Saturday, October 17, 2009

Guts: Trust them

So for those of you interested or involved in the medical field, I'd like to provide a quick disclaimer before I get on my soapbox. I do not doubt that medical school provides very in-depth education and specific training and I believe our blessed country has some of the best, most advanced medical care in the world.

That said, I think doctors sometimes forget the art of observation and listening to their patients' complaints and instinctual reasoning. They may have the 8 years' of education backing them up, but it's still the patient's body, and only the patient can really know how he/she is feeling.

My family has a pretty elaborate history of health woes. Diabetes, thyroid malfunctions, mental/emotional troubles, heart disease, cancer, and addiction have all surfaced in both mom and dad's extended family. Within the past 15-20 years we've discovered that my female predecessors have shown a strong susceptibility for endometriosis, a disorder of the uterus, fallopian tubes, and ovaries which, if unattended, will lead to infertility.

Endometriosis has some shockingly far-reaching side effects. The textbook case will likely include such troubles as severe abdominal and back pains with menstruation as well as violent emotional peaks/troughs and bowel and bladder irregularities - symptoms which don't seem logically related to the uterus at all.

Without going into too much detail, I had been suffering these and other symptoms for 4-5 years and all the while figured (based on my aunts' and cousins' experiences) that it was normal for me. When the emotional symptoms got too intense I went to my doctor and was presrcribed an anti-depressant to regulate the mood swings. It didn't have fantastic results, but it was enough for me to scrape by.

Because of my complaints about severe menstrual pain, my doctor recommended birth control. I was hesitant - this seemed a little extreme, after all it was just some bad cramps (I ignored other symptoms since they weren't as interfering with my daily life). I sought the advice of a gynecologist, but they said the same thing. My aunts had tried birth control as a solution to their problems and had all suffered such side effects as infertility and significant weight gain so I stubbornly refused; putting on pill weight didn't sound like a good solution to depressive episodes.

I toughed it out for about a year and a half, pain and weird symptoms getting continually worse. One of my mother's sisters who had been suffering from severe endometriosis for 8 years was told by her doctor that she was barren as a result. Since she was engaged to be married and desperately wanted children, she sought the advice of a specialist in Nebraska. Her symptoms were a more severe version of mine, so I got scared and went back to the gynecologist. After just talking to me (and not doing any tests or exams) they ruled out endometriosis (even though I described hallmark symptoms).

Meanwhile the violent emotional difficulties and incapacitating menstrual cycles started affecting my school and work. My parents were concerned as I was starting to despair and think this was my predicament indefinitely (lest I cave and start taking birth control). After some particularly bad incidents, we managed to find a doctor who didn't prescribe birth control at all, and after one session with her, I felt my hope restored.

Based on my descriptions she told me I almost definitely had endometriosis (and was incredulous as to how 2 other doctors had so cavalierly ruled this out). She explained how all my symptoms (even the emotional craziness) were connected to this disorder and scheduled me for a laparoscopy, a surgical procedure which is the only way surefire way to diagnose and treat endometriosis.

I went in for the laparoscopy yesterday morning. The surgery went well, and sure enough my doctor found inflammatory fluid and adhesions (scar tissue) already beginning to form on the fallopian tubes. Had I taken the initial advice of other doctors and gone on birth control, the medication would have not only masked the symptoms and thus hidden the real problem, but actually fed the scar tissue with the estrogen it produces and rendered me infertile after a year or so.

Moral of the story? Doctors aren't always right. If you're not getting the results or options you want, seek a second, third, or fourth opinion - you might dodge some pretty frightening, unforseen outcomes.

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