Unknown abdominal pain caused me to collapse. Not happy with GP's reaction

June 11, 2012 11:39 AM

Unknown abdominal pain caused me to collapse. Not happy with GP's reaction

Sharp, excrutiating pain came on suddenly after several minutes of this I passed out. This is most unusual for me, until a couple of months ago, I never had any menstrual cramps at all. I've never fainted during a period. The one thing this reminds me of is the time I crushed my hand in a piece of machinery and went into shock with the pain. It was exactly like that but in my lower abdomen.

Colleagues called an ambulance. I regained consciousness and pain gradually subsided to a dull ache. Cyclist ambulance response turned up and told me to get thyself to a doctor asap as this is not normal etc etc. I stupidly talked them out of calling an ambulance to take me to the A&E and said I would go to my doctor. So I went to my straight to my GP (not that I have one, I tend to get shuffled from one trainee doctor to another), expecting I might get referred for a scan or a blood test or whatever and I get: "Oh it's a period pain, I can give you some pain killers or put you on a pill" I really pushed the point with him and asked for a referral but he said "Oh let me talk to my colleague and I will call you back later today". And I never heard anything back.

In my home country they would have ultrasounded that sucker and sent me off to the blood labs straight away. I walk out of there with nothing, no advice, no further tests, (apart from feeling like I'm a silly woman making a drama over a period pain), nothing. I leave office so upset I burst into tears when I get home. I know I'm answering my own question here but should I get a second opinion? I feel uneasy and I want this checked out. I don't even know what it is an whether it will happen again which is making me very unhappy.


I am new to dealing with NHS. Should I go to another doctor or will it be the same no matter what clinic I visit? Should I go private? Can I see a gyno without a referral, and if so can anyone suggest one in Central or East London?

posted by BAKERSFIELD! to health & fitness (20 answers total)

Yes, second opinion! This happened to a friend some years ago - he collapsed on the street - and it was either gallstones or a kidney stone, I can't remember which. He's fine now.

I will leave the navigation of the NHS to those who know better than I.
posted by rtha at 11:45 AM on June 11, 2012

This all happened today? I would absolutely go to A&E right away.
posted by grouse at 11:49 AM on June 11, 2012 [2 favorites]

Ovarian cyst rupturing?
posted by elizardbits at 11:50 AM on June 11, 2012 [5 favorites]

Write to your GP. State plainly that you have been menstruating for XX years, are familiar with menstrual cramps, and that this is far outside the normal presentation of any menstrual cramp you have ever experienced. Tell them you are unhappy with your assessment and follow-up and would like a conclusive diagnostic assessment.

Put your mobile on the letter and ask them to follow up with you as quickly as possible.

The NHS is a fine institution but 90% of it is being able to advocate for yourself. You need to be prepared to demand the best care.

PS: You did absolutely nothing wrong here but in future, if an ambulance is called, get in it. You will have faster access to more imaging equipment in a hospital than at a typical GP, and oncall specialists including gynes.
posted by DarlingBri at 11:53 AM on June 11, 2012 [5 favorites]

Write to your GP. State plainly that you have been menstruating for XX years, are familiar with menstrual cramps, and that this is far outside the normal presentation of any menstrual cramp you have ever experienced. Tell them you are unhappy with your assessment and follow-up and would like a conclusive diagnostic assessment.

I would submit that this avenue will be a waste of time for all involved. You received a professional opinion (not necessarily a correct one) that brought you to tears. In my ample experience, from here on out virtually nothing else that is said and done is going to lead to a happy conclusion with this physician as trust is already lost, and particularly because you don't really even have an established relationship with them. If you are inclined, send your letter for the purpose of voicing your displeasure with the GP's service, and leave it at that.

