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zehriya

Member
What is the name of your state (only U.S. law)? NY

I am looking for advice.

Quick explanation

I was diagnosed with a blighted ovum/missed abortion and schduled for a D&C with a hospital. About 5 weeks after the surgery I had Debilitating back pain, pelvic pain, Bm pain, urinating pain, (Over the counter drugs do not work) and had still not mentruated. The same thing happened again about four weeks after that. This second time the pain was worse and lasted longer. After some research I did manage to speak with a specialist (too far for me to see as a patient) who confimred my suspiscions that I could have devloped Asherman's syndrome from this D&C (first ever). He also mentioned that (most likely) until I am diagnosed with something and treated.. I will continue to have this every month.

When I experienced the pains the first time I called the emergency number that was provided to me. I was instructed by them to go to the ER. The ER doctor did NADA for me but a pregnancy test and sent me home. I decided to wait for my follow up exam. During my follow up exam I explained all the pains I had to her. She gave me the most basic pelic exam and a pregnancy test and declared me healthy, not so much as a sonogram.

When it happened the second time I went to a small clinic afterwards. They admitted that they weren't too sure what it could be, but did give me a sonogram.

Today I went back to the hospital to try one more time with them. I told the doctor all of the above. He told me not to worry about not mentruating and that the pain could be coming from a twisted ovary.

My issue with this is that I do not have symptoms for a twisted ovary, and there is no reason to beleive that I should have a twsited ovary. If I had an Ovarian cyst that caused a twisted ovary it should have come up on one of the many many endovaginal sonograms I took before the surgery (in the beginning they thought it was ectopic) and the one I had after. I wasn't satisfied with his answer so I questioned him.

I asked if the D&C could have caused a blocakge, and if that is why I am experiencing cyclic pain and no menstruation. His answer to that was no. (which was a lie). I asked if he was sure it couldn't be connected and he said yes. His reasoning for it was that since I was regularly mentruating before the surgery, and since I had a successful D&C that the cervix must be open.(All lies, and I did havemy mom in the room with me at the time)

If I had not done my research before, I would have been fooled. Instead, I pushed him further. He finally budges and says that there could be a small possibility of Asherman's but he highly doubts it becasue this was my first D&C, and that he is only worried about the pain I am experiencing. (Makes no sense, I think it is pretty clear that the two are connected.)

This is frustrating, So now he wants me to come in for a sonogram to look in to his twisted ovary theory. After that, a second appt to look at the results form the sonogram. If that comes up with nothing, then he wan't me to wait 6 months before even looking in to the possibility of Asherman's syndrome.

Maybe this is nothing. I don't know. Why look in to something that doesn't match my symptoms opposed to something that does. It makes no sense that they want me to wait while they poke around with random other theories. (sorry for the rant). I am seeking other health care.

I know nothing can be definitively said about this until I am diagnosed, but any advise would be helpful. Can they just lie to me like that? if things turn out for the worse and I do have this Syndrom (and possibly other issues ) is this some kind of negligence on there part?
 
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lealea1005

Senior Member
You need to stop trying to diagnose yourself via internet sites and get yourself to ONE Physician for continuity of your care/diagnosis/treatment.

When it happened the second time I went to a small clinic afterwards. They admitted that they weren't too sure what it could be, but did give me a sonogram.
What kind (pelvic/transvaginal/abdominal)? What were the results?

His reasoning for it was that since I was regularly mentruating before the surgery, and since I had a successful D&C that the cervix must be open.(All lies, and I did havemy mom in the room with me at the time)
That is a totally reasonable deduction, not a lie.

This is frustrating, So now he wants me to come in for a sonogram to look in to his twisted ovary theory. After that, a second appt to look at the results form the sonogram. If that comes up with nothing, then he wan't me to wait 6 months before even looking in to the possibility of Asherman's syndrome.
Again, totally reasonable and well within the standard of care.

Why look in to something that doesn't match my symptoms opposed to something that does. It makes no sense that they want me to wait while they poke around with random other theories. (sorry for the rant). I am seeking other health care.
There is a saying they teach medical students who are learning diagnostic skills that goes something like this: "If you hear hoofbeats in the woods, think horses, not zebras." Your symptoms match numerous, more common, diagnoses. The Doc(s) needs to rule out the obvious before looking further for an esoteric diagnosis.
 

zehriya

Member
The only reason I had to resort to looking in to the internet research is becasue on the two occassions I went to the hospital (ER and scheduled follow up) They completely disregarded my symptoms. I don't see how that is with the standards of care. The follow up nurse didn't even do any blood work or a sonogram to check for the simple complications. Also, I am looking for a good specialist I can see for the continuity.I have appointments with two other gynecologist that know more about Asherman's. Only problem is that they are booked. One I can't see until the end of December.

