2 erpc's in the same hospital- very different experiences. Curious for your comments.

[jocesar]

This post may be a bit rambly and boring but I wanted to get if off my chest and would love to hear any comments you've got.

I've had 2 recent MMC's- in January and again now. Thankfully have 2yo DS.

Both times I opted for ERPC and had the proceedure done at the same hospital- Dorset County- but in different departments each time. Had very different experiences and very different treatment protocols and I would suggest at very different costs to the tax payer. I don't understand much about the NHS or how hospitals are run and so would like to hear any comments.

ERPC1- was an 'elective' proceedure so managed to get on an operating 'list' in the Day Care Unit. (Had to wait 7 days to get on the list as was over xmas and New Year). In at 8am, on a bed immediately and blood pressure/pulse ox and history taken by a nurse. Nobody listened to my heart/chest, no bloods taken. Quick chat with anaesthetist and signed consent form with surgeon. No compression stockings. No pessary given. Walked to theatre, catheter placed there and anaesthetised immediately. Awake 30 mins later, 2 cups of tea, 2 pieces of toast, a trip to the loo and I was out of there and back in my own bed at 11.30am. Altogether an efficent and physically painless proceedure. Although it still riles me today that not one single staff member that dealt with me (probably 10 in all) expressed any sympathy towards me or my loss. Are they trained not to acknowlegde what the patient may be going through or do they simple not give a shit?

ERPC2 (last night)- was going to have to wait too long to get on an elective list so was put on the 'emergency list' 36hrs after the scan confirming mmc. This was to be done at the 'Short Stay unit'. Was told to eat a small breakfast at 7.30am then to be in at 10.30am. I was told I may have quite a long wait as there was a real bed shortage that day. They weren't wrong! But some regular updates would have been appreciated. There were 2 of us in for MMC that day and we were kept sat in the waiting room for over 6 hours- beds kept being promised but never came. We eventually got a bed at 6.30pm. Then had a full clinical examination by a (very young, definately new graduate Dr) who then tried but failed (bless him) on 2 occasions to get the iv cannula in but was sucessful the third. Then had bloods taken- a pre op profile and blood group and Rhesus (but surely these should have been on file from my first pregancy?- what a massive waste of money.)
They then tried to give me a pessary which I refused as I hadn't needed one last time. The gynae nurse said I didn't need one, the young Dr said I did! Had compression socks put on and thankfully a drip as now absolutely starving and thirsty. Went to theatre at 10.30pm. Awake by 11.30pm, 2 cups of tea/toast/wee then they wouldn't let me home as it the 'policy' to keep people in for 4 hours. Had a bit of a strop and signed myself out. Home at 1.30am.

Both procedures seem to have gone fine and very little pain involved but how different the experiences and then you get confused about which way is right eg pessary or no pessary, immediate discharge or wait 4 hours??

I must admit as a footnote that I do have a slight agenda. I'm a vet and run my own small animal practice to a very clinical high standard and also to a high compassionate standard. Every week clients complain about the cost of treatment which does wear you down as most have no concept of medical costs and therefore have no idea whether vets are overcharging or undercharging or (perish the thought) actually charging very fairly. But I know we offer a far better service. I start to feel bad if I've kept a client waiting 10 mins (cf 6 hrs), our patients and clients certainly get far more hugs and cuddles and we would certainly not leave a dog lying in its own faeces for 30 mins (as happened to the senile lady next to me in the ward last night). I fumed for 30mins before ringing for the nurse and asking her to do something about it.

OK rant over- think I'm still a bit high from the anaesthetic drugs- expecting to fall into the deep black hole again soon and then slowly pull myself out to ttc again.

Congratulations if you got to the end of this

[MrsEagle]

Hi
Sorry to hear your experiences and so sorry to hear about both of your losses. 1 is hard enough. I've beeen through 1 ectopic, 1 mc & 1 mmc all in last 2 years myself. I have to say my mmc experince was very similiar to yours. I decided on the ERPC but it was booked as an emergency procedure not elective. However as the scan was on a Friday I had to wait til the Monday so not that urgent then.
The day itself was awful, my husband wasn't allowed to stay with me (even though we'd been told on the Friday he could) and as with the the staff were indifferent and unsympathetic. Its all over my notes why I am there so its not like they don't know. Infact one nurse who I had the misfortune to be mian one dealing with me was downright rude. I was so angry at how I was treated especially given my very delicate state.
The next day I called the PALS (patient liason service) as I was too angry to just leave it. The lady there was great, she took all the details and give me the much needed sympathy that wouldn't have cost anyone anything the day before. She gave me the options as to what she could do about it - I could have just had a moan to her about it if I wanted. She even put me in contact with a specialst midwife/counsellor who works at the hospital and specialises in mc. She was fantastic too. I'd recommend PALS as it helped me feel like I'd done something about it.
My local hospital is Mayday in Croydon so very far from you but very similar problems.
Big hugs to you, hope your OK xxx

[banana87]

I have had 3 ERPC's, the first 2 were private, and the 3rd NHS. The 3rd ERPC was not directly for mmc, as I had already had an ERPC but they did not get everything and as a result I started bleeding very very heavily and had no choice but to get to A&E.

My experiences were different as well.

ERPC 1: Had a pessary, down to theatre, awake 30 mins later, able to get a sandwich and tea as soon as I got to my room, but did have to stay in for 3 hours (the consultant came back to see me).

ERPC 2: No pessary, was actually asked by the nurse why I was there/what I was having done :(....and then I had to drink water before they would bring me a sandwich. Stayed about 2-3 hours, until consultant came to see me.