Just get a second opinion, preferably from someone that comes recommended -- and be at least open to the possibility that more tests may not always be the answer if nothing pans out following a careful examination.
posted by drpynchon at 12:07 PM on June 11, 2012 [6 favorites]

I have had friends who almost died from ectopic pregnancies because the male doctor attributed their pain to periods. Another friend died, yes, died, of appendicitis because her male doc said the same. Please go to another doctor, take a strong-minded friend to support you, and stay until they've given a more accurate diagnosis.
posted by mareli at 12:09 PM on June 11, 2012 [13 favorites]

See a GYN right now. Now now now now now. I say that as if it's possible, and I don't know how things work on the NHS, but as close to "now" as is reasonably feasible.

Pain that causes you to faint is something severe, not something usual.
posted by Sidhedevil at 12:25 PM on June 11, 2012 [3 favorites]

Go to the emergency room. And when you feel better, indulge yourself in making that doctors life miserable by complaining to all and sundry about them.
posted by fshgrl at 12:44 PM on June 11, 2012 [6 favorites]

drpynchon, are you basing your opinion on experience of the NHS? Because what I suggested is what I myself have had success with, more than once, on the NHS. I did not just pull that suggestion out of my arse. In addition, your suggestion that the OP "Just get a second opinion" indicates to me you are not familiar with how the NHS works.
posted by DarlingBri at 12:47 PM on June 11, 2012 [2 favorites]

I had my NHS GP tell me I was "just having period pain" with similar abdominal pain to yours.

When I finally went to casualty and collapsed at the counter, they saw me immediately and diagnosed a rupturing ovarian cyst.

So if it's bad enough to make you pass out, it's serious enough to get yourself to casualty. Good luck.
posted by vickyverky at 1:01 PM on June 11, 2012 [4 favorites]

You can and should get an opinion from another doctor about this. You can phone up your surgery and ask to see a different GP, and then explain to them that you've already seen Dr So-and-so about this but weren't at all satisfied with the answer you got and are still very worried. (You can also ask to see a female GP if you'd be happier with that.) I took that route when a GP brushed me off in a similar way; the surgery didn't have a problem with it and the second GP referred me to a consultant straight away.

I'm really sorry you got such an unhelpful doctor, but it should not put you off advocating for yourself and getting the care you need here. Passing out from the pain is not normal for menstrual cramps, and you absolutely need to get medical advice from someone who'll listen to your concerns.

If this just happened, though, you should seriously consider heading down to your local A&E.
posted by Catseye at 1:02 PM on June 11, 2012 [3 favorites]

drpynchon, are you basing your opinion on experience of the NHS? Because what I suggested is what I myself have had success with, more than once, on the NHS. I did not just pull that suggestion out of my arse. In addition, your suggestion that the OP "Just get a second opinion" indicates to me you are not familiar with how the NHS works.

Fair enough, I am not well versed in the roadblocks of the NHS, and didn't mean to suggest that you weren't speaking from your own experience. Getting a second opinion may not be so simple, but regardless of the health care system, in a situation like this it is likely to be necessary -- not so much because of the particulars of the case, but because the patient-physician relationship is so frayed on an emotional level.
posted by drpynchon at 1:07 PM on June 11, 2012

You should definitely be able to see a different GP at your practice - many practices these days only really allocate patients to particular GPs for administrative reasons, and in reality you can see whoever you want, or whoever has an appointment available first. You can also request an appointment with a female doctor.

If all else fails, you can probably get in to see a doctor at a sexual health clinic by claiming to be worried about this sudden change in how your reproductive system is behaving and whether it could be related to your sexual health. They might not be the best place but they will be able to refer on appropriately.

To be honest if you'd come into A&E you may not have got anything useful out of it - if the pain had subsided then you would no longer be an emergency and therefore would get prioritised waaaay down the list and probably told to get referred via your GP, which is what you ended up doing anyway (albeit unsuccessfully).