When the doctors failed to even take any of my pain in to consideration, I reasearched my symptoms. Had I not done any research the last doctor would have told me that there is no way my cervix could be closed from the D&C... And I am sorry to say that is a lie. I have spoken too many people where this exact thing happened and becasue of it they aren't diganosed for months to years after; Allowing the scarring to get worse and increase the chance of infertility.

I called another gynecologist that told me straight over the phone that she "doubts the doctor will want to touch me".. I think it is only natural that I start trying to research in to my own health.

but addressing the other issues you brought up.

For the small clinic, they gave me a basic pelvic exam they didn't find anything. Pregnancy test negative, and an endovaginal sonogram to look for retained tissue (Which is something the hospital should of done during my follow up, It was also very tender and a little painful when she brushed it against my cervix to get the sonogram- 2 months after sugery). Nothing came up on the sonogram.

As for his reasoning, this is not a totally reasonable deduction and it was a lie. Asherman's syndrome is a so called known risk of the D&C and can cause scarring that can block the cervix wether through the entrance adhering to itself or scar tissue blocking it.

Most common symptom is the blood from mentrual cycles being trapped. it either retrograde or gets abosrbed back in to the lining and has been found to possibly cause endometriosis and infertility. I am not pulling this out of thin air. I spoke to a few Asherman's victims and a specialized endocronologist who explained it to me. Unfortunately, he is too far away for me to see as a patient. If it was just the lack of a period I would think maybe hormonal, but it isn't. I can't sit or walk during this pain.
The specialist stated it could be the blood trying to come out.

I asked the hospital doctor if this was possible and he told me no more then once. How can something that is a known risk not be possible???????????

I don't understand your last comment. In this case Asherman's would be the horse, and a twisted ovary would be the zebra.

Possible Symptoms of a twisted ovary are:
nausea, fever, a swelling of the stomach, and a lump that you can feel. Also this is usually caused by an ovarian cyst that enlarges and causes the twisting. Some of my symptoms do match up with an ovarian cyst, but not the twisted ovary. However with all the endvaginal sonograms I had, a cyst would have been spotted (my last one being Oct 26)

I am going to the appointment, and I am going to do the sonogram with them. However it is highly unlikey that it will be a twisted ovary. I had 4 endovaginal sonograms before the surgery (within a week before), so I didn't have it before the D&C and one after.

Your basically saying that he is ruling out a twisted ovary since it is more common even though my symptoms do not match up with it and the likelihood of it bing that is slim. While in the meantime delay in ruling out Asherman's can cause me more harm. Also why is it ok for me to suffer the monthly debilitating pain that is getting worse for 6 months before they even look in to this known risk?
 
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lealea1005

Senior Member
No, I'm saying there are issues other than Asherman's that need to be considered/ruled out first. Endometrosis and, yes, ovarian torsion are just a few. It very well may be Asherman's, but the other, more common stuff needs to be ruled out first.

The specialist stated it could be the blood trying to come out.
:confused::confused: doubtful...perhaps you misunderstood.

You stated all the ultrasounds were normal. So why do you take for granted you have uterine adhesions?

Bottom line: you are not a Physician and diagnosing is not as cut and dry as you (without the medical degree) may think, or as simple as listing symptoms on an internet site. Good luck with the new specialist.
 
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Dave1952

Senior Member
Sorry to hear of your problems. As I understand you: you had a D&C, 5 wks later you experienced considerable pain and were instructed to go to the ER, the ER doctor determined that your problem was not serious, you returned to the Doctor who had done the D&C (?) for a follow-up visit and discussed this painful event, the Doctor observed nothing wrong, 4 wks later you experienced pain again, you went to a small clinic where they did an exam including a sonogram but found nothing obviously wrong other than the recurrent pain. After that I get confused. I think you returned to some Doctor ( this is odd, why aren't you seeing the same Doctor for your post-surgical care) for another follow-up. This physician is now convinced that there is a problem but you are unhappy with his plan of action.
You did some internet research and now believe that you have uterine adhesions, a rare occurrence but not unheard of.
I'm puzzled that you are seeing so many different Doctors. Why isn't your Gynecologist handling all of this? I'm not surprised that the Doctors each try to begin with the common problems. Stick with one Doctor, you'll get diagnosed quicker. In the meantime discuss with your Doctor the pain problem and get a prescription that helps you until the Doctor decides on a course of action.
Is there a legal problem?

Good luck
 

zehriya

Member
For lealea1005, I knew it would be hard to explain since it is not very known.

