of her body, and during that time, her stomach became visibly flatter. The results of her follow-up MRI 6 months later were drastically improved.  “It was a very different result from the first one. You could see the reduction of them; it’s supposed to take a year plus for everything to take. Unlike a myomectomy or anything else where you go in and take them out, it doesn’t work like that. You have to give your body time to let everything work. It’s a slower process, but the beauty of it is that the procedure has changed the environment that allows the fibroids to grow; if the fibroids were to return, it would take about 20 years. Whereas with a myomectomy where you just take them out, the fibroids will grow back faster because the internal conditions are the same.”

Josea’s overall experience at Bayview was a great one. Along with the procedure’s success, the way people dealt with and spoke to her put her at complete ease. “They made it a really warm and inviting experience in which to have the procedure. There was nothing that felt ominous at all. The nurses checked on me every hour on the hour, making sure I was ok….The food was very good, too!”

Asked if she would recommend having the procedure done to anyone else Josea gave a resounding yes. “I’ve already sent three or four of my friends to get this procedure done; that’s how pleased I am with this procedure. The best thing to do is speak to Dr. Brookes because there are alternatives, and he can guide you. He has a very calming demeanor, and when he talks to you and explains what is in the procedure, you feel so at ease that nothing ruffles you. So that is a real testament to his skill and experience.”