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29.08.2018- When periods are more than just a pain

Wednesday, 29 August 2018


As I've touched on in a couple of posts of late, at the end of April I went into hospital for an operation- specifically to get the bottom of what had been causing me chronic period pain over the last few years, as well as a few other equally unpleasant symptoms. Four months on, with my scars healing and *touch wood* starting  to feel much better, I thought it might be worth sharing my experience, especially if you might be experiencing something similar- I found talking about it with friends was one of the most helpful things throughout the whole process, so if you're in the same boat, I hope that this post provides a little bit of illumination into what can be a pretty daunting process. 

Starting at the very beginning- taking it back two and a half years or so- I'd been experiencing intermittently painful periods so headed to the doctor to see what they could recommend. Whilst no two periods are the same, there were a couple of commonalities which would crop up more often than not during the week of mensuration, making life generally pretty miserable- stomach and back pain so bad that I could barely stand up, vomiting all over the shop for the first day or so and comparatively heavy bleeding. Nothing seemed particularly out of the ordinary as far a I was concerned at this stage, and this initial trip to the surgery was more to enquire about the possibility of stronger pain relief than that which I had been getting over the counter. After making an appointment with a female doctor, I was duly rewarded with a prescription for magical Mefenamic Acid- a pain blocker rather than a pain killer, with the idea being that dosing up the day before my period was due to arrive would help me sail through and be able to carry on with day-to-day life, rather than having to worry about taking time off work and not being able to do things, as had been the case more recently. As well as this, I was given Tranexamic Acid, which, as a blood thinner was designed to help ease the flow and alleviate some of the associated symptoms of heavy bleeding- at least that was the theory! Suffice it to say that after not even taking the recommended dose of TA (the day before I was due back at work after Christmas!), I found my vision blurry and got very lightheaded- known side effects, so decided that I was much better not taking it to err on the side of caution.  

For a good eight months or so, the tablets worked perfectly. I was able to keep on top of the pain with very little effort, and everything seemed to be calming down. However, towards the end of 2016 I found that the pain would creep back sporadically, and it would at times often be quite difficult to manage. As well as that, I had started to experience other symptoms too, such as persistent bloating, lower abdominal pain and bleeding between periods- not a huge amount, but just enough to set those alarm bells ringing. I duly returned to the doctor, and was listed for an abdominal ultrasound to check that there was nothing out of the ordinary going on. Then, on the morning of my scan, I had a call from the surgery to tell me that the sonographer was off sick and that there was no way I'd be seen that day. Whilst this was by no means the end of the world, it felt like somebody had pulled the floor away from beneath my feet- I'd arranged to have that afternoon off work, had got mentally prepared and was banking on there being something concrete to take away from that day. Having been told that I'd have to wait over a month for a new slot to become available, I felt even more panicked- another month of not being sure what was going on, another month of potentially debilitating pain coming and going without any progress. I explained (quite forcefully, it has to be said!) my situation to the practice manager- luckily, and I think in part because I wouldn't take no for an answer, I was given a slot at the ultrasound facility at the local hospital that afternoon instead- something which, looking back, felt like the biggest relief, but was only the start of a long journey. 

If you're not pregnant, having an abdominal ultrasound is a pretty bizarre experience, especially as they usually happen in the maternity wing if they're being done in hospital. Even more stress-inducing is having to down as much liquid in advance as you can and not go to the loo until after the scan. Not easy at the best of times, and even harder when the waiting area is right.opposite.the.bathroom. Full bladder aside, the scan was fine, and the sonographer was lovely. They had a bit of trouble finding my left ovary but after a few attempts it appeared- and all seemed clear as far as they could see- this sort of scan is never definitive but is helpful as an initial tool in ruling certain things out. Relieved (in more ways that one), I made my way home, happy in the knowledge that I was just cursed with painful periods and that there was nothing more severe to be concerned about. 

Thinking about things in slightly broader terms, I think that part of the problem in terms of the delay in diagnosing gynecological conditions is knowing when pain is just pain and when it is something more serious. Women in particular are so used to managing illness and getting on with things that it can be quite tricky to know when regular period pain ends and other symptoms begin. We're told repeatedly by society that no pain means no gain, and that periods are supposed to be carefree, simple and easy- especially with this 'amazing new brand of sanitary towel®' which means you're able to run/cycle/do as many cartwheels in your whiter than white shorts and carry on as you want without the inconvenience of bleeding, pain, or any other symptoms. We're conditioned to keep going- so much so that it makes it difficult to feel like you're not making a fuss when you're 100% sure that crouching on the floor of the disabled toilet at work whilst intermittently being sick in the sink isn't normal. Certainly, I continued for almost a year after my ultrasound thinking that all of the pain, sweats, shivers and other monthly joys were just because I was serially unlucky, rather than because of anything more concerning.

