First Hospital Appointment

[BellaBoo93]

Hi there, I've (FINALLY) got my first gynaecology appointment with a consultant tomorrow after almost three years of trying to figure out what is causing my symptoms with a GP that because of my "young age" (I'm 21) is hesitant to put it down to anything more than "getting used to my cycle". This is despite my mum being diagnosed with Endometriosis at 17 and two other GPs saying that they strongly suspect that is what is wrong with me too.

Anyway, my question is what should I expect? I have had internal examinations done before which were very painful, so I am really nervous about tomorrow. What normally happens? Is it more thorough than a normal internal exam? Will it hurt more? Sorry if I'm being silly, but have been nervous about this since I got my appointment letter through weeks ago and the actual appointment is tomorrow I'm a nervous wreck.

Any advice or answers would be SO greatly appreciated.

Thanks!

[upoupo]

Just go with an open mind.

Be prepared to tell the consultant everything that you have been going through so maybe write a list as it is sometimes difficult to remember everything.

I would guess that you will definitely have an internal examination but you will have a nurse with you just remember to try and breath slowly and relax as much as possible and you must tell the doctor if it hurts and where.....this may help them to pin point what is going on.

If you have questions that you want to ask also write a list of these......this is your appointment for you and your health.

Good luck i hope you get a step nearer to where you need to be xx

[Alixxx11]

Don't be scared! This is a good step they are bound to do an internal examination which I think depending on you and your anatomy and then where your endometriosis if any is could possibly hurt :(. But the consultant will need to do it I think.

Have you been for an ultra sound scan? I was lucky I has been for mine already sent by the GP and I had already been on the pill since I was 15 so the next step for me was a laparoscopy... Xxx

[BellaBoo93 in reply to Alixxx11]

I've been on various types of the pill since I was 17 but it hasn't really helped at all as my pain is not just durning my period, and my bleeding at random points throughout my cycle continued even when taking it. Not had an ultrasound done yet no, but my previous GP who was much more helpful had mentioned that it was her next step for me - sadly I moved soon after that appointment and my new GP disagreed, so I'm hoping that will be done tomorrow too. Do they usually go straight to a laparoscopy after that? How long did it take for you to get referred for that? Sorry about all the questions, just so sick of waiting for answers, especially since it is now really getting in the way of various parts of my life

Thanks for getting back to me my poor boyfriend has heard more about this in the past few days than most men do in a lifetime I think haha, so it's good to have other people to talk to about it. Xxx

[Impatient]

i didn't have any internal exam by the gynaecologist - i was on my period at the time.

i don't think it would have made any difference anyway. Endo is not up the vagina but usually inside the tummy and they can find out lot more from a diagnostic surgery that any physical examinations.

If this is your 1st, you might be offered hormone treatments to try and calm things down and determine if the pains are likely to be endo or hormone cycle dependent conditions.

Having a pain diary can help show the monthly cycle of events, an ultra sound scan can determine if there are other issues to consider like fibroids, hydro salpinx, ovarian cysts, any deformities of the organ shapes or positions to take in to account which may impact on any treatments offered to you.

If you have not yet had a transvaginal ultrasound - using a probe inserted into the vagina, then that is something which you might get referred to have. It is most unlikely it will happen in the very short time frame of the 1st appointment.

You may be offered one of several contraceptives to try and stop your periods and see if you get relief from your symptoms that way. If you do then you might want to stay on them longer term rather than have a surgery at a young age.

Do also remember that if you find a speculum being opened up inside you too painful you have the RIGHT to insist on pain relief and anaesthetics for any procedures done through the vagina - whether its a mirena coil being inserted or a smear test, or hysteroscopy or anything down below.

It won't be offered to you with help - women are not made aware they can have help when it is too painful - because hospitals get paid bonuses to keep women having these things done without costing extra in medications, but you dohave the right to demand that help if you are one of the women who finds these things excrutiatingly painful - as many endo ladies do.

Something to bear in mind for the future too. No need to be brutalised and in agony when it is unnecessary and something can be done to make you more comfy.

These things will still hurt afterwards and you need to have pain killers before and keep taking them after till the pain has calmed down.

IF you have already tried stopping your periods and it has shown that you have found life less painful by doing that -which points to endo or adenomyosis - then you have every right to stick to your guns and insist that you want a surgery to diagnose what's wrong.

Don't dwell so much on relatives having endo - only 50% of endo cases are hereditary - it is much more important that you let your own symptoms speak for themselves when you are describing your experiences.

