Well, I made an appointment to see Dr W today and ended up walking out before it was over. I went to see her because I've been having vaginal bleeding, off and on, for the last 2 1/2 years. I saw the clinic's gynecologist 2 1/2 years ago when the bleeding first started, after the dildo cam couldn't find anything. The gynecologist didn't find anything either when he did the endometrial biopsy.
I've been taking Relafen for arthritis pain, and Cymbalta for depression/fibromyalgia for almost 3 years, and last week I googled drug interactions for those 2 particular drugs. Guess what one of the side effects is? Vaginal bleeding. Now, I quit taking the Cymbalta about 4 months ago because of the side effects it has on one's sex drive (and most antidepressants will kill your sex drive, so you get to choose between being depressed and having sex, or not being depressed and not feeling like having sex - some choice). But the vaginal bleeding, off and on, didn't stop. So I googled Relafen and side effects from it, and vaginal bleeding is one of them (granted, it's not a common side effect, but it does happen).
So I go in and tell my doctor all this, and what does she say? "I don't think the relafen is causing the bleeding, I think you need to see the gynecologist for another endometrial biopsy to rule out endometrial cancer." I ask her about the fact that the gyno said my cervix was stenotic, and she said that's not a factor, that I could still be bleeding from my uterus (all this without doing an exam). I told her that I had stopped taking the relafen, and hadn't been taking any NSAIDs that acted as blood thinners because of the bleeding, and would she prescribe something else for the arthritis pain. That I was tired of being in pain all the time and the relafen just wasn't working all that well. She said she wouldn't prescribe narcotics - I wasn't fucking asking for narcotics, I was asking for something that worked better than relafen or ibuprofen and she wouldn't even consider anything else. She said maybe it was time to see the orthopaedist again and see what he had to say about my knee if the cortisone shots and Syn-Visc shots weren't working, maybe he needs to scope my knee. WTFE, I'll make an appointment with him and see what he'll prescribe for the pain, he may be more reasonable than she is (he usually is pretty good, and doesn't seem to be fat-phobic).
So I asked her about the fibromyalgia pain too. I told her my body felt like one big bruise and that it hurt for the cat to walk across my legs, and that shouldn't hurt (granted, Marty is a 15 lb cat, but still). That I was tired of being in pain all the time. By this time, I was in tears, because she was basically ignoring anything I had to say, like I didn't know my own body, and didn't know what I was talking about. She said that I could get mad at her, but my weight was causing a lot of my pain and if I would just lose weight, the pain would go away. I asked her what more I was supposed to do - diets hadn't worked, phen-fen hadn't worked, and the WLS hadn't worked. I want to know since when has it been that being fat caused fibromyalgia and arthritis? If being fat causes those diseases, then why do thin people get them?
She said she'd send me to an in-patient program to lose weight, and I lost it. I said "I've had it, I'm done with this." I got up and walked out and I'm not going back to see her ever again. I'm done being blown off and treated like a child who doesn't know shit from shinola. She doesn't seem to give a shit that I'm in pain all the damned time, all she sees is a fat woman who refuses to diet and get thin to suit her idea of "healthy" (BTW, my blood pressure was 124/67 this morning and my weight was the same as it has been for the last 3 years). So fuck her and the horse she rode in on and the fleas that rode in on it. I'm looking for a new doctor and she can take her "healthist" attitude and shove it up her ass.
ETA: For the privilege of being treated like a child and having my concerns blown off, and being told that if I'd just lose weight my pain would go away, my insurance is being charged $135.00 (and we wonder why health care is so expensive.....)
Wednesday, November 10, 2010
18 comments:
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I don't blame you one bit for your anger and your decision sounds about right to me as well. Basically, this doctor was telling you to go get a whole other body, rather than deal with the one you have. Her ignorance about the failure rates of diets and WLS (all well-documented, she should pick up a medical journal sometime) is just so predictably distressing. Besides she doesn't need a journal actually, she has a living breathing human example of the failure of diets, WLS and diet drugs: you!
