Misdiagnosis led to a world of pain

To Evita Yu (於忠林), a 29-year-old interior designer, watching the days leading up to her menstrual period used to cause her fear and to tremble. They reminded her that it would soon be time to go through days of extreme pain all over again.

"I would get really nervous and just have no desire to go to school or work," she said.

Yu had suffered this ordeal for seven years.

She consulted various doctors, underwent ultrasonography, and even tried some alternative treatments, but none of them offered any solution to her problem.

To relieve her pain at work, she would swallow four to five pain killers a day. The pain eventually became so bad that she could not even defecate normally. Eventually she was forced to check into her local hospital's emergency room to seek release from the unbearable pain. Following a doctor's advice, she decided to have part of her large intestine removed. But not even such a radical move seemed to have any effect.

Yu eventually found Liu Wei-min (劉偉民), chief of endoscopy and gynecology at Taipei Medical University Hospital, who determined that she suffered from Deep Infiltrating Endometriosis, a disease that began initially at one of Yu's ovaries and then spread to her digestive system. She improved after the cyst was removed from her ovary.

At a presentation yesterday, Yu said that she did not plan to press charges against the doctors who failed to detect the disease in the first place and even made wrong diagnoses. She said that she just wanted to make more women aware of the issue by speaking out about her experiences.

She added that she hoped this would also encourage communication between doctors.

Yu said she plans to create a Web site based on her case history.

Endometriosis normally occurs in seven to 10 percent of the female population and in up to 50 percent of premenopausal women.

Liu said that the disease is characterized by symptoms including chronic period and pelvic pain, bloody urine, constipation and diarrhea. When the condition gets worse, it leads to complications in the intestines, bladder, umbilical cord and even the brain.

Women with a family history of endometriosis are 10 times more likely than others to have the disease.

He added that Yu's case was probably the worst he had seen.

Liu said that ultrasonography, which most doctors use to detect the disease, is not always effective in making a diagnosis.

"Something must be wrong when one chronically suffers from period pain, accompanied by other abnormal symptoms," Liu said.

"Even if the ultrasound scan did not find any tumor, it does not mean there is nothing wrong with the patient," he said.

Sometimes cysts grow in blind spots where they will not be detected by ultrasound scans.

Based on statistics from the hospital's obstetrics and gynecology division over the past three years, 743 patients have been diagnosed with endometriosis, of which 25 percent suffered the rarer form.