Eventually though, enough really was enough. When the prescription painkillers stopped working as well as they had, when more months were passing punctuated by vomiting, serious bloating and my bladder seeming to shrink to the size of a pea, it seemed like it was high time to get to the bottom of what was going on once and for all. At the end of December 2017, I was referred by a fantastic new doctor at my local surgery to a consultant who I saw in early March this year. After sitting down and talking through my symptoms, and a further short examination, I was referred for an exploratory laproscopy, to investigate suspected endometriosis. This keyhole procedure, performed under general anesthetic, is the only way that this and a number of other gynecological conditions can be definitively diagnosed and, in many cases, treated at the same time. The date for my procedure was set for the end of April- and everything happened really quickly once I'd been referred.

There's nothing which can really prepare you for this sort of procedure- and even more so if you've never had it done before. Aside from an operation to have a tooth out when I was 11, I'd never been admitted to hospital before, and although I felt really well informed after my pre-operative assessment, as well as talking to doctors and my wonderful friend Katherine, ultimately everybody's experience of a procedure like this will be unique. I tried to avoid Googling too much in advance too, especially as there was nothing from a medical perspective which hadn't been explained to me by the consultant or nurse I'd seen. With my blood test done the Friday beforehand, the morning of the procedure arrived with an early start for me to allow for a little bit of breakfast (dry toast at 6.30am, not the best Monday morning I've ever had!), as well as some water. I had to be totally nil by mouth after about 11am, so got ready to head out of the house amidst bouts of feeling really nervous and crying- all perfectly normal, but something which took me by complete surprise if I'm honest. After such a long wait, the day was finally here, and, looking back, I'd become really worked up about it, convincing myself that the plug was bound to be pulled at the eleventh hour, or that something else was destined to go wrong. Happily, that wasn't the case, and I arrived at the hospital to find myself first on the list for the afternoon's operations. Result, I though- I'll be home in time for Pointless and a nice cup of tea...

Obviously, being first on the list was a status which didn't last for long! As the surgeon made her way around the six ladies on the ward due to have procedures that afternoon, things got reshuffled a little bit and I was (rightly!) bumped from first to fourth. On paper, my procedure was routine and nothing to be concerned about, so priority was given to some more complex patients, two of whom were lovely older ladies who were whizzed back onto the ward within an hour of being taken into the operating theatre. With the promise of sandwiches and all the tea I could wish for once I'd been into surgery, I settled down in my very comfy chair, donning a new dressing gown, as well as regulation hospital nightie and some very fetching surgical stocking! By this time, it was about 3pm, and the patient before me on the list had just been taken through. I was next up, so went for approximately my 456th emergency trip to the loo of the day before coming back and trying to take my mind off of things with some reading.

Easier said than done, it turns out. Waiting is by far the hardest part of days like these, and I don't think that there's anything which can really prepare you for how tiring it can be to sit around with one eye on the clock, especially if you've been nil by mouth all day. By this time it was 5pm, and I was convinced that I'd end up being cancelled, sent home with nothing to show for the day but a few more pages read and a lot of calories in deficit. Twenty minutes later, however, I was being prepped for surgery, being wired up and cannulated ready for the anesthetic. I'd be lying if I said I wasn't scared witless at this point, but having been alone on the ward all day, I was relieved to be one step away from home and even closer to those sandwiches which were waiting for me. I can't really remember anything about what happened from here on in (as you might expect!), apart from being looked after absolutely fantastically by the doctors, nurses, anesthetist- everyone. The next thing I knew, I was waking up in a delirious, drug-induced haze in recovery feeling like my head was going to fall off because I was so dizzy. The routine surgery, which was supposed to be more exploratory than anything else, had taken three hours, and ended with the removal (in three parts) of a substantial cyst from my left ovary. I won't go into too much detail here about what exactly it contained, but suffice it to say, it wasn't particularly pleasant!

