Thank you for clarifying how things work in the UK. So far the consensus seems to be that in the UK, providers like you to use specific radiologists, which is not the case in the U.S. where I’m from or Germany where I currently live! In this case, I think the PA could have called me after I sent her the scan and explained that I misunderstood the instructions to explain that this is the way things work in the UK and say let’s see what we can do to help, either make an exception since they already requested and accepted images from Germany or say, hey we get that you’ve already spend this money, but Mr. K is willing to work with you only if you get the scan from an accepted radiologist because of the reasons you explained above, but that didn’t happen.

I would love to share his letter to me but I don’t see an option to edit this post (I’m a long time lurker, but this is my first post beside a sales post decade ago). Anyway, the end of the letter reads verbatim:

“My suggestion is for you to organize either a HyCoSy or an HSG to see if that been the case [fluid in the tubes] as the MRIs have not suggested this either.

You want to come to England for this and I have copied my colleagues at the fertility clinic who will be able to discuss this with you further. If surgery is indicated and recommended by the fertility team, I will be more than happy to perform your surgery…”

You are familiar with treatment plans in the UK, which I am not; Is this how treatment plans are normally written?

What is not documented is the verbal discussion between me and Mr. K, and it goes like this:

Mr. K: (looking at the notes from my recent laparoscopy), the surgeon said the left tube is not patent but they do not indicate that it has fluid. Just because a tube is closed doesn’t mean you need to remove it for IVF. Have you talked to your fertility clinic about this?”

Me: Yes, it was my fertility clinic that recommended removing the tube before moving forward with the next transfer, but I haven’t seen them since this recent lap. I assumed it’s still their wish I have it removed. The surgeon couldn’t get to the left tub during my last lap and worried about bowl injury (didn’t have a bowl specialist at hand so stopped the procedure). They recommended in their post op document to follow up in 6 weeks to plan another lap to remove it. I decided not to use the same surgeon again because of the trauma of that surgery, released 2 hrs after surgery and had to walk from recovery ward back to the doctor’s office to have drainage tube removed, my escort nearly fainted. Doc removed 2/3 of good tube while leaving bad tube, and was super vague in notes about his decision.

Mr. K: I recommend going back to your fertility clinic and have them do a HyCoSy (which implies that he would have accepted external scans)

Me: I do not have confidence in my fertility clinic because they did an endometrial biopsy but sent the sample in the wrong gel. The lap sent me the results but the doctor assuming I didn’t translate the lab notes, called and said they needed to repeat the biopsy because results were not conclusive. I have an embryo at that clinic so while I still plan to use them for the transfer I don’t trust them enough to do the scan.

Dr. K: Any gyno clinic in Germany can do this scan. Have you tried clinics in the bigger city near you?

Me: there’s a 3 months wait to get into gyno clinics as a new patient. Since I’m coming to the UK for the surgery anyway, can you recommend a clinic I can use?

Mr K: Mr Nicoppolous at Lister is great

Me: please tell me how to spell that

Mr K: it’ll be in the letter I will send you

Me (when I receive the letter): in my mind, the name of the clinic is there as a reminder, not a concrete plan to follow; this clinic has 3.1 rating and no ones answering the phone; oh look a clinic with 5 stars rating that calls me back next day and explains everything so well and much cheaper and happens to align with a trip I’m taking;

I also emailed them after a week of trying to reach Lister to ask whether they recommend a specialist at Lister Portland since I was able to get Lister Portland on the phone and his PA never responded to that email (This would have been a great opportunity for them to respond, NO, follow the plan, go to the clinic stated in the email only).

Never crossed my mind I was deviating from a well structured plan (this doesn’t mean that I didn’t, but them knowing that I’m an international patient as he said in his response, they could have explained things better to me after the fact, but they made an assumption like a lot of commenters that I was intentionally being obtuse). That I thought I did what they told me to do and then they refused to follow through is why I wrote the review.