Pre-assessment for a hysteroscopy? Why?

[AuldJosey]

Apparently I've to have one of these Friday to see whether I'm fit to go through the hysteroscopy.
Can anyone tell me what that involves? BP? Bloods?

I just fail to see the reason for a bloomin test about a test!

Thank you very much to the posters who have taken the time to explain. I understand now. Thanks again.

I hope you're more polite to the NHS staff who ensure you don't die during your procedure than you are being to those answering your queries.

I don't think people understand just how dangerous an anaesthetic is. The Anaesthesist is completely suppressing your normal bodily functions then maintaing your breathing and blood pressure with medication and equipment until such time that the medication wears off. So much can go wrong and that is why they must see you pre op to ensure you're as fit as can be. Obviously if you're already unwell then they need to know this. If you aren't fit for the procedure then they can give your slot to someone else.

The reason you have to come on at 7am is so the staff can ensure you're still fit, and you're ready to go as soon as theatre staff are ready so as not to waste time if you don't appear on time or take too long to get changed etc etc. It's a well oiled machine and you're not the only person going through it on that day or any other day. It's routine and you will just have to deal with the appointments if you want your procedure.

I really don't want the procedure to be honest!

The Queef I had a spinal for mine and ended up not going home until 11 p.m. because I couldn't pee until then. Everyone else had had a general anaesthetic and had gone home hours earlier!

I had hysteroscopy under general anaesthetic recently and so this pre assessment. It was done by a nurse. She checked my weight, height, blood pressure and asked a lot of questions about my medical history, smoking, drinking, even about vitamins, explained what I need to do before the procedure. She checked that I will be collected by responsible adult (DH) and won’t be alone overnight, gave leaflets with info and ward phone number to DH. The appointment took less nearly an hour but just because I had a specific question and she went to check something. Actually before the appointment I planned to walk home ( 10 minutes) but she said that it’s a bad idea and advised DH where to park our car and what’s note to put.

It's all being rushed through at alarming speed which is worrying me more. I'm sorry I'm not some graceful patient - taking it all in my stride. I'm a very stressed patient. If I get a diagnosis, then I might become graceful or something, but right now, I'm not. I'm just stressed. And annoyed and in pain etc.

Missingthesea

I’m an anaesthetist and was about to say similar. Even with the smallest doses of the shortest acting spinal anaesthetics it can take hours for the bladder to wake up. Sorry!

By the way I actually was very nervous before the procedure ( nearly destroyed) and pre-op assessment calmed me down as I had a chance to voice my worries.

Well, if shoving a flexible wand up your foof and pumping in fluid to have a good look around for what's causing your problems isn't an operation - sorry - surgical procedure, I suppose the risks of one don't apply to you.

accidental damage to the womb – this is uncommon but may require treatment with antibiotics in hospital or, in rare cases, another operation to repair it
accidental damage to the cervix – this is rare and can usually be easily repaired
excessive bleeding during or after surgery – this can occur if you had treatment under general anaesthetic and can be treated with medication or another procedure; very rarely, it may be necessary to remove the womb (hysterectomy)
infection of the womb – this can cause smelly vaginal discharge, a fever and heavy bleeding; it can usually be treated with a short course of antibiotics from your GP
feeling faint – this affects 1 in every 200 women who have a hysteroscopy carried out without an anaesthetic or just a local anaesthetic

There's also the possibility of an allergic reaction or non response to the particular local anaesthetic they use, you might find it painful and need pain relief, they might find firbroids that need to be removed and decide to put you under general anaesthetic.

You might need biopsies taken, polyps removed. All of these entail risks.

And the treatment of these events/complications means that they need to know you're healthy otherwise, Oh, and not pregnant.

Auld, I understand your frustration as I've just had a pre-assessment for a hysteroscopy too. It is because you are having a GA, same here. So, they can assess you beforehand to make sure they know what they need to know before the day and it gives them the time to process your results. They wouldn't have time to process them if you had them done on the day of the procedure, that's just not how the NHS works. And thank gawd for the big old truck that the NHS is, it may be clunky and frustrating but we are lucky to have it.

Agree that they need to make sure you are fit for surgery.

Any anesthesia is a risk. They need to make sure the risk is acceptable.

