Devastated need advice! - Page 3

Vickieh1981 · Mar 30th, 2010, 15:07 PM

Quote:

Originally Posted by whyme

Just wanted to say, that you don't have to wait before ttc again after the medial/Tablet option as I see someone has posted. I took the tablet, and asked all these questions before hand - we were advised to wait one AF before TTC again and first AF arrived within the time scale they advised - this was three weeks after the bleeding following the MMC stopped.

I was going to comment on that too. You don't have to wait after the tablets (I wonder if the PP is confusing it with the methotrexate injection for ectopics which is a 3 month wait).

I was told I could try straight away and even if I fell before the first af it wouldn't matter.

Vickieh1981 · Mar 30th, 2010, 15:09 PM

Quote:

Originally Posted by Livia

Thanks a lot, Vicky!

It makes sense the risk of uterine perforation is low (as with bladder damage, etc). Moreover, those statistics are probably quite good, as such things would not normally go unnoticed. Apparently, once treated they should be fine.

The problem with Asherman's is that nobody gets a hyteroscopy/HSG "just to check" after a D&C, and the scarring doesn't show up on ultra-sound normally. The other symptoms: missing periods, shorter periods, or painful periods may just be blamed on hormones or the body being "confused"... Future miscarriages will also not ring any bells unless you get to the magic number 3, and even then they may not check for that, or not at first. I'm 36 so the whole scenario scares me to death to be honest.

I'm aware that some of the results you see on Google are too high if you've only had one D&C, as they refer to people having undergone two or more. But I'm rather uneasy about something where they really just don't know. I've asked in an asherman's support forum and there's certainly people who have got it after just one D&C.

What is "low risk" anyway? Many people choose to forgo amniocentesis because it carries a 0.5-2% risk of miscarriage. Even if risk of Asherman's is only 1% it may put your fertility and future pregnancies at risk...

From what I know now I would have chosen expectant management, followed by medical management and only a D&C as a last resort, for medical reasons. I just see no value in going through a needless risk. The supposed "closure" effects just don't make it worth it for me, personally. I understand other people may feel differently. I just wish I had been told about this before I had it done to myself.

An interesting article I've found:
"Prevalence of Asherman’s syndrome after secondary
removal of placental remnants or a repeat curettage for
incomplete abortion"
http://humrep.oxfordjournals.org/cgi/reprint/13/12/3347
This talks of 40% risk after a repeat procedure.
It gives other interesting statistics, like risk if your periods don't come back, or come back significantly lighter.

But as hard as I tried, I haven't got hold of any statistics for Asherman's after 1 procedure only. But again, it's not like many people study or check for this. Lesley Regan's book on Miscarriage doesn't even have it in the index. It does have a section on uterine adhesions (which are part of Asherman's). She says they are extremely common but most resolve on their own... Yet when you read Asherman's stuff they stress things shouldn't be left for long, as some scarring can harden over time. I just ache for some hard facts, to be honest... "low", "high"... all seem suspect to me now.

Again, I don't mean to scare anyone... but I believe we should decide knowing what's at stake.

Any other findings on the matter are very, very welcome. I'd love to see evidence of a really low risk, honest. That would really bring me closure.

I don't like what I can find from googling. It seems over the top - as I said I know multiple people who have had at least one d&c and had no problems conceiving again.

I know you are really worrying about it (and tbh I am a bit now after googling) so am definitely going to double check with her tomorrow and will report back to you hun.

