AIBU - GA for Hysteroscopy and Biopsy

[CountryGirl189]

Hi all,

I’m only 28, never had children, however we were going to start trying soon and I’ve been tracking my ovulation.

I’ve noticed over the past few months that on the odd occasion, I have slightly brown discharge during ovulation.

Anyway, I mentioned this to my doctor and he sent me immediately for an urgent scan where they found my lining was 14mm (I was four days before my expected period and they classed this as the upper limit), increased vascularity, a bulky uterus and an uneven lining. The radiographer put it down to either a polyp or cancer. (I personally think it’s Adenomyosis based on my research and other symptoms).

SO, as if I wasn’t freaked out enough already, my GP called me immediately afterwards to say that I need an urgent referral to Gynae. I received the letter through and it’s to be a Hysteroscopy and Biopsy.

However, I am absolutely terrified, so much so that I’ve been having non-stop panic attacks, almost had a fainting episode the other night and have been constantly shaking, unable to eat properly.

This probably sounds really dramatic, but I have a deep fear of medical situ’s and it takes me a lot to even go and have a smear, which I do make sure I do! Once I had to go to the Dr for swabs and nearly passed out from her going waaaay too much near my cervix!

So, a long story later, my question is: AIBU to ask the consultant for GA for the procedure? (I’ve tried calling and calling his secretary for advice, to no avail - she never answers or returns my messages!) and secondly, how do I ask for it?

The latter half probably sounds daft, however part of my horrendous anxiety is coming from having to ask and stand my ground for it - I hate confrontation!

P.S. I completely understand I’ll have to wait longer for a GA and that’s fine by me!l and I don’t really have much anxiety around GA, which I know probably sounds weird, but as long as I don’t know what’s going on during the procedure, I’m all good!

YANBU, but try not to worry. I’ve had almost the exact same situation as you - spotting, ultrasound scan, thickened endometrium, suspected polyp, referred for hysteroscopy and biopsy. I had the hysteroscopy with no anaesthetic, and it was fine. Biopsy pinched a bit but over in seconds. There were a lot of polyps, so they referred me for a hysteroscopy under GA to remove them all. This was about 7 years ago (pre-kids). More recently (post-kids) I had an ultrasound scan due to ovarian cyst, and again they picked up a thickened endometrium, so again I had a hysteroscopy and biopsy (no anaesthetic).

You’re not being unreasonable to ask for a GA, OP, and I know women experience pain differently with hysteroscopy. If you can’t get through to the consultant or secretary you might have to wait until your appointment to discuss it. With my first one I had a general appointment with a consultant first, before getting the date for the hysteroscopy. Or you could contact your GP and ask him/her to write to the consultant.

If you’ve any specific questions regarding my experience of the procedure, awake or under GA, I’d be happy to try to help.

I think you should insist on it.

YANBU. Stand your ground.

it is worth waiting for the very low dose-short time frame GA. It should be standard that the procedure is done as a day case with GA, & not expected that we experience extreme pain because doing the procedure while we are awake/conscious is convenient for the healthcare team

Thank you so much for replying, it’s hugely appreciated!

I’ve definitely decided that I’d like it under GA, so that if they do find polyps, they can remove them there and then and it’s all done in one go if that makes sense! Rather than having to book another appointment.

My appointment is Monday morning, hence why I’m so stressed about having not been able to reach anyone - I’m flapping about what to say to him as I know Drs are encouraged to try and persuade the patient not to go down that route, but I wouldn’t feel that I was giving proper consent if I let them do it whilst I was awake.

Any advice on how to broach the subject with him would be incredible!

Thank you so much!

There's been a lot of reports in the news about how women are meant to put up with painful, invasive procedures. There's starting to be a shift in opinion on us just having to get on with it. If you want a GA, insist on it.

Thank you for replying - I really appreciate it!

Thank you for replying, it means a lot!

I feel so daft asking for it, but then I have really empowered moments where I think, hang on, why the blinking heck should I have to go through with something I’m not comfortable with, just because it’s more convenient for them?

It could be painless for me, uncomfortable or downright painful, but to be honest, I’m at the point where I’m not willing to find out!

Any tips on how to stand said ground, would be massively appreciated!

