Emergency medical recs in London (TMI for the squeamish)

[Circe]

I posted a few weeks ago about travel and early pregnancy: unfortunately, I started bleeding a few days later, had two ultrasounds a week apart, was told it was a miscarriage and I could go back to life as usual. This was about 10 days ago. Since then, I actually did travel to London, figuring that location wouldn''t really matter.

Unfortunately, after what I thought was a fairly normal pattern (light bleeding into heavy bleeding into light bleeding which I thought was tapering away) I started bleeding fairly heavily again last night. Now I''m having really bizarre cramps to boot. If I was home, I would just go to my usual doctor: as it is, I''m not quite sure what to do.

I am not bleeding so heavily that I feel like a need an ER. We are not talking about the every-website-says-to-panic kind of bleeding. But it''s weird enough in terms of timing, volume, and sensation that I am worried. Those of you who have any experience with the British system - what does one do?

In the states, an ER visit really only makes sense of imminent death, which I don''t think is the situation here. In the UK, should I go to a hospital, should I start calling gynos and hoping for an opening, or should I just schedule an appointment when I am home at the end of the week and hope for the best? Bonus points if anybody can recommend a specific doctor or practice, if it''s the second case ....

 

[Mrs Mitchell]

Circe, I'm sorry you're having more distress, especially so far from home. I'm in Scotland, so I don't have any specific recommendations for London, but I'm hoping Pandora will see this.

In the meantime, a few of suggestions - first, can you contact your insurance provider? They may have a list of overseas clinics or individual practitioners they could refer you to directly for an appointment.

Are you staying in a hotel? You could ask at reception for details of a local General Practitioner. S/he can advise you as to whether you need to go to a hospital. I'd ask for a GP, rather than a gynecologist, as they are more accessible - most specialists here require a GP referral in the first instance anyway.

Also, go to NHS24 http://www.nhs24.com/content/?gclid=CNOU8Zfg6qECFRUslAodihzJKA and work through the self help guide. It will tell you at the end if you need medical treatment, in which case you can phone their helpline and take advice about where to go to get treatment.

I don't know where about in London you are, but St Bartholomews Hopsital has a minor injuries clinic - like ER but for less serious or non life threatening issues. You can go without a GP referral.

This page http://www.bartsandthelondon.nhs.uk/forpatients/in_an_emergency.asp gives details and has some info for emergencies.

Finally, if you really are worried, take a trip to Accident and Emergency (ER). Don't take any chances with your health.
Hugs
Jen

 

[Hudson_Hawk]

Circe, I have no guidance for you, but I wanted to chime in and let you know that I''m thinking of you. I''m so sorry to hear this news

 

[janinegirly]

I''m sorry to hear the news as well...

There are NHS walk in clinics, but not sure about ER''s. I agree about asking your hotel or see if there is a help number for NHS on the internet which can tell you nearest emergency care. I remember when I was in London I went into a walk in clinic and while the wait was long was impressed how wel I was treated as a walk in foreigner (including provided with nearly free antibiotics and ironically being seen by an American dr.).

I hope you find something and are seen soon---keep us posted!

 

[Lorelei]

Circe

I only just saw this, what you need to do is go to Accident and Emergency ( A&E) at your nearest hospital, they will take it from there. Bring any relevant documentation you have as you are a visitor ( ID/ passport etc). Normally you don't need to call in advance, just show up.

 

[Puppmom]

Good luck, Circe! I''ve never been abroad but it sounds like you''ve gotten some good advice so far. I''m sure everything will be okay and you''ll have a wonderful trip!

 

[Lynnie]

Oh, Circe... I just wanted to share my condolences. I hope you''re doing alright. ((((Hugs))))

 

[Porridge]

Oh you poor thing Circe, I hope you feel better soon.

Get along to A&E, that would be the best route and the quickest. Ask the hotel which hospital is nearest/best. I really don''t imagine you''ll be charged, but I''m not positive how it works for non-euros.

 

[somethingshiny]

Circe~ I''m sorry for your loss. I hope you can get yourself taken care of while abroad.

 

[Mrs Mitchell]

Circe, are you ok? Thinking about you.

Jen

 

[Circe]

Thanks, guys. After a morning of worrying, I finally got through to my gyno's office in NY, and they were sort of ... unconcerned. They'd like me to come in for yet another ultrasound/bloodwork when I'm back home on Thursday, but apart from that, they didn't seem worried. Apparently bleeding after ten days is not uncommon? As the receptionist put it, "It's not like there's anything the doctor could do to stop the bleeding, anyway ...."

I don't find it reassuring, and today has been a completely wasted day of sitting around and worrying/trying not to aggravate it, but the silver lining is that it hasn't gotten worse. So, I am crossing my fingers and hoping it's just ... my period popping up right on the heels of the miscarriage? SOMETHING. But I also find it tremendously reassuring to know more about what I *should* do if anything gets worse. Thank you, to all of you.

