Worse Appointment Ever.

I met with the reproductive endocrinologist, Dr. E-H, today. I almost jumped across the desk to punch her. I’m still too angry to write the whole thing out, but I WILL NOT go back to see her again!

The gist of the appointment went like this: I get taken back to her office. She starts talking about my referral notes saying I was being sent to her for osteopenia following chemical menopause to treat endometriosis, and she has my bone density scan results. And that’s were things stop going well.
ALL she wanted to talk about was my endometriosis. Which was NOT why I was there; I was there to address bone density loss- which I actually had before starting the aromatase-inhibitor – the letrozole didn’t make it go down that drastically. So she starts asking why I got of the letrozole, which I tell her is because I ran out of pills and my new insurance doesn’t cover it. Then she starts pushing lurpon. –insert collective groan–

I tell her I WILL NOT, under any circumstances, go on lupron. I don’t believe it is a sound choice for managing endometriosis, and the only reason I agreed to go on the letrozole was because it makes more sense than just shutting down the ovaries, since the endometriosis lesions can produce its own estrogens whereas lupron is a GnRH-atagonist and only shuts down the ovaries. So she tells me, “endometriosis can be activated by the ovaries so shutting them down works, and letrozole doesn’t get rid of all the estrogens either.”  Which, may be technically true, but it just because both don’t suppress all the estrogens you produce, that doesn’t mean lupron an attractive option.

So then I tell her that I don’t know how my periods will be, since I’ve been on it since I had the surgery, and the excision of my disease should have removed it. She decides to tell me the disease can’t be removed completely, and I answer that that is controversial. Her reply, get this, “No it isn’t. I research endometriosis”

.. Okay BITCH. I’m no stranger to research, and while I may not conduct endometriosis research 1) I DO have a Master’s of Science in Reproductive Physiology, so I’m not clueless, and 2) stay as up-to-date as I can on contemporary endometriosis research. And I haven’t seen your name anywhere. And I’ve seen data from surgeons that shows 0 recurrance of the disease that has been properly excised (thank you to all the talented surgeons and researchers who share their data and opinions on EndoMetropolis) AND 3) JUST BECAUSE YOU MAY CONDUCT RESEARCH IN SOMETHING DOESN’T MEAN YOU KNOW EVERYTHING ABOUT IT. I’m a PhD student – I clearly know a thing or two about research. You can’t tell me any researcher knows everything about a particular topic. And anyone who does, I know is full of bullshit.

So I’m FUMING by now. And she looks at me and goes “Well I don’t know what you want me to do, why are you here?”
UM. Because a doctor I trust thinks I have loss too much bone mass for my age, and thinks why should be investigated. Because of the OSTEOPENIA that the referral said.

So she starts talking about how if I go back on letrozole, she’ll have to add back some estrogen. And I tell her, again, that I won’t be going back on the letrozole because my insurance doesn’t cover it (I think I told her that at least 4 times).

She repeats “Well I don’t know what you want me to do.”

ARE YOU FUCKING KIDDING ME?!?!

So she finally agrees to check my parathyroid hormone (PTH) levels, since my thyroid panel was just checked and came back normal. And “your thyroid or parathyroid hormone usually are the cause of bone density loss, I’ll run the PTH but I think it will come back normal. So if you go back on letrozole to control your endometriosis I’ll have to put you on some estrogen and progestrone too.”

o.O

What great listening skills she has.

THEN, to top it all off, she asks me and A (he drove me, because he’s the best and the appointment was an hour away) if we’re planning on having kids anytime soon. No, not until we’re out of grad school. So she’s like “well, you’ll need some birth control pills.”  … So I laugh. I literally laugh. And tell her that won’t be a problem. We don’t have intercourse. And I look to A for back up, and he collaborates that we’ve had sex once in the past year. And Dr. E-H goes “well it only takes once.”

Yes, I know. I have a Master’s of Reproductive Physiology. I literally MADE BABIES during my master’s (cow embryos anyway). AND, OH YEAH. THERE ARE THESE THINGS CALLED CONDOMS. I don’t need to be on pills to have safe sex.

I mean, talk about pushing hormones. Damn.

I left so mad. When I seem my PCP again I will tell her I will NEVER go back to Dr. E-H. And if she is really concerned about why my bone density 80% of age matched peers, then she’ll need to send me to see someone else – maybe a regular endocrinologist would be a better approach.

Oh, and I looked up Dr. E-H’s publications. She has 8 publications total, and only 1 of those is related to endometriosis. The entire publication is 1 page long, and the study is incredibly poorly designed. Like the kind of publication I’d tear into during a journal club meeting, and throw out completely if doing a literature review. … And she says she researches endometriosis. Apparently not well …

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