No anaesthetic: am I being a wimp?

JackK ...You can choose to have this procedure under GA if you choose this method. I had the procedure in December. The hospital leaflet just advised taking over the counter pain killers and said the procedure could cause 'mild period like' cramps. It did state that the procedure could be stopped at any time and the need to put this in the leaflet raised my curiosity and I looked at appropriate nhs sites and had a chat with a doctor in the family. After all, any procedure can be stopped on request and the same hospital hadn't felt the need to mention this when I had a colonoscopy. I did feel that if the likelihood was mild period pain, who would need to stop a necessary medical procedure and go through it all again at a later date.

Although my hospital didn't mention the choice of GA the NHS choices site gives a list of reasons why you can request a GA, including choosing not to have the procedure awake.

It is cheaper for the NHS when women choose the procedure without anaesthetic and that is fine if this is a genuine choice. I had a transvaginal scan which was supposed to be followed up by hysteroscopy without anaesthetic. The staff were perfectly lovely and a bit persuasive but as soon as I mentioned NHS choices and produced the information they agreed totally that I could have the procedure under GA. The consultant came to have a chat with me and told me that as I would be having a large polp removed the procedure would be painful and I would probably have it stopped anyway.

All fine. Had the hysteroscopy and polp removed under GA two weeks later. However I do feel that the hospital leaflet should have warned that the procedure can be extremely painful so that women can make a properly informed choice.

Don't feel like a wimp if you do choose the GA route. If you feel you want to, do take the NHS site information about choices with you. I think there is another route on offer in some hospitals where you can have conscious sedation, a bit like when a colonoscopy is performed.

Good luck with which ever route you choose. Do come back and let us know how you get on

I find it rather sneaky that leaflets talk of 'slight discomfort' or 'some people find this uncomfortable'.
Why do NHS leaflets never use the word 'pain'? 'Uncomfortable' is not another word for 'pain'. We should be given the facts and allowed to make up our own minds. If we were told the procedure would be over quicker and cost the NHS less money without sedation, but that we could choose to be sedated or even 'out of it' we'd know where we stand.
But we should be told that some people found it painful - so we would have the correct information to make a sensible choice.

My consultant deadened the area with an anaesthetic.
It was odd and uncomfortable but ok.
I have had vaginal births btw.

You've all been so helpful! Thank you so much!
I shall report back ...

I had one two years ago and the consultant could see how much pain I was in (2 c-sections,) and wouldn't carry on. I was booked for a GA.
I am currently waiting for a repeat procedure. I don't know if they will book it as a GA straight away

I've not had this procedure but I guess they are trying to get through the back log of cases caused by Covid and obviously a GA requires a theatre and an anaesthetist so you may have to wait longer. Good luck, I hope it goes well

foxie48

I've not had this procedure but I guess they are trying to get through the back log of cases caused by Covid and obviously a GA requires a theatre and an anaesthetist so you may have to wait longer. Good luck, I hope it goes well

No this isn’t the case - this debate has been around long before Covid and probably depends more on the sadistic tendencies of the lead consultant ( only partly joking).

Reading this post after speaking to my husband in hospital after a kidney stone removed he was in horrendous pain after and I rang him and told him to speak up. Good job he did as he’d had a really bad reaction to the op and needed extra pain relief.

foxie48

I've not had this procedure but I guess they are trying to get through the back log of cases caused by Covid and obviously a GA requires a theatre and an anaesthetist so you may have to wait longer. Good luck, I hope it goes well

My friend’s experience was pre-pandemic. She was specifically told that to have a GA or sedation was less convenient for the unit.

I don't know why they do not just give people gas and air - it is so simple.

You are going in as a day case so that's the reason they are not giving you the option of a general anesthetic and I can't see why you can't have a local.
You would need to check this with your GP, I am sure they will try and accommodate.

jeanie99

You are going in as a day case so that's the reason they are not giving you the option of a general anesthetic and I can't see why you can't have a local.
You would need to check this with your GP, I am sure they will try and accommodate.

I was a day case and had a GA - my dd had surgery and a GA as a day case. Adequate pain relief in a rich country in the 21st century is a right not something to be grateful for

SueDonim

foxie48

I've not had this procedure but I guess they are trying to get through the back log of cases caused by Covid and obviously a GA requires a theatre and an anaesthetist so you may have to wait longer. Good luck, I hope it goes well

My friend’s experience was pre-pandemic. She was specifically told that to have a GA or sedation was less convenient for the unit.

Oh well that’s ok then - whatever’s convenient for the unit. You couldn’t make it up could you ?There shouldn’t be this variation should there?