An ultrasound/sonogram is not a reliable method to diagnose Ashermans. There are other methods such as a hysteroscopy that are used to see the inside of the uterus and rule out/diagnose Asherman's. So my many sonograms being normal actually rules out ovarian cysts/twisted ovary but does not rule out Asherman's syndrome.

I am not a physician, but I am not an idiot. If you were in my situation I am sure you would be doing research as well. You are also neglecting to acknowledge that I spoke to a gynecologist/endocronologist specialist who has confirmed that this is a high possibility for me given my situation and symptoms. Also, I am not attending the best of hospitals. I have no insurance, so I needed to work with a hospital that would work with me financially.

Did you ever stop to consider that if I didn't do the research, that the last doctor I went to would have told me that it is absolutely impossible for me to have uterine blockage/adhesions from a d&C (KNOWN RISK) and I would have just accepted it.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Hello Dave, and thank you for your response. As for why I am seeing different doctors, blame the hospital. That is how they are set up unfortunately. For the surgery one doctor did it, but when I came for my scheduled follow up at the same hospital they had me see a different person. When my symptoms persisted.... and I got no help from the hospital follow up or ER... that is when I tried the clinic and finally got a sonogram (The hospital wouldn't do it).

The clinic Appointment was Oct 26, so I didn't have that last sonogram too long ago. There is only so much a clinic can do and I know that. I went there in hopes that they would at least do sonogram and they did.

Since I still didn't have any answers and I am not looking forward to the immense pain that is going to hit me in a week or two, I made another appt at the hospital gynecologist (same hospital). I didn't have the number so i called the women's health services department (area where the surgery was performed) and they transferred me to the gynecologist. They also warned me that I would have to tell them that I want to be seen by a doctor because if not the non doctors (RE i guess or nurses don't remember) would see me and just send me back to them for birth control.

I assume that is why I kept seeing different people at the hospital. Other then that I don't know why they keep having me see different people.

I am unhappy with his plan of action (Though I will still go along with it, I don't have much choice.) Like I stated above, all the endovaginal sonograms I had should make having his theory very very very less likely.

ALSO

A twisted ovary causes sudden, severe, unremitting pain on the side of the affected ovary, and should be supposedly looked in to right away because the ovary can be completely lost from the lack of blood flow. Does it really sound like I have this? and I am asking seriously.. I am concerned about my health..

when it comes down to it.. I do not have the symptoms. If I don't have the symptoms for it, why look in to it as your first theory. While looking in this theory my actual symptoms are still being ignored.

But let me not play devils advocate. Despite me not having those symptoms lets work with his theory. If a twisted ovary is really a concern for him, and he really believes that this may be the problem (since it was his first theory)... Why on earth did he set up my sonogram to be at the end of November (Nov 30th)? On top of that, we don't even go over the result from it then. I have to go back home after the sonogram and wait until Dec 13 to come back in to go over the results of the sonogram.

For an injury that is so serious, they don't seem to be taking it very seriously. Surgery is needed in order to save the ovary and avoid serious complications. This is my second month complaining about these pains, by time I get answers from the sonogram it will be three months complaining and 4 months from my original D&C surgery.

