Painful hysteroscopy felt like insides were ‘clawed’
Wendy McLean was due to start her seventh round of IVF when her doctor said she needed a hysteroscopy – a procedure to examine the inside of her uterus.
“It was sold to me as a smear test, basically. A thin narrow camera up through your cervix.
“It’ll take minutes. You won’t need pain relief. You’ll be absolutely fine,” she said.
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Wendy, 38, took over-the-counter pain killers before the outpatient procedure at Aberdeen Royal Infirmary in case it was uncomfortable, but this did not prepare her for what happened.
‘Clawed, like sharp nails’
“It felt like getting a hot poker, like getting my insides ripped out. I think I described it to somebody before as like being clawed, like sharp nails, just ripping at my insides.”
Wendy said she lost consciousness twice, vomited and asked for the procedure to be stopped.
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It was only when searching online she discovered thousands of other women had had similar experiences of painful hysteroscopies without anaesthetic.
NHS Grampian said they were sorry to hear about Wendy’s experience and encouraged her to get in touch with their feedback team.
“It shouldn’t be happening,” Ms McLean said. “I never realised it was happening to so many people. I thought I was a rarity, I thought I was different and awkward and I was embarrassed.”
What is a hysteroscopy?
A hysteroscopy is a procedure to examine the inside of the uterus by passing a thin telescope-like device through the cervix.
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It’s described as the “gold standard” in diagnosing gynaecological conditions – including cancer.
It is used to investigate problems like heavy periods and post-menopausal bleeding. Doctors can also perform biopsies and remove fibroids or polyps.
According to the Royal College of Obstetricians and Gynaecologists (RCOG), a third of those undergoing a hysteroscopy report pain levels of seven or above out of 10.
It says patients should be offered local or general anaesthesia for the procedure and their medical history should be taken into account, including trauma or difficulty with smear tests.
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But despite RCOG producing new clinical guidelines promoting pain relief and choice, many women say they are not being offered it.
Procedure was stopped
May Hooper was scheduled to have an ultrasound to investigate post-menopausal bleeding at Stobhill hospital in Glasgow in July 2022.
During the procedure she was told further investigations were needed, but she said she was not told she was having a hysteroscopy or offered pain relief.
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“It’s indescribable,” she said. “I really felt as though I was in a medieval torture chamber. That’s how it felt. It’s just that, I can’t believe you’re doing that to women. I had every indication under the sun for them not to do that.”
Ms Hooper asked for the procedure to be stopped and it was rescheduled – this time under general anaesthetic. The 73-year-old has complained to her health board, NHS Greater Glasgow and Clyde (NHSGGC).
She is now fighting for women to be given more information about the risk of pain and pain relief options – including general anaesthetic.
“It is a very important diagnostic procedure, absolutely, but it does not have to be painful. This is 2024 – we’re not living in the 1600s.”
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NHSGGC told BBC Scotland News it would not comment on an individual case but said it followed all appropriate national guidelines while striving to ensure patients’ needs were met as treatments progress, with alternative pathways available if required.
Dr Lucky Saraswat is a consultant gynaecologist in Aberdeen, who trains doctors on how to perform hysteroscopies. She says the procedure is not painful for the vast majority of women but it’s important for patients to know they are in control.
She said: “We just have to help people make an informed choice of how they want to do it.
“Some people wouldn’t want to have an anaesthetic, as the anaesthetic is not without risks either. So, a lot of people choose to have it done in outpatient settings. Some will make a choice of having an anaesthetic.”
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Campaigners claim the new clinical Green Top Guidelines minimise the risk of pain that patients may experience.
Dr Geeta Kumar, consultant gynaecologist and vice president of RCOG, said they had listened to patients’ concerns.
“Clear accurate written and verbal information must be provided, both at the time of referral, and at the procedure appointment,” she said.
“This will support a woman to make an informed choice, including whether they want to proceed with the procedure and if so, their preferences for treatment setting and pain relief options.”
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Katharine Tylko, from the Campaign Against Painful Hysteroscopy, said: “It will have no impact whatsoever, apart from a few very conscientious and compassionate fighting-types of gynaecologist – young women who will say – ‘We want decent care for our patients.’
Last week JPMorgan made headlines by announcing it planned to cap its junior bankers’ working week to 80 hours (“High pressure, long days, crushing workloads: why is investment banking like this?”, FT Alphaville, FT.com, September 13).
The media and most western professionals and other workers will see that figure as extraordinarily high — but the small print makes clear that the cap will not apply when junior bankers are working on “live” deals.
The 80-hour working week, it seems, is the routine baseline expectation.
