Thursday, April 15, 2010

I'm Just Too Much Patient for You & You're Not Doc Enough to Admit It

I saw an endocrinologist a few months ago as part of my quest to manage the PCOS.

He believed I got fat and 'gave' myself PCOS. I tend to believe that science made me fat by failing to diagnose the PCOS for over 10 years and a medical, as well as societal, paradigm that urges people to eat lots of carbs laden with high fructose corn syrup, but whatever. He's not the first doctor who thinks I stuff my face and sit on my ass all day.

He didn't believe I'd had Cushings. This disbelief is so common, I don't get it--it's not like the treatment for Cushings is a lifetime supply of Vicodin and ER visits with a chief complaint of 'my ass hair is too long'. I had chosen him precisely because he was in the network that had diagnosed the Cushings so at least he was able to look up the records to see the data for himself (which thank God that was available to him).

He wanted to cram me into the Metformin box come hell or high water. He wanted to ignore my previous experiences with it going so far as telling me I didn't remember what happened right and that I was wrong. He assumed all my problems with Metformin were due to diarrhea without asking if I had diarrhea while on Metformin (I didn't.)

Basically, he left me no place to go with him. By the time someone is denying me the credibility to report what my own body experiences, there's just no hope for a good working relationship, you know?

We also had discussions that went like this...

"You should take iodine."

"Okay, how much?"

"Just whatever is in your multivitamin."

"I don't do multivitamins. I take everything separately for a few different reasons. How much iodine should I take?"

"Don't take any."

"You really should take Metformin. There is no way you had any problems with it."

"Okay. I'm game. How are we going to ensure it's truly safe for me?"

"Well, I'm not going to prescribe it."


"I'm not going to prescribe spironolactone because it exacerbates the estrogen dominance of PCOS."

"Oh okay. I didn't know that."

"But if the dermatologist wants to give it to you that's okay."

WTF? That is NOT what I'm looking for. I went to this ass precisely because I don't want every Tom, Dick, and Harry treating separate symptoms of PCOS as if they aren't related. I don't want someone to prescribe something for me that is NOT a good idea for PCOS. This was the WHOLE point of seeking the care of an endocrinologist, to get coordinated care.

I think I was simply too much patient for him. It was clear he didn't want to deal with me. He was quite condescending and visibly irritated with me and my questions. He actually had the balls to tell me I was 'going in circles', when he was the one saying yes then backtracking to no.

His ideas were incredibly rigid I thought--he was a specialist living in a very very small box. 'You have PCOS. This is the treatment regardless of your personal circumstances or medical quirks. Nothing you say or experience matters. Just sit down, shut up and take Metformin. I do not care if it kills you because I've decided you are a liar. Goodbye.'

How is that practicing medicine?

Last year, I tried another endocrinologist and that visit can be summed up as follows.

"We don't know anything about weight loss, but you eat too much. I will not do anything for you. Goodbye."

It's not going well over here on the endocrinology front. Everyone focuses on the weight, when that is NOT the entire picture. Of course, they scoff when I tell them weight loss doesn't do much. Still annovulatory with horrid lipids. Because I guess all patients are too stoopid to ever be listened to. Do some people lose their souls in medical school? I wonder sometimes.

So now, I have an appointment at a world class system that is known to be pretty detail oriented. I did IVF there. I'm hoping I can find someone who wants to find answers and who can think outside the damn box for once.

Granted, there may be nothing more to be done for the PCOS, but the prednisone=low blood pressure thing needs to be looked at and the enlarged thyroid needs to be properly assessed for Hashimoto's, which has not happened even though I was given that diagnosis. Ironically, going by their lab work--the diagnosis of Hashimoto's is not even supported by the lab results.

So WTF BBQ people? Get it together! Please! I am counting on you. Yes, you to bring your A game. Otherwise, take your stethoscope off and go home and stop fucking around with my health.

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