"The highest standard of treatment and care anyone would hope to receive"

I am a liar! 6 months ago I declared that if ever I needed a hysteroscopy again I wouldn't be as nervous. Poppycock! The recommended pre-procedural analgesia unexpectedly returned 10 minutes after swallowing! (would I now experience more pain?)

Left 1.5 hours ahead to allow time for standing/walking on arrival (normally 35-40 minute journey). Cue tree and hedge-cutting with horrendous stop-start queues. Expletive-ridden, stressful, journey inflicted on brother! Arrived just past allotted time. Would I still be able to tolerate a position for the procedure to succeed? Also more embarrassed than previously as menstruating and now no time to clean myself up (although I'm sure this would have been given if asked.) The sum of this: anxiety and trepidation increased tenfold to first visit. Thanks to the lovely member of staff on reception for their calming nature.

I thank the booking coordinator for rearranging the initial appointment, and the consultant for adding me to his list despite my guilt at potentially taking a place of someone with more urgent need and heightened worries over their own diagnosis.

Following introductions by all 4 staff involved, the equally outstanding support and treatment I received by a different team from the first time was evident again. My difficulties made their roles unconventional and harder, hence I thank them profusely for everything they did to facilitate (like offering to hold my leg in a less painful place), and undertake the hysteroscopy and biopsies successfully. My trial was travelling in a car and then concentrating as much as possible on keeping still for as long as I could tolerate my normal pain before needing to shift slightly.

The actual procedure for me involved very fleeting levels of discomfort, (not pain), despite not needing the local anaesthetic injections needed last time for dilation and use of the slightly larger equipment for polypectomy.  In fact, thanks to his skill and professionalism, for all I knew the consultant could have been using his monitor playing x-box as the vast majority of time, procedurally, I wouldn't have known that anything was within me/happening at all! Despite my initial embarrassment re. bleeding, my dignity was maintained as best as possible throughout, even considering I couldn't wear the gown properly over my left leg.

I'd like to note how interesting it was to me how the consultant introducing himself by his doctor title, followed by his forename made the procedure to follow, and whole appointment, less intimidating (if that's the right word, but can't think of more apt alternative). I didn't envisage this simple act would affect me given that through my years as an NA then RN, I was accustomed to us nursing, allied health and non-clinical staff using forenames but, excluding medical students, I can recall only one of my medical colleagues doing so.

Despite the introductions, I could not focus enough to remember and now recall your names, but I want you all to know that although I may not remember what you said and did, I will remember the the way you made me feel throughout courtesy of your support and professionalism. This reinforces further my experience at all 3 appointments of a department that excels in recognising each patient's own unique journey and strives to deliver the highest standard of treatment and care anyone would hope to receive.

I'd also like to highlight an issue with gynaecological positions. I had been taught that women should be supine or in the left lateral position, briefly searching online with regard to cervical screenings. You often hear of patients with physical difficulties trying but unable to get tests. Ashamedly, despite my nursing background and knowing my symptoms of worsening HMB with large clots and flooding over a few years (leading to repeated and worsening anaemia), and more worryingly, IMB over a few months could be suggestive of something sinister, I sat on my symptoms given my inability to achieve any of these positions, hence, not initiating medical help or investigations in the first instance. I really should have known better and put my faith in those in my vocation and medics.

There needs to be more emphasis on the need for patients to discuss any barriers they perceive to have in accessing care and, similarly, those in primary and secondary care should be advised during their education to briefly look at a patient's history for anything that may be obstacles, other than personal choice and preference to decline tests/treatment, to following recommended care.

I owe a big thanks to all staff at Brannel Surgery for initiating health reviews/checks as, in all honesty, I probably still wouldn't have made an appointment to begin my journey along the gynaecological road.

Hence, given my difficulty with positioning, Brannel referred me to colposcopy for a cervical screen which, if I didn't have any symptoms that could be indicative of cervical cancer, I would have declined. I felt terribly guilty for being there when I felt their valuable time and expertise should be reserved for those women anxiously waiting as their screenings have already shown signs that warrant further investigation. 

I thank Rebecca the nurse colposcopist and nursing team for not making me feel bad. Despite my horror at seeing the gynaecology chair when I can neither sit nor lie on my back, let alone put my leg in the required position, it was this first departmental visit that, with their professionalism, assistance and adaptations made, demonstrated how I would be able to approach and tolerate any further investigations I may have had to undertake. For this. I'm extremely grateful. 

It would be interesting to know if stirrups/footrests could be fashioned to attach to couches in primary care and shared between groups of practices perhaps. Finally, in six months time, I will definitely not be so anxious?!!