Choosing Her Path

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Last April, Amanda Portoghese, 25, of Winter Park, woke at 2 am with severe abdominal pain. Three hours later it happened again, and this time she was finding it difficult to breathe. Her fiance took her to AdventHealth Orlando's emergency department at the insistence of her father, who is a general surgeon there.

A CT scan revealed Amanda was bleeding from a cyst that had ruptured a blood vessel on her right ovary a result of her ongoing battle with endometriosis. Ashley Hill, MD gynecologist who practices at AdventHealth Orlando, performed emergency laparoscopic surgery to save Amanda's ovary and stop the bleeding.

I've had painful, irregular cycles since I was a teenager and have been on and off birth control to manage it, Amanda explains. Before, I joked about not wanting kids, but when I thought I might lose my ovary and my chance of having kids, I realized I want a family.

What Causes Endometriosis?

Endometriosis occurs when tissue that lines the uterus typically shed during a menstrual cycle grows outside the uterus. It commonly involves the ovaries, bowel or tissue lining the pelvis. Symptoms include severe pelvic pain, painful intercourse, extreme fatigue and disabling cramps. It's also the most prominent cause of infertility.

It can be a difficult condition to treat, says Dr. Hill. Depending on where a patient is in life and if she's had children, treatment includes birth control pills or other hormones, surgery, and in extreme cases, hysterectomy.

Amanda's Treatment Success:

Because of her age and overall health, Amanda required only a two-night hospital stay, but it took nearly three months to recover fully because of the blood she'd lost. After surgery, Dr. Hill prescribed birth control pills to give her ovaries time to heal. But after gaining weight, Amanda stopped taking the pills. A month later, she developed another cyst. Dr. Hill gave her three options to help control her endometriosis: remove her ovaries, freeze her eggs and remove her ovaries, or continue with birth control until she's ready to have kids. Engaged to be married in November, Amanda opted for option three until she and her fiance are ready to start a family.

I'm thankful to Dr. Hill and AdventHealth for the level of care they gave me, Amanda says. My symptoms are under control. I've recently lost weight and begun an exercise regimen, and I'm excited about my future.

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