Have to make a decision - fatty liver disease, perimenopause & hysterectomy

I have been told by the doctors I have to make a decision on whether to have a total hysterectomy or not. They said that given my symptoms it would be recommended to have one but also that it would be better for them to do it when I completed menopause...but they also said that my blood glucose levels are likely being effected by all the hormones fluctuating and dropping. Last time I had spikes like this having was just two or three years ago, when I had covid and all the jabs, which pretty much coincided with all my perimenopause symptoms starting up. Took a long time figuring out what was going on because long covid was a possibility for most of my early peri symptoms, and also because my main GP kept telling me my suddenly very heavy periods where perfectly normal. After two years I finally had a consult with a gynaecologist and turns out it was not perfectly normal. They did a CT scan and ultrasounds which showed a lot of fibroids, at least one that is very big, and two very large cysts on my ovaries (one is 10cm by 9cm) and they didn't mention it but I read my own scans and it said I have a fatty liver and a a spot on my liver that might be a hemangioma but needs to be checked.

They wanted to operate in July but needed to wait for me to try and control my blood sugar better, after living here for ten years I was told there was a diabetic clinic I should have been referred to (by the same GP who told me my periods being so heavy was perfectly normal ) so now I have had check ups, I own my own blood pressure monitor, a fitbit, and I'm trying my best not to wallow in self pity. I have my next set of blood and urine tests from the docs at the beginning of December and follow ups with the diabetic clinic the week after. I have to talk to them about my liver because that's apparently tied to the diabetes, and there is no way I'm going to leave that with my GP given my experience with them the last couple of years.

Has anyone had to deal with *any* of these things? Anyone have any notes on how to deal with things during recovery from surgery, especially if there is anything I can do to help make my recovery from surgery easier / faster (they're saying 16 weeks minimum right now). Anyone had to deal with fatty liver disease? I barely drink any alcohol but I've been gaining weight since I hit perimenopause and finding it *really* hard to lose it, I've had a lot of injuries that have made exercising hard, I'm not over-eating or eating badly but I've started feeling hungry a lot so dieting doesn't seem that feasible (even when I was dieting I wasn't losing weight anyway) so I'm not sure what is the best way forwards on any of this.

I'd rather not have to have the operation at all but the other options don't sound that much better and a second opinion agreed that they almost certainly would need to operate to do the total hysterectomy eventually if I decide to put it off for now, I have no idea what my decision will be, everything is just a little much right now.

WJK said:

Hello. I had a total hysterectomy during the summer (robotics). Signed off for 4 weeks and started to walk after a week and did increase a little each day. Probably diabetics related but one of my incisions did not heal so under the practice nurse got about 4 weeks to be dressed. I did not notice any change to my blood sugars

Click to expand...

4 weeks sounds a lot more manageable than 16 weeks, I wonder why they're telling me such a long recovery time.

Thing is I've been on a low carb diet for a while, I went lower again recently and back on the Metformin since my blood sugars were considered bad...but in November with no Metformin and less than adequate exercise because of injuries my test results were all fine, my estimated average blood glucose was 7.3, liver function was fine, cholesterol levels were all within normal range. I have a low fat, low carb diet, even with all my allergies I'd been managing without the drugs.

Now I'm back on the drugs and my digestive sytem hates me again...but my blood sugars are better. I'm trying to exercise more but it's hard work getting back into it as a few months without being able to walk really took it out of me.

Having more protein seems to spike my blood glucose but later after the meal, but I'll keep trying this even lower carb thing and see if that helps.

@Pipp @JoKalsbeek

I was originally diagnosed with PCOS when I was first diagnosed with T2 diabetes, the large cysts they reckon are something to do with perimenopause.

I only just found out when talking to these gynaecologists that you can be diagnosed with PCOS without having any cysts, which is not what I was expecting at all, I was asking whether maybe I was misdiagnosed since they didn't see multiple cysts on the scan which is what I had assumed would be the case. I hadn't really researched it when I was diagnosed because I was given a lot of information from the NHS and was in a major depressive episode at the time when they finally figured it out.

Anyway, one of my large cysts is 10cm by 9 cm and the other around 5cm, and either one may still be growing. So that seems likely to be the reason for the extended recovery time estimate, thanks Pipp for that information. It's also a big reason that I think I might have to go through with the op.

When I told the consultant I would be doing my research before making my decision he told me not to, I think they're scared of doctor google but my degree is in molecular biology and I'll be going to science journals, because that's what I do, but I also wanted to pick the brains of people who may have experienced the same because that's also really helpful...and things like large cysts needing to be removed in a different way that may take more time to recover isn't something I've found but now I know I can tailor my searches a bit more.

They have started talking about metabolic syndrome but all my previous blood tests have been fine. In fact if I didn't push for the gynae appointment, and didn't tell them I was told I had two tubes from one kidney but I didn't know which one, they may not have done the CT scan...and then if I didn't read my own CT scan I wouldn't know about the NAFLD because no doctor mentioned it until I asked them to explain what I was seeing and what the radiologists report meant (I'd already looked it up but didn't want to tell them that given how the consultant reacted to me saying I wanted to do research about my options).

I feel like the main thing I've learnt through this is that you really do have to be your own advocate here, and maybe that's the same anywhere.