Slash or Burn Part 2 – NHS Rant

finger surgeonOn the left is my NHS fertility consultant. She’s ‘treating’ me for my PCOS and apparent inability to A) ovulate with any regularly B) get my progesterone scores into double digits and C) hang on to an embryo for more than 6 weeks if I actually do manage to conceive. It’s been a blast.

Three months ago I was advised that if the next, massive dose of drugs didn’t work the next step was ‘ovarian drilling’. Hopefully not carried out by roughnecks, but you never know.

Yesterday they decided on a total u-turn. I am to receive no more treatment for the next six months and that the surgery was always a non-starter due to my BMI. ‘Always?‘ So why dangle it as an option in the first place? This is emotionally charged enough without you tormenting my hopes and moving the sodding goalposts on me!

To get IVF on the NHS, you need a BMI of 30 or below. This is due to improving chances of conceiving. To receive ovarian drilling on the NHS, you need a BMI of 30 or below. This is due to the increased risk of surgery for anyone over 30 BMI. To receive bariatric (weight loss) surgery on the NHS you need a BMI of 40 or more.

So the NHS will leap at the chance to offer me gastric surgery, process my +30BMI husband for his non-life threatening, non-reproductive-issue surgery but reject me for reproductive surgery. Sounds like a tick-box lottery with a heavy (excuse the pun) discrimination against bigger women who have bona-fide, non-voluntary, biological fertility complications that the NHS also categorise as a ‘Disease’.

I find it ironic that the fertility consultant admitted that losing weight with PCOS is a very difficult process in one breath, and then in the next stated that I would need to hit the 30BMI target in six months.

finger cat‘Fair-do’s’ I said, ‘point made. Now what?’

‘You’re on your own.’ they said.

‘Gee,’ I said. ‘let me thank you for your support, your clarity of message and your dismissal. I thank you, my husband thanks you, even my cat* thanks you. And we each thank you in the same visual way.’

*It’s not my cat. It’s probably a CGI middle finger. If I could teach my cat to flip the bird on demand I’d quit my job and become his manager.

If I lose 2lb per week for the next six months, assuming no plateaux, then I’ll have a BMI of 33. It’s in the right direction but it won’t make them happy. I have friends who have been through this process. They will refuse you an IVF referral if you are as much as 1lb over the maximum limit.

The NHS follow the NICE Fertility Guidelines, so I read them. The aspect I remember most is the immortal sentence ‘Consideration should be given to minimising cost when prescribing.’  Glad to hear it, after all it’s my money that helps the NHS to keep going.

The NHS isn’t free, we pay for it at source (before we get paid). It is over-burdened. It is also a process-driven machine where process and budgets appear to come before people. Did you know that before your miscarriages are taken seriously you have to have three of them in a row? After my second miscarriage I asked the doctor if this was not a little brutal. He was stunned to silence.

Wayne_Slob

I sometimes wonder if my husband & I should quit work, engineer a move into a council house, apply for as many benefits as possible, including faking a long term disability forcing us to lie on the sofa all day in our matching cheap velour tracksuits watching Jeremy Kyle*. I’m convinced we’d be machine-gunning out sprogs all over the place in no time. Mission accomplished, then we get back on the employment/mortgage/better dressed gravy-train.

*Not sure which will be more challenging, sitting through Jeremy Kyle each day or, as our IQ’s will have dropped sharply for the duration, not being able to shout grammatical corrections and deportment advice at the TV.

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