I think it is quite impossible for me to of had a twisted ovary for 2 months now without the unremitting pain . My pain only comes once a month for 4-8 days around when my period should come, and then lingers until it eventually disappears completely.

~~~EDIT FOR lealea

doubtful...perhaps you misunderstood.
You really do not know much about Asherman's do you. I can't get mad at that because a lot of people don't. I am not mistaken. Yes I found the info through research, but it was confirmed by the specialist.

Most patients with Asherman's have scanty or absent periods (amenorrhea) but some have normal periods. Some patients have no periods but feel pain at the time each month that their period would normally arrive. This pain may indicate that menstruation is occurring but the blood cannot exit the uterus because the cervix is blocked by adhesions.
 
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lealea1005

Senior Member
AGAIN....I am not saying you don't have Asherman's....I'm saying other things that are more common need to be ruled out BEFORE rendering the diagnosis.

I also find it hard to believe that a gyne-endo would give you ANY advice or opine on your medical condition over the phone, ESPECIALLY if you are not a patient.


I
am not a physician, but I am not an idiot. If you were in my situation I am sure you would be doing research as well.
Probably, but I would also rely on the advice of the Physician (you know, the one who went to medical school?) examining me and reviewing my diagnostic testing.

An ultrasound/sonogram is not a reliable method to diagnose Ashermans
Ultrasound is an excellent tool to help diagnose adhesions. Hysterosalpingography is used to evaluate the extent of those adhesions. You claim your ultrasounds were normal.

From what you told us, you are being treated within the standard of care and have no damages. Obviously, that is not the answer you want to hear.

I hope you are able to get regular care by the same Physician who will diagnose and treat you properly. Good luck to you.

Over and out.
 
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zehriya

Member
I thank you for your responses and effort lea lea

You have not addressed anything I said about the twisted ovary. I never said you said I didn't have it. i don't even know that. What I am saying is given the circumstances it is a valid concern that is being ignored.

As for the specialist, are you trying to say I lie about speaking to one. I am not sure but that is how is sounds, and I am a little insulted.

Dr. March info
Sent by mhv less than a minute ago
Dr Charles March - USA
California Fertility Partners
11818 Wilshire Blvd #300
Los Angles CA 90025
Phone: (310) 828-4008
Fax: (310) 828-3310
Email Address: [email protected]**
Website: Los Angeles Fertility Clinic- Specializing in Infertility | California Fertility Partners

That is who I spoke to if you would like to look it up. He is a very kind person that has been consulting with people suffering from Ashermans for free via phone and email. He was referred to me by someone who is actually seeing him now.

If you can rely on my normal sonograms to rule out Asherman's as a likely suspect to support what the doctor has said, why can't I rely the normal sonograms to think a twisted ovary is not a likely suspect.

It is not that what you are saying isn't what I want to hear. It is that what you are saying doesn't seem to address any of my issues.

1)You don't believe I spoke to a specialist.

2)You won't even address my concern about why the doctor is looking in to something that I have no symptoms for. You keep saying he has to rule out the more common possibilities. Last I checked, I thought the doctor was suppose to take my symptoms in to consideration when deciding to look in to a possible cause. I don't have a PHD but it doesn't take rocket science to know that.

3) You say you know about Asherman's syndrome yet think that it is false that that a blockage caused by adhesions/scars can trap the blood in the uterus, and that can cause the increased debilitating pain. If you think that (not to be rude) Then maybe you need to check your resources.

I thank you for your effort though, and will wait to see Dave's to response. He seems to at least be taking everything in to consideration.


EDIT FOR DAVE!
I am so persistent about this because I DID talk to the specialist and this is a very real possibility. AND it has been getting worse. (I almost passed out on the floor and broke a sweat from trying to pass a BM during the last episode, and could barely leave the bed) , and I won't have the money to see a gynecologist specialist for a while. If it is Asherman's I would rather catch it earlier rather then a year later.

I'm puzzled that you are seeing so many different Doctors. Why isn't your Gynecologist handling all of this? I'm not surprised that the Doctors each try to begin with the common problems. Stick with one Doctor, you'll get diagnosed quicker. In the meantime discuss with your Doctor the pain problem and get a prescription that helps you until the Doctor decides on a course of action.
The follow up doctor literally disregarded my symptoms completely. She said sometimes people take longer to get back to normal, which is 100% true. But refused to address any of my pains, told me not to worry about them and that it probably wont happen in again (Mind you I told her pain medication doesn't work.) . I was skeptical... but listened and ended up in immense pain 2.5 weeks after that. Same with the Er doctor.
 
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Dave1952

Senior Member
This is a legal forum. You don't seem to be seeking legal advice.
You've been seen by a number of Doctors. None of them seem to be greatly interested in your Asherman's hypothesis. I do not see an argument that all of these Doctors are handling your case poorly.
If you really want a hysterescopic exam then you'll need to locate a Doctor who will do this. Any insurer will insist that this is an elective procedure so expect to bear the cost.

Good luck
 

zehriya

Member
OK, thank you.

I will just come back and ask after I find out what is wrong with me. It isn't that a number of doctors don't seem to be interested in the Asherman's syndrome as a possibility.

It is that the hospital that did the D&C in the first place is saying it is impossible (And only them!) and have refused to even look in to it so it can be ruled it out.. -- which is a contradiction since it is a known risk. Can't have it both ways.

