Monday, December 31, 2012

Hysterosalpingogram – say that three times fast.

Warning: this post is not for the faint of heart.  It's graphic, but so is life, so suck it up.

According to WebMD, obviously the most legitimate medical source around, "a hysterosalpingogram (HSG) is an x-ray test that looks at the inside of the uterus and fallopian tubes and the area around them".  Well that doesn't sound so bad, does it?  How ever could you want to write a blog post complaining about such a thing, you might be asking yourself, that is nothing compared to the tubey thing from hell.  Just wait, there's more. WARNING: this is somewhat graphic.  WebMD goes on to say that "during a hysterosalpingogram, a dye (contrast material) is put through a thin tube that is put through the vagina and into the uterus. Because the uterus and the fallopian tubes are hooked together, the dye will flow into the fallopian tubes."  Yea - not so fun anymore is it?! 

On the Tuesday following my MRI, I had to have an HSG done.  Why did I do the HSG? The long answer, which I don't care if you wanted or not, would be that when a couple comes in for a new patient visit, they get to know the physician, the physician gets to know their history and then, if the patient has done all of their prescreening, the physician comes up with a plan of action.  If a patient needs prescreening, the first steps include day three blood work, an ultrasound, an HSG and for the male partner, a semen analysis.  The prescreening can take about a month to complete because certain things have to be done on certain days.  Obviously day three blood work has to be done on day three of a woman's cycle. The HSG has to be done between days five and eleven of a woman's cycle.  The results of the prescreening allow us to get answers about what we need to do.  The short answer, which I am sure you would have much rather gotten from the beginning is, if we were going to sit down with Dr. Levy I wanted to have as much information as possible so that we could get our plan of action.  More information + plan of action = one step closer to a baby.  I know what you're thinking, and you're right, I totally should have been a math teacher with those addition skills.

Back to my HSG trauma.  The morning of my HSG, I was nervous.  When I am nervous, I pee... a lot.  Something I have told patients hundreds (ok, that may or may not be an exaggeration) of times is that prior to the HSG you need to have a full bladder.  The medical assistants need to do a urine pregnancy test.  Somehow, the morning of my HSG, I completely forgot this fact.  So when I got upstairs to the PACU and Angie asked me to go pee in a cup, I freaked out.  Oh my God - I have been peeing all morning and now, when I need to pee, I can't.  Thank God there was a little bit of a back-up thanks to a patient being late and I would have more time.  I started chugging water, bottles and bottles of water (ok.. fine, just two of them) and I waited.  I sang the annoying little chants that people sing when you have to pee, you know that whole "rushing water, rushing water, Niagra falls, Niagra falls".  Well, that didn't work.  Finally, I was able to give Angie the most miserable little sample and she said I wasn't pregnant.  I wanted to tell her, "yea, no shit - I wouldn't be doing this if I was pregnant".  Now I understand why patients are so annoyed when we tell them they need to pee in a cup for a pregnancy test prior to the HSG.

I went into the exam room, undressed from the waist down and sat on the little table.  Dr. O'Brien and Karen (one of my absolute favorite MAs EVER) came into the room.  I had to scooch to the end of the table, to the point that I could have sworn my half-naked self was going to fall off the table.  Yea, can you imagine?  That is something that I would never ever be able to live down.  The girl who fell off the HSG table.  Woof.  Dr. O'Brien promised me that she had never had that happen to her and I definitely was not going to be the first.  Then the speculum went in, the catheter went in, we looked at my uterus, and she's a beauty Clark, the dye went in and we saw fill and spill and I was done.  It all happened so fast that when I was finally comfortable with the whole thing happening, it was over.  Dr. O'Brien is damn good at what she does.  WARNING: Apparently, I like to be graphic today.  I have had pap smears that were more uncomfortable than the HSG.  I got myself so worked up and so anxious over nothing.  It was easy, peasy, lemon-breezy.  So really, for me, the hardest part about the hysterosalpingogram was just saying hysterosalpingogram.