I am a rational woman

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 what?’

‘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.

Thought so.

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]

11 responses to “I am a rational woman

  • QoB

    I just googled ‘clot colic menstruation’ and you were the 3 in the results.

  • Hairy Farmer Family

    1) Younger Drs tend not to know shit about obs & gynae peculiarity (although I’m a tad surprised he couldn’t bring a menstrual cycle to a chemical close!). I know that sounds such a flip, dismissive phrase, but I’ve had to draw enough pictures on the backs of envelopes to enough SHOs and locum GPs that I now feel my data sample is large enough.

    2) The thing about youngers Drs, though, is that they’re all staggeringly bloody bright. And although that doesn’t necessarily = people person, I’ve never met one that was the least bit embarrassed about their (to use the obvious phrase) ignorance. If they don’t know something, they seem to be perfectly happy for patients to educate. I like to think that my usual short lecture on Mullerian Duct Anomalies, for instance, has assisted in the propulsion of any number of SHOs through their Obs & Gynae rotation exams! Judicious googling has taught me that the examiners often sneak a Mullerian question in, and my personal standby in sorting the sheep from the goats is quizzing ’em on the difference between Uterus Didelphys and Bicornuate Bicollis. Anything below Senior Registrar tends to fall at that fence!

    3) If I had a quid for every doctor that has (usually… cautiously) asked me about my ‘medical background’ i’d be a… well, not a rich woman, exactly, but I’d be able to buy a fair-sized round.

    4) Not sure about the term Clot Colic, but I knew about the phenomenon. GP is not confused, merely using interchangeable slang, I think. During one of my miscarriages, I returned to hospital (with what I now know to have been a twin pregnancy, having already lost one) with raging pain caused by what was first assumed to be infection, but when they examined me they found a large clot – foetus number two, I assume – just emerged. They attributed the pain to that, and said that when clots get stuck in the cervix, it’s highly, highly unpleasant. Which it is.

    5) Poor H! Get better soon, sweetie!

  • a

    Well, I’m guessing that was longer than the usual 15 minutes that appointments take for me. I guess I don’t expect much from GPs, since they don’t have as much specific knowledge as general knowledge. Although I have a GP, I rarely go to see him. My daughter sees him, and whenever I have a question about something, he comes up with an answer and seems confident. However, when my daughter developed a skin irritation, he kept giving random answers, so I took her to a specialist who diagnosed her in about 7 seconds. (Of course, being an annoying patient, I ignored 2/3 of his advice…the other 1/3 worked fine).

    Clot colic, eh? Sounds…ugly in every way, so I guess it’s a good title based on your description.

  • wombattwo

    I’m sorry, I just wet myself…
    Have nothing much to add about “Clot Colic”, although it sounds hideous.
    Apart from that, agree with HFF. There’s really nothing else to say!

  • MFA Mama

    Yes, I think this GP is Confused, but in a Deliciously Apt Manner. Clot Colic! It sounds as vile as it is! I used to have bouts of that when (look away, ye squeamish) I’d pass clots nigh-on to ping-pong ball size and OH GOD THE PAIN. For what it’s worth I think contractions at the peak of transition are merely comparable and perhaps a hair more tolerable in that you know those will end in a predictable time-frame. Ugh!

  • Womb For Improvement

    That is the best description of how provera works I have ever read. For that I thank you. Am I am impressed at you Doctor management.

    Hope H recovers before birthday shinanigans.

  • Betty M

    I am embarrassed to say that clot colic sounds to me like something more suited to Vetinary science. When I put my sensible hat on though I entirely agree with HFF.

  • Lilian

    Clot colic sounds as foul as it obviously is.

    I can empathise with you about doctors looking startled and distessed at your medical history. It is rather disconcerting!

    As always, am in awe of how you get through all these things and remain relatively sane and sensible and able to explain medical things to doctors in a calm manner, etc.

  • twangy

    We need to make a leaflet for doctors:
    Look, Drs. It’s like this. We want you to be neither stony-hearted nor bleeding-hearted. But just sort of in the middle, as in, human. Okay?

    Clot colic, oh my. That sounds right. Horribly so.

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