Grr! Need a de-brief after seeing gynae consultant!

[lilysma]

Saw gynae consultant today (with DH) after 8 months unsuccessfully TTC and having increasing back-pain, PMS and spotting before AF (4-5 days which is new for me in last few months).

I really shouldn't be surprised but he was totally rude, cursory and dismissive of any of my experiences and totally uninterested in my symptoms or problems beyond the potential (secondary) infertility. I have been charting and produced these, which suggest ovulation, to be dismissed with "not very reliable", a breath before suggesting that he would probably prescribe clomid (but we would have to pay for it privately as we have a DD - this was news to me). He kept getting my basic history totally wrong as well, having obviously not read my notes and not being bothered to ask. Anyway, the upshot is that he's going to do more blood tests (no big surprises).

I'm still trying to disentangle my reaction (from the initial rage ) but just wanted to check a few things out with anyone who has any experience of these matters...

Is spotting for 4 days before AF with back pain 'completely normal' ("I can't think why your GP thought this needed checking out")? Lots of things I have read suggest it isn't, and it certainly isn't for me. My ultrasound and basic bloods were fine.

Does the presence of a corpus luteum cyst on my ovary (as seen on ultrasound) suggest that I ovulated this cycle?

Outrage and similar stories of horrible gynaes will of course be welcome too

Am sorry to read of your bad experience today. BTW was this a private practice gynae or were you seen under the NHS?.

TBH I'd be asking the GP to refer you to another and hopefully more sympathetic gynaecologist.

There is good and bad in all professions and you saw a poor gynae today. Don't settle for poor treatment because a poor start like this rarely gets better. It is vitally important as well that the three of you can work as a team and that is unlikely to happen here with this person.

Am no expert but would say that persistant spotting 3-4 days before AF with back pain is not normal at all. It should be investigated further; infact any changes to cycle from your "normal" pattern should be checked out. BTW too, has your actual period changed in other ways like increasing pain leading up to and or during menses?.

I thought he would dismiss the temp charts, they often do so for the reason you stated.

You will need to be persistant in order to get answers, it is all too easy to be fobbed off.

I don't have much experience in this specific area but if your gp thought it was worth referring you then he must have had a reason. They don't just do it for fun.

Remember you are always entitled to get a second opinion and I would tell your gp this is what you would like and they can refer you to another gynae. The one you saw sounds like a generally unpleasant person!

Also sorry you've had a bad experience, it is frustrating when you wait to see a gynae and then are dealt with so briefly.

I have also had a similar experience, ttc second child for eighteen months, went to see gynae and was dealt with extremely quickly and sent on my way with a prescription for clomid.

The clomid has actually been free for me (NHS) even though I have an older child although I suppose this must vary throughout the country. I do also have a mild case of endometriosis so am not sure if that meant it was free for that reason.

Don't have any personal experience of this but a friend of mine was diagnosed with secondary infertility and had an HSG initially she was told following this that her tubes were blocked and she would need IVF - all said behind a screen in a ward full of other women by an unsympathetic gynaecologist!!!
Turns out however that she had her tubes cleared and was put on a course of Clomid (so far unsuccessful) but this was also free and she has a DS. But as Lakefarm said it maybe varies from trust to trust throughout the country.

He sounds like a idiot.

May I make a suggestion? You take EXACTLY your post, make it into letter form and copy it with a letter of complaint to PALS, your GP and the gynae in question. And ask for a 2nd opinion. You poor thing.

I hate gynae/obs consultants, all of those I have ever come into contact with (have been arrogant and patronising.

And, breathe!

Oh, and you wanted Takes of Horrible Consultants? OK, here goes:

I was 19 and had PCOS to extent was menstruating about twice a year. Referred to gynae and on examination found I had a cervical polyp. The SHO doesn't know what to do, so calls for consultant. Consultant tells me to face the wall and procedes to pull out the polyp with NO warning, NO local and NO explanation. All the time questioning me very aggresively about why I though I might have problems conceiving.

Oh God, I've burst into tears writing that.

Right, and the 19 year old me bursts into tears too. I felt like someone had assaulted me (which, thinking about it, they had) He eventually apologised very perfunctorily.

Oh yes, and the reason it had hurt so bloody much? Because it wasn't cervical, it was uterine and actually had progressed through the os into my cervix. I know this because he only broke off the stem and I had to have it re-done under GA a year later. I cried all the way home on the bus. I wish I'd complained. I wish I'd bloody sued.