sophster · Mar 30th, 2010, 16:38 PM

Hi

according to the NHS 50% of those who miscarry naturally need to go on to have surgery; but according to the miscarriage association it is only 15%, things like the duration of the pregnancy before the miscarriage need to be taken into account also I suppose. I've heard the risk of needing further surgical intervention is very low before 10 weeks but increases dramatically after that. I have also heard that asherman's can occur when the material in the uterus is not removed properly; i.e. due to modern vacuum methods or them being overly careful not to scrape too hard. There have been women on here who have needed repeat d&cs. However what if they do not scan you after thev operation as often happens? While I do think there is a need for surgery in cases; and of course its a woman's right to choose; I agree with Livia that it shouldn't be painted as a risk-free easy option. I also don't like how women are pushed into surgery to 'just make sure' when they have already passed the vast majority of the miscarriage, if this has happened its very likely the rest will pass on its own but many women are misled to believe that they will have infections or problems from retained products if everything doesn't come out at once. I miscarried naturally (and it was a missed miscarriage so I know the waiting game although it ended up being only 24 hours after they actually told me what had happened) they checked up on me very thoroughly afterwards, my period came back within 6 weeks and my cycles are now more regular and 'normal' than they have ever been in my life. Again its everyone's personal choice but I do often feel that women are given false information about what a natural miscarriage involves; and the risks it involves.

Sophie

Vickieh1981 · Mar 31st, 2010, 09:57 AM

Livia - I spoke to my consultant today. She is very experienced. She said in 25 years experience she has only encountered Ashermans once and that was a woman whose placenta was so deeply embedded she had to have three d&cs in a row. She said the risk is so small it not even really worth thinking about. xx

LucyJ · Mar 31st, 2010, 12:25 PM

I had my d&c today I am now home and feeling shaky and in pain but know it was the right decision for me. I spoke to the consultant before hand after feeling quite stressed and worried about scarring and my future fertility after reading some comments she said it was so extremely rare that they didnt even include it on the possible things that could go wrong retained products where on their list. She said that the d&c procedure used to have a risk of scarring as they used a metal instrument that scrapes away the tissue but these days the erpc procedure as it is called now they use a plastic instrument which has a hole in it and it sucks (sorry if to much information) out the tissue. She said the procedure is something they carry out on a regular basis and that she has never known a case of a women being left with scarring after the procedure.

Also she said to me to avoid looking up things on the internet as a lot of the information is misleading and not accurate. I felt confident having the procedure done the staff at the hospital were wonderful I cried before and after but I feel that my husband and I can start to greive for our lost little one but before we couldn't as I was still carring our little apple-pip. Thank you for all your kind support I am sure I will be staying around to seek support with dealing with our lose. I send all my love to those suffering as I have and going through the same things it is a very difficult time.

Vickieh1981 · Mar 31st, 2010, 12:32 PM

Quote:

Originally Posted by LucyJ

I had my d&c today I am now home and feeling shaky and in pain but know it was the right decision for me. I spoke to the consultant before hand after feeling quite stressed and worried about scarring and my future fertility after reading some comments she said it was so extremely rare that they didnt even include it on the possible things that could go wrong retained products where on their list. She said that the d&c procedure used to have a risk of scarring as they used a metal instrument that scrapes away the tissue but these days the erpc procedure as it is called now they use a plastic instrument which has a hole in it and it sucks (sorry if to much information) out the tissue. She said the procedure is something they carry out on a regular basis and that she has never known a case of a women being left with scarring after the procedure.

Also she said to me to avoid looking up things on the internet as a lot of the information is misleading and not accurate. I felt confident having the procedure done the staff at the hospital were wonderful I cried before and after but I feel that my husband and I can start to greive for our lost little one but before we couldn't as I was still carring our little apple-pip. Thank you for all your kind support I am sure I will be staying around to seek support with dealing with our lose. I send all my love to those suffering as I have and going through the same things it is a very difficult time.

I am glad you feel some closure from it. As I said above my consultant said the same about it being incredibly rare - almost enough to not mention it. She couldn't believe it when I told her some of the numbers quoted online. I trust (and have done in the past) trust this woman with my life.