They'll do things such as check your vital signs, probably weigh you, ask about your health, and even do things such as look at your teeth! (This is to ensure that you don't have any broken or damaged teeth. These can end up in your airway if they put in a breathing tube. They'll also want to take a look at you physically to see if they might have trouble with your airway. Usually in theatre they have a "difficult intubation tray" that they can have handy if they think it will be needed.)

Pre op clinics are there, amongst other things, to ensure the surgical list is a list of people who ARE going to have the procedure.

The pre op tests have to be done (regardless of whether it is a procedure or an operation) before you and every one else on the list can go to theatre.

Do they can have people come in at 4am for tests and then wait for results and have some people sent home,not because they are not fit but because blood tests have not come back or the ECG department doesn't open until 9am, or they can do a pre op clinic.

The clinic is a few days before so that any blood test and MRSA swabs will have been sent to the lab and results come back.

It also gives you a chance to ask any questions about the procedure.

Finally they often give you soap or shower gel to use for 2-3 days to reduce the risk of MRSA.

So, OP, you were given the choice of local or general anaesthetic and opted for general and now you're complaining. If you didn't want to have to go to the hospital twice then you could have chosen local anaesthetic. And then you wouldn't have had to be at the hospital at 7am.

You chose this and now you're moaning about it.

OP it’s absolutely fine to ask questions, but you were incredibly dismissive and rude about your pre op which is there to protect you and keep you safe.

If you’re having the procedure in outpatients / ambulatory without anaesthesia, I guess pre op requirement is more debatable. Some places are phasing it out or doing a questionnaire type pre op which can be done over the phone or by you completing it and sending it back in. But there are still things your doctors need to know to make sure you are suitable for the procedure and to keep you safe.

I know it’s scary & you don’t feel well- I was the same. But I had no idea about my b/p for example- I’ve since found out that doctors call it the ‘silent killer’ as it often doesn’t present symptoms.
I recovered from the GA OK , got treatment for my fibroids which seems to be working. I hope it all goes OK for you.

@Cistavay - sorry to derail the thread slightly, but how long did it take you to recover from your hysteroscopy? I've been told up to 4 days.

I had a or of bleeding afterwards and had to stay overnight. I had cramps and bleeding for about 4 days- but mine was on a Friday and I was back at work on the Monday.

What's worrying me is that they sent me a thing saying I'm being investigated for cancer. I have a lot going on, so I'm sorry if I'm not Pope Pious III here, but I'm stressed. I asked a question. Tell me I'm rude - where? Can you not understand fear coming out?

Anyway it's tomorrow - so we'll see how the pre-assessment goes.

I think sometimes I feel that nobody is seeing the whole pic (though the cons did go through entire history) and other times I just want to just back out.
Received a voicemail to call back about procedure Wednesday but couldn't get through so left wondering were they cancelling it or rescheduling and do I still have to go tomorrow..
I'm stressed to the hilt and I'm not sure how I'll cope.
It's really hard for me because I'm going through what I suppose you would call a mental crisis at the moment.

It just feels like there's too much stuff going on at once and I'm not coping.

I hope you got your kicks from telling me to grow up.

Good luck, OP. Sorry you have this big worry hanging over you.
Do you have IRL support?

Ignore the people baiting you on here, I get how you feel. If you’re constantly going back and forth to hospital it seems like the last straw to have to go for such a short session, especially if it costs you money to do so. You can be annoyed and still be grateful for the care you’re being given.

Of course you’re stressed. I was just the same before my investigation and the relief afterwards when they said it was just a polyp was palpable. The call is probably just to remind you to go in. I’m hoping you have good news and try not to worry too much.

Good luck.

I feel like if they just tell me what's wrong, then I can deal with that. But it's not knowing and getting leaflets telling me what to expect when investigated for cancer that is perturbing me.

Of course you’re perturbed. Read the leaflets, then file them away. Just focus on getting through the next few days and out the other side. Plan a treat for yourself for when you get home.

I hope that the pre-assessment went well OP.

Oh well - what a kerfuffle! OP postponed as potassium too low, other bloods not right and something dodgy with ECG (heart rate was 107). At one point they were about to bring me straight over to A&E (seemed to think I was on the verge of a heart attack or something - kept asking me whether I had chest pains!! , then after another wait while the docs spoke among themselves they decided that I was fine to go home and see GP asap. Didn't really give me too much details - basically told me that the GP will be able to see whatever results they found dodgy and just to go to GP. Poor nurse was all in a flutter, I think she was afraid I was going to collapse in front of her or something - bless her.