Prelude and background:

How to say what I want, no need to say. Speaking up is not a problem, speaking with eloquence can sometimes be a challenge. This letter is primarily intended for the medical community it also applies to anyone who works with the general public, and one I’ve debated whether to write for several days now. I am probably not the first person to have an experience like the one I had, and the need to speak up in the hopes that one voice will make a difference in the future is strong.

I recently sought medical help, due to health problems that I had not experienced in over a year. During that year we had changed insurance companies and I have to start over with new doctors that I have never met before. It is not helping that almost all of the ‘in-network’ doctors listed on the insurance company website either no-longer practice at the offices listed or are not accepting new patients. That is an issue we will be addressing directly with them, since it their staff who will need to research and update all of the information. An irony with all of the bumps we’ve been experiencing, from clerical errors, to wrong information has made me miss the high priced HMO we used to have.

About me; I’m educated and love to research new information to stay informed, I don’t dress fancy but always wear clean and sensible clothes; aka jeans and a simple shirt/blouse. I dress for the weather which means if it’s on and off rain I’ll be wearing my rain poncho over my comfortable jacket along with a hat. I’ve never been a super fancy person; I prefer comfort over high fashion and don’t feel the need to try to emulate the ads in fashion magazines, so no make-up either (and given my husbands allergy to cosmetics this helps our relationship). I’m a bit on the heavy side, but through small changes that I’ve been able to maintain I also weigh over 60 pounds less than what I did at my heaviest. While not perfect about it, I do try to take good care of my health and lead a busy and active life, which means I don’t go to the doctors unless I really need to.

 

The Letter:

Dear OB/GYN Doctor,

Today was the first time we met; I was in a lot of pain and not feeling well. To compound matters my hormones were a bit off which makes me more susceptible to crying jags. To my knowledge this is all part of a) being a woman, b) perimenopause/menopause which I’ve already started and know I have to work/live with for up to 10 years give or take a year or so. I came to you hoping to find answers for my problem; answers that would include why and any solutions (not drugs) to help fix or minimize the problem.

Your staff, all lovely, caring and clearly very happy with you, gave me confidence that I was in a good place. When you entered the room, you were warm and welcoming. You faced me while we spoke; your vocal tones were welcoming even as you were matter of fact and straight to business.

Then we began to go over my medical history. We got to a question I knew would come up; I’ve had to deal with it in the past and have trained myself to be matter of fact in my response. To be less than honest would have been disservice to both of us, this is not to say that I don’t have strong feelings regarding those choices.

The question was the standard question on pregnancies; how many, how many live births, and what became of the other pregnancies.

I was honest but not emotional about it. Now I wonder if it would have helped you had I been an emotional wreck when I answered, or just outright lied. That is neither here nor there and would not have helped the appointment or the reason why I was there to see you.

I was there because I was in pain, to be more precise I was experiencing extreme ongoing pain in my lower back and had been for 5 days, and since the pain was one that I have only ever encountered with my menstrual cycle I felt that seeing a doctor who specialized in women’s health was the best choice. After my response to the above questions your whole demeanor changed. Your vocal tones became brusque and harsh; you turned your whole body away from me and no longer looked me in the face as we spoke. In retrospect I should have ended the appointment right then and there, but I needed answers and still do as to why my body goes through the back pain it goes through each month, so we proceeded with a standard pelvic exam.

As you inserted and expanded the speculum there was no “you might feel a slight discomfort” warning. When you pushed the first time on my uterus, I winced and made some sound to indicate that it hurt. My past experience is the doctor will say something to the effect of “Sorry, for the discomfort but it’s necessary to check” and maybe not push as hard on the next spot, you didn’t do that instead you pushed even harder on the next spot. I could feel my face tightening and clenched my lips tight to keep from crying, from the pressure you applied. Afterwards my uterus spasmed and cramped for almost 45 minutes adding to the discomfort I was already in. That was not something I had ever experienced after a pelvic exam before, which was topped off by sharp stabbing vaginal pains intermittently over the remainder of the day. Perhaps it was coincidence and perhaps not, either way both were not sensations I was used to experiencing.

As we finished the appointment, you very callously suggested that I “should get my uterus removed since I wasn’t using it anymore”; that I shouldn’t expect the progesterone medicine I was on to be a magic pill and that it was fine, you brushed aside my statement that I had indeed had regular cycles while on the medication that such a thing wasn’t feasible, you also said that the problems with my back “could not be related to my cycle and I should follow up with a regular doctor”.

I thank you for your time and respect the training you have had to become a doctor.

Having to have one’s uterus removed is not a casual choice and should never be spoken of in the off hand and offensive manner that you did. It is true that my husband and I do not plan on having anymore children, but my uterus is still a part of my body and one does not casually remove body parts in the same fashion one gets a hair cut or ears pierced. Surgery’s are never with out risk and don’t always solve the underlying problem.

I know quite a bit about my medication thank you. I know it is not a magic pill; I’ve also done my homework on it back when I first started the treatment so I knew what to expect. I am concerned because my experience this month is outside of what is known to be expected; what I had experience over the last 13 months, of which I have kept very precise records of which you brushed aside, that I’ve been on the medication; and according to the mayo clinic an indicator of possible problems that warrant immediate medical attention.

I am still uncertain how something which I have only ever experienced in conjuncture with my cycle could not be a part of it that does not mean I will discount your statement that I could possibly have some other unknown back condition. I will be following up with a primary doctor, in the hopes of finding both answers and a solution, hopefully one that does not involve surgery. In the end if surgery is the only option then that is what will have to happen, but only after exhausting all other options.

I hope you will not be offended that I will not be returning to you. Since after this one encounter I’m not sure that we can have a healthy patient doctor relationship, and I strongly prefer my relationships to be healthy ones.

Sincerely,

M-D

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