QuestionQUESTION: Around August 8 I was found to pregnant at a hospital (while being looked at for something else). I had conceived around July 14th.
I visited a clinic in mid August. They couldn't find the baby so they had me come back in 2/3 days to do some more tests. I went back and they confirmed they couldn't find what they needed to find and feared and Ectopic. So, they told me to visit the ER.
At the hospital they concluded it was a missed abortion and scheduled me for a D&C the following Monday. No one really discussed much with me, but being that it was an ER I am not surprised.
I had the D&C August 23 and they set up my follow up exam for October 6. I have not bled a drop since coming home from the hospital the day of the surgery.
Around Sept 27, I called the emergency number they provided me with because I was having severe acute pain (pelvic) and Acute pain during urination and Bowel Movement.(I did have a fever for one or two days, but am not sure if it is related since it did go away.) They told me I had to go the ER, so I went.
When checking and stating the reason for my visit to Triage, I told her I think I am having some complications due to my D&C. When I told her the date of the D&C, she shrugged it off and said she highly doubted it had anything to do with it since this was 5 weeks later.
When the ER doctor saw me he gave me a pregnancy test(neg) and felt around my pelvic area and declared me fine (I would like to mention that normally I suffer from very very little cramps, if any at all during my period.) a few days later the pain subsided.
I went to my Follow up visit and told the doctor there what happened. She also only gave me a pregnancy test and basic pelvic exam (?felt my pelvic area and inside). She said I was fine and wanted me to start birth control.
Being hopeful, I went home and decided to wait some more for my period. the week before the week of the Oct 26 I started getting regular cramps and thought my period would soon follow. By Oct 24, I was suffering from the same pains I had around Sept 28.
This time it was more intense and lasted longer. I also had some pain in my lower back and around my sides; as well as pain during sex(deep)
I went back to the clinic where this started and asked them for help since the hospital wasn't helping. They gave me a sono (found nothing) and pregnancy test (neg). They said they are unsure of what was going on and recommended birth control pills to jump start my period. (When given the sonogram I noticed tenderness when it would brush against the cervix.) Like last time the pain eventually subsided. I am not a professional, but I am pretty sure it will come back every month
Due to research and internet help I have narrowed down the very HIGH possibility of Asherman's syndrome, but that still doesn't explain all of my symptoms.
I'm at a loss, and any help would be greatly appreciated.
Thank you
ANSWER: Hello Simone from the U.S.,
Have you seen a Gynecologist? Going to the ER is great for emergencies but terrible for routine or non-emergent care. ER docs are specialists in emergencies. They have very little training in many other things. Also, it does not sound like the clinic that you went for follow-up is a Gynecologic clinic because a Gynecologist would not just disregard everything. What it a Family practice, primary care or public health clinic?
There may be the possibility of Asherman's syndrome as you have found, but other things could be going on as well. Based on the ultrasound and pregnancy test, the only things you know are that your are not pregnant and there are no large tumors, cysts or masses in the pelvis causing your pain. But ultrasounds cannot see adhesions, such as in Asherman's syndrome, or endometriosis, or pelvic infections. In order to check those out, you would need cultures from the cervix, a hysteroscopy to look into the uterine cavity and a laparoscopy to look at the pelvis. Only then will the appropriate diagnosis be made and treated. Birth control pills are not the answer to all pelvic problems.
I strongly recommend that you go see a competent Gynecologist to get to the bottom of this problem.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
---------- FOLLOW-UP ----------
QUESTION: Thank you for your quick reply.
I had two follow up exams. The first was at the hospitals Gynecologists. They set me up for that appointment the same day as my surgery. The Gynecologist there disregarded all my concerns.
I only went to the ER before this appointment because I was instructed to when I called womens health services about the pains.
Because of my concerns, I personally set up an appointment for an annual check up at Planned parenthood. During my annual I brought up my concerns to them. They didn't fully disregard my concerns. I had a sonogram done (finally) along with my annual. (That was when I first realized the tenderness). They just admitted that they weren't sure about what was going on.
Both places want me to start birth control.
I called another gynecologist and tried to be seen, but they made it very clear they weren't comfortable about looking in to something that someone else may have messed up.
The other gynecologist I contact is booked till Dec 27th. That is when my appointment is.
So I guess all that is left is to wait and/or keep searching.
Thank you.
AnswerHello Again,
Well, I am sorry to hear that no one has taken responsibility for you but that is the problem with not having a personal physician. The ER gynecologist cared for you only because you showed up in the ER and was only to make sure there was not an emergency situation. Planned parenthood is great for minor gynecological things like annual exams and birth control, but is not a gynecology specialty practice. In terms of not taking care of someone else's problem, that gynecologist should be shot. We do that all the time because we are specialists. I would suggest you keep looking for a gynecologist that can see you soon instead of waiting until the end of December. That is your best and only choice. Could it be because you don't have insurance or are on public health insurance like Medicaid? If you are on Medicaid and are facing this problem of not being able to get to a gynecologist, this is one of the major problems with government health care, and unfortunately, a problem you likely to keep facing. If you are paying cash for your visits, let the doctor's office know that you are paying cash and want to be seen right away. I doubt they would turn you away.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
