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Re: Advice please! How to be assertive with doctor? (Long, sorry!)
From: Abigail (anonymous@obgyn.net)
Fri, 18 Jan 2002 07:25:43 -0600 (CST)
Hi,
I am glad that you guys have found Dianette, which I have been told is
used widely in Europe for women to ensure a good complection (re: the
acne). For me, however, the drug has made no improvement on my
hirtusim, despite taking the medication for 4 years now. I have even
had a second drug introduced in conjunction, a 50mg progesterone
derivative acetate, which I took for 12 months, only to find no change
in my facial hair had been made and I had also increased in weight by a
stone.
I am now pleased to read about the fact laser treatment is used on the
NHS to treat people in our situation. This gives me some hope! But for
dealing with doctors, is another story. Many of my visits have just
been used to act meerly as another statistic for a journal paper, so it
doesn't make the human being here very happy! My advice for dealing with
them is just as Clair says and to be very determined to argue your case.
Personally, I like to see the crib sheets for blood results and really
know what is going on in my body. Don't be happy unless you come out
with what you want, after continuing, as without we patients, there
would be no stats or change in prescriptions! Sometimes, I bet if you're
really well prepared you could know more than a GP!
Good luck,
Abbey
At Thu, 29 Nov 2001, Claire wrote:
>
>Hi Chris,
>
>I'm a PCOS sufferer from the UK. I used to take the contraceptive pill
>Dianette (which I think is the Diana-35 that Kimberly refers too).
>
>I had to come off it because of migraines but I just thought I'd let you
>know that I was on it for about 10 years on and off and it worked really
>well for me.
>
>I had pretty bad hirsutism and it really cleared it up and worked
>wonders. Especially on my face.
>
>Doctors in the UK also prescribe Dianette for acne sufferers - and it
>works really well. I had a friend (not a PCOS sufferer) with really bad
>acne - Dianette cleared it up completely.
>
>This is just my experience but I thought I'd share it with you.
>
>When it comes to being assertive with Doctors I think that preparation
>is the key. Do your research and get your aims really clear in your own
>mind. What do you want to get out of your consultation? I always write
>down what i aim to get out of a consultation. I also write down my
>questions so I don't forget them. It's so hard sometimes when you have
>so many questions and so little time in which to ask them.
>
>Good luck.
>
>--
>Claire
>
>At Thu, 29 Nov 2001, Kimberly wrote:
>>
>>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
>>
>--
>Claire
>
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