Thank you :)

I can't help with the NHS but I needed a similar ish procedure before IVF, and under GA with added removal of endometriosis whilst in there, it came to £3k privately. We paid privately because I couldn't bear to wait for the NHS anymore and because it seemed to be a much higher standard of care. It's a lot of money so it might not be feasible for you but if it is, it's something to consider.
I also had another gynae procedure under 'sedation' which was for all intents and purposes exactly the same as a GA - I fell asleep the same, came round the same and didn't remember a single thing. So you could ask for this?

Thank you!

I just hope the consultant is somewhat sympathetic to my cause and isn’t too ‘old-fashioned’.

I usually have to take Ibuprofen and Paracetamol together just for my periods (have always had not so great ones!) and that barely touches the pain, so I dread to think how my pain would be during a Hysteroscopy, if I did feel any!

Any tips on speaking to him about a GA would be much appreciated - thank you! :)

Yanbu.
I insisted on a GA for mine years ago. I wanted them to get on with the procedure and me to not be distressed by it.

Thank you for replying :)

We have discussed this and if it came to an absolute no way on the NHS, for whatever reason (although can they refuse treatment because you won’t have it without GA?), we have decided we will pay privately to have it done. If you have any recommendations of consultants/private hospitals etc, I’d hugely appreciate it!

But obviously it is an extortionate amount of money and so I would rather try and pursue it on the NHS first - I just think that we don’t pay National Insurance for nothing!

Thanks again :)

Thanks so much for popping this on here!

Please could I ask how you asked for it/discussed it with the consultant?

I fear that I’ll be hugely dismissed by him!

Thank you so much! :)

My mum had a hystroscopy without anything. She said it was fine.

I had hysteroscopy and biopsy and there was no suggestion of being done without GA, it was a given, GA was required. I'm in Bristol, it was at the Maternity Hospital.

Hold your ground, demand GA.

OP I had/have very similar symptoms and it's adenomyosis and fibroids. So try not to worry.

Talk to the consultant about your anxiety. Are you having a consultation before the actual treatment?

If you want it done under GA they will almost certainly have to cancel your appointment and reschedule for another day. They clinics are not geared up for a GA and won't have an anaesthetist or recovery facilitiesz

I had a hysteroscopy, biopsy and fibroid removal under GA in April. I’ve got severe pelvic and back problems since having children so wouldn’t have been able to have kept my legs apart long enough. I did have to fight a bit to have the GA and the wait ended up being 15mths because of Covid.

Good luck.

Thanks for all the replies!

I’m hoping I have a consultation beforehand as I’d still like to get his opinion on the ultrasound and if it was polyps/fibroids/adeno, then what the effect will be on natural fertility.

I am absolutely completely aware that I’ll have to have a separate appointment for a GA and know that there will be a waiting list. I’ve been very conscious that I don’t want to waste the clinic time on Monday so have desperately tried to get in touch with his secretary or someone else who can help, but she’s never available and doesn’t return my messages and everyone else I’ve spoken to says I’ll need to speak to the consultant 😩

Definitely doesn’t help my overwhelming anxiety!

Poor you. I have had a bunch of these types of treatments (with the BMI chain, like a previous poster I was unwilling to trust myself to the NHS after bad experiences). Every single one was under sedation. I didn't realise until seeing it on here the NHS does them without pain relief . I would have thought it makes their job harder actually to have a patient wiggling about!

Getting private care is straightforward. You ask the GP to write a referral and you phone up the nearest hospital chain and say you want to self pay.

The phrase to utter generally is 'I do not give my informed consent to this.'

I had a GA for that procedure 4 years ago, I wasn't offered anything else! I'd ask for one yes

I had exact same thing done a couple of years ago.
All I felt was a bit of a stinging feeling ( I remember I jumped!) when they did the biopsy and afterwards I bled for a while.
I had what felt like period pain afterwards but just took some pain killers.
Not nearly as bad as what I thought it would be.

I can tell you one thing for sure - after all this is over, I’ll be investing in private medical insurance! 😅

I honestly thought I would be ok without and tried but just couldn’t so was offered GA. I had polyp removed without any pain relief in the past and thought I would be ok this time but no.

It's your right to insist on a GA.
Look up the facebook group "Campaign Against Painful Hysteroscopy " for advice and support.
I had to endure two very traumatic OP failed procedures before having the GA and I wish I'd had more information before attending my first appointment.

You poor thing!

I am so, so worried they’ll say no that I’ll probably burst out crying as soon as I walk in - what a pansy! 🤣

But I would just rather they get up in there and if there’s something they need to sort out, then they can do it all in one go and Bob’s your uncle 👍