Asherman’s Syndrome – Diagnosis and My Very Own Hole-in-the-wall

I had my hysteroscopy scheduled for 18 April 2017, the Tuesday after the Easter weekend.  I walked to hospital in the sunshine and remember feeling very positive.  I was almost skipping down the street – in hindsight this might seem like odd behaviour for someone who was heading to hospital to be put to sleep…. who doesn’t love a daytime nap?!
I figured I wold be under for 5-10 minutes – after all this was just a quick check that everything was as it should be in my uterus.  I thought I’d be out for a few minutes, wake up, recover and then skip out of the hospital into that beautiful, sunny spring day.  I met the anaesthetist, the surgeon and signed the usual consent forms.  All set.  “See you in a little bit”, I said to H and then casually strolled into the theatre in my [sexy] hospital nightie (you know the one with an open back where you’re showing your bottom to everyone else on the ward).
I woke up hours later in a daze and in a lot of pain – and I could hear H saying “can I take a picture of the records” followed by “is that negligence?”. I  was wheeled into the gynecology ward where they wanted to monitor me over night. I remember feeling confused: (a) why was I on the ward; and (b) why was I in so much pain?

A hysteroscopy is a a procedure by which you diagnose and, if necessary, treat problems of the uterus.  A hysteroscope is a thin, lighted telescope-like device with a camera (sound fancy!).  It is inserted through the vagina into the uterus.  The hysteroscope takes images inside your uterus and transmits them onto a screen – perhaps not the selfie you’d normally go for?!  Then the surgeon uses other instruments along with the hysteroscope to treat any conditions of the uterus (such as Asherman’s syndrome).  A hysterscopy is done under general or local and normally takes between 5-10 minutes if you are diagnosing a condition and it can take up to 30 minutes if you are treating a condition.   Thankfully I was having my hysteroscopy under general anaesthetic.
The hysteroscopy had confirmed that 40-50% of my uterus was covered in scars, also known as Asherman’s Syndrome.  Asher-what???, I thought.  During my hysteroscopy, the surgeon had been burning off the scars.  While burning through my scars (which sounds like a witch-like procedure if you ask me), the surgeon had managed to burn through my uterus wall.  So, I had my very own hole-in-the-[uterus]-wall – classy!
So, they needed to fix the hole-in-the-wall and performed a laparoscopy  The surgeons performed keyhole surgery through two places in my tummy – through the navel and on the left side of my tummy – and glued the hole together again.  I fared better than Humpty Dumpty on his wall!
As a result of the hole-in-the-wall, the surgeons had to stop the removal of the adhesions (same thing as scars) and 10-15% of my uterus was still covered in adhesions.  Great.
I spent the night on the ward – exhausted and in pain. I woke up in the middle of the night screaming “help” with excruciating pain in my right shoulder.  That doesn’t make sense, I can hear you think.  I thought I may also have gone made in the procedure.
The surgeons fill your tummy with CO2 gas so that they can perform the laparoscopy and see what they are doing — essentially they blow you up like a balloon.  When the surgery is over some gas remains in your abdomen and the gas causes phrenic nerve irritation to the diaphragm.  When you sit up, the gas  moves upwards to the diaphragm and irritates your shoulder.  This side-effect is unique to laparoscopy, go figure.
The one silver lining of staying the night on the ward was stunning view of the Houses of Parliament (see below).  You’d pay a lot for this view!
St Thomas view

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