Hysterosalpingography - AKA: HSG

It has taken me a while to come to terms with this particular aspect of the journey.

The X-Ray, known as Hysterosalpingography or HSG for short!

So it all started on the first day of the "new" cycle, when I had to call a number linking me directly to the radiology department at my local hospital in order to book an appointment between days 10 and 14 of my cycle.I actually couldn't get through, as it was late afternoon by the time I tried to call them, so I called the next day - day two of my cycle... time was ticking!! The lady I spoke with said she would need to check with the nurses to find out if there were any clear spaces in the appointments diary, and would get back to me after taking my details. She also told me... sorry advised me... that intercourse from now until I'd had the HSG. I had some important meetings that day, so nervously explained to my manager the situation and asked if I could be excused when the call came through... It's funny how often I checked my phone throughout those important discussions!

No call came through.

Day three arrived and again I waited anxiously to find out when I would be expected to attend. By lunch time I wondered if they'd forgotten and what the protocol was for calling back! And then I noticed a voicemail had been left on my phone. It was the hospital. They had an opening next week and would call me again to arrange the time for me to attend.

I did think it was a bit strange they had an opening but not the time - surely the opening included the time of the proposed appointment...?? I guess that's why I don't work in healthcare!

So... more waiting... more checking of my phone, into the weekend... If I hadn't heard after the weekend, I determined I would call them to find out what time I would be required. I'm uber-organised and like to plan ahead. I like to know what I am doing and what is expected of me well in time. Finally, on day seven, a letter arrived in the post from the Radiology department. My appointment had been arranged for 10:30am on what became known as day 11.

A couple of days before the appointment I had to pick up the prescription given to me by the consultant for some antibiotics. The antibiotics are to prevent infection from the x-ray procedure and needed to be taken two hours before I arrived for my appointment! The chemist had to order them, as they didn't have any stock, and for the sake of two tablets, I was hit with a huge NHS bill! There goes the Chinese take-away I had been planning for after the x-ray!! Lol! When they arrived, it turned out that the two different types of tablets ended up being a total of nine tablets to make up the prescribed  amount of 1000g each.

Then on day nine, I received a call from one of the radiology team, asking if I would mind changing my appointment time from 10:30am to 9am. Wahhh!! My day-off lie-in... disrupted!!! "Sure," I replied, "I may as well get it over with sooner rather than later." Oh man! Because I had to take the tablets two hours before  I was due at the hospital, that actually meant a 7am start! Lovely!

I don't think I slept much the night before. I don't like the unknown and tomorrow's procedure was a total unknown. All I had been able to do is read the information pages I had been given and do a Google-search to find out more about what a HSG was for, what they do etc....

So, when the alarm went off in the morning, I yawned my way down to the kitchen to have breakfast and the antibiotics. I don't normally have breakfast as soon as I wake up, so this with the combination of all the water made me feel really uncomfortable and nauseous. According to the paperwork, they needed me to arrive with a full bladder. This was so they could test to make sure I wasn't pregnant. No chance of that if we've not been able to... you know... before the x-ray. Have you ever needed the toilet so much you might be sick??? Yeah?? That was me!

Hubby had agreed to come with em, so we arrived at the hospital at around ten to nine - and realised there were two radiology departments on the map I had been sent. Neither of which was highlighted to be the one I needed to head for. One was the "Out-Patients Radiology Department" the other was the "Main Radiology Department". As I was an outpatient, I headed for there. There was no one in the reception area, but a little dinky bell with a sign saying "Ring for attention". So I did. A girl came out and I showed her my papers and asked if I was in the right area. She said she was new, and would need to check, so she disappeared, coming back about two minutes later to tell me I was in the wrong Department. She directed me to the Main Radiology Department and hubby and I made our way. I was now two minutes late for the appointment! I hate being late! So not cool!

I arrived at the second reception, and the lady who was there was on a call. When she finished, she took my details and invited Hubby and I to sit in the waiting area opposite her. Which we did. And waited.

A nurse came out and called my name. Hubby asked if I wanted him to come in or wait where he was. I asked him to come through, but the nurse told him he couldn't as there were other patients around. It wouldn't matter though as I was just going to have my sample checked. So I gave a last look to Hubby before walking through the double doors.

The nurse asked me to give her a sample, handed me the bottle and a wider dish to pee into, then showed me to the toilets. I duly did as I was told in private, and then emerged from the toilet to hand her my sample. She tested it to makes sure I wasn't pregnant. I wasn't (what a surprise!!).

The nurse then asked me to follow her to a cubicle where she explained what was to happen. I needed to take off my own clothes and dress in the attractive hospital gowns, complete with unattractive slit at the back. You get the picture! Yeuch!!! It was cold in there too!! Before I undressed, I went out to where Hubby was waiting to give him my rings and necklace. I told him I was about to go in and asked him to pray for me as I was quite anxious. He reassured me I would be OK but he would pray. Love that man!

