Yesterday, I went to see the GP, as threatened. My local health centre has about a dozen GPs, and I can’t always get to see Doc Tashless (or even the gorgeous Doc Sweetie who I reduced very nearly to tears back in January with my Tales of Woe). Instead I got a GP I’d never seen before in my life, and when I announced that I was there to get Provera, he looked a little bewildered. What did I want it for? So we went back through most of my medical history.
It still disconcerts me utterly when a doctor looks startled and distressed by my medical history. Seriously? That bad? Oy vey.
Anyway. I pointed out that I’d been given provera before to bring on a period when the PCOS was having a resurgence and I hadn’t ovulated for a while. ‘Oh?’ said the GP, ‘How does that work?’ And that is how I found myself calmly explaining how the provera suppresses the excess oestrogen and mimics a normal luteal phase, so when you stop taking it, the drop in what the body assumed was progesterone triggers the shedding of the uterine lining and the start of a new menstrual cycle, to a doctor. Possibly one of the more surreal moments of my medical history. The GP asked if I had a medical background, at this point. Ah, no. Just, five years of this shit and an enquiring mind.
The GP then bought up the subject of my period pain (given that all those prescriptions for mefenamic acid and co-codamol and tramadol on my notes). I gave a brief and I hope coherent description of the joys of adenomyosis. He pointed out that my symptoms sound like I suffer from excess prostaglandins and the deliciously named ‘clot colic’ as well.
‘Clot colic. When you are passing clots of blood, the uterus goes into a spasm, much like labour pains, until the clot is through the cervix. It can be very painful.’
I opened my mouth, looked wildly about me, and closed it again. There’s a term for it? Doctors know about it? I’ve bitched endlessly on this very blog that extra clotty flow, or big clots (ugh) make me feel like someone’s putting the Cute Ute through a sausage machine. I always thought it was one of those nameless things that medicine thinks too subjective to bother with. And here’s a GP telling me about it? I… I… Boggled? Yes? What? (‘Clot colic’. Sounds utterly foul).
The GP recommended trying tranexamic acid and mefenamic acid together, to suppress at least the prostaglandins. I pointed out that mefenamic acid makes me throw up, and tramadol shuts my guts down, and tranexamic acid gives me wicked heart-burn, and would combining all three actually be a good idea? The GP looked rueful and said nothing.
After that, there was nothing to do but take my provera prescription and go and buy H some Lemsip (poor chap is having his own wrestle with an incarnation of the Cold of Filth, and has spent most of this week Feeling Like Hell).
On getting home, I got out a calendar and did mathematics, and saw that given the GP had prescribed 14 days of provera, at 10mgx2 a day (ie 20mg a day) (is that a lot or fairly normal for period induction? During the stupid clomid cycles of anovulation, I took it for 5 days, but I can’t remember at what dose, damn it). I also saw that if I started taking it at once I’d be at high risk of getting my period during H’s birthday weekend mini-break. This is a horror not to be thought of, I decided. I shall take the provera next week.
And then I looked at my temperatures over the past few days, and considered the state of my undercarriage, and wondered if I’d ovulated on Monday or Tuesday after all.
No! No! We think not those thoughts! That way madness lies!
[ETA - Dr Google tells me the term 'clot colic' usually applies to blood clots in the kidney or ureter, and yes, they are AMAZINGLY PAINFUL. Am now confused as to how confused my new friend the GP is, or is not]