All of the other places I have appointments have confirmed that this is a possibility, and are having me come in to be checked out. No other doctor I spoke to shrugged it off. The only downfall is that everyone is booked until the end of December. I will know what is wrong for sure then unless I save enough to see the secialist earlier.

Hopefully I won't have a need to come back. Though I am hoping for the best, I am a realist.

After I am seen by someone else (other then the doctor in the hospital who did the D&C) If they confirm I have this, and confirm it should have been something to look in to, or/and could have even been avoided. Would I be justified in coming back here to seek advice.

Thanks,
 
"A twisted ovary causes sudden, severe, unremitting pain on the side of the affected ovary, and should be supposedly looked in to right away because the ovary can be completely lost from the lack of blood flow....

I think it is quite impossible for me to of had a twisted ovary for 2 months now without the unremitting pain . My pain only comes once a month for 4-8 days around when my period should come, and then lingers until it eventually disappears completely."


I have lost an ovary due to it being twisted. The pain was excruciating, but was NOT unremitting. It came monthly for a few days around the time of my period. If I had been correctly diagnosed when I first sought treatment, it's possible I would have saved my ovary. If this is actually your problem, it's not something to delay getting diagnosed.
 

ecmst12

Senior Member
This is a perfect example of why internet research needs to be taken with many grains of salt. The internet can tell you how the symptoms TYPICALLY present, but not every case is typical. That's why doctors have to go to school for so long and have all the training AFTER school, so they can gain the experience to diagnose patients as individuals.
 

ajkroy

Member
I am at a loss as to why, if you don't have insurance, you are getting some of your care at a hospital emergency department? They are set up for emergencies (which this is not) and you will end up paying a much, much higher fee to them -- and likely for less information than if you had saved up and gone to a specialist in the first place.

Clearly, money isn't an issue to you, so why not become a patient of the doctor you talked to on the phone? That one seems willing to explore your Asherman's diagnosis. Why not just go there from now on?

In addition, be careful of insulting the seniors on this board. Lealea probably has more medical knowledge than anyone you have ever met...and she volunteers her time and advice here to help people. Grateful people.
 

zehriya

Member
"A twisted ovary causes sudden, severe, unremitting pain on the side of the affected ovary, and should be supposedly looked in to right away because the ovary can be completely lost from the lack of blood flow....

I think it is quite impossible for me to of had a twisted ovary for 2 months now without the unremitting pain . My pain only comes once a month for 4-8 days around when my period should come, and then lingers until it eventually disappears completely."


I have lost an ovary due to it being twisted. The pain was excruciating, but was NOT unremitting. It came monthly for a few days around the time of my period. If I had been correctly diagnosed when I first sought treatment, it's possible I would have saved my ovary. If this is actually your problem, it's not something to delay getting diagnosed.
Hello Cassandra and thank you for the information. The pain could be caused by a twisted ovary. Do you know if it could also stop periods? There is no way for me to get it diagnosed before Dec. 13. The hospital sees no reason to rush looking in to the twisted ovary possibility. That was another one of my concerns. So if it is that, yes it is possible for me to lose the ovary in the delay. (it has already been 2 months since the pain started). I brought this up earlier in the topic and it seems to be irrelevant.. so if I lose an ovary after not being diagnosed after complaining for 3 months.. I guess that is just my fault and my bad luck.

ecmst 12 Internet research and asking around does help, but in the end it is all worthless until I find out what is actually wrong with me. The reason why i became iffy with what the hospital told me is because they stated it is IMPOSSIBLE for me to have this problem from a D&C AT ALL. I know that isn't true and find it odd that they would rule out something that is a known risk to this specific surgery.

I am 27, no children and I just moved in with my BF last year. I am scared of this possibility being overlooked by the hospital and possibly causing issues with my fertility.


Ajkroy - I have no idea where you got the idea that money isn't a concern for me. I have straight medicaid and am collecting unemployment. The medicaid is taken by all the hospitals but not by the specialist. I only went to the ER once. The hospital performed the D&C at there women's health center, and I was sent to the hospital gynecologist department for my follow up. I also went there for the last appointment.

That is why I haven't already said screw this and went to a specialist. Without insurance help, I can't afford it. So I am basically screwed. Also the other hospitals I called are booked up to Dec 27.

I am sorry if I offended lealea but she really is wrong with her statement. It is true that something else could be causing my pains, such as a twisted ovary(even though I have had 5 total sonograms already), same way it is true that a blockage could be causing my pain (As in something like Asherman's). The same way a twisted ovary should be ruled out Asherman's should be ruled out. I only got these problems after the D&C and usually have very regular periods with very little to no cramps. Then all of a sudden DIRECTLY after my D&C surgery I am broken and the hospital refuses to look in to the surgery being the cause..

Even lealea has admitted that it could be a possibility. She said she never said I couldn't have it. So if even she can accept it as possible.. Why can the hospital tell me it isn't and that they refuse to look in to the surgery possibly causing this. Meaning I won't be able to have someone look in to this until I go to the other hospitals (which have agreed I should have this looked in to), or until I magically come up with money to pay a specialist.

Honestly, I am glad I am getting some more feedback. Thank you for that. However, it has become obvious that I am not going to get any answers until I get answers about what is wrong with me.
 
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