ReplyDeleteBest of luck seriously on finding a doctor that is interested in reality not fantasies.
It might not hurt to notify the insurance company that you walked out of the appointment because she did not address your concerns.
ReplyDeleteGood for you! I cannot tolerate these arrogant doctor's bullshit, either. No one deserves to live with pain! I wish I had been there with you because I tell you what? I might have just smacked her! Might have done her some good. I am guessing she had no intention of examining you the second she laid eyes on you. It makes me sick and angry and sad. I don't know that you're willing, but I would certainly complain, formally! I would do anything I could to point to her obvious bias/fat hatred. You couldn't have been more cooperative. Damn! I am so sorry that this has even happened to you. No one should be treated like this. You'll find a great doctor who will rid you of your pain.
ReplyDeleteMay I ask if you've tried massage therapy? It sounds simple/silly but my husband is a CMT and has worked with ladies who have Fibro and have seen some results. I'll be thinking of you! *gentle hugs*
Good on you! I really, REALLY wish I'd had the guts to stand up from the examining table, look a doctor of my past in the eye, and tell him calmly, "Okay, then. Thank you for your time." and walk out.
ReplyDelete(What is it about doctors? They may have gone to medical school and have more context for evaluating medical literature, but some act as though the entire rest of the planet has become incapable of reading and interpreting the written word or their own bodies!)
You go, Mariellen! I hope you're able to find a new doctor who will treat you with the respect and consideration you deserve.
OMG good for you for breaking up with your doctor. What a load of CRAP. Good luck finding a new one. I'm so sorry this BS happened to you. I hope you are able to find a great doc that can help!!
ReplyDeleteI'm on Cymbalta for the same combo (fibro/depression) and have had no issues - thankfully. I appreciate the heads up though on that.
I had one doc take me off of Ultram for the pain and put me on Vicodin instead for severe pain. Apparently the Ultram + Cymbalta has a higher seizure risk. I don't mind vicodin, but it turns me into a super happy drooly idiot-type so I can't take it at work, which leaves me out in the cold for 40+ hours of my week. Plus, god help me if I become an addict on that stuff.
I swear we could do a better job diagnosing and treating ourselves than the crap some of them dish out.
silentbeep - The things she said that hurt the most were that she knew that WLS didn't work for everyone (no shit Sherlock, I'm a prime example of that) and that if I would just exercise and diet, I could lose weight, it's calories in/out (and she and I have had this argument before, she's still adamant that diet and exercise work long-term to get and keep weight off, never mind the fact that it's damned hard to exercise when you're in excruciating pain and she won't give me anything stronger than 500 mg of relafen twice a day for pain). So to hell with her, I'll either find another GP, or I'll deal strictly with the specialists I've been seeing and do without a GP.
ReplyDeleteliving400lbs - I'll be calling TriCare and Medicare tomorrow, for all the good it will do. They will probably pay her anyway, even though she didn't address any of my concerns, simply because she did see me and that's the way the government works (nah, I'm not a cynic, not at all.....lol).
notblueatall - I haven't tried massage therapy yet, for a few reasons. I'm not sure if TriCare/Medicare will pay for it and if I have to have a referral from a GP, and right now, parts of my body are so tender to touch that even the kitten, who only weighs 3 lbs, walking on me hurts.
Sherry - I used to put up with whatever doctors dished out, but at my age (57 next week), I figure I'm too old to deal with bullshit anymore, been doing it for too many years. And I've learned a lot since I've joined the fatosphere and been reading all the research about weight loss, dieting, and how hard it is to maintain weight loss (like I didn't know that from experience.....lol). So now I stick up for myself and I'm willing to tell my doctor to take a hike when I know she's wrong.
