Gynaecology 1st appointment

[JessMcL]

I’ve finally got my referral form for gynaecology. What can I expect for my first appointment?

[princessk09]

Hey, they will just ask you questions about your symptoms and general lifestyle questions. They may do a pelvic exam which aren’t very nice ngl.

It took me seeing 7 different gynaes and a private endo specialist at spire to get answers.

If you need any advice or someone to talk to, you can always message me xxx

[Marmite83]

My appointment involved me and my husband both answering lots of questions because we're trying to get pregnant. I also had an internal scan where the consultant found two endometriomas so I've now been referred for a laparoscopy. The internal scan wasn't exactly pleasant but it wasn't painful. Hope you get some answers x

[Missy100]

Some questions to be prepared for are: When was your last period? How long do your periods last? Are they regular? What sort of bleeding (heavy/light/moderate)? Do you pass clots? What symptoms are you experiencing and how do they affect you (example: do they stop you from being able to work/go to school)? If you experience pain, where is the pain, what words describe it (sharp/dull/achey/crampy/etc), when does it occur, and how bad is it (scale of 1-10)? When was your last pelvic exam and was it normal? Own medical history and any relevant immediate family history (reproductive, genital, hormonal, cancerous, etc). Any surgeries you have had. Any medication you are currently on. Any medical conditions you currently have. Re you sexually active? If yes do you have a single or multiple partners? Do you use birth control? If not, are you trying to get pregnant? Have you been pregnant before (If yes, they may ask about your pregnancies). A pelvic exam should be expected. They may send you for blood tests and they may also arrange for an ultrasound (this may be internal or external - I have had both at different points) at a later date. They may arrange to send you for a hysteroscopy which may include a biopsy. They may discuss possibilities of what might be causing your symptoms, but they may also wait to see what results come back from any tests they send you for.

I recommend making a list of answers to questions that may be asked and any questions you have. The appointments can seem to go really quickly and it is easy to forget something until afterwards - especially if you are anxious or feel over whelmed in any way.

[JessMcL in reply to Missy100]

Thank you so so much for all of this. This will be a massive help. I have brain fog all the time and I also have anxiety, so writing things down is my coping method for any appointments, so having these questions in advance is a great help.

[Missy100 in reply to JessMcL]

I am glad to be able to help

[luthien]

All of the above is amazing advice, I can't really add to it other than; there is a document on this at the endometriosis uk website, under information - publications - Consultation Questionnaire. endometriosis-uk.org/public...

I found what helped so much was having a page a month diary type - google search and I think it's called timeanddate website. Put on there your symptoms, pain intensity from 1 to 10 (your own scale), cycles and periods, how long periods are, heaviness, any medication you take even if it's painkillers and when, ovulation (if you know it), any spotting, sex dates and pain during / after. That kind of stuff, you get the idea! My consultant found it really useful as he could see immediately a laparoscopy was needed with 90% certainty of endo - he included the hysteroscopy in that too, and biopsies. He booked me in for internal (transvaginal) and external (normal) ultrasound as it would help him work out what other issues there are such as cysts, layout of organs (scar tissue moves them around), if they're stuck to each other etc. He did ask about planning vs not for the future but wasn't too fussed about the answer as his priority was see if there's endo and remove it then see what to do if symptoms are still there.

Take someone with you as another person is great to listen in, you'll forget stuff! If you have a partner definitely take them as it involves them and your future, plus it's great for support.

Have a think about what your main goal is - as mine asked me what I wanted to do / what's my aim with seeing him - I said be out of pain and have less symptoms, better quality of life and just be me.

Hope your first appointment goes well xx

[JessMcL in reply to luthien]

Thank you for replying, it helps when I have an idea of what things others have done and said / asked for, and been through so thank you. What if my appointment is before my next cycle? I won’t have been able to do a sheet for them, I know my periods very well though with all the gory details so hopefully it will be enough, and I know when I have pain other times. I have other chronic illnesses so I’ve learnt to listen to my body and take mental notes of what’s going on

[luthien in reply to JessMcL]

I'd still do a few months of page a month diary things, but perhaps list on around when you had pain and medication etc (so a rough guess) use coloured dots for periods etc and common symptoms (have a key). Explain it's only a guess as you haven't been keeping track day by day but XX here is your most recent one ...it isn't complete yet... that sort of thing. They'll appreciate any sort of written notes really but the calendar helps both you and them see the cyclical changes. If your periods are regular predict the next and any stuff you usually get with it if that's predictable too. Written notes also help in-case you forget anything or recall it later, you don't want one of your bad symptoms to sound like "oh and I also get xx" makes it seem less important. Best to get it all out there.

A good specialist will ask questions anyway to help, and will listen to your concerns / methods of treatment / future plans / quality of life. Remember you don't need to decide any course of treatment straight away.. it's your body.

Hope all goes okay xx

[JessMcL in reply to luthien]

Do the decide by your symptoms if it sounds like you’ve got endo or other problems? Like is there a possibility I will be dismissed because a doctor doesn’t think there’s a need to explore anything

[luthien in reply to JessMcL]

They will go on your symptoms, they may have a feel of your pelvic area / stomach. Usually a specialist will want to know what's going on and will sort a lap out as they can see what's happening plus take biopsies. Yes you could have end but if it's not there could be cysts, fibroids, adhesions.... so it's good if you feel comfortable pushing for that lap, mention that you want to know what's going on too - if that's what you want. If possible see if they can remove anything horrible they find at the same time as this will avoid waiting for another lap that could be months later - you don't want to be getting worse in that time.

They may want to do the scans and then see you again with the results, but do talk to them about what happens if the scans come back okay / aren't okay. If they come back okay that doesn't mean you're clear of endo as it can't always be seen that way - so what would be your preferred method of finding out what's going on an treatment - remember it's your body. Ask them if they do the lap / suspect endo what's usually their treatment suggestions - that'll give you an idea as to whether their plans line up with yours - some will say wait for a bit, some will say remove endo via lap, some will say have hormones, some will say have children, some will say remove uterus. The last two are not treatment options - they are life choices and very personal. Endo doesn't stop growing so there is potential for it to affect more organs / get worse, so really excision by lap is the best method of treatment - but it is surgery so it isn't always a preferred personal choice at that point in time.

Sorry my posts are soooo long lol!

hope all goes okay at your first apt xx

[JessMcL in reply to luthien]

Don’t apologise I’m just so grateful to have someone to talk about this at this point!! So thank you so much! I had a look at the link you sent me and it’s been very helpful. I also found the symptoms of endo section and printed it off and circled which ones I had, I have so many more than I even realised because I’ve always blamed it on something else. Up until this point I’ve tried very hard not to deal with my body and just keep going / say it’s something else. Like for example IBS. I’ve never been diagnosed of it, I was diagnosed of an irritable stomach found by endoscopy. But I have constipation, diarrhoea, pain in rectum before and during bowel movement, sharp pains in that area, worsening when on my period, and all of the other things mentioned, I’ve always put them down to it must just be IBS but now I’m realising it could be something else. Recent health scares have made me change and start taking my body seriously so I’ve been fighting to get to the bottom of things now but IBS is still on my list of doctors appointments for example. I’ve also ignored the pain during sex too and brushed it off. Time to start figuring things out. Anyway the chart of symptoms on the endometriosis website, there’s only two that I don’t have 😔 the rest I do