When we left the clinic on Friday, we'd been given information about ovarian hyperstimulation syndrome (OHSS). The symptoms included:
- Weight gain of 2kg or more in the days following an egg collection
- Abdominal (tummy) pain
- Abdominal bloating or swelling
- Nausea or vomiting
- Decreased urine
- Shortness of breath or difficulty breathing
- Severe headache
I felt that I had the second and third symptoms on the list and perhaps the first but none of the others, so I rang the clinic's nurse on call, Nurse E, to see what she thought. She didn't seem to mind being woken in the middle of the night, thankfully, but suggested that we go to the after-hours medical centre in the city, a private medical centre which is not attached to a hospital. I was a bit reluctant to go to a potentially very busy hospital A&E on a Saturday night.
So D drove me in, we spoke to the receptionist and explained that I was undergoing fertility treatment and that I'd had 12 eggs harvested the day before. We were seen by a nurse fairly quickly and she took my history and all my vital signs, and then we were seen by Dr D. He had a good poke and prod of my tummy (painful!) and weighed me. It seemed that I'd put on 4kg since we'd started the stimulation drugs, which explained the bloated feeling. Dr D rang the gynaecologist at the hospital for advice. It was felt that I should go home with some panadeine (paracetamol and codeine) and return in the morning if it wasn't any better, at which point they would organise a scan through the women's hospital.
This morning, after a very restless night, I woke at 9.00am still uncomfortable and sore. I rang Nurse E again, just to keep her up-to-date, and we went back to the after-hours centre. Again, we were seen quite quickly, although they were busy, and we saw a different doctor, Dr A, and went through the history and symptoms again. She rang the women's hospital and arranged for a referral to the gynaecology department there. Throughout all this time, the bloating had eased off a bit and I was still uncomfortable, but it was only painful after I'd been examined or when I tried to cough. At this point it was about 12.30pm and we thought we were going to have a scan at the hospital and be sent home - but we were wrong!
When we got to the gynaecology department, the nurse there took my vital signs again and took a urine sample. Then we waited. And waited. Thankfully we were in a small consulting room by ourselves with a few chairs and an examination bed and we'd brought books to read, but it was two hours before the doctor was able to see us. Dr S again took my history and noted my symptoms, which were still abdominal discomfort and a bit of bloating, but no nausea or shortness of breath. We were a bit taken aback when she asked me what day of my cycle it was (um, we're in the middle of IVF. What do you think?). Then she took some blood from the back of my hand (rather than from the inside of my elbow), which was quite painful. We wondered why the nurse hadn't done a blood test when we'd first arrived. The results took more than an hour to come back, so it wasn't until 4.30pm that she came back and explained that I needed a scan but that they wanted to admit me overnight so I could have it in the morning.
We were already tired and annoyed, so I had a difficult time staying calm while I explained how long we'd been waiting and that, no, I most certainly didn't want to stay overnight. We had thought that I'd been referred to the hospital for a scan, not a wait of a few hours and some tests. An additional complication was that D is flying out of town for a work commitment in the morning, so I would have no transport home and no support. Dr S went away to speak to the registrar to see if it was possible for me to come back in the morning for the scan. I was over it and I just wanted to go home.
While Dr S was away, Nurse K came in and very sympathetically listened to us grumble. She could see no reason why I couldn't go home and come back for an appointment in the morning, so she promised to suggest this to the doctors and hopefully they would agree. It was another short wait before Dr T, the registrar, came in and explained everything all over again, including that I probably had a mild to moderate case of OHSS and that they would very much like me to stay so they could keep an eye on me. We had a good discussion and in the end it was agreed that as long as I watched my symptoms and promised to return straight away if anything changed, they would make an appointment for me to have a scan at the hospital first thing in the morning. I am to drink lots of fluids and continue the panadeine if I need pain relief. So an appointment time of 8.30am was agreed and we left feeling exhausted but happy to be out of there.
On the way home I rang Nurse E again and explained everything that had happened. She is going to arrange for the clinic to contact the hospital's radiology department in the morning so they will know the results. She said that I should still come to the clinic as arranged at 12.30pm, even if it is decided that I do have too severe a case of OHSS for the transfer to go ahead. I am sure that won't be the case because my symptoms aren't very severe and haven't changed much at all in the last 24 hours. I really am feeling okay, just uncomfortable in the tummy. But today has been long and hard and I have to try to get a good night's sleep so I can handle whatever tomorrow brings.