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torquillToday's moral: do not get angry at the screwdriver when it tells you it's the wrong tool for the job.
I saw my gynecologist. We agreed, based on the most recent test results, that nothing malignant is going on -- just hormones. So that's something.
That's about where the productive stuff stopped, though. I talked about what I thought might be happening, and asked for some hormone testing so that we could figure out trends going forward. She refused. Absolutely, flat-out refused. It took several minutes of back-and-forth before I finally understood what she was trying to say: she wasn't saying that those tests were not useful at all. What she was saying was that she, personally, could make no use of them, trend lines or no. And as the supervising physician (she did not say), she couldn't in good conscience order tests which she could not interpret in a way which would help her in recommending care. The numbers could be obtained, but it was far outside her own comfort zone to make use of them, and she wouldn't just stand back and leave it up to me.
Once I figured out it was not an arbitrary refusal, but simply running up against a boundary that she had in what facets of medical care she felt qualified to handle, I calmed down again. She was just not the person for the job, and there was less than no point in getting angry with her. (I had a long talk with Amy later about that.) If I wanted to pursue stuff like that, she recommended finding an independent alt-med practitioner. Maybe if I win the lottery...
She agreed that my analysis of the situation was probably accurate, and that if I wasn't tolerating prescription estrogen, that she could prescribe pills which were just progesterone... her scenario was that I could use them to regulate my cycle, similar to the two-hormone pills, and therefore get rid of the spotting and the excessive bleeding both. I told her I wanted flexibility (after all, I didn't know how much it would take to get rid of the spotting), and she made it a 5mg dose, where 10-20 is a normal daily dosage. That way I could take several of them if necessary while working things out, and she made sure to write up plenty of them up front.
So she's given me some raw materials (while having an ostensible plan in place, if I go outside her recommendation it's my lookout) and she's standing back. She also offered to make me an appointment to consult a more experienced gynecologist -- presumably the "she might know" person in that office -- but that gyno is on a two-month vacation right now. So we'll see whether I sort things out before my appointment there.
She is not able to make cross-department referrals, I discovered. So I'll hurry up with making an appointment with my PCP, discuss all this with them, and get a few things like thyroid tests etc. I will also see if I can get a referral to endocrinology; if my gyno doesn't feel qualified to monitor or mess with hormone levels, it's possible that an endo will. It's worth a shot. If nothing else, I might be able to get a testing schedule, because even if I have to do all this myself, I'd rather not have to do it blind.
So I have raw materials: progesterone, in case dropping P levels are the cause of my issues, and grapeseed extract, in case rising estrogen is the problem. I have a plan: I'll stay on the Nuvaring until the end of next week, unless it becomes an issue -- currently I'm just mildly crampy. After that I will cease all hormonal birth control and have an uncontrolled bleed. I will also start monitoring my morning temperature again, so that I can track where I am in my cycle. After a month off of birth control, I will assess my symptoms and either start suppressing estrogen or adding progesterone. I'm prepared to accept higher levels of testosterone if that ends up being a side effect; I can't be sure what will happen there without blood tests going on. I just hope I don't have to start shaving more things.
A little more testosterone sounds good at the moment. Right now I feel like I can't invoke my masculinity properly; I feel unbalanced and dysphoric. It's hard to describe, but I feel... softer, gentler, more laid-back and thoughtful. I'm lacking ambition, aggressiveness, confidence. I hope it's just that the estrogen is swamping the T levels, and that I can get those qualities back in relatively short order.
One thing's for sure: August is really going to suck.
Also: Damn but I'm tired of having to do this sort of thing on my own. Doctors as partners, pah.
I saw my gynecologist. We agreed, based on the most recent test results, that nothing malignant is going on -- just hormones. So that's something.
That's about where the productive stuff stopped, though. I talked about what I thought might be happening, and asked for some hormone testing so that we could figure out trends going forward. She refused. Absolutely, flat-out refused. It took several minutes of back-and-forth before I finally understood what she was trying to say: she wasn't saying that those tests were not useful at all. What she was saying was that she, personally, could make no use of them, trend lines or no. And as the supervising physician (she did not say), she couldn't in good conscience order tests which she could not interpret in a way which would help her in recommending care. The numbers could be obtained, but it was far outside her own comfort zone to make use of them, and she wouldn't just stand back and leave it up to me.
Once I figured out it was not an arbitrary refusal, but simply running up against a boundary that she had in what facets of medical care she felt qualified to handle, I calmed down again. She was just not the person for the job, and there was less than no point in getting angry with her. (I had a long talk with Amy later about that.) If I wanted to pursue stuff like that, she recommended finding an independent alt-med practitioner. Maybe if I win the lottery...
She agreed that my analysis of the situation was probably accurate, and that if I wasn't tolerating prescription estrogen, that she could prescribe pills which were just progesterone... her scenario was that I could use them to regulate my cycle, similar to the two-hormone pills, and therefore get rid of the spotting and the excessive bleeding both. I told her I wanted flexibility (after all, I didn't know how much it would take to get rid of the spotting), and she made it a 5mg dose, where 10-20 is a normal daily dosage. That way I could take several of them if necessary while working things out, and she made sure to write up plenty of them up front.
So she's given me some raw materials (while having an ostensible plan in place, if I go outside her recommendation it's my lookout) and she's standing back. She also offered to make me an appointment to consult a more experienced gynecologist -- presumably the "she might know" person in that office -- but that gyno is on a two-month vacation right now. So we'll see whether I sort things out before my appointment there.
She is not able to make cross-department referrals, I discovered. So I'll hurry up with making an appointment with my PCP, discuss all this with them, and get a few things like thyroid tests etc. I will also see if I can get a referral to endocrinology; if my gyno doesn't feel qualified to monitor or mess with hormone levels, it's possible that an endo will. It's worth a shot. If nothing else, I might be able to get a testing schedule, because even if I have to do all this myself, I'd rather not have to do it blind.
So I have raw materials: progesterone, in case dropping P levels are the cause of my issues, and grapeseed extract, in case rising estrogen is the problem. I have a plan: I'll stay on the Nuvaring until the end of next week, unless it becomes an issue -- currently I'm just mildly crampy. After that I will cease all hormonal birth control and have an uncontrolled bleed. I will also start monitoring my morning temperature again, so that I can track where I am in my cycle. After a month off of birth control, I will assess my symptoms and either start suppressing estrogen or adding progesterone. I'm prepared to accept higher levels of testosterone if that ends up being a side effect; I can't be sure what will happen there without blood tests going on. I just hope I don't have to start shaving more things.
A little more testosterone sounds good at the moment. Right now I feel like I can't invoke my masculinity properly; I feel unbalanced and dysphoric. It's hard to describe, but I feel... softer, gentler, more laid-back and thoughtful. I'm lacking ambition, aggressiveness, confidence. I hope it's just that the estrogen is swamping the T levels, and that I can get those qualities back in relatively short order.
One thing's for sure: August is really going to suck.
Also: Damn but I'm tired of having to do this sort of thing on my own. Doctors as partners, pah.
no subject
Date: 2015-07-24 01:23 (UTC)One of these days I'm going to run across a doctor who actually *can* help with my overall care, and I'm not going to believe it.
no subject
Date: 2015-07-24 02:00 (UTC)