Finding the Right Physician is Life-Changing for Patient

Dr. Barbara O'Connell

View the 2009 Obstetrics and Gynecology Annual Report

Physicians are taught to recognize the obvious. In medical school students are told, "When you hear hoof beats think horses, not zebras." That training serves most patients well most of the time. Common symptoms often add up to common conditions. Often, but not always.


Sometimes finding the right diagnosis takes the right physician - one who is willing to find the zebra among the horses. This was the case for Alicia.


Alicia Mitchell (not her real name) had an uncommon medical condition that presented with symptoms similar to several common disorders.


Over a three-year period she saw a series of gynecological specialists, but her condition persisted and she was unable to get relief for her pain. Then, in 2005, Alicia moved to Madison and met Barbara O'Connell, MD, a UW Health physician specializing in gynecology and gynecologic surgery. For Alicia, finding the right physician was the start of a medical journey that would ultimately change her life.


"When we moved to Madison, my ObGyn referred me to Dr. O'Connell," says Alicia. "I was immediately comfortable with her. Her compassion was evident. She clearly cared about what I was going through and was committed to finding a solution."


Alicia has a condition known as Vulvar Vestibulitis Syndrome (VVS), or as recently redefined, Localized Provoked Vulvar Pain. This is a pain condition involving the vestibular glands, which are located at the opening of the vagina. It is often characterized by sharp or burning pain when inserting a tampon or with sexual intercourse. It can make sexual relations extremely painful and limiting.


"The first step is to actually diagnose the condition," says Dr. O'Connell.


Providing a Definitive Diagnosis


Many women are not diagnosed correctly and simply suffer with the pain. Some of the symptoms, such as burning, are common to other disorders. Patients may be misdiagnosed initially or treated for the wrong thing.


"Listening to the patient's history of symptoms and conducting a thorough examination can help provide a definitive diagnosis," says Dr. O'Connell. Once defined, there are a number of options available to the patient, including physical therapy and medications.


Dr. O'Connell's approach was just what Alicia needed. Surgical therapy is an option if the medical therapies are not helpful. In Alicia's situation, the medical treatments provided only minimal relief of her pain; therefore surgery was scheduled.


"The success of the surgery is due in part to selecting the right patient," says Dr. O'Connell, "and Alicia was a good candidate."


The procedure included an overnight stay in the hospital.


"Dr. O'Connell came to see me after the surgery and again the next day," says Alicia. "She was great about providing support to my family and me."


Sweet Success


Alicia was sent home with care instructions and a personal message from Dr. O'Connell to call her with any follow up questions or concerns. After a considerable recovery period, Alicia discovered that she was virtually pain free right away. The surgery had been a success.


At her final post-surgical check-up, Alicia told Dr. O'Connell that she and her husband Lucas wanted to start a family.


"Dr. O'Connell was very encouraging and supportive," she recalls. "She urged us to not get discouraged, to just relax and let nature take its course." 


"When she came to see me that day," recalls Dr. O'Connell, "Alicia mentioned that her period was a few days late, but she did not think she was pregnant. I recommended we go ahead and do a pregnancy test just to be sure."


They did a pregnancy test in the office. The line was very faint, so Dr. O'Connell drew blood to get better results.  


"She called me at work an hour later to tell me that I was pregnant," says Alicia. "She was so excited for us."


Working with her obstetrician, Alicia was able to have a normal vaginal delivery. Her recovery was routine, and she continues to be pain free today.


"Dr. O'Connell's skill and care as a surgeon is the reason we have Joshua," she says. 


And to make the success even sweeter, she and Lucas are expecting their second child this spring.