To expect to have the procedure I went in for and the same advice from two drs?

[Howaboutthisone]

Firstly- this is not an NHS bashing thread. I am hugely grateful for our NHS and appreciate all that the wonderful people who work in it do particularly when they are battling against being so under resourced.

I've been having horrible gynae issues for the last year. Bleeding has been constant and very heavy and has made leaving the house difficult on many days. Not ideal with two young children and when working full time.

Two issues that have really worried me in the last two days.

Firstly. I had been told by one registrar, and also had it confirmed in writing via email from her, that the regime of norethisterone tablets I have been taking would also act as an effective method of contraceptive in the way I am taking them. Been taking them and relying on them as contraceptive since April. I was told yesterday by a different gynae dr that I should be using a condom/hormonal contraceptive in addition to taking the norethisterone as it is NOT a contraceptive 🤯

Secondly. I arrived for my operative hysteroscopy- first dr had told me that's what she was referring for. I'd also had confirmation from the clinic bookers who had also sent me a patient info leaflet for an operative hysteroscopy where my fibroids and polyps would be removed. Went in for my appt and the dr told me that she would not be removing anything and that she would be doing an exploratory hysteroscopy with a biopsy.

I don't understand how the information I get as a patient can be so different and how I can arrive being told I'm having one thing, then having something different.

Sorry- think I'm just venting disappointment and frustrations. Was so hoping this appointment would put an end to the months of evil discomfort and bleeding as I'd been promised.

What dose of norethisterone are you taking?

5mg three times a day every day without breaks.

According to the BNF, 350mcg daily, taken at the same time per day, is the dose for contraception. So 5mg 3 times per day far exceeds that.

It scares me then that the dr I saw yesterday. Who wouldn't preform the procedure I went in for, categorically told me that norethisterone is not a contraceptive and that I should have used something else. She didn't ask me to do a urine sample after this bombshell either before doing the other procedure 🙄

Thank you for your replies.

In a bit of limbo again now waiting to see when the other thing will be done-if it will be done.

I sympathise with your heavy bleeding. It's dreadful and stressful.

Just to clarify you'd had investigations and a diagnosis and were expecting to have an operation but they just did more investigation?

What operation were you expecting? That dose is way above that in the Noriday contraceptive therefore by default I imagine acts like one?

I'd had an ultrasound and an an appointment with a gynae. She then said she was referring for me to have my fibroids and polyps removed. When I had the appointment letter through there was no detail so I phoned to check I was having a procedure and not just another talking appt and was told I was booked in for a polypectomy to remove the polyp and fibroid. They they sent me out a leaflet explaining that procedure. Then on the day the dr told me that she would be looking at my womb with a Hysteroscope and taking a biopsy but wouldn't be removing anything on that day, that it would be more of an investigation. She did though fit a Mirena. Originally I hadn't wanted a mirena fitted until the fibroid etc was removed as it felt like a sticking plaster without solving the problem but ended up agreeing to it as I was a bit in shock/confused/disappointed by that point and thought at least this would be a step forward.

I would want clarification as to why the operation had changed. And without a reasonable explanation would be making a complaint.

As much as I appreciate the NHS they do need to be held to account over some of their actions. I understand they lack resources but that's not a reasonable excuse in my view. Clearly someone thought the removal was the best option for you so that's what should have been done.

I've seen it too many times that the best course of action has been replaced with a cheaper option because it'll do. A family member with an incurable illness was prescribed some meds, after they had to change the GP they saw the meds they were on got changed. Moved doctors surgery and got told there was more effective meds on offer (the original ones they'd been on) and they should be on them, but that the more effective ones are more expensive so that's probably why they got changed.

This is what has confused me. And then the conflicting information about the tablets I'm on too. I have the email of the secretary for the dr who originally referred me and think I might contact her to explain my confusion and ask why/what happens now.

But were you expecting to have a GA and stay overnight? Generally there's pre-op stuff to be done first.

No-they can do the one I was expecting either as an outpatient case (which I agreed to try as they waiting list would be shorter) or as an inpatient GA op.

I'm wondering if the first dr thought that the ultrasound was clear enough to operate from but then the one who was due to do it didn't think it was? I think it's the difference in what the two drs are thinking that's confused me as I don't understand how they can have such different views. Especially on the contraceptive point.

I think the one who will do the actual surgery always gets the final say about the operation, not the one who referred. So it could well be that they saw something in the ultrasound that they wanted to check, or it might be that they thought it possible you'd need something more major or whatever. I don't think that it's a bad thing that the surgeon gets to make that call, and I think it's standard for all operations. Until the surgeon gives the go ahead, things can change.

It is likely to be different opinion/practice. Some consultant don't fully value the experience e of registrars, sometime unfounded, sometimes not.

It is very confusing, so don't hesitate to raise the issue of being told different things and asking for an explanation.

Good points. I think I will email the secretary just to ask and be less confused.

Make a complaint. The medical staff have not communicated effectively with you and have left you confused and feeling misled about what procedures you are supposed to be having and the effects of medication you have been prescribed.

This is actually pretty serious and most trusts should take this complaint seriously as they are always trying to improve patient communication. Sadly some medical doctors still seem to confuse their god complexes with decent bedside manner. Have a look at you NHS trust's patient charter, I expect that you will find they have fallen short of their commitments in it in how they have communicated with you.

To be honest I'm getting ready and more annoyed the more I think about it. Surely it can't be right. Especially the conflicting information on contraceptive if nothing else! Though I still can't understand-to take a biopsy of the fibroid, why not remove the fibroid and send that away for testing??

I did email the secretary and she has passed it to the consultant. He's asked her to get the comments from the two drs involved so that he can review my case. I also mentioned that my blood pressure was up and the dr that performed the procedure told me that that isn't a side effect of the medication I'm on despite it being listed in the medication leaflet as a side effect.
I was also told at the appointment that she would write to me personally as well as my gp but that was a week ago and I've had nothing-is that normal?
I was also told I'd have a follow up appointment in 3 months. Now I've had an appointment through which will be three weeks after the procedure. It was posted the day of the procedure. So now, whilst I'm glad to be seeing someone sinner rather than later, I'm also worried as to why they want to see me sooner. I'm then telling myself it can't be due to the biopsy results as it was sent the day the biopsy was taken so they wouldn't have found anything out by that point anyway would they??

Sooner not sinner

If theres something really wrong they tend to get in touch sooner.

Re the letter - it will take much longer than a week!! For DS2 we sometimes get them months later.

Thank you-that's reassuring. I hope DS is ok.

Just re read-did you mean they tend to get in touch sooner than three weeks, or the fact that I'm being seen sooner is a bad sign?

If it was something sinister I'm sure they would see you in days not weeks, so I'm sure its nothing to worry about. My DD has had many hospital appointments. We have had letters containing the summary of the appointment arriving a couple of days to a couple of months after the event.

Thank you for the reply.