After undressing, my clothes were placed in a plastic basket with a handle. It really resembled a supermarket shopping basket!! So the nurse made a joke with me about it when we were going into the x-ray room. I followed behind her like a lost puppy, silently praying Jesus would come now so I wouldn't have to go through with this. When we reached the x-ray room, I was introduced to the Radiologist and her female assistant. Phew! I was dreading a male being involved and relaxed a little. Not a lot though.

As the radiologist prepared the equipment, her assistant went through a checklist of stuff with me, including checking Hubby and I had refrained form intercourse, what date I'd started my last period, that I was between day 10 and 14 of this cycle. She explained the procedure, then asked me to sign the card to say I was happy to go ahead with the x-ray.

I then was invited to climb onto the bed in the middle of the room, complete with a pillow in the centre. "I need you to pop up on here, and we'll arrange you so your bottom is on the pillow." I tried to get settled into position as elegantly as I could muster. the gown was removed from under my bottom and the two ladies continued to prepare for the procedure.

Now... if you don't want to know all the graphic gory details, click away now!!

When they were ready, the gown was moved to my stomach area, and as with a smear test, ankles were brought together and knees maneuvered flat toward the bed... as far as I could - I'm not as flexible as I like to think I am!! Some large, white, disposable sheets were placed around my lower body to preserve my dignity as much as possible in that situation. The Radiologist explained she was about to insert a speculum, which will allow her to see where she is inserting the catheter. Before she did that she used an antiseptic cleaning wipe, apparently this helps to minimize the discomfort of the procedure  When she inserted the speculum, it was ice cold. Being the first patient of the day, clearly the thing had not been brought up to room temperature. This was really uncomfortable and added to the discomfort of tube being inside anyway! If you've ever had a cervical smear test, all of this so far will be akin to what you have experienced.

The catheter followed and was positioned, although the Radiologist did struggle a bit to insert this thin tube into the uterus. When she removed the speculum, the catheter popped out. I don't think it was supposed to do that! So the whole procedure was repeated. Painfully. But this time the Radiologist decided she would leave the speculum in place so as to ease the pain of removing it, and in case it caused the catheter came out again.

She then inserted the dye through the catheter into my uterus and took x-rays of the images being produced. When the dye went in, the cramps added to the pain of the speculum really wasn't pleasant. Then the speculum fell out, bringing the catheter with it. OH no!!! I hope they don't have to do it all again.

The Radiologist checked with her assistant that they had enough images, and upon checking affirmed they wouldn't need to try again. What a relief!

The white disposable sheets were removed so my legs could stretch out and the gown replaced to cover me again. Together they checked the images, while they blocked my view and encouraged me to relax.

Then the images were shown to me. The results of the HSG were given to me. Alone. While Hubby was sat in another room. I wished he'd been with me. To hold my hand. To wipe my tear at the bad news. One blocked fallopian tube and I am at high risk of ectopic pregnancy. She said she would be recommending that I be sent for an ultrasound to see in more detail the cause of the blockage.

I was helped up from the bed, offered a hot drink and led to the bathroom with a towel, a disposable sponge which became soapy when held under water and a sanitary towel to catch the dye when it fell out again.

In a daze, I went into the bathroom, cleaned myself up and changed into my own clothes. In a daze I sat down and obediently drank the hot water they had left for me. In a daze I wished Hubby was with me. In a daze I wondered what this meant. What had caused the tube to be blocked. Had it always been blocked? Had it become blocked? Can it be unblocked? In a daze I smiled back at the nurse when she smiled at me. In a daze I returned the cup to the nurse and asked if I could leave. In a daze I walked back through those double doors to where Hubby was waiting. In a daze I observed the row of men who were also waiting for their wives and girlfriends, and located Hubby. In a daze I took his hand as we left the hospital. When we sat in the car I told him what I had been told. He had questions, but we had no one to answer them. So in a daze we drove away.

For the rest of the day, and the following day, the pain from the procedure was quite intense. I curled up on the sofa with my hot water bottle till we had to go out. I think at one point the pain was so bad I just burst into tears and Hubby prayed for me.





It took four days before the news actually hit me.

It's taken longer for me to come to terms with it, as I wait for the consultant to send me details of my next appointment so we could have our questions answered. Until then I don't know why or what can be done.

First Appointment at Fertility Clinic

I wasn't sure what to expect when I arrived for my appointment. So it was very nervy! I was glad hubby had the day off work so he could attend the appointment with me - and it turns out it was necessary anyway! Our local hospital is very modern, so in order to book in for the appointment, I had to type in a reference number to a special booking-in computer. A quicker process - but very impersonal. It takes away the human contact element - a smile would have helped to make the experience a little less stressful.

So, we went in to the waiting room, and found a couple of chairs amongst other waiting couples.  Not all the women there looked as if they were undergoing the fertility stuff I was - there were some older women, as well as women waiting on their own. I like to people watch, so did wonder what some of them were here for, just as much as a younger couple who were sat opposite were wondering about Hubby n I... I overheard the young wife whispering something, to which her husband replied "I don't know, I can't see and I don't have x-ray vision!" Other than that - it was SILENT in the waiting room... I wanted to speak to Hubby, but felt pressured to "tow-the-line" and keep my thoughts to myself. I pulled out my phone and read the news, lOl!!!