A word of warning if you are given a follow up of progesterone after polyp removal. I had to take the tablets daily for 6 months but no-one warned me what coming off them after 6 months would be like. I had stomach cramps and very heavy bleeding (I was frightened to sit down) for well over a month. Indeed I lost so much blood that I had to have a blood test for anaemia but thankfully all was well. Just be aware.

Not a hysteroscopy procedure but similar. I had a coil that needed removing and the nurse gave it a gentle tug and pulled off the strings leaving the coil still inside. After several attempts/rummages by several doctors, who all had hands like shovels, (I swear they were running a book as to who would manage to remove it) it was just getting too uncomfortable to bear, so they sent me home with something that dilated my cervix, I cant remember if it was a tablet or a pessary. Sitting on the bus in what felt like the early stages of childbirth wasn't great, but a few hours later when I returned it was a quick, simple painless procedure to remove the offending article! Would this be an alternative option to a GA?

You are not being a wimp but I had a one and they used a type of gel which froze the area. I was OK and I am a wimp. Take care. X ?

Good post BrightandBreezy @00:31:24
Completely agree that information giving around procedures like this isn't always helpful. I was completely misled when I had a colonoscopy several years ago and it has really affected my confidence about some major surgery that I know I will need sooner or later. However it is worth pointing out that there are very real risks associated with general anaesthesia that need to be weighed up for each individual.

GrannyLaine

Good post BrightandBreezy @00:31:24
Completely agree that information giving around procedures like this isn't always helpful. I was completely misled when I had a colonoscopy several years ago and it has really affected my confidence about some major surgery that I know I will need sooner or later. However it is worth pointing out that there are very real risks associated with general anaesthesia that need to be weighed up for each individual.

Yes - it’s all about informed consent isn’t it? In one of my working life roles I was involved in the production of information leaflets for patients in clinical trials. Sometimes a procedure would be part of the trial - maybe as simple as a blood sample but sometimes a biopsy. I nearly always had to make them beef up that section in terms of how much pain could be involved and what pain relief would be available. It was quire common for medics to underestimate a safe, routine procedure in terms of impact on patients just because it was so routine for them .

You're definitely not being unreasonable. I've had four in the last two years. The first was so painful they couldn't complete it and I had to go back as a day patient and have it done under GA. The second and third I managed to scream my way through. By the time I had the fourth I was traumatised. Even the consultant admitted it was painful and said the he was amazed I'd come back again. He asked me if I'd like a local anaesthetic which I did. The injection was uncomfortable but nothing like the pain that comes with the procedure. Once it took effect I felt no pain. So don't let them tell you that local anaesthetic isn't available. It is.

vampirequeen

You're definitely not being unreasonable. I've had four in the last two years. The first was so painful they couldn't complete it and I had to go back as a day patient and have it done under GA. The second and third I managed to scream my way through. By the time I had the fourth I was traumatised. Even the consultant admitted it was painful and said the he was amazed I'd come back again. He asked me if I'd like a local anaesthetic which I did. The injection was uncomfortable but nothing like the pain that comes with the procedure. Once it took effect I felt no pain. So don't let them tell you that local anaesthetic isn't available. It is.

Your experiences sound like some form of medieval torture not a rich country in the 21st century. Why do we as women think this is anywhere near acceptable? Before anyone thinks I’m victim blaming, what I mean is what has resulted in some of us accepting the idea that we should not be offered appropriate sedation whether local or general ? And what are those professionals involved playing at? I wonder also how many appointments fail and thus resources wasted plus some women then being hesitant to seek further treatment? The OP brought in the word ‘wimp’. I thought that was really sad.

This is from the RCOG guidelines

9.3 Should injectable local anaesthetic be administered to the cervix and/or paracervix before outpatient hysteroscopy?
Application of local anaesthetic into or around the cervix is associated with a reduction of the pain experienced during outpatient diagnostic hysteroscopy. However, it is unclear how clinically significant this reduction in pain is. Consid- eration should be given to the routine administration of intracervical or paracervical local anaesthetic, particularly in postmenopausal women.
A

Patient accounts - the same story over and over again

www.pslhub.org/forums/topic/68-painful-hysteroscopy/

www.hysteroscopyaction.org.uk/

A group of women have set up a campaign group so women are fighting back. It’s very heartening to read this but dreadful it is necessary.

www.hysteroscopyaction.org.uk/

silverlining my gp (admitting not my own a young mani might add) refused to give me any tablet to calm me when I was very nervous over a dental procedure he said I d get addicted I asked for one blooming tablet for one event