Can they actually say this?

[Pumpkin31]

So last week I wrote a post for the first time about what my symptoms are and about how my GP said it definitely sounds like I have endo but the Doctor at the hospital said no way after an examination and told me it was probably IBS and heavy bleeding so I should go on the mirena coil and stuff.

Had a copy of the letter she sent to my GP sent out to me too. In the letter she acknowledged I've had 4 healthy births...but also only 4 pregnancies. No mention on the 4 miscarriages, 3 of which only happened last year. Now in my opinion, and from what I have also read, 3 miscarriages one after the other is not normal. To me, and what I've read, it indicates there could be an issue within me. She also wrote at the end of the letter that she believes I have IBS which could be exacerbated by the possibility of endometriosis. Whilst I'm sort of happy that its been acknowledged that she thinks I have it, its the opposite of what she told me so I wouldn't be able to put a complaint in now as its a case of she said, she said.

After it says I may possibly have endometriosis, she goes on to say she is reluctant to give me a laparoscopy due to my BMI. Can she actually refuse because of this? Like not in a sarcastic way, I am genuinely wondering? Because to me, if I needed another form of keyhole surgey such-as for the gallbladder or my appendix or something, they would have to perfom the surgery, wouldn't they?

Just looking for advice on that before I proceed to my doctor asking for a second opinion just in case she can actually say that. Though, I do wonder why my GP referred me for it if I had to lose weight. She weighed me whilst I was there so surely if it was necessary she would have warned me to try and lose some before my appointment, considering there was about a 4 month wait.

Thanks for any replies.

Pumpkin

X

[Purple_Badgers]

Hi Pumpkin, I’m so sorry you’ve had your time wasted like this. I’m not sure the gynaecologist at the hospital knows what she’s talking about… If I were you, I’d ask your GP to refer you to someone else, preferably someone who has a special interest/ extra training in endo. (You can Google individual gynaecologists & find their list of interests/specialties)

New guidelines actually recommend scans, rather than a lap, as the first way to diagnose endo, though you need someone skilled at interpreting scans and locating endo. I’m not sure what examinations you had in your appointment, but it doesn’t sound like it was enough for her to declare it’s not endo (though she seems to have contradicted herself now!)

Unfortunately, I have heard of patients being asked to lose weight before surgery. I’m not sure who decides on the max BMI that they are prepared to operate on? Maybe it varies between surgeons, hospitals or trusts? Or depends on the type of operation? Perhaps your GP didn’t think your weight would be a problem?

It seems that this particular gynae didn’t dare mention weight in your consultation - but then accuracy/communication doesn’t seem to be her strong point… The bottom line is that you don’t have to continue seeing this gynae if you’re not happy. But I think you may come up against the BMI issue again in the future.

Good luck - I hope you get an appointment with someone better next time x

[Pacotj]

sorry to hear about you stressful time, receiving diagnosis is something I’ve still yet to manage as I have been on a waitlist for gyn since 2020 with no appointment in sight either.

With regards to bmi and surgery, I work in a day surgery unit which only performs elective cases including diagnostic laps. Our general rule is that a bmi higher than 40 wouldn’t be accepted for day surgery. As all surgery carry’s a risk because of the general anesthetic, it is weighed up the pros and cons of carrying out surgery and so emergency cases such as appendix or gallbladder being removed are a necessary procedure for the life of the patient, as opposed to a diagnostic lap. I hope this helps understand why they may be reluctant to carry out surgery and maybe also know what it is they need you to be at because sometimes just knowing what they need is half the battle!

Take care x

[Avourneen]

Hi Pumpkin,

I'm so sorry you have been treated like this. I comepletely second what Purple Badgers is saying below. If you can afford it I would go privately to a really good sonographer and get a scan MRI or TV ultrasound . The gynae at the hospital cannot possibly have diagnosed you as having endo or not just from an examination. There is no way he/she could tell just from this and without a scan, I would go as far as to say that is completely unprofessional to have pretended they could. This gyane sounds very poor so look for a better one. You don't want to go straight for a lap with no scan as it's a pretty big procedure.

Sometimes people do have to lose weight before an op as it could be dangerous to do an op if the patients BMI is too high. Can you work out what your BMI actually is ? and then you can see if this is a real issue or a convenient excuse.

You have been through so much with miscarriage after miscarriage, they might not be related to endo at all though it could be something else so I think finding a really good gynae is important to get to the bottom of this too. I'm so sorry to hear you have been through all this and then have to deal with unempathtic doctors who don't listen to you.

Get a good scan, find a better gynae and good luck. I hope everything improves for you.

[Stitchrunner1]

My take on this is that. it could be a good idea and go back to your GP. Plan your visit. Get it clear in you mind what you want to ask, Write down you questions and concerns, Take the letter with you with the bits that concern you highlighted. Then ask the questions like you did here. It can be very tough talking to doctors because they seem to be in authority, but they are there to help you. If you don't feel you got on with the doctor who referred, you can see another GP in the practice. You don't have to give a reason. The problem with the sort of consultation you have had, is a lot of information all in one go. The letters are a brief synopsis. They don't capture the whole of it. It is perfectly reasonable to come out feeling as though you haven't been heard or with a muddled mind or just plan confused and angry. It does not have to be the end of your story. Your GP is the person who can put your mind at rest. Don't ever be afraid to ask for an explanation. You are in partnership with your doctor about your health. They go on blissfully unaware that there is anything wrong if you don't tell them. You don't have to be rude or shouting but neither do you have to be diffident and shy. Just take a deep breath and go in there and put you point of view.

[TogetherWeAreStrong Moderator Endometriosis UK]

Stitchrunner1 this is amazing advice and support, specifically about the relationships we have with our GP's, Consultants and all of their wider Teams, they are here to help us, and we need to keep open channels of communications, which does include when we are not happy with the service we have received, and that is quite hard to do. Stand firm ladies. You know your own body better than anyone.