The thing that really set me off about her wanting to send me to an in-patient weight loss facility was the fact that she acted like I don't have a life outside of losing weight to suit her aesthetic of health. Like I can just pack up and go, and not have to worry about my husband (who has type II diabetes and I give him his insulin shots and figure out how much he needs, and figure out meal plans and groceries, etc), nor do I have a house to take care of, or pets, or anything else. Yeah, I can afford to pack up and take off from all those responsibilities for a couple of months, just so I can try to lose the 200 lbs that would put me in the "overweight" BMI category and take me out of the DEATHFATZ BMI category (like that would happen in a couple of months anyway....geebus).
~Sarafina~ - Fortunately (or unfortunately, depending on the person), Cymbalta doesn't affect everyone's libido the same way. This may be TMI for some people, but I don't have a strong sex drive to begin with, but I did enjoy a good sex life with my husband before I started taking Cymbalta. Afterward, well, the enjoyment just wasn't there. Now that I'm not taking it anymore, the enjoyment has come back (but according to my doctor, that's another rare side affect and it was all in my head, even though I didn't know it was a side affect until I googled it long after my libido decreased).
ReplyDeleteI've taken Vicodin for pain, but it's always been a short-term thing, like when I had teeth pulled, so I don't know how much it would help if it would be prescribed on a long-term basis. Which is a moot point, Dr W refuses to prescribe anything that might even remotely begin to touch my pain because she's just positive that my pain is all the fault of my fat and if I'd just lose 200 lbs yesterday, I'd be miraculously healed.
I'm not sure that 'addiction' is actually the proper term for what happens when you're taking a narcotic painkiller for a long time, especially when you're in severe pain and it helps you fight the pain. Yes, your body will need the drug to fight the pain, but it's not an addiction as in the "getting high" kind, if that makes sense.
And I totally agree that sometimes we could do a better job of diagnosing and treating ourselves than doctors do, especially when they have those "fat blinders" on.
All I can say is good riddance. You have been justifying your needs to this ridiculous doctor for far too long now and you were overdue in finding another one. I know what a challenge that is to both stand up to the "experts" AND break in a new doctor. It's a challenge that you are well prepared for since you have the knowledge and experiences to deal with on a daily basis. I'm positive you will find someone who can meet your needs, cuz you'll be able to spot a phony a mile away. I once had a dr. tell me that Google made his life a whole lot more complicated. My response to this walk-in clinic doc was snarky. I said, dripping with sarcasm, how unfortunate for him that patients can get more knowledge about their possible ailments and maybe catch something before it kills them. He just rolled his eyes like I didn't understand....as if explaining things to patients so that they could be more informed about their conditions, or the lack thereof, was a BAD thing! Knowledge is power...and a good doctor will respect the fact that you know your body better than he/she does and are taking an active role in your health.
ReplyDeleteI hope your female issues clear up soon. What a pain in the ass to have to deal with that at this stage of the game. How many years post menopausal are you? And WHY wouldn't a dr. want to get to the bottom of this asap? Beats the hell out of me! It just seems like she wrote you off (or considers you non-compliant) long ago...time to move on! Good luck!
Bless your heart, you didn't deserve to be treated like that, no one does.
ReplyDeleteI had significant bleeding too, that has seemingly been resolved by getting my thyroid under control, not that it has to be the same problem with you. (I already know I'm not going to have kids, for god sakes, I can't wait for menopause.) I was always so ashamed to go to the doctor because I knew he'd tell me that the bleeding was due to my weight and nothing else. In fact, the gyn I have now I only keep because he doesn't lecture me about my weight, but I swear to dog that he's completely incompetent. I'm soon, I got off track.
I highly suggest massage, I started going and I was nervous because I'm such a fat load and because I'm typically in pain because of autoimmune arthritis, but I was finally desperate that I went and I'm so glad I did. I don't think that's something insurance usually pays for, but I think you can apply your health saving account money toward it (no guarantee).
Finally, when I was Cymbalta, it made me way more depressed, way way more depressed. I was so depressed I didn't really care that I had no sex drive. I'm so happy I survived that experience.
Good luck to you.
Regina - It's been about 7 years since I had my last menses, and I'm long past the hot flash/night sweats/mood swing stage of menopause, and she knows that, it's in my records (as is the fact that I'm NOT diabetic, but she still asks me that every time she sees me).
