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Not melodramatic to say I was traumatised by the experience

Posted By CeeJay1260

"Not melodramatic to say I was traumatised by the experience"

About: Chesterfield Royal Hospital / Gynaecology

(as a service user),

Having had a previous, excruciating hysteroscopy (at an appointment I just thought was to discuss a polyp found by my GP) I was anxious when referred for a second, with biopsy.

At the appointment I was advised that a Mirena coil would help with my endometrial hyperplasia - this I also suspected would be extremely painful. I outlined my fears and asked about anaesthesia only to be told that a Local Anaesthetic (LA) would be worse than the procedure. There was no mention of any further options. I was asked rather brusquely if I gave consent and, at this point I felt I had no choice but to reluctantly continue, with no form of anaesthesia or analgesic at all, in the hope that I’d remembered the pain wrongly. In effect my fears and wishes were disregarded.

The procedure was, as expected, excruciating. I was subjected to what I believe is called a “vocal local” which was ineffective and which I consider patronising. There was little empathy from the consultant (and observer) and being told I was doing, really well, and to, curl my toes, no matter how kindly delivered by the nurse in attendance, did nothing to help me through the process.

After a while I was offered gas and air but this only served to make me feel sick and did not alleviate the agony. It was quite obvious that I was in extreme pain. I was not asked if I wanted the procedure to stop, nor was any offer made to stop. When it finally was all over I was not asked how I was feeling but directed to a small curtained-off area of the treatment room to get dressed. I then had to make my way - shocked, in pain and bleeding - all the way back (no small distance) to the main entrance.

I was not asked on the day what my pain score was, nor asked for any feedback. I have not been asked for feedback to this day. I am a post-menopausal woman and therefore, I believe, at higher risk of severe pain.

I feel I should have been offered the option of returning for a General Anaesthetic (GA) given my history and previous experience which I clearly articulated - on the contrary I was effectively refused a LA.

It seems standard procedure at this hospital that an OPH (outpatient hysteroscopy)- described by many women (including myself) as barbaric and medieval - is done without any form of sedation or analgesia (unlike say colonoscopy where it is standard), and the onus is on the woman to request it. It should be offered as a baseline, with women being able to opt-out and not, as is the case, to opt-in. This is 2023, not 1823.

Although the appointment was in January of this year it would not be melodramatic to say I was traumatised by the experience and it invades my thoughts every day. Also, I was never given chance to read the leaflet about the IUD - it was given to me either immediately before the procedure or just before I left, I can’t exactly remember - so I do not consider that I was in a position to give informed consent with regard to either the pain of fitting or the potential significant side-effects and risks.

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Responses

Update posted by CeeJay1260 (a service user)

I notice that all the responses from the hospital seem to be related only to positive experiences: I have not seen any for the negative ones. I shall wait a little longer to see if I receive a response before deciding what my next steps are.

Response from Vikki Develin, Patient Experience Manager, Chesterfield Royal Hospital NHS Foundation Trust 12 months ago
Vikki Develin
Patient Experience Manager,
Chesterfield Royal Hospital NHS Foundation Trust

Submitted on 19/04/2023 at 08:30
Published on Care Opinion at 09:37

Thank you for taking the time to give your feedback on Care Opinion. I was very sorry to read about your experience with your hysteroscopy - and I'm sorry you haven't yet received a response. We do take concerns of this nature seriously. I will speak to the relevant department and ask them to investigate and provide you with a response as soon as possible.

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by CeeJay1260 (a service user)

Thank you.

Response from Chesterfield Royal Hospital NHS Foundation Trust 12 months ago
Chesterfield Royal Hospital NHS Foundation Trust

Submitted on 26/04/2023 at 10:30
Published on Care Opinion at 10:59

Response from Women's Health Unit Matron.

Thank you for your feedback. As the Matron for the Women’s Health Unit, I was disappointed to read about your experience with the unit regarding your hysteroscopy.

I am sorry if we have not met your expectations and that you feel traumatised by your experience, as this was certainly not our intention. I will be personally feeding your comments back to the team.

Generally, Entonox (nitrous oxide) is the only form of pain relief we can offer in an outpatient environment, as other stronger medication would require hospital admission or observation for at least 4 hours after the procedure. We do recommend that patients take pain relief (400 mg of ibuprofen and/or 1 gram of paracetamol if able) at least 1 hour before the appointment and I apologise if the leaflet containing this information was not posted out to you. Local anaesthetic can be administered in the form of an injection into the cervix; however, this is often more painful than the hysteroscopy itself. Local anaesthetic is usually administered when treatment is required such as a LLETZ procedure (LLETZ stands for large loop excision of the transformation zone, which is minor surgery to remove a small part of the cervix) or biopsy.

I am sorry that you feel you did not have the option to abandon the hysteroscopy and were not listened to. We can list patients for a general anaesthetic if they are unable to tolerate the procedure, and we do usually ask for feedback, including asking how painful the procedure out of 10. It seems from your feedback that these important questions are not always being asked. I will feed this back to the service to ensure improvements are made.

Once again, I do apologise on behalf of the WHU at Chesterfield Royal Hospital.

Update posted by CeeJay1260 (a service user)

Thank you for your comprehensive response and I appreciate your willingness to listen and take note of comments made. I do believe that what happened was not the intention. I also feel strongly that unless patients feed back constructively they cannot expect positive changes to be made. To that end I do have some other comments to make: however they are too lengthy to outline here. I would prefer to make them anonymously if that is possible and would appreciate some advice as to how to do that.

Response from Rachel Walker, Patient Experience Advisor, Chesterfield Royal Hospital NHS Foundation Trust 12 months ago
Rachel Walker
Patient Experience Advisor,
Chesterfield Royal Hospital NHS Foundation Trust

Submitted on 27/04/2023 at 10:03
Published on Care Opinion at 10:03

picture of Rachel Walker

Dear CeeJay1260,

Thank you for your further response, we are keen for you to provide us with your further comments. Should you wish to do this anonymously, there are a couple of options you have. You can email crhft.acs@nhs.net and provide us with these comments via email. These would go to our Patient Advise and Liaison Service, or alternatively, you can email myself at crhft.patientexperience@nhs.net, and I will be happy to review and feedback your comments to staff.

We also have a facility on our website in which you can leave comments and this will be signposted to the Patient Advise and Liaison Service to feedback to the relevant department.

With kindest regards

Rachel Walker

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Update posted by CeeJay1260 (a service user)

I have sent an email: thank you.

Update posted by CeeJay1260 (a service user)

I have not received any acknowledgement of my email, nor a reply to a second email I sent asking if it had been received. I am disappointed in the lack of engagement given the initial willingness to listen and respond to my concerns.

Response from Vikki Develin, Patient Experience Manager, Chesterfield Royal Hospital NHS Foundation Trust 11 months ago
Vikki Develin
Patient Experience Manager,
Chesterfield Royal Hospital NHS Foundation Trust

Submitted on 06/06/2023 at 11:07
Published on Care Opinion at 11:07

Dear CeeJay1260

I'm sorry you haven't received an acknowledgement or response. I have investigated this today and sent you an email, which I hope will give you some options of how to proceed.

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by CeeJay1260 (a service user)

Many thanks for your comprehensive reply which I have read. Will email back in a day or so when I have considered how I wish to proceed.

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