When you do get in to see another GP, useful phrases may include:
"sudden change"
"debilitating pain causing loss of consciousness"
"worried about this happening in a more dangerous situation" - you could mention driving but I would hesitate to make them think you might not be safe driving!
"worried about going out by myself"
"family history of . . ."
I'm never going to advocate for over-exaggerating but I can see why you are worried, and GPs vary in quality - sometimes you have to know how to push the right buttons.
posted by kadia_a at 1:18 PM on June 11, 2012 [1 favorite]

DarlingBri: I am totally pissed off with myself that I did not let them get an ambulance for me. That was half the reason I was so upset when I left the doctor. And yes NHS has been really good for me up until now.

drpynchon: there is no doctor - patient relationship, never saw the guy before but you're right he did not establish trust. He diagnosed me without really looking at me. Listened to my heart, took my blood pressure. The ambulance woman did more than he did.

kadia: I did use those phrases. I explained I was worried I didn't know if it would happen again. He just said that was unlikely without giving me adequate explanation why he thought that.

I don't drive but have worried I might pass out on the tube. If there are severe delays on the Jubilee in the next few weeks (or god forbid the Olympics) think of me, I've probably had another "cramp"

I am definitely going back in some way, though I'm not in acute pain now, this has happened and I need to follow it up.
posted by BAKERSFIELD! at 1:32 PM on June 11, 2012

What am I saying, there are delays on the Jubilee every day.
posted by BAKERSFIELD! at 1:36 PM on June 11, 2012 [2 favorites]

I was turned away from an A&E for "Period Pain" that had me laying on the floor in the waiting room trying to knock myself out to stop the pain, luckily my brother was there and insisted on a more careful examination (and sweet sweet pain relieving drugs). Turned out to be gallstones. Get a second opinion, and a third if needed, until you get a doctor you can trust and an answer that makes sense, ask to see the tests and reasoning behind their diagnosis.
posted by wwax at 1:53 PM on June 11, 2012

If it's reassuring to you, I have passed out from abdominal pain that turned out to be nothing. Well, let's say irregularity-related. I just have a hair-trigger vaso-vagal response. No one did any ultrasounds, and I'm in the US, with good health insurance. It happened a few times until I fixed the irregularity that was causing the pain -- and yes, once on a subway. Several strangers rushed to my aid.

I'm not saying you shouldn't get a second opinion, just that it's not necessarily the case that passing out from abdominal pain means you have a serious underlying medical issue.
posted by palliser at 2:40 PM on June 11, 2012

Go back to the doctor and demand a follow-up. The fact you are still having pains (although not as acute) is your in - your period/ovulation is over and you're still in pain. Look, we've ruled that out you stupid doctor!

A few years ago I went to the ER and the doc on call tried to dismiss my abdominal pains as menstrual cramps... I repeatedly insisted it had nothing to do with any of that. Almost twelve hours later they were finally prepping me for an appendectomy. The delay in treatment resulted in complications during surgery and convalescence.

To this day I still shudder knowing that I could have died because I was initially given an ER doctor that didn't understand I know what my own period cramps are like.
posted by Lt. Bunny Wigglesworth at 3:00 PM on June 11, 2012 [1 favorite]

I agree with others about getting a second opinion - it may very well happen again. I had this happen repeatedly: about once a year for a few years (insane delirious-making abdominal pain, blacking out on the sidewalk). The magic phrase that got me taken at least somewhat seriously was "blood in the stool" (it was a pretty trace amount, but that perks their interest).

The punchline is nobody ever figured it out. Ultrasounds and colonoscopies later - they expected to find ruptured cysts and found zilch, and it just sort of stopped happening. I was always very dehydrated as I seem to lack a thirst instinct, so that probably didn't help. In any case, might want to stamp your foot and get some more work done. The encore performances are decidedly un-fun.
posted by oneaday at 9:33 PM on June 11, 2012

You need to go, as soon as possible, to your nearest sexual health/GUM clinic (preferably one in a hospital). Speaking as a woman who has had similar worries in the past, they are absolutely the best people to a) take you seriously and b) get you the treatment you need. These days I don't bother going to my GP for sexual health worries, as invariably they (especially male doctors) dismiss it as "female troubles".

You can search for your nearest NHS clinic here. If you don't like the service you get at the one you choose, go to a different one until you find someone who will help you.
posted by fight or flight at 2:54 AM on June 12, 2012