Former investment banker Craig Coben, author of the FT Alphaville piece, outlined the history and factors that make the long-hours culture a seemingly intractable fact of life across the investment banking industry — and other related sectors such as Big Law.
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As investment banking is a bespoke service the work cannot fit into a standard nine-to-five schedule. The question is: does this bespoke service require regular “all-nighters”?
Is this really the most efficient approach? Research shows that working long hours does not improve productivity. Studies document diminishing returns after a certain threshold — typically around 50 hours per week.
Coben also pointed to the mega-salaries junior bankers earn. In the end, there is no such thing as a free lunch in life.
They know what they are getting themselves into. The reality may not be as glamorous as it seems. Assuming an entry salary of £90,000, as indicated in the article, an 80-hour working week for 47 weeks a year — admittedly a very basic calculation — junior bankers would earn a higher hourly rate by doing private tutoring!
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Yes, this is partly down to the nature of the business but it is also a self-perpetuating culture that is blocking efforts to at least mitigate its worst excesses.
Addressing this could, in fact, positively impact productivity as well.
Sonia Falconieri Professor in Corporate Finance, Bayes Business School (formerly Cass), London EC1, UK
“We asked for a thorough investigation,” says Olivia.
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“That’s definitely what they’ve done as it’s been a while now.
“I hope the FA do the right thing.
“It’s important we don’t skim over what happened.”
Regardless of the outcome, the 25-year-old says there’s no way things can stay the same in women’s football.
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“I’d like to think that after what’s happened to my sister, there’s no way there can’t be any change.
“Maddy ultimately lost her life and her spirit to football and it’s important that nobody else goes through that.”
Maddy’s family has launched a foundation in her name to support women and girls in football and hopes to be a voice for them too.
“You can’t bury your head in the sand,” says Olivia.
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“You need to stand up for these girls and stand up for Maddy ultimately as well.
“We just really wanted to find what was missing and give these girls a voice.”
They recently hit a £50,000 milestone, something Olivia says she “never even dreamed of”.
“It made me really proud,” she says.
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“I thought, we could really change the game here and change young girls’ lives.”
‘I’m going to be like Maddy’
Some of the money raised goes towards supporting girls like eight-year-old Neveah, who idolised Maddy.
Neveah’s mum, Beth, tells Newsbeat the love started when she was assigned the same number football shirt.
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“She’d see Maddy play and say, ‘Mum that’s me – I’m number eight, I’m going to be like Maddy’.”
Last year, Neveah was a mascot for Sheffield United and chose to walk out with Maddy, which Beth says helped to “grow her love of football”.
When Maddy died, Beth says Neveah “took it really hard” and, in December, the foundation offered to pay for her to have new boots – something the family had done for Maddy every Christmas.
Since then it has also sponsored her kit.
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“She was very touched by that,” Beth says.
“We always get in touch with the family because she likes to tell them how many goals she’s scored for Maddy.”
Although Neveah is sometimes the only girl on the pitch, she is generally supported and encouraged in the sport, says Beth.
But she knows that might not always be the case, and that is why the work of the foundation is so important.
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“[Girls] need to know that support is available for them,” she says.
“I just hope Neveah’s journey through football, however long it is, continues to be positive.”
Olivia says her sister was “loved and adored and an inspiration to so many”.
“My main focus with the foundation is to carry that on for as long as I can and to bring her to life for as long as I can as well.”
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There will be a vigil for Maddy later and she will also be remembered at a match between Sheffield United and Derby County – the club Maddy supported – on Saturday.
“She would’ve been there for sure,” Olivia says of her big sister. “With a beaming smile.”
A spokesperson for Sheffield United told Newsbeat they were pleased to mark the anniversary with the match.
“The thoughts of everyone associated with Sheffield United Football Club remain with the Cusack family, as well as Maddy’s friends, colleagues and team-mates,” they added.
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The FA said it would not be appropriate to comment while it was still investigating.
If you’ve been affected by the issues raised in this article, help and support is available via BBC Action Line.
Listen to Newsbeat live at 12:45 and 17:45 weekdays – or listen back here.
No publication has bettered the FT for the coverage of Boeing’s downward and tragic flight path resulting from putting financial engineering (sic) before real engineering. Rereading John Gapper’s piece about the revival of Rolls-Royce’s fortunes (Opinion, September 13) I was surprised to see no words of caution about the possible consequences of too much “squeezing” of a product that must work perfectly throughout its life, and no warning on the potential for a Boeing outcome.
For me, I am always reassured when I look out from a window seat to see the classic black and silver RR logo on the engine housing. Long may this continue.
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