Cross yer fingers - doctor try #4

[politicat]

So I have a new doctor - insurance changed. That's fine; I really disliked my previous doctor A LOT, and his NP was worse.

So I'm goin' in... I've been trying to get two things done for 10 years: a tubal ligation without having a child (or four) in tow, and someone to look at my family medical history and treat my incipient thyroid disorder BEFORE it turns into a bigger mess than it is. (My mother, grandmother and great-grandmother all have thyroid disorders that were dismissed until they were in their 50's, leading to obesity and obesity related disease.)

I've had a hell of a time finding any of them willing to give a look at the family history, and the family history of reproductive disorders (and as far as anyone can tell, there have been no men involved in this family - it's like we're the product of parthenogenesis, we're so medically alike).

I figure I'm going to let her deal with my knee and its lack of connected ligaments first, then with the rest of the body. Build up a good rap and such.

Any tips on dealing with physicians?

[NashVegas]

1. "Oh, By The Way .."

There was an article on the so-called doorknob syndrome that showed up in LBN the other day. You might want to read that.

I don't have a GP currently, been putting it off for ages.

[politicat]

2. I don't do that. Just the opposite in fact.

Which may be one of my problems - I'm so far outside the norm that it scares them into not wanting to do with me. I go in with a diary of all of my issues, symptoms, dates (like when I had my biking accident, my food diaries, my exercise diaries, etc), having done my research, very organized. It may be too much.

And in the past, I've tended to be very, very upfront about the fact that my family has a thyroid issue that is very hard to detect until late middle age, at which point a lot of damage has already been done, and that I understand the chemistry of thyroid hormone, and that the risks from the thyroid hormone supplemental therapy are far less than the risks from long-term, middle-age obesity. Which bothers them. Back in the 50s and 60s, thyroid hormone was prescribed as weight loss to many; now doctors are paranoid about prescribing it when the standard test is okay, even if other symptoms of thyroid malfunction are present.

[Pool Hall Ace]

3. I've dealt with doctors regarding the tubal ligation.

Has it been a problem finding a doc because you are childfree?

I had a tubal in 2001 (right after King Chimpy's coronation). My gyno didn't do surgery, and the surgeon she referred me to had a lot of letters on the wall from patients thanking her for helping treat their infertility. While I was waiting for her, I was concerned that she would condescend me, tell me I might change my mind someday, children are life's greatest joy, blah blah blah. I made sure I was calm and rational, and had all my reasons ready for wanting the tubal. If she refused, I would politely thank her for her time, and tell her that if she wouldn't perform the tubal, I would find a physician who would. Fortunately, everything went okay.

I see from your profile that you are in Boulder. I don't know that much about it; is it a conservative town? Given your family history of reproductive problems, I can't imagine why you would be turned down.

If there is a concern about how you will react under anesthesia, perhaps you could talk to the doc about the Essure procedure.

Good luck with the new doc; let us know what happens. :hi:

[politicat]

4. Boulder? Conservative??!?!

:rofl:

Um... no. Boulder is about as liberal as you can get in this state; I can't think of too many communities that are more liberal (We're up there with Berkeley, Greenville, NC, Sedona, Corvallis, Vancouver, and Madison in lifestyle.) University town - home of Ward Churchill, as a matter of fact.

The issue I have is that I'm 29, my husband has had a vasectomy, and in theory, there's no reason for me to have a TL (save that it's my body and my fertility). I've done the calm and rational routine; I have 3 years's worth of daily diaries that I take with me. One of them is solely to answer this set of questions, and I ask myself these every day.

Do you want a tubal ligation? Do you realize that it's permanent and non-reversible? Do you realize that it is a surgery that requires general anesthetic, recovery time, and a risk of death or damage to your life and health? Do you realize that if you have a tubal ligation, there is no chance ever that you will bear a biological child? The decision is today: make your choice. I have never answered "no, let's hold off," or "no, I think I'm not interested in a TL." Some days it's pretty simple: "Yep. I want to do this." Some days (especially after being around my nephew for 3-5 days at a time) it's EMPHATIC. ;-)

The problem is not whether the area is conservative or not; it's the concern about being sued for malpractice if I do change my mind. The fact that it's not going to happen is hard to get across, even with diaries and exceptional articulation. I can understand a doctor's fear, and the fact that I won't put up with a doctor that gives me the typical line about changing my mind (like, if I have a kid, I can change my mind...) means that I don't develop relationships with them. Why I should I? I don't develop relationships with pro-birthers, either.

I have never had an anesthetic reaction - and I've had enough surgery to make three surgical addicts happy. While there's a first time for everything, she'll also probably have records from the wrist and knee surgery I need ASAP (the TL being far less urgent, since DH is snipped...)

We'll see. At least she's sensible and has the bloodwork done the week before the appointment, so that the all the test results can be talked about at once.

[Pool Hall Ace]

5. I guess there are too many people who are

hardwired to believe that deep down, all women want to, or should have at least one child. Sad. :-(

I'm sorry about all the grief you're going through with these docs. Three years of daily diaries -- that's impressive. I hope sensible doc #4 is the magic ticket.

[Lars39]

6. Have you tried an endocrinologist for your thyroid concerns?

At the very least a baseline of functioning could be established, with
follow-ups every so many months.

[politicat]

8. Requires dealing with a doc long enough to get a referral.

And to get them to look at family history instead of just the TSH level. We have great TSH levels.... and horrible free TSH, TSH 4, and function levels.

So far, so good. When I said "we have to do the full spectrum; I have a family history of thyroid disorders", I got a "okay, no problem.

Woohoo!

This doc's smart - does the bloodwork the week BEFORE the appointment, so the picture is really clear when I'm in there.

[BamaGirl]

7. Good luck

Sorry, I don't have any tips. I have issues with my own docs lol. I like my internist a lot, but can't stand the gyn practice I'm supposed to go to. I've put off going for way too long and have issues I just can't ignore anymore. I'm really dreading it.

[politicat]

9. Ug. It could have been worse, I suppose.

I'm 30 pounds over my "ideal" (but considering that 17 pounds over ideal at my height is obese is frustrating.....). However, I haven't been at my "ideal" weight since before I grew boobies. Ah, the joys of being short AND densely boned.

Once again, the thyroid disorder showed up in symptoms, but not lab tests.

She is willing to listen on the non-procreation front.

Grade: C+.