Pauline

Age at interview: 83

Brief Outline:

Since being diagnosed with uterine prolapse (when the uterus slips down into or out of the vagina), Pauline has had vaginal pessaries fitted. Sometimes the pessaries have become dislodged and there’s been bleeding. Pauline is on a waiting list for hysterectomy and hopes this will give her “a better quality of life”.

Background:

Pauline is a retired housekeeper. She has four adult children. Her ethnicity is White Irish.

Condition: pelvic organ prolapse

More about me...

Pauline was diagnosed with uterine prolapse (when the uterus slips down into or out of the vagina) in 2013/2014. She experienced discomfort which gradually became worse over time. Pauline described, “what happens is the muscles get lax, the muscles collapse, and they won’t support the uterus anymore”. She thinks that having four children and doing very physical work, as well as a lot of exercise cycling to get around, contributed to her developing a uterine prolapse. Pauline needed to keep working but had to cut down her hours when her prolapse became worse. She says it is important to still exercise, like going for a walk, but to avoid heavy lifting. Pauline’s son recently bought her a shopping trolley that she can sit and rest on if she becomes tired.

When Pauline first went to a GP about prolapse, the doctor wouldn’t examine her and “didn’t seem to realise that people with prolapse should be treated”. She thinks this was related to funding cuts to the NHS, and she had to ask a more senior doctor for help. Since then, Pauline’s had vaginal pessaries fitted at hospital. Pauline says the nurses there have been “very caring”. She adds that it’s important to relax for the pessary fittings and not tense up. Sometimes Pauline’s pessaries have become dislodged and she has had to return to have them refitted. She has also been prescribed Vagifem and Ovestin creams, Pauline has sometimes phoned the clinic with a question or concern: “if there’s any problems [like bleeding], they send me straight for a scan”. Sometimes Pauline wears incontinence pads, especially if the pessary has come out. She is very glad that the pessary clinic stayed open to seeing patients during the pandemic.

Pauline is on a waiting list for hysterectomy – a suggestion which has “been in the air for a while”. She hopes it will give her “a better quality of life”. Pauline feels a bit uneasy thinking about possible risks of the surgery but is also at the point where “you wish you could have the procedure done and be done with it”. She plans to discuss with her doctor what support will be available for her during recovery.

Pauline has also experienced cystitis (inflammation of the bladder, usually caused by a bladder infection) and kidney infections. She has some other health conditions, including thyroid problems, pernicious anaemia and a heart condition. She thinks that her prolapse may have contributed to having depression, which she sought treatment for. Last year, Pauline also had Covid and went on to experience Long Covid which required treatment in hospital.

Pauline’s first impression from a GP was that she should just put up with her prolapse. She had to insist on being examined, and thinks that the reluctance she encountered was because of NHS funding cuts.

I used to go to this doctor years ago who was-, she didn’t seem to realise that people with prolapse should be treated. Yes, so that was going back a bit, that’s going back, that’s going back a while, yeah.
 
So what happened then, were you going for an appointment-?
 
I had to go and see the top man at the surgery to get him to examine me.
 
Oh gosh, so she won’t even examine you?
 
She, she wasn’t, she didn’t even think that it was serious enough unless-, I think it was the time when the cuts started in the hospitals. You know, the cuts started?
 
Yeah, when the funding was cut, yeah.
 
Yeah, things started to be-, and people, people, well it was the NHS because they only wanted people to go to the hospital with urgent, for urgent treatment.
 
 

 

Several years ago, Pauline went to her GP with suspected prolapse symptoms. She felt her GP was not interested in examining her, which she thought was to do with NHS funding cuts.

I used to go to this doctor years ago who was-, she didn’t seem to realise that people with prolapse should be treated.
 
I had to go and see the top man at the surgery to get him to examine me.
 
I think it was the time when the cuts started in the hospitals.
 
Things started to be-, and people, well it was the NHS because they only wanted people to go to the hospital with urgent, for urgent treatment.
 
I had to do it, if I wanted treatment. And then I was working, don’t forget. At the time and I had to do something about it.
 

 

For Pauline, who currently uses a pessary, the suggestion of a hysterectomy has been “in the air for a while”. She takes the lead from her doctors. If she could, she would like to have the operation as soon as possible.

I do exactly as they tell me, and what they do is they put in a device which helps to control it.
 
When a condition becomes chronic, you just get to the stage where you feel you should have it [hysterectomy] done.
 
Now when you get to the point where you wish it was all over, but you wish, you wish you could have the procedure done and be done with it. But it’s not my decision. It’s not my decision. No, it’s not my decision. Because when they put you on the waiting list, that’s a good sign, isn’t it?
 
Well I think that if I was very demanding, I probably would have kept asking for a hysterectomy maybe. But I don’t know what to say about that. Some cases you’ve got to wait your turn, especially at the moment with the circumstances with Covid-19 and hospitals and everything.