Jen - thank you so much for all your advice. I did call my insurance company, and while I have full coverage, they couldn't really suggest any specific doctors. But the website is a tremendous help (much more so than the hotel, which was, er, well-intentioned, but sadly sort of useless. Thank you, for the advice, and for the support.

Hudson, Puppymom, Lynnie, Somethingshiny thank you so much, ladies. It really does sort of ... hearten me. I feel like such a wuss whenever I succumb to physical infirmity! But, I also have to acknowledge that this is bizarrely ennervating. I started writing this post right after I called my doctor ... seven and a half hours ago!

Lorelei & Porridge, thank you. That is good, solid, practical advice. I hope I won't need it (hoping, hoping, hoping that the bleeding goes away again after a day of taking it easy), but if I do need it, it will be invaluable. I really appreciate it.

Jen (again) - you are such a dear, and I am so glad I did a last double-check before I posted! I really did take forever in responding. It's been the weirdest day of being sluggish and listless and worried, all at once. Productive? No. And in London, worst of all - if I was going to be lazy, I could have thought of much better ways to do it! But hopefully I'll be better tomorrow. Fingers crossed ....

 

[Hudson_Hawk]

Circe-glad you''re feeling a little better...

While losing the baby is a tragedy at any point in pregnancy, in terms of physical effects and discomfort, etc; the earlier the better.

 

[Pandora II]

Circe, sorry just saw this.

Please call 020 7188 7188 and ask for the Early Pregnancy Unit.

St Thomas’s Hospital
Early Pregnancy Assessment Unit, 8th floor, North Wing
Lambeth Palace Road. London
SE1 7EH.

They are 24/7 and so nice to talk to. They had me in the next morning for a u/s when I started bleeding.

Oh, and if you fancy a coffee or anything, other than Wednesday pm, I'm around all week!

 

[lizzyann]

Circe, again I am so sorry for your loss. I don''t know if this is a comfort or not, but I had two miscarriages before conceiving my son and both times they started as a spotting and then within a week moved on to heavier cramping and bleeding. So your NY Dr. could be correct not to worry, but if you feel that something just isn''t quite right I would call Pandora''s contact and go from there. IF anything, it will give you peace of mind.

 

[Dreamer_D]

Hugs honey! I am like you in that I don''t generally go to the doctor unless there is something really wrong like major and unbearable pain... in your case from what others have said it seems like this is a normal pattern, I hope it gets better soon.

And I hope this does not seem crass to change the subject a little, but I am very jealous you are in London. It is one of my favourite cities in the world to visit, they are just so well set up for tourists! For better or worse I guess. The British Museum is the top of my list of things to do there, all that world pillaging really resulted in a great collection

If you feel up to it I hope you are able to see some of your own favourite sights!

Hugs again and please let us know how things go...

 

[yssie]

Oh Circe, I'm so sorry for your loss.


I'm very glad you're feeling a little better though. I'll be thinking of you.

 

[Mrs Mitchell]

Hey Circe, glad you checked in, good to know that you''re ok (if not exactly happy). I had bleeding for about two weeks after m/c, which my Dr said was less common but certainly not unusual. The only real concern my Dr had was the risk of an ectopic pregnancy, where there was a second egg that hadn''t been spotted at the U/S. Not trying to be alarmist, just wanted to highlight that severe pain needs immediate attention even though it''s really hard to navigate a different country''s health system. If your usual Dr isn''t too worried, then I think I would be reassured, since s/he will know exactly what''s going on. If things do start to concern you more, Pandora''s suggestion is probably the best one.

The NHS24 website and phoneline are both good (in Scotland anyway, I presume the English version is the same). Sorry the hotel people were useless, I can''t imagine they''ve never had to find a Dr for a guest before, that''s really annoying. Usually they have stuff in the info pack about what to do if you need medical attention. Lame!

How disappointing that you are having to deal with this on your London trip. I really hope you''re feeling better today and that you can do some of the things you want to. Take it easy though! Maybe a little retail therapy? I believe there are some rather fine shops in London...

Jen

 

[PumpkinPie]

I''m sorry Circe

I don''t have any advice, but I wanted to share that I''m sorry you''re going through this.

 

[hearts-arrows_girl]

Circe, I'm soooo sorry for your loss!

(I had a miscarriage 23 years ago. I want you to know, my condolences are genuine and heartfelt)

 

[HOUMedGal]

Circe, just wanted to let you know I''m thinking of you, and that I''m so sorry for your loss. When I had my MC, I bled for a good three weeks, and that was even after a D&C. And I went from heavy to light to heavy again at least once. Please do seek medical attention at one of the above recommended places if you feel like you need to...especially if you begin to feel other symptoms like fever, body aches, etc (which could signal an infection from retained tissue). Big big hugs to you, and I hope you''re getting to enjoy your trip to London despite the sad current circumstances!