By now, it was about 9pm or so, and, because of the length of time that the surgery had taken, I was going to have to be kept in overnight, just to make sure that I'd hadn't had any adverse reaction to the anesthetic or any of the medication, and could go to the loo without any problems. This required transport by ambulance to the next largest hospital (much closer to home!), so there was a little bit of waiting involved; at this time I honestly couldn't have told you what day of the week it was, let alone anything else. I do remember feeling absolutely dreadful- the whole room was spinning, and those much-anticipated sandwiches could not have been further from my mind. Into this maelstrom, however, stepped the figures of my mum and dad, who'd called the hospital to find out what was going on when it had past 8pm and they hadn't heard from me. I don't think I've ever been happier to see anyone in my life.

The ambulance arrived just before 11pm to drive me the forty minutes or so up the road, but by this point time had become completely irrelevant. All I could focus on at that moment was how ill I felt- so much so that I was being sick in response to the anesthetic and painkillers. I honestly can't thank the nurse who had looked after me all day any into that evening enough- she stayed with me, changed my bloody sheet before I was transferred and chased and chased the ambulance when by rights she should have clocked off at 6pm. How lucky we are to have the NHS and the wonderful staff that devote themselves to helping others. I arrived at my local hospital just after midnight into more wonderful care- whizzed by the most fantastic ambulance crew onto a ward and instantly settled down for the night. Mum and dad headed home, and I was promised a next day discharge- on the home strait at last.

That night was pretty rough, with two further bouts of sickness (it turns out you very definitely can vomit when you've not eaten anything!), but I was able to use the loo- a big tick in terms of being allowed to go home the following morning. Again, I was surrounded by angels in NHS scrubs, who looked after me so much, including taking me to the bathroom and dosing me up on anti-sickness medication. The surgeon came to see me early that day, and I was given the green light to go as soon as I'd had some breakfast. She checked over my wounds (four in total), made sure that I was feeling well enough and explained to me what they'd found- complete with photographic evidence! She was just as surprised to find what she did as I was when she told me, but if I'm honest it was a relief to know that there was a quantifiable root cause for all of my symptoms- and even more of a weight off of my mind to know that the cyst had been successfully removed after what had been quite a complicated procedure.

Getting back to semi-normal has been quite a slow process, but the healing power of the human body is amazing. Adjusting to having to take things a day at a time was a bit of a challenge for me too, and I remember getting really frustrated at not being able to do things for myself- something which, in hindsight, seems totally ridiculous. The real sticky thing in the week or so after the operation was the pain from the gas which they pump into your abdomen to make things easier to see- sore chest, tight shoulders and lots of burping which seemed to last for ages- not fun! Every little step along the road to recovery has felt like a huge milestone- whether that be something as everyday as having a shower, going for a walk or taking my dressings of the week after the surgery. I've never been more grateful for the support and help of my mum, both in terms of helping me with physical tasks and also for giving me a good talking to when I was doing too much too soon. As well as that, the friends who sent flowers and kept me sane with texts and WhatsApp messages- every little thing made such a massive difference to how I was feeling.

In all honesty, I've been surprised at how long it's taken me to get to a point where I'm starting to get my stamina and energy back- proof positive, I suppose that everyone recovers differently and that listening to your body is key. More than that, I have to keep reminding myself that what was supposed to be a short, routine procedure turned into something a lot more invasive, which is why I'm still feeling a little bit sore as the repair process carries on. Above all, I couldn't have wished for better care, and am so grateful to the NHS for looking after me, as well as being oddly relieved that all of the horrible symptoms which I had been experiencing could, at long last, be attributed to something solid. Raising awareness of gynecological conditions, whether it be endometriosis, PCOS, cysts or anything else is something which couldn't be more important- especially as getting that diagnosis in the first instance can often take years at a time. In short, I'd say that if you notice something out of the ordinary, and no matter how trivial it may seem in terms of other things you've got going on, pop to to doctor and get things investigated. If you're still struggling to get any answers, you're well within your rights to see another GP for a second opinion too- persistence really does pay off.

There's lots of information about specific conditions online, but one of the most helpful resources is the Endometriosis UK website. They've also got a brilliant petition on the go to teach menstrual wellbeing in schools, which is essential in raising awareness of conditions and busting taboos. If you're reading this and have any further questions, please do also feel free to get in touch, either in the comments section, via email or on Twitter.

(Image credit: Sarah Farrell, please do not reproduce without permission.)

2 comments:

  1. I'm so glad you finally got it sorted, Sarah! This was such a great article too! I hope many women see it. I have to admit, I had no idea how scared you were and thought you were some sort of superwoman all along! xxxx

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