ReplyDeleteI'm seeing an endocrinologist next week because Dr W doesn't seem to be too worried about my thyroid being enlarged, even though there's a history of thyroid cancer and hypothyroidism in the family (I also have nodules, which she told me I didn't have). To top it all off, when I told her that my grandmother and one of my uncles had problems with vitamin B12 deficiency and needed shots for it, she said that years ago it was all the "rage" for people to get B12 shots for extra energy. When she tested my B12 level, it's at 1000, but is that because I take 5000 mcg of sublingual B12 every day? And what would that level be if I wasn't taking that much B12 every day? I'll see what the endo has to say next week and go from there.
Kate - I'm hoping the endocrinologist can give me some idea of where to go/what to do about my thyroid. It's enlarged and has nodules, and my paternal grandfather had thyroid cancer. By the time they found his cancer, it was so advanced, they couldn't remove all of it. If they had, he wouldn't have been able to talk or swallow. He was told he only had 3 months left to live after the surgery, and he fooled them all - he lived another 3 years (he was 87 when they did the surgery and he died at the ripe old age of 90, when his doctor wouldn't approve him getting his last 4 teeth pulled, he said to hell with the doctor, he'd just damn well die with the teeth in his mouth then if pulling them might kill him, and die he did).
ReplyDeleteAs for the Cymbalta, I didn't really see any improvement in my depression at all (and I can deal with it without drugs most of the time), but it sure as hell put a damper on my sex life. And the fact that my doctor doesn't believe that Cymbalta and relafen have vaginal bleeding as a drug interaction is just too bad. I googled it and found it on drugs.com, which seems to be pretty reputable.
A B12 deficiency can definitely be a contributing factor to bleeding wackiness like you're experiencing.
ReplyDeleteWhat type of sublingual is it? If it's methylcobalamin, sometimes it doesn't have quite as good an effect on some people who have problems with the methionine cycle. You can get the other form of B12, adenosylcobalamin from iherb and the like. Your B12 should probably be higher than 1000 if you're taking 5000mcg a day of sublinugal.
Check out the massive amount of information at the Pernicious Anemia Society forums:
http://pernicious-anaemia-society.org/phpbb/index.php There are lots of people there who have thyroid and other issues as well.
Harpy - It's cyanocobalamin, according to the back of the label (and I always buy the same brand/dose every time). According to the test results from Dr W, 190 - 980 pg/ml is normal and my level is >1000. But then, according to her, normal TSH is 0.40-4.00 uIU/ml (she saw nothing wrong when my TSH was 3.5 and now that it's down to 1.41, she thinks I'm worried about nothing). I also take D3 (D3 cholecalciterol, 1000 IU twice a day), don't know if that has anything to do with the change in TSH, since I started taking the D3 6 months after the high TSH test (I had an MRI that showed some small lesions on my brain, neurologist thought they could be indicative of MS, I read somewhere that vitamin D was helpful with that). The MRI was to diagnose migraines, I take topamax for that, which works fairly well as long as I stay away from chocolate (seems to be a trigger for me).
ReplyDeleteI'll check out the Pernicious Anemia website, thanks :)
Huzzah! You've been putting up that energy sucking hard heart for way too long. I know you've had to because of access issues and so forth, so I know it must have taken a lot out of you, to bring it to this.
ReplyDeleteI hope your next one is supportive and understanding, you know like those who take a pride in their profession and don't believe it's an opportunity to play Dog.
I know you're probably not at that place now, but she so deserves to get reported, to her professional body or even a word to your insurance company. Either way, her attitude should be on record. Above all do no harm means if you can do nothing, make sure you don't do that.
Best wishes Vesta.
wriggles - I thought about reporting her to the clinic, but she's the president of the board of directors there, so I can't see that reporting her to them would do much good.....
ReplyDeleteI am calling my insurance companies to let them know what happened, however. And I may look her up online and see what kind of organizations she belongs to, and report her to them (AMA, etc). And if she belongs to an online referral, where patients can leave feedback, I'll do that too. She'll find out it was a big mistake to not address my concerns and treat me like I don't know what I'm talking about.
