PCOS Messages for November, 2001: Re: Advice please! How to be assertive with doctor? (Long, sorry!)

Re: Advice please! How to be assertive with doctor? (Long, sorry!)

From: Kimberly (anonymous@obgyn.net)
Thu, 29 Nov 2001 00:11:17 -0600 (CST)

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Reply: Claire: "Re: Advice please! How to be assertive with doctor? (Long, sorry!)"

Chris - I can't give advice about being assertive because I'm not too good at it either. My endo gave me ortho-tricyclin and I came home, read about it and was weary of trying it. I did and I lost one month of my life to a depression that was overwhelming. Then I decided to take things into my own hands, did some research and decided I wanted to try the anti-androgen BCP Diane-35 -which has been used for years around the world- since it is not available here I checked the net and found it for the same price I would have paid for the ortho (after insurance benefits.) It runs about $8 a month and I have had no problems whatsoever. When I went to my endo I told her I did not do well on the ortho and that I had discovered a BCP specifically for PCOS that is not available in the US and gave her the prescription info that was included in the box (which actually mentions PCOS). She said it was fine, wrote what the ingredients were to keep my file up to date, and that was that. There is a comparable BCP in the US now called Jasmin - you might want to tell her you have heard about a new BCP that many women with PCOS have had great success with - my endo, who had prescribe the ortho was even aware that it is new and being used for PCOS, so maybe yours will be up-to-date by now too. (it has anti-androgen aspects and I believe it came out in January, but I figure the Diane 35 is just as cheap for me anyway and has been in use for much longer, so I'll keep ordering from overseas). The best sight I have found for Diane 35 is anagen.net where you can order three months for $26, free shipping.

--
Kimberly M.

At Wed, 28 Nov 2001, Chris wrote:
>
>Hi-
>
>I finally have a follow up appointment with my new endocrinologist.  She
>drew blood the last time, and my results were normal except for high
>DHEAS (400), low estradiol (30), and a funky LH:FSH ratio (2:1).  So
>anyway, here's my question...when you know what drugs may help you,
>*how* do you ask the doctor for them without seeming pushy? I have
>really made great strides in the last few months with getting more
>assertive, but I still have a problem with requesting drugs.  For
>example, when I left the lst appointment, she gave me a sample of
>Estrostep bcp.  I asked, "Wouldn't a monophasic pill be better?" And she
>said no, she's had good luck with this pill.  So what could I say? Well,
>I got home and went into one of my research frenzies (!) and found that
>Estrostep has one of the highest androgen contents of all the bcps.
>(Acne is my main complaint of PCOS.) So I didn't take it.  What I think
>I need is a higher estrogen, lower progestin and androgen monophasic
>pill for birth control (like Ovcon or Orthocyclen) and possibly a little
>extra estrogen, (like Alora or Vivelle but NOT Premarin) to help my
>fatigue and memory loss.  I have read several articles that indicate
>that Premarin is the most widely prescribed estrogen, but contains no
>17-beta estradiol, which is our natural estrogen, and therefore many
>women do better with actual 17-beta estradiol given transdermally.  But
>I can just see it now, she'll say, "Let's get you on a low dose of
>Premarin and keep taking the Estrostep." So, do I lie and say I spotted
>on the Estrostep (which I never took) and I'd like to try Ovcon? Do I
>say my mom had bad results with Premarin (another lie, my mom never took
>it) and I'd like to try a 17-beta estradiol? I hate to lie, but I also
>hate to be pushy and act like I know more than she does.  How do I
>assert myself without sounding like a know-it-all? Help!!!!
>
>Thanks so much for your time-
>Chris

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