No-one should have to put up with the "care" you received OP.

littlesilver in your position i would be tempted to follow this up even now. fucker. just as a matter of curiosity, are the vile gynaes all male (i am not implying that all male gynaes are horrid, incidentally) or has anyone come across a horrible female one?

i've not read all the replys but just wanted to say there are some crappy gyne's out there. when i lived in birmingham i saw a crappy one who didnt even write up my notes properly and surprise surprise they have gone missing.

but where i'm living now i have a lovley gyne, really supportive and listens to everything i tell her. i would suggest you ask to be refered to another gyne as your not getting on with this one. you are allowed to change, your post suggests that he is truley awful, ask your gp for a new referall asap.

Lilysma- To answer the corpus luteum question yes it is a good sign that you have recently ovulated and would be in the luteal phase of your cycle.

The one I mentioned upthread was female

Wow, I didn't manage to get back on for a while and am now overwhelmed by all your messages. Thanks so much for the support!

TBH I'm a bit embarrassed to be complaining when I read some of these experiences. Little Silver (sorry I can't get the bold to work) I am truly shocked at yours and agree that this was definitely assault and I would be tempted to follow it up too. Unbelievable (not literally of course, I do believe you!).

Barry Kent, this sounds like just the kind of attitude this gynae was displaying - the total assumption that you know nothing and that your experience counts for shit .

It saddens me to realise that women's health/gynae medicine still seems to be stuck in the dark ages and this is what our taxes are spent on . It does seem to be a cultural problem rather than 'a few bad eggs'.

My concern about trying to change consultants right now is that I guess it would take me back to square one with all the tests for infertility if I asked for a change now (wouldn't it?). It took a month to get the first appointment (not too bad, but the next one is another two months' time). But I'm glad some of you think it is worth asking for a second opinion on the menstrual stuff. I think I might have to go back to the GP and ask for a second referral to someone else just on that. To expect to be treated as a 'whole person' seems too much to ask for

Atilla thanks for your informed comments and questions as ever. To answer your questions, it was the NHS (our local women's hospital, where the care I have received in the past has been quite good, including treatment of an ectopic five years ago). I have had new pain in the lead up to AF (four or five days of lower back pressure and pain, which is completely new for me) as well as reasonably severe emotional symptoms (anxiety and lack of concentration) which are also new. Some of the latter may just be stress about TTC I guess, but it seems unlikely to explain the former symptoms. The problem is that I don't really know what kind of issues this might suggest. Endemetriosis? What is the reason for dismissing charts - I understand that they don't tell the whole story, but surely they offer some clues? But this guy was not interested in any detective work. But he is running an HCG as well as the usual bloods (Days 3 and 21) and sperm test for DH, so it seems worth getting the results from these at least!

Sorry, what a long post! Thanks again to everyone for your supportive posts and sharing your experiences. It is good to feel less along

I forgot to add thanks for the suggestions re PALS. I guess I could do that and still go ahead and get the tests and another referral (not that I want to have my cake and eat it )

Thanks for helping me think things through!

Oh, and did I mean HSG, not HCG? Acronym confusion!

This post may be a little late, but have you heard of an 'anti mullerian hormone'test www.advancedfertility.com/amh-fertility-test.htm

I had a text book first pregnancy, but then had to have an emergency ceaserean (sp) and my tubes got a bit tangled... I've had 2 (half) courses of IVF - both failed. Then insisted on an HSG and the other one (so one through key hole surgery, and the other where they go up your bits...).

I then found about this hormone test. it's more relaible than just an FSH test (mine all came back healthy) - and gives a greater indication of fertility levels. I had to pay for the test (just the cost of a blood test) but found it really useful.

Hope this helps.

Thanks, I will look it up!

Thanks babybecks, and I forgot to reply to your question re the US. I did have an internal one because my bladder wasn't full enough so they couldn't do an external one .

It strikes me that what the consultant I saw will do to 'check if I am ovulating' is measure progesterone at days 3 and 21, which is basically measuring the same thing as the charts since the temp change as I understand it is directly related to a rise in progesterone! Obviously the blood test is probably more accurate, but one is an indication that the other may come back normal, it seems to me. And also neither are infallible in proving that ovulation has happened. There were lots of questions I wanted to ask this guy about my charts, but he wasn't going there.

Hope all comes good with your nice gynae!

It amazes me how many gynaes actually seem to dislike women. That tale is horrendous LittleSilver and it makes me dread seeing them all the more

Lilysma good luck. And oh, the bold thing - you need to put an asterisk around every word rather than the whole phrase!

Yes, why oh why would you go in to obs and gobs (as my clinical colleagues call it) if you actively dislike women?? [hmmm]. But many seem to... or maybe they see it as a good way to torture us!

Thanks for the bolding advice - I never read instructions properly

Nor do I do emoticons properly