Explain your bowel movements if they are affected monthly - do you get constipated before a period and then it eases off during, or do you have the runs instead?

When do the pains start and how many days a month are you dosing up on pain killers? How many pain killers are you needing to take?

What type of bleeding are you having? heavy or light, long lasting or sporadic some days heavier then a break then heavy again?

What is your cycle like - settled or erratic?

Whether you have specific areas of pain besides your womb region?

Do you get pain and bleeding when you ovulate mid month?

Do you get pain and bleeding after sporting exertions or sexual activity?

Can you still insert a tampon or is that too painful at times even if you are not sexually active?

There's a lot of clues to be gained by running through your own symptoms each month and what you have done to combat these symptoms to help push the need for a diagnosis.

It also pays to add things to be done at the same time as the op to make it good value for money for the NHS.

You might want to ask for a mirena coil to be inserted at the same time - they last up to 5 years of stopping your periods and while agony to be inserted without anaesthetic - grabbing these rare opportunities to get it installed while you are asleep under general anaesthetic are to be jumped at. Doesn't happen too often and well worth it to not be aware of it going in, plus they use ultrasound to make sure it is in the right position. which they don't do if you get it put in while awake in a clinic setting.

You might want to ask for an HSG test which is running dye through the fallopian tubes to check they are still tubes and still able to have an egg passed down them. If blocked already then you know right away you will not be getting pregnant naturally and will have to use IVF in the future, which while bad news on the one hand, is great news to have up front so you can start saving up for that, and make lifestyle choices that allow you to build up your nest egg for IVF. You might decide you'd rather not get your hair cut and dyed so often and save the pennies for baby making - might want to go for a 2nd hand car instead of new to save what you can here, there and everwhere for the baby making fund in the future.

Take notes with you to remind you of questions you want to ask, because your mind tends to get addled in these short conversations. most of the questioning will come from your surgeon trying to determine if you are a candidate for surgery soon or whether there are other options and tests to be done first. Also to quiz you on what your future plans are to some extent. ie in your young age - fertility is likely to be a majorly important factor for you come what may, but someone my age (mid 40s) its the pain relief and quality of life that is much more important now. Ask for leaflets on any procedures they offer you and write down names of any medication offered so you can go online and check them out for yourself before deciding that is or is not something you want to try.

Use the search box on the green bar at the top of the page to look for previous discussions on the medications - we have discussed most of them hundreds of times before, but if you are still unsure about them you can post questions and we will try and answer them from our own experiences and research.

All drug patient information leaflets are freely available online through google to read before you pay for ny prescriptions if you have to pay - but also with contraceptives even though they are free of cost - you can read up about them ahead of deciding what to try next.

Please don't panic - stay calm and know what you want and stick to your guns. If they insist that you are not ready to be considered for surgery yet - then get some assurance that if you do try a particular treatment, once that is over that you can come back and get on the surgery waiting list if everything is still pointing to endo. Very best of luck. Hope it all goes productively and you can get some help from the appointment.

[Alixxx11]

I think I went to the doctors back and forth for about three months I was referred to a gynaecologist in the February I think I had the ultrasound in the march. Then my appointment came through in about May. I had my lap then in the December but it was nearly cancelled luckily for me I managed to keep my slot. Then it was a 6 week follow up. I think depending on where you are in the country is most likely to determine waiting times and bed spaced for if you needed a lap xxx

Aw my fiancé was in the same boat to I think he's only now realising the impact it's having but he's been amazing there for me all the way. I am major hard work and I think before I started my zoladex treatment the pains were so bad he would get frustrated because he couldn't do anything to help and I was snappy because of the pain and that's the one time he sort of walked out and it's come between us. Since then being on the zoladex I feel abit sorry for him I think he feels like he's got his 16 year old girlfriend back again with mood swings but an over weight flushed out 22 year old body lol xxxx

[BellaBoo93]

I'm in Edinburgh so not sure what the waiting times are like here, but we'll see if that's what they want to do.

That's exactly the same as my boyfriend! We've been together 2 1/2 years now and although it's been going on since before we were together, it has really started to frustrate me more in the past year, and I know I've taken it out on him at times, which isn't fair but it's so hard not to! He has said he hates me being in so much pain, but because he can't do anything about it he gets grumpy and almost a bit distant sometimes, but it's just cause he feels like he should be helping me or fixing the problem, but he can't. It's not much fun for either of us haha xxx