NatoPMT · Mar 31st, 2010, 13:01 PM

Lucy, glad you're back home and the initial decisions are over, I hope that you are looking after yourself - i didnt have any pain after the procedure, so i hope that clears up for you very very soon. My FIL is a chemist, and he said nurofen is better for the pain than co-codamol, but he gave me both and said to use the nurofen and top it up with the co-codamol if necessary, but im sure you have been given what you need. If you need to chat about how you are feeling, then defo come back, it does help to have others you can talk to who have been through this - unfortunately, i now know lots of people in real life who this has happened to, who have told me when i explained my situation

the ashermans thing, we should have another thread about that as i wanted to talk too but wasnt sure about posting on Lucy's thread - when i read the original link it scared the bejeezus out of me, espec as i havent have a first AF and prob wont for another 5 weeks or so, and im sure theres lots of women reading this who have had terminations in their youth which means they have had more than one D&C i assume? What put my mind at rest slightly was the ashermans org site said that for prevention, the op should be done with scanning guidance, and in my case, i had to wait in theatre for 20 mins for them to get the right equip, which the nurse said meant they had to get an ultrasound before they could start. I hope that means that they did the op under the guidance of a scan, but i dont know

w8ing4bean · Mar 31st, 2010, 15:42 PM

Livia · Apr 1st, 2010, 10:27 AM

LucyJ, glad you're out of it. Hope normality returns for you soon! And sorry to have hijacked your thread...

Thanks, Vicky and NatoPMT. However, I can't just trust her word, I'm afraid. If she doesn't do HSGs or similar, she just wouldn't know who did or did not get Asherman's, would she? Does she do fertility follow-ups? Or follow ups of any kind that may reveal Asherman's cases?
Sorry, but unless she does I can't trust unscientific experience over scientific studies (which some of things you find on the web are). To say we shouldn't read on... well, I find that extremely patronizing.

Plus... I had the metal-scrapy kind... so some of the comments above may not apply. Not to mention there's opinions that the suction kind is also bad.

To be honest I think half the time they don't know what's going on, but pretend to do so or hide in their silence. They don't know why we miscarry; they don't know why some people get their period back in 4 weeks and others take 10. Sorry... I don't want to rant on...

Thanks for trying anyway!

Vickieh1981 · Apr 1st, 2010, 14:07 PM

Well she said that pretty much everyone who has a d&c goes on to have a healthy baby next time. She also deals with fertility problems after.

She says it's not common like is made out. I guess that if you are that worried about it though nothing anyone will tell you will make you feel better.

Mar 30th, 2010, 16:38 PM	#23
sophster On a break (TTC) Active BnB Member Join Date: Jul 2009 Posts: 391	Hi according to the NHS 50% of those who miscarry naturally need to go on to have surgery; but according to the miscarriage association it is only 15%, things like the duration of the pregnancy before the miscarriage need to be taken into account also I suppose. I've heard the risk of needing further surgical intervention is very low before 10 weeks but increases dramatically after that. I have also heard that asherman's can occur when the material in the uterus is not removed properly; i.e. due to modern vacuum methods or them being overly careful not to scrape too hard. There have been women on here who have needed repeat d&cs. However what if they do not scan you after thev operation as often happens? While I do think there is a need for surgery in cases; and of course its a woman's right to choose; I agree with Livia that it shouldn't be painted as a risk-free easy option. I also don't like how women are pushed into surgery to 'just make sure' when they have already passed the vast majority of the miscarriage, if this has happened its very likely the rest will pass on its own but many women are misled to believe that they will have infections or problems from retained products if everything doesn't come out at once. I miscarried naturally (and it was a missed miscarriage so I know the waiting game although it ended up being only 24 hours after they actually told me what had happened) they checked up on me very thoroughly afterwards, my period came back within 6 weeks and my cycles are now more regular and 'normal' than they have ever been in my life. Again its everyone's personal choice but I do often feel that women are given false information about what a natural miscarriage involves; and the risks it involves. Sophie

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Mar 31st, 2010, 09:57 AM	#24
Vickieh1981 Other BnB Addict Join Date: Mar 2010 Location: Hampshire, UK. Posts: 3,848	Livia - I spoke to my consultant today. She is very experienced. She said in 25 years experience she has only encountered Ashermans once and that was a woman whose placenta was so deeply embedded she had to have three d&cs in a row. She said the risk is so small it not even really worth thinking about. xx

