#11 Women's health - haemorrhaging

Female health issues are not the easiest of subjects to publicly discuss, but they should be dealt with; this is real life. By revealing experiences and treatment, it might be possible for others to find solutions, or at least gain a degree of comfort in reading a familiar story.

Over the years I have occasionally suffered torrential menstrual bleeding (menorrhagia). With the approach of menopause, this debilitating condition has been exacerbated and my bodily mechanisms have not corrected the issue naturally, as has mostly happened in my younger years.

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I’m comfortable talking to my GP, and have confidence in his diagnosis and treatment of me and my medical problems. But, the doctor/patient ratio in the Hunter Valley has been likened to that of Outback Australia; i.e., the worst in the country. Consequently, securing a short-notice appointment with my doctor can be virtually impossible.

Therefore, with the onset of an episode of heavy and unending haemorrhaging a few months ago, in desperation I took an appointment with a female doctor, presuming a female approach to a female problem would be beneficial.

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As I prepared to dress after showering in readiness for my appointment, a gush splattered the floor. This was a regular occurence. I was at a physical and emotional low, and quite concerned about my health.

I voiced my very real concern: “I worry I could bleed to death”. Her uncompassionate response was: “Although it’s possible, it’s not likely”. My visit to her certainly did not alleviate any of my fears, or instil me with any confidence or understanding of the situation. She prescribed a low-dosage contraceptive pill. I asked about the likelihood of a curette being necessary, but she informed me, without any expansion on the subject, this procedure was no longer performed.

So I started taking the Pill, and the bleeding slowed to ‘spotting’ within a few days. Having previously been prescribed this medication for the same condition, I expected the nuisance spotting which was always unannounced and often embarrassing, but it was a small inconvenience in comparison to uncontrolled and prolonged flooding.

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Menopause is not something I have looked forward to, but at 51, I now wish it would just happen. I want to be rid of my menstrual cycle and its associated pain, discomfort and side effects without the necessity of a hysterectomy. But of course, wishing is of no help.

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Two months on, the Pill gave my body a much-needed break from menstruating, but the freedom didn’t last. After ten days of torrential bleeding, I made an appointment at the doctor’s surgery, but unfortunately couldn’t see my GP, so took whoever was available again.

After fearing he had missed my place in the appointment queue, I interrupted him as he called yet another patient as I sat in discomfort. His apology was issued without a hint of sincerity and my 15 minutes for $58 was reduced to a mere few minutes in an obvious attempt to make up lost time due to his arriving 45 minutes late for his first scheduled appointment; or to brush off my medical concerns as irrelevant – or at least, that’s how he came across to me from start to finish.

He issued me a prescription for Provera, and stated that if this did not stop the haemorrhaging within a few days, I should have a curette. I was so confused by this conflicting information, and so upset by his apparent lack of attention to my condition which was evidently ongoing, that I left the surgery in tears.

But true to the doctor’s expected outcome, bleeding stopped within 5 days, and although I was physically worn out, I headed off to visit my unwell parents and give them a helping hand as planned. I continued to take the medication as prescribed.

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Very heavy bleeding recommenced within 3 days. I drove 5 hours home and had my scheduled ultra-sound the following day. If I was to secure an appointment with my own doctor, I was informed I would wait 3 and a ½ weeks, so I rang the surgery every morning in the hope of obtaining one of the few emergency placements. Two days later I got an appointment with the surgery’s pregnancy specialist doctor, and although he was not my regular doctor and I had never seen him before, I was pleased. His reputation as an excellent, attentive doctor with a pleasant manner had preceded him.

Along with my own medical problems, I had coped with a visit to my aging parents, and assisted my pregnant daughter through her medical problems, rendering me emotionally fragile. I didn’t cope with the long waiting-room wait well, especially as I had just left my daughter being attended to at the hospital, got my granddaughter to school late, and had my grandson in tow. I was extremely grateful of the assistance and understanding offered by one of the receptionists when my thought processes overwhelmed me. She was a gem.

As expected, this doctor was thorough and attentive to me and my problems. Firstly, he explained that test results showed I was extremely anaemic which resulted in lack of energy. For this, he prescribed a high-dose iron and folate medication, and explained that it would take a long time to get the iron to an acceptable level in my body.

He then read results of the report of my ultra-sound, which showed my reproductive organs appeared free of malignancy, although some areas were not clear enough and might need further examination. He referred me to a gynaecologist.

He then took the time and patience to explain in simple terms the difference between menstrual bleeding and the haemorrhaging that I was experiencing. Without prompting, he also explained the difference between the outdated procedure of a curettage (which I had previously had), and the new procedure of endometrial scraping of small growths called polyps protruding from the lining of the uterus with a camera inserted for investigation. This new proceedure is called a hysteroscopy and includes dilation and curettage. He then prescribed Cyklokapron (500mg), a clotting agent, 3 tablets 4 times a day. The haemorrhaging should cease within four days.

I left his office with a much better understanding of what was happening to my body, and of what I could expect.

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However, late that afternoon my energy levels dropped dramatically and I was unable to walk unaided any further than across the hall from my bed to the toilet. I was frightened and rang my husband and asked him to come home. I also rang my doctor, and he instructed me to have someone at home with me who could look after me, or he would admit me to hospital for a few days.

[Note: at the foot of the page is an added note regarding an unexpected side effect of the Cyklokopron medication.]

My other half has been a wonderful carer. My energy levels have improved, and although the bleeding has slowed, it has not stopped. I am on to the fifth day of the 4-day medication, and have an appointment to see the doctor tomorrow. As I have to wait 4 weeks for an appointment with the gynaecologist, I am hoping he is able to have me slotted in earlier as he did suggest.

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My life will busy and exciting over the following few months with the birth of a grandchild, a visit either to or from my son and his family who have recently left town, a 5-day break in the bush with my husband, and a solo trip for me. It is extremely important to me that my physical and emotional health is improved to a point that I can enjoy these upcoming events.

I had planned to attend the caesarean birth of my grandchild in two weeks time, but I fear I will not be healthy enough to do so, but I definitely wish to be able to help my daughter cope at home following the operation. So I am doing all I can to improve my situation. My emotional wellbeing is just as vital to me as my physical wellbeing.

Note: Upon visiting the doctor yesterday (11 Feb 08), at the cessation of haemorrhaging, I have discovered that "giddiness" is a rare side effect of the medication Cyklokopron. That explains why I could not walk through the house without hanging on to furniture for support. It is such a relief to know the reasons for worrying symptoms. A common side effect of Cyklokopron is gastro-intestinal upsets, which I also experienced.

An update will follow my visit to the gynaecologist . . . . .