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  (#1 (permalink)) Old
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Advocating for myself with doctors. - January 2nd 2019, 01:24 AM

Hey all,


I've been having a lot of menstrual issues. Honestly, my period has been a wreck! Within the past few years, I've been to three gynecologists abot the issue. Two of them didn't test me for anything and just kept prescribing me different forms of birth control. One of them was also fatphobic to both me and my sister who had her at the time. Birth control has always worked for me for a while and then it stops working. I've been on several types of pills in my life. I also tried the shot but had side effects, and was on the implant until recently before my new gynecologist removed it and put me on a new pill. I'm uncomfortable with the IUD or ring, and my first gynecologit said the patch has an increased clot risk.


I've only been to the third gynecologist once and she did test a theory, so I can't count her out yet. The theory she had didn't pan out, but at least she's willing to try something, so maybe she'll help me. I see her again in February.


I want her to look deeper into things. My sister has PCOS but her GYN (who was also my first GYN) said it was just because of her weight and refused to test her, so she had to see other doctors to get diagnosed. When my mom was younger she also had ovarian cysts and extreme fertility issues but they didn't have a name for this type of thing yet, so it's possible she had it too. The people I've talked to have also said "lol this sounds like PCOS."


So, I want my new GYN to look deeper and run tests for PCOS or other reproductive issues that may impact my cycle. I'm tired of symptoms like too frequent periods, increased depression and risk of self harm, breast pain, etc. I'm tired of them just giving me a pill and calling it a day without trying to identify the root cause.


How do I advocate for myself and insist that she runs the tests? If she won't run them I'll ask my primary care provider, but I want to advocate for myself and be stern about my concerns and what I want. What do you suggest?


Thanks,
Dez


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Re: Advocating for myself with doctors. - January 2nd 2019, 04:27 PM

Hey Dez,

I'm so sorry to hear that you've been having such trouble finding a doctor who will help you. Sometimes it definitely seems hard to find someone who's willing to hear you out. After all, you know your body best!

I would lead with your family history, if you haven't tried that already. Let your doctor know that your sister was diagnosed with PCOS and that it's very likely that your mom had it as well; I find that sometimes doctors listen better if you have some "evidence" to back up what you're saying. Not that you should be required to provide "proof" that you're genuinely suffering, of course, but I feel like doctors can sometimes fall into the trap of writing the problem off as the result of something else, like weight or even a psychological issue. If you can lead with something concrete, then your doctor might be more inclined to listen. Let her know that because of your family history, you want to run some tests as a precaution.

If things don't end up working out with this most recent doctor (I hope they do!), would it be at all possible for you to get in to see the doctor that diagnosed your sister? I know sometimes that can hard, especially if you're on different insurance plans, but it probably wouldn't hurt to ask your sister about the process she went through to get diagnosed if you haven't already.

Don't be afraid to repeat yourself. If your doctor suggests another course of treatment, let her know that you're open to discussing other possibilities but that you also want to run tests just to rule out any underlying causes. At least that way you can both know for sure whether or not you have it, and that will make both your jobs easier. You can tell her that you've tried many different kinds of treatment but that nothing has really helped, making you think that there might be more to it than just an irregular period. If you emphasize that you've already exhausted other avenues, she might be more willing to run the tests.

I don't know if this was helpful, but I wish you the best of luck!
   
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Re: Advocating for myself with doctors. - January 2nd 2019, 08:10 PM

I agree with Reommencer is saying. I think you just need to be firm. Make it clear as heck that you have a family history of this sort thing and you want to rule out any underlying issues.

If she brings up her weight, tell her that while you understand that things such as your weight could impact your fertility and menstruation, you also know that not everyone who's overweight automatically has these issues, and that there are loads of people who are overweight who are healthy and that you don't appreciate her assuming that this is a causal issue (correlation doesn't equal causation in all cases).

Also I mostly believe that information is a helpful too. For example, you could look up the Edmonton Obesity Staging System -- not that your obese, but I've used it and I a "merely" overweigh and all of my stuff is either absent/stage 0 (medical, functional) or mild/stage 1 (mental) meaning that there is really nothing for me to worry about.

Also, it's really not productive to just assume that weight = the cause just because weight = correlation. They won't know if it is the cause if they don't rule out other issues, and it's just lazy medicine to blame weight instead of ruling out other issues if a person is having a persistent problem. If they've ruled out issues via testing, then, sure, they can talk to you about improving your weight, but that shouldn't be the go-to problem. I mean, maybe if you're very obese they should talk to you about it being PART of the problem, but still... any ways, I think the thing you gotta do is just be firm about it.
   