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Mar 31st, 2010, 12:25 PM	#25
LucyJ Mum (Mom) BnB Addict Join Date: Feb 2010 Posts: 4,399	I had my d&c today I am now home and feeling shaky and in pain but know it was the right decision for me. I spoke to the consultant before hand after feeling quite stressed and worried about scarring and my future fertility after reading some comments she said it was so extremely rare that they didnt even include it on the possible things that could go wrong retained products where on their list. She said that the d&c procedure used to have a risk of scarring as they used a metal instrument that scrapes away the tissue but these days the erpc procedure as it is called now they use a plastic instrument which has a hole in it and it sucks (sorry if to much information) out the tissue. She said the procedure is something they carry out on a regular basis and that she has never known a case of a women being left with scarring after the procedure. Also she said to me to avoid looking up things on the internet as a lot of the information is misleading and not accurate. I felt confident having the procedure done the staff at the hospital were wonderful I cried before and after but I feel that my husband and I can start to greive for our lost little one but before we couldn't as I was still carring our little apple-pip. Thank you for all your kind support I am sure I will be staying around to seek support with dealing with our lose. I send all my love to those suffering as I have and going through the same things it is a very difficult time.

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Mar 31st, 2010, 13:01 PM	#27
NatoPMT Other BnB Addict Join Date: Mar 2010 Location: Northerner in London, innit. Posts: 3,540	Lucy, glad you're back home and the initial decisions are over, I hope that you are looking after yourself - i didnt have any pain after the procedure, so i hope that clears up for you very very soon. My FIL is a chemist, and he said nurofen is better for the pain than co-codamol, but he gave me both and said to use the nurofen and top it up with the co-codamol if necessary, but im sure you have been given what you need. If you need to chat about how you are feeling, then defo come back, it does help to have others you can talk to who have been through this - unfortunately, i now know lots of people in real life who this has happened to, who have told me when i explained my situation the ashermans thing, we should have another thread about that as i wanted to talk too but wasnt sure about posting on Lucy's thread - when i read the original link it scared the bejeezus out of me, espec as i havent have a first AF and prob wont for another 5 weeks or so, and im sure theres lots of women reading this who have had terminations in their youth which means they have had more than one D&C i assume? What put my mind at rest slightly was the ashermans org site said that for prevention, the op should be done with scanning guidance, and in my case, i had to wait in theatre for 20 mins for them to get the right equip, which the nurse said meant they had to get an ultrasound before they could start. I hope that means that they did the op under the guidance of a scan, but i dont know

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Mar 31st, 2010, 15:42 PM	#28
w8ing4bean Pregnant (Expecting) Chat Happy BnB Member Join Date: Jan 2010 Location: Kent Posts: 1,123

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Apr 1st, 2010, 10:27 AM	#29
Livia Other Active BnB Member Join Date: Nov 2009 Location: Back in the UK Posts: 199	LucyJ, glad you're out of it. Hope normality returns for you soon! And sorry to have hijacked your thread... Thanks, Vicky and NatoPMT. However, I can't just trust her word, I'm afraid. If she doesn't do HSGs or similar, she just wouldn't know who did or did not get Asherman's, would she? Does she do fertility follow-ups? Or follow ups of any kind that may reveal Asherman's cases? Sorry, but unless she does I can't trust unscientific experience over scientific studies (which some of things you find on the web are). To say we shouldn't read on... well, I find that extremely patronizing. Plus... I had the metal-scrapy kind... so some of the comments above may not apply. Not to mention there's opinions that the suction kind is also bad. To be honest I think half the time they don't know what's going on, but pretend to do so or hide in their silence. They don't know why we miscarry; they don't know why some people get their period back in 4 weeks and others take 10. Sorry... I don't want to rant on... Thanks for trying anyway!

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Apr 1st, 2010, 14:07 PM	#30
Vickieh1981 Other BnB Addict Join Date: Mar 2010 Location: Hampshire, UK. Posts: 3,848	Well she said that pretty much everyone who has a d&c goes on to have a healthy baby next time. She also deals with fertility problems after. She says it's not common like is made out. I guess that if you are that worried about it though nothing anyone will tell you will make you feel better.

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