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Rant-long! Just getting my appointment related frustrations off my chest! Again!From: AH (anonymous@obgyn.net)Sun, 24 Aug 2003 16:43:43 -0500 (CDT)
Ugh! It's like one step forward and 3 steps back with these specialists I see. Maybe I will go private just so I can see the same person for once! Even if the treatment is no better at least I will know what to expect! I have never to this day seen the same specialist! Anyway, my latest appointment consisted of me trying (successfully) to persuade the latest specialist not to take me off ALL my medication AT ONCE! because he didn't believe it was working (well, he had a point there) to be replaced with nothing! What a waste of time! I wait over 6 months for that! After it took me over a year to get a metformin prescription in the first place! No increase in dose (I am on 1500) and it was a fluke last time that I found someone who was willing to experiment with metformin.) The appointment consisted of going round and round in circles as the doctor said 'We cannot treat the disorder, as we do not know what causes it. We can only treat the symptoms. We cannot treat a symptom before it appears, hence we cannot prevent symptoms.' And so on. I am thinking of amassing a list of classic quotes from these specialists! I argued the metformin case, and he finally conceded that metformin was helpful in treating some symptoms in a small subset of patients, but that the only reason they prescribed it to PCOS women at all was because we kept walking in and asking for it! He said 'you cannot have been prescribed metformin to improve your hormones because we cannot treat your hormones.' Also why would I want to ovulate even if I wasn't on the pill since I don't want to get pregnant etc etc. Yeah, being normal is such a drag! Who in their right mind would want normal female hormones! He said that of course lots of small studies show metformin to be helpful because that's what always happens in clinical trials. They get to the larger scale ones and the results are not maintained. Well, that is a fair point. I concede that point. But since whoever it is that flogs Glucophage don't seem interested in getting an indication for PCOS what are we supposed to do? It is not like it is a particularly dangerous or expensive drug! He then started banging on about placebo responses and I said that people couldn't change their hormones with their subconscious. He said they could. Then I said, well, I wish someone would show me because it would be a pretty handy way of treating my PCOS! Things had degenerated somewhat! (I don't usuallly answer back to the doctor in this way, this is not what has been impeding my treatment.) Then he said that if finasteride wasn't working for hirsutism/hairloss then no anti-androgen would. Well, I am sorry but I am certain this is not the case. The small scale studies do not suggest this. Also the drugs have different potencies, and act in different ways. Anyway, he said that I couldn't try any other anti-androgen. Finasteride reduces DHT. It doesn't stop androgens from binding to the receptors or anything, at least not as far as I know. Anyway it looks like they'll take me off met soonish if I can't affect some kind of significant change in my appearance. Well, I suppose it is a big incentive to try harder and exercise again in the hopes that something will happen. Or I could just lie next time. Also at my new hospital, which has a PCOS clinic, the gynecologists treat the PCOS, which I don't think helps matters. Yes, I know I am being very ungrateful and it's not their fault that they can't help all that much. I suppose they are not supposed to think outside the box. I am going to have to rethink my medical treatment. It's just that the one doctor I did see privately who I quite liked, apparently doesn't believe in metformin either. (The last specialist told me.)But he did believe in insulin playing a part because he told me. But I got the impression that he thought this problem could be solved by an (unspecified) healthy diet and exercise. I mean, what do they think I've been doing for most of my life? OK so I haven't been exercising for a while but for heaven's sake. If it were that simple...
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