Last Tuesday I had an appointment with my gynecologist to go over my test results and determine next steps.
I was equally unimpressed with the receptionist (same one as the first appointment), but I had a new nurse who was much nicer. I wasn't as impressed with the doctor this time, but my opinion was probably colored by having to wait 90 minutes past my scheduled appointment to see the doctor. Though I will say that the 90 minute wait probably made me a little less willing to be nice/friendly/agreeable, which helped me to advocate for myself during the appointment.
As it turns out, all of my test results were indeed normal (as indicated on the form letter with checked boxes), including the "best" FSH I've ever had, though as a friend reminded me, your worst set of test results tend to be the most accurate predictor of fertility. I ended up getting the results in advance of my appointment (thanks for the tip to get them directly from the lab, Obie!), so it sort of helped me frame how to think about the appointment.
There was nothing to even remotely explain the hot flashes. She even threw out the idea that maybe they were psychosomatic and suggested that I take Prozac (an SSRI), which would also help with the wicked PMS/PMDD. I don't have any issues with psychiatric medications and I think they are a wonderful tool for people who need them, and I know that there have been studies done to show the effectiveness of SSRIs in treating hot flashes, I just felt like she was implying that they are all in my head. I swear to god that they aren't in my head.
There was no more conversation about my longer than average periods. Honestly this is my lowest level concern because I've had 8-10 day periods for most of my life, and now is no different. The part that is surprising to everybody but me is that I have 8-10 day periods in spite of the IUD. And the fact that they are so much lighter compared to pre-IUD periods, I can definitely live with them!
So next came the conversation about the pain. The pain is hard to describe. Sometimes it's like stabby pain right in the middle of my uterus. Sometimes it's more like period cramps (when not on my period). Sometimes it feels like my uterus is trying to expel itself from my body. Sometimes it's more like a million pin pricks all over my abdomen. Sometimes it's like a lightening bolt struck me in the cervix. These pains occur randomly throughout my cycle, but always during my period or in the days leading up to it. Those are the pain symptoms that come and go. The pain symptom that is constant is in the vicinity of my right ovary. It's not a cyst or anything else that can be seen on ultrasound or felt during an exam, but the pain is constant and has been for almost three years. The intensity of the pain varies, but it's always there. There is always some sort of pain somewhere. I have long suspected endometriosis is the culprit. No doctor has ever really listened when I described this pain. I don't know that this doctor believed me either, but at least she's willing to investigate.
I have a diagnostic laparoscopy scheduled for November. If any endometriosis is found, it will be removed to the greatest extent possible. I don't really have time to recover from something that is technically considered surgery, but my need for answers outweighs any inconvenience at this point. Once the blood tests and ultrasound came back normal, I think she was keen to let me walk away without further investigation just like so many doctors throughout the course of my life. I had to push harder for the laparoscopy then I should have needed to, but in the end I got what I wanted, and in November I will hopefully have answers. I've literally had it with the pain and I've had it with not being taken seriously. For the first time in my life I'm actually thankful that I had a long wait in the waiting room because I think this put me in a little bit of a bad mood and gave me the courage to stand up for myself.
Oddly enough, I stumbled across this article on doctors not taking women's pain seriously and shared it on my Facebook news feed. Of the people that commented on the article, three people experienced at least one ectopic pregnancy, one had a miscarriage, one had a large non-cancerous ovarian tumor, and one had a brain tumor removed after 18 months of having debilitating migraines and no one bothering to do a scan (and once they found the tumor, she was having brain surgery in less than 48 hours). So I guess whether it's acute pain or chronic pain, women's pain isn't taken seriously.