I also have a vitamin B12 deficiency and us a sublingual. I don't know if I'm at my optimum level, but I was having massive muscle pain in my quads that went away pretty quickly after I started taking the B12.
ReplyDeleteDoctors are too reliant on tests and don't listen to their patients enough. I guess a lot of that has to do with how many patients they have to see to get paid. I went to an endocrinologist to have my thyroid tests and she said I had nodules, but it wasn't a problem. She didn't explain how it's not a problem, so that just freaks me out. I'm still shocked it was my GP who decided I needed thyroid replacement.
I'm keeping my fingers crossed for your appointment.
This cracked me up: "So fuck her and the horse she rode in on and the fleas that rode in on it."
ReplyDeleteGood for you for walking out! She wasn't listening to you and she certainly wasn't treating you with respect. Even if she disagreed with you about causes, she shouldn't be trying to force you into treatment you don't want. You have the RIGHT TO REFUSE TREATMENT and not be harassed about it. She did not behave ethically by trying to push you into this.
Low B12 and low thyroid can cause a lot of joint pain, but your numbers on those seem okay. Still, if you can find a way to get it covered, a good analysis with a naturopath might be helpful. They pay a lot more attention to nutritional deficits and how they can affect the body. Since you have a history of WLS, getting a really good panel on your various vit/mineral levels sounds like a sensible thing to do. A lot of folks who have had WLS earlier end up having a lot of pain and nutritional issues later, so it should definitely be checked out.
If you can find a way to afford it, acupuncture can do a lot towards pain control. It's not a miracle cure, mind....you'll still have some pain, in all likelihood. But it can really drop down the level of the worst of it. I use it for knee pain after my car accident and while I still have pain, I'm a lot more mobile and functional than I would be without it.
If acupuncture is not covered by your insurance, there are places in some cities that do sliding scale acupuncture, or if there is a Chinese Medicine college near you, that's another option for cheaper treatment.
Lipedema can cause excruciating pain (not lymphedema, LIPedema). I have it, and my cats walking across my legs causes tremendous pain. However, lipedema pain is typically only in the legs, so if yours is all over, it's more likely from the fibromyalgia.
Hang in there. Write a letter of complaint about your doctor and send it to the doctor, to the practice, to your insurance, and to the hospital she's affiliated with. It may not do much good in terms of action, but it DOES get noticed and it does create heat for her. Don't let her roll over you without creating some pushback for her.
Quote some stats on how unsuccessful wt loss diets are, mention you've already done WLS, and criticize her for focusing only on weight as the source of your pain and nothing else. Remind them that you have the right to bodily autonomy, and YOU HAVE THE RIGHT TO DECLINE TREATMENT after considering all the benefits and risks of it. Remind them of the importance of evidence-based medicine, and question why they are promoting wt loss so strongly when evidence shows that trying to lose weight is more likely to make you GAIN more wt in the long run. Quote a couple of studies showing that significant weight loss may increase mortality rates as well, and question her belief that weight loss will automatically improve outcomes.
Keep the letter unemotional, fact-filled, and to the point, and be sure to cc: it around so it at least brings some unwanted attention and heat to her. You may never see satisfying results from the letter, but trust me, they notice these things.
Medical bullying is the new trend, and it MUST be confronted whenever possible.
Yes with that history glad you are getting thyroid dealt with. I think your thyroid problems could be causing some of the bleeding too, hormones will do all sorts of wackey stuff to people. There are doctors out there who do not take pain seriously and if you are fat, its like they are programmed to think that is automatically causing all the pain. I think fibromylgia, some of them even after all the scientific studies seem to barely believe it exists, maybe she was one of those doctors.
ReplyDeleteDealing with doctors, can be very scary enterprise. I've had a few very rude ones in my past and had to fight many of them years ago to stay alive. She sounds horrible so better you were able to move on to someone else.