Re: Rant-long! Just getting my appointment related frustrations off my chest! Again!
From: click (anonymous@obgyn.net)
Sun, 24 Aug 2003 18:58:42 -0500 (CDT)
I hear you. I haven't had a problem with medical care since I was first
diagnosed but I've never delt with public physicians--I don't know where
you live or I'd recommend a few places to go for treatment. The best
thing I can recommend is finding yourself an endocronologist and a
gynecologist who are both familiar with PCOS--call around adn ask
offices to find out if their physician is familiar or not.
I have been on glucophage (metformin) for three or four years now, and
when I first started it made me lose a good 35 or 40 pounds and now it
has helped me maintain it (I had had excessive weight gain before
treatment so this was great)... I'm only 19 though, so I'm sure our
hormone situations are very different, but I'm confident that the right
physician can do wonders--metformin, glucophage, glucophage XR--they all
work--maybe you should try the latter--XR--it's more expensive, but it
seeme dot work more consistantly for me than the generic metformin which
gave me stomach cramps etc.
Caroline
At Sun, 24 Aug 2003, AH wrote:
>
>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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