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Re: Advocating for myself with doctors. - January 2nd 2019, 09:05 PM

Thanks to both of you!


Quote:
If things don't end up working out with this most recent doctor (I hope they do!), would it be at all possible for you to get in to see the doctor that diagnosed your sister? I know sometimes that can hard, especially if you're on different insurance plans, but it probably wouldn't hurt to ask your sister about the process she went through to get diagnosed if you haven't already.

I wanted to see this doctor, but with my schedule it wasn't possible. The day I have off from school also happens to be the day she has off from work, and as a grad student I can't afford to miss class. I am in the same office though, just with a different doctor.


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Re: Advocating for myself with doctors. - January 3rd 2019, 07:03 PM

Are you in class all day every day though? I've never had a solid block of classes. If you have 2 hours to spare, maybe you could go then?
   
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Re: Advocating for myself with doctors. - January 3rd 2019, 07:30 PM

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Originally Posted by Latte View Post
Are you in class all day every day though? I've never had a solid block of classes. If you have 2 hours to spare, maybe you could go then?
Mine are all in the evening, but I also donít drive and live on campus.


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Re: Advocating for myself with doctors. - January 3rd 2019, 08:40 PM

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Originally Posted by Melancholia. View Post


Mine are all in the evening, but I also donít drive and live on campus.
Are you able to get a ride from someone, or take public transit?
   
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Re: Advocating for myself with doctors. - January 4th 2019, 05:24 AM

I'm so sorry that you're having this experience with your doctors. When we're already dealing with something awful, the last thing we want is for the people who can help to not even take us seriously.

This is going to sound like a super weird suggestion, and it's not something I've tried personally, but I've heard many women say that their female gynecologists didn't take them seriously and that they've had much better experiences with male gynecologists. I'm not sure why this would be (there certainly are lots of great female gynecologists!); maybe men are more likely to be sympathetic because they can't relate at all to what you're going through, so anything you describe to them sounds pretty awful!

Again, weird suggestion, and this might not even be something you're comfortable doing, but female doctors not taking female patients seriously does seem to be a horribly common problem, and I've heard many women say that they were taken much more seriously once they saw a male doctor. So who knows, that could be worth a shot if nothing else pans out! I hope that all this gets sorted out very soon and that you start feeling better.
   
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Re: Advocating for myself with doctors. - January 8th 2019, 05:05 PM

So I called the office yesterday because I realized I'll am out of birth control refills and I need to refill my birth control before my annual next moth, so I wanted to know if my doctor wanted me to stay on them for now until I see her since they're not actually working.


The refill line also happened to be the "medical questions" line so I'm assuming I got a nurse or something. She basically just said "some women just have irregular periods." For all eleven years of my life, to the point where I have tried multiple methods and only had relief when I lost my period for two years on the implant? To the point where it impacts my mental health? :/


She said she'd get back to me but the doctor was with a patient, so I'm hoping she actually calls back at a convenient time. But I'm so tired of being invalidated and feel like I'm just going to get to the doctor for my appointment and just angry cry. :/


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Re: Advocating for myself with doctors. - January 9th 2019, 10:50 PM

I'm really sorry the nurse responded that way, Dez. That must feel really invalidating. You deserve to be listened to and have your problems taken seriously. Did she end up calling you back?

I would go in prepared. I don't know about you, but I really love lists, so I would make a list of all of your symptoms that you can either read off of or hand to the doctor. I would be very specific about your concerns and symptoms so they really understand the extent of the issue. You could even make a list of symptoms, followed by a list of treatments you've tried (and that have failed) in the past. I find that sometimes having something written out makes it easier for me to advocate for myself and really get my message across.

I don't know if this is helpful, but I really hope your appointment goes well and that you get some help with this.
   
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Re: Advocating for myself with doctors. - January 10th 2019, 01:27 AM

They never did call bac actually! I’m going to hopefully call them again tomorrow or Friday.

The list idea is great, thank you! I get in there sometimes and forget everything I wanted to say, so writing it down will help.

EDIT: I called back to follow up today and the nurse who I talked to said things have been hairy with delivering babies this week. She’s going to reach out to my GYN again.


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Last edited by Melancholia.; January 10th 2019 at 07:06 PM.
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