ERPC 3: Was admitted and put on the 'emergency list' as I was bleeding so heavily. Bleeding slowed and jr dr came to see me. She took me off the emergency list and put me on the list for a scan THE NEXT MORNING, so it was an overnight in the hospital on a ward full of old ladies who had just had bowel surgery...needless to say, that was NOT an enjoyable night, I had no sleep and knew EXACTLY when to put my ipod on (thank god I had it!). Next morning I was left, not even offered a shower or given any updates. I asked several times for my scan but no one would tell me what was going on. Finally had a scan at 12:30, (mind you I was nil by mouth since 7am "just in case"), followed by surgery around 2pm. I was then not given any food, was just left until my friend came (at 7:30pm) and got me some food. She also kept bugging them about letting me go home as NO ONE had mentioned it. Finally discharged at 9pm.

I know there will always be differences in NHS and private, but even nurses in private hospitals dont have much compassion, you are just treated (i.e. procedure) and seen to when you call.

[jocesar]

banana that third one sounds a pretty shambolic experience but I fear it may be nearer the norm. I too was in a ward full of old ladies making the most grim wet farting noises all night. Didn't have an ipod unfortunately- must remeber next time.

[MummyAbroad]

Not at all rambly or boring Josecar! Thanks for giving us the chance to compare and get things off our chests as well. Funny how it all gets stuck in your head for such a long time afterwards.

MrsEagle and banana87 I am sorry that you suffered such horrible treatment in the hospitals. I wonder how typical this is?

I have had two ERPC's, the first one at Kingston hospital a month after giving birth to a healthy boy. I rang the labour ward when I started bleeding very heavily, they asked me to come in and jr doc (a man, does that also have something to do with it?) left me on a bed for 16 hours with antibiotics via a drip. I tried to go to the toilet by myself and collapsed which caught the attention of a more senior (woman) doctor. She whisked me in for an emergency ERPC and after I had to have two blood transfusions. Nurses were extremely sympathetic. Maybe because it was a labour ward? I had stockings but no pessary by the way.

The second was in a private hospital in Costa Rica for a mmc that was suspected partial molar. I had no pessary, no stockings, but also no waiting, no unpleasantness of any kind. The waiting area looked like the lobby of a posh hotel, complete with water feature, internet access and cafe. I left almost as soon as I woke up. The only difficult thing was that everyone smiled cheerily when they greeted me and asked me how I was. I think well trained hospital staff are told to do this to everyone. They all looked away sheepishly when I told them I was miserable, scared of getting cancer and being infertile forever!

One weird thing was that I was given the option of local or general anesthetic. I chose general- does anyone in the UK have this procedure with a local??! I was asked to show my Rhesus blood results which I had been told to bring along beforehand.

The whole thing cost me about £1200 pounds, but I also had to pay a lot for blood test and consultants fees in the previous weeks, perhaps another £800 altogether. Ironically money I had saved in order to pay for the birth. I know the NHS sucks a lot of the time, but it IS world class free healthcare. Over here, if you cant pay you are in real danger of just dying.

Sorry to end so morbidly and thanks again for letting me ramble!

I really hope you are all feeling better soon ladies. Especially jocesar, I saw your story on other threads, get well soon xxx

[jelliebellie16]

I have had ERPC and I was very dissatisfied with how the hospital treated me.

I found out i had MMC on the Friday and had was told to go for the procedure on the following Thursday. I was told to arrive at 08:30 and that I would go down on the morning list.

Kept waiting in the day room for 6 hours, asked repeatedly why I was there/what was I having done, didnt get a bed until 19:30 and wasn't taken to theatre until 22:30 by which time I was so dehydrated I had to be put on a drip. No pessary, no stockings, awoke 45 minutes later laying in a pool of my own blood nobody came to help me after ringing the bell 5 times my mum stripped my bed for me and strip washed me. i was disgusted at the way i was treated :(

[Tallybear]

I'm so sorry for all of you who had bad experiences with the ERPC. I had one on Wednesday after finding out on Sunday at the 12 week scan that our baby had died at 9 weeks. (Just when we naively thought that we'd got past 12 weeks so everything must be OK).

I had my scan and procedure at Bath hospital and I was very impressed with all the staff. I was in at 8am and out at 2pm. I would have been out earlier but I tend to have low blood pressure and had to wait in recovery for a while until it came back up (listening to the nurse's gossip!)

We're surrounded by pregnant friends and colleagues at the moment, so that will be so hard when we venture back into the 'real' world.

I came onto Mumsnet today to remove myself, as it was no fun getting the emails, but I spotted these forums and it helps to know I am not alone - sometimes it feels like I'm the only person going through this, even though I know I'm not.

I wish you all the best of luck and fingers crossed it will work out for all of us.

[mamadoc]

From the other side of the fence as it were- I am a Dr but not surgeon or gynae but I have been around a bit in hospitals so I may be able to shed some light. I have also had 2 miscarriages myself although never ercp
The most important difference is between elective and emergency list. You will always have a better experience on the elective list. You have a definite slot so don't have to wait and you will get the more experienced staff who are less prone to fail to get cannulas and have less need to adhere slavishly to protocol.
On the emergency list you will get bumped down the list by things deemed to be a greater emergency eg kids burst appendix. The staff will also be worrying about these other emergencies and have less time and care for you. It is crap but its the way it is.
The NHS could do with being a lot more 'patient centred'. I love the NHS and I think it is very good at fixing serious medical problems but it is organised a lot more around the convenience of staff than patients, there is never a lot of care for emotional aspects.