Ten minutes after my appointment time, my name was called by one of the nurses who had been rushing backwards and forwards calling out the women in the waiting room. We were led to a small room which had a weighing chair, a blood pressure monitor and a desk - oh and a height measure against the wall. I was asked to sit in the chair so the nurse could read my weight (something I have not done myself for about three months!!), then she took my blood pressure and asked how tall I was (with or without heels????).

It's funny how this information is gathered but we aren't told the outcome of it - or if we are, how many of us actually understand what it all means!! Anyway, she said it was all fine and normal. Then she asked Hubby to sit in the chair. Neither of us had expected him to have to undergo anything, so he looked a bit confused. "She's not going to get pregnant on her own!" the nurse replied to his query. "What's it for?" Hubby asked. The nurse explained they take some information to check if we would be eligible for IVF, should the time come. Apparently for a woman to be eligible she has to have a BMI lower than 30 and a man has to be lower than 35. Hubby and I both fitted within this criteria.

On our way back to the waiting room, Hubby and I briefly discussed this element, and agreed IVF was not something we would want to consider. My reasons I will explain in a separate post another day.

We waited another fifteen minutes before we called to the Consultant's office. I followed the nurse in, and was greeted by a male Consultant, and a young female student, "Are you happy if we have the student in the room with us?" I was at the door of the room, with the young girl looking at me. "Sure" I replied. How can I say otherwise when she is right there!!! I think this should be asked before we are in the room, personally!!

In the room, Hubby and I were invited to sit down in two chairs against the wall, next to the Consultant's desk. He explained he was going to ask us some personal questions in order to work out what the next stage would be, and pulled out of "my" folder a pink form. The questions went along the lines of:

The Consultant then explained the tests he wanted me to have during the current cycle and at the beginning of the next cycle as there are specific tests which need to be done on specific days - one of the first examinations I had was an external check of my abdomen - as the Consultant wanted to check if he could feel any swelling from my uterus. There was none. The next test Hubby and I had together was a karyotype blood test, so we moved from the fertility clinic to the blood test area and waited a further 20 minutes before our number was called. A karyotype test basically takes a photograph of the chromosomes. It is used to identify and evaluate the size, shape and number of chromosomes in a sample of body cells, and to check whether either of us has any extra, missing or abnormal chromosome pieces which can either prevent a woman from conceiving - or if there are problems which can be passed onto Bubba - when he or she arrives. I think it is really interesting how they can take photographs of something which is so microscopically small and read the information from it!

•  
• When did I stop using contraception?
• What had I been using?
• How often we have intercourse?
• Have I ever been pregnant before?
• Have either of us had any STI's?
• Does Hubby have problems with erections/ejaculation?
• Do I have any pain during intercourse?
• When did I last have smear?
• How old Hubby's son is?

As you can see, nothing is left in "the bedroom", so to speak. Nothing is out-of-bounds. It caught Hubby off guard - well actually both of us - because we had both been under the impression I was the one being investigated as Hubby has a son already. Even more so, when they asked him to produce a sample to be tested at some point during my cycle! It was actually quite embarrassing to be asked all this in front of three strangers!!

A few days later, I had to have a triple swab, whereby they check the cervix by taking a sample of cells from inside the body to ensure there is nothing I have contracted or had in the past (not that I have, but they have to rule out everything which can cause problems with a woman conceiving) or if there are / have been any infections (such as TB or thrush). The swabs are taken from the neck of the cervix - which is the entrance to the womb, as well higher in the cervix.

Next will be a blood test on day 21 of my cycle to check progestrone, thyroid, LH (Luteinizing Hormone) and FSH (Follicle-Stimulating Hormone) levels. A surge of LH actually triggers ovulation within a woman, while the FSH stops being produced after ovulation. So the tests are used to identify whether I am ovulating OK.

Following these tests, if I still haven't conceived by the time my next cycle begins, I will need to have a further blood test between days 2-5 to again test the LH and FSH levels - as one of the functions of FSH hormone is to tell the eggs when to be released; as well as Estradiol - high levels of this can indicate a cyst in one the ovaries or a low level of activity in the ovaries (where the eggs are stored and released from); and prolactin - which can interfere in the secretion of FSH or LH. Then a HSG (hysterosalpingogram) examination - which is an internal x-ray between days 10 - 14. when a dye will be inserted so the radiographer can check to see that the Fallopian tubes are open enough, and not blocked, in order to allow the egg to travel through.

All of these tests will be gathered together and at my next appointment with the consultant the results will be shared with Hubby and I. Until then, others will know the outcome as they discuss the contents of my "folder".

In the meantime though, if I am honest, I am praying and hoping I will not have to go through some of these tests - they sound really intrusive!