 

[Circe]

Hi, guys - sorry for the long hiatus between postings. I felt very hangdog and generally eeeccccccch for most of the week, and spent almost all of it in the hotel room, working quietly and hoping like hell that the bleeding would stop. It got heavier as the week progressed, until on Wed. I was very nervous about flying the next day without a diagnosis. I wound up going to St. Thomas - Pandora, thank you *very* much for the recommendation, and for giving me such detailed information. The day I went, they didn''t have an ultrasound available, so they couldn''t give me too much info. Unfortunately, that only became clear after I''d been waiting for 6 hours ....

... this is going to be a brief digression, just because I want to vent a bit. Why, why, why do doctors condescend? Do not ask me if it hurts when I "wee" - the word you are looking for is "urinate!" Do not tell me that you can''t give me a proper diagnosis because you "can''t see up in my tummy" - what you want to say is that you can''t get a clear picture of my uterus, cervix, or reproductive organs! Gaaaaaaah.

See, after the 6 hours, and after seeing a very nice nurse, I got an awful doctor who kept braying that at least I was on hooooooooooliday (yeah, lady, trust me, even if you haven''t been on vacation since med school, this is *not* how you want to do it) who told me to come back the next day to do an ultrasound if I wanted to be told if I was safe to fly. She then proceeded to tell me that, after all, it could be ectopic, the embryo could be in the abdomen, heck, in some cases, you could miscarry one pregnancy and still have a second lurking somewhere in the system - one never knew! So I should come back for another wait prior to my noon flight.

So, okay: I''ve made it through 6 hours of being scared and in pain and I apparently have to come back to do it the next day. So I go to the nurses station to ask when they start doing ultrasound''s the next day, and ... the nurse looks at me like I''m nuts and says, "We''re not doing ultrasounds tomorrow, either!" And that is when I started to cry.

I hate crying. I do it a lot, mind - it doesn''t mean I''m incoherent or anything, just that I''m upset. But the nurse started worrying on my behalf, and called another doctor to talk to me: he proceeded to condescend the hell out of me by repeating everything the first doc had said, complete with the aformentioned infantalizing language. I still wish I had bitten him.

But, instead, I left, bought some paracetemol, got on the flight, and came home. The next day I was at my usual doc''s office by 8:30, and they squeezed me in for an emergency ultrasound, and a doctor I hadn''t seen before gave me a thorough talk of my options (she also apologized for talking so fast and going over so much halfway through, and I was like, NO, really, I love you! talk medicalese at me, seriously!). Basically, Wednesday''s HCG read 107, which means *something* is still going on ... but nothing showed on the US. So I have to wait till Tuesday (yay, holiday weekend ... not) to see what is up. According to the informative doc., if I still show as pregnant with this blood test, it probably means ectopic, and I will have to take methotrexate. That sounds pretty damned awful, so I am sincerely hoping that it will turn out to have been my body flushing the last of the matter, or something ....

At any rate: thank you all for your kindness and support. I really cannot emphasize how much it means to me. Also, apologies for the teal deer ... I sort of figured that after taking so long, I ought to give a thorough accounting!

 

[somethingshiny]

Circe~ I''m sorry you had a miserable experience at the hospital. I would hate being talked to like that. Your HCg could still be showing if there''s any matter left whether in your tube or uterus. A DNC may need to be done. I don''t want to throw more stuff at you, but I didn''t want you thinking that it had to be ectopic if you still have HCg.

 

[Dreamer_D]

Egad. I am so sorry you had to go through all of that! You should have bit the doctor, you could blame it on being American

I too am hoping that everything is fine and your body is just taking its time to flush out. Please keep us posted, I will be anxious waiting for your news on Tuesday.

 

[Porridge]

Wow Circe I''m so sorry you had such bad luck at the hospital. How upsetting. I hope you start to feel better soon. {Hugs}

 

[lizzyann]

So sorry to hear all of this Circe. I hope you have some finality and a game plan on Tuesday. The uncertainty is the worse so I am sure this weekend has gone by so slowly for you. Hang in there. We will all think good thoughts for you.

 

[Bliss]

Circe, sending prayers your way that everything will be OK. I''m glad you''re home now and with doctors who can give your the information you need. I''m so sorry you have to go through this. Hoping you feel better soon.

 

[Pandora II]

Circe, sorry you had a bad time at St. T''s - I''m really suprised they didn''t have a sonographer available.

The baby-talk thing is a total PITA. Unfortunately the area the hospital is in is one of the most deprived in the UK and a lot of people are too uneducated or don''t speak English to understand things unless spelt out in words of less than 2 syllables. When I was in postnatal I thought I would scream if anyone else told me that the ''Baby Doctor'' would see me in an hour.... aaaarrrrrrgggggggggggggggggghhhhhhhhhhh. I did flip at one point and said I''d prefer a grown-up doctor please, but I don''t think they got it.

Oh, saying things like ''wee'' instead of ''urinate'' is normal here, not sure I''ve ever heard a doctor say ''urinate'', all a bit too clinical!

Anyway, I really apologise for the crappy experience and that you didn''t get a chance to enjoy London.

I hope you get some answers tomorrow and things work out the best way for your health.

Big hugs, P x