I know there is probably no Blogger-Blog Reader privilege, and even if there were you would have to report anything you heard that indicated a crime was about to be committed, but I am going to tell you this anyway:
I am going to kill The Special GYN.
Although—wait, I am not calling her that anymore. She was originally christened Special GYN after my last doctor referred me to my current clinic for the Laparoscopy That Never Was. I asked my doctor if there was anyone Special I should see, and she recommended The Special GYN. After yesterday, I have decided to rechristen her the Hateful & Incompetent Bane Of My Loins. I am breathing heavily with rage even typing her new name—which is why, my chickens, I didn’t update you yesterday. Between the sobbing and the throwing things and the drinking and the babbling of curse words and the planning of GYNicide, I simply couldn’t find the time or inclination to sit down before my computer and write a coherent account of my appointment.
The wanding was the highlight of my day. If that sentence filled you with shock and foreboding, well, it should have. I showed up with a mostly empty bladder, which they tried to work with for about 15 minutes before sending me to drink cups and cups of water. They seemed hell-bent on doing the transabdominal first. However, the tiny young girl wielding the wand was very considerate, and her kind, unpressuring demeanor actually relaxed my bladder enough that I was able to partially empty it (one.drop.at.a.time) before the transvaginal. My half empty (half-full, for you optimists) bladder necessitated much more wanding than I would have liked (55 minutes) but you can’t have everything, you know.
I was told that my uterus is “Very Curvy” (vavavavoom!) and leans to the side, and that my left ovary is “Quite Long.” This is all the wand wielder was permitted to say. What I saw for myself was that my left ovary is HUGE and rimmed with rows of cysts. It looked so much like the online pictures of polycystic ovaries, with their classy “string of pearls” cyst formation that I had to blink as fast as I could to keep from crying. It was day 15 of my cycle, there were more cysts than I had the strength to count, and they were all roughly the same size. I didn’t see my right ovary clearly because at that point I hadn’t yet gotten up the courage to ask the wand wielder to turn the screen towards me. What little I managed to see by stretching my neck looked blurry, not as dramatic and instantly recognizable as my left.
Later, in the office of the Hateful & Incompetent Bane Of My Loins, the H&IBOML bustled in and informed me that my lab results weren’t back yet.
“But…Nurse Parrot already gave them to me, over the phone.”
“Well, they’re not in the computer, and I can’t explain them to you if I don’t know what they are.”
Here is where I made my first mistake.
“Well,” I said, sheepishly, “I actually happen to remember them, if that helps.”
The H&IBOML stared at me.
“You’re kidding,” she said.
“No,” I said sheepishly, and started rattling off my results, with reference ranges.
The H&INBOML looked horrified, and scuttled out of the room. Twenty minutes later, she returned with a printout of my lab results, and sat across from me flipping through them. It was obvious she was seeing them for the first time. She ran down the list, reading each result followed by the phrase “So that’s normal.”
I let this go for the first few, but when she got to “Fasting insulin was 15.4, so that’s normal,” I spoke up.
“Um, actually, and of course I am not a doctor or anything, but other people I have talked to, and the research I have done, all seem to say that my fasting insulin indicates insulin resistance.”
She looks at me blankly.
“…Apparently anything over 10 means there may be some insulin resistance, and over 13 is strongly indicative of insulin resistance.”
The H&IBOML makes an exasperated noise.
“Well, I don’t know about that, all I have are the reference ranges the lab gives me.”
I asked if it wasn’t true that those reference ranges were meant to screen for tumors and such, rather than the subtler hormonal imbalances of endocrine disorders. She looked at me as though I had asked if it wasn’t true that hamsters running inside the earth are what cause it to spin on its axis.
“I’ve never heard that before,” she said.
When she pronounced my free testosterone normal, I asked if it wasn’t supposed to be under 3.6.
“Yours is 1.4,” she said
“Um…I think that is my percentage of free testosterone. My actual free testosterone was 4.4.”
She looks at her notes.
“Yes,” she says “4.4, which is fine.”
“Oh.”
“If your testosterone were high you’d have hair sprouting out everywhere.”
“Ah.”
Eventually she got to my LH/FSH ratio, which even she pronounced “High.”
“It’s less than two, which is good, but still higher than it should be.”
“Isn’t it over two?” I asked politely.
She looked annoyed, and said:
“9.4 divided by 4.5 is–”
“–2.1” I finished, through gritted teeth.
“Oh, I guess so.”
She told me that my ultrasound was very characteristic of PCOS, with multiple cysts. When I asked for more detail, she said “It doesn’t really matter.”
Then she told me she would like to put me on birth control pills, which will “Freeze my fertility in time.”
I asked What About Migraines?
“We’ll have to see. Hopefully you won’t get any.”
I asked about Metformin, and she looked at me like ‘Excuse me, I am a Licensed Twatologist, who are you?’ and said she thought the birth control pills would be fine “For Now,” and when I decide to start trying I should endeavor to get pregnant my first month off the pill, (Oh, O.K.!) because that would be my best chance for ovulation.
I asked the H&IBOML about miscarriage risks and she sighed and said:
“There is absolutely no reason to think that you will miscarry again just because you have before.”
…Except the greater than 50% PCOS miscarriage rate that is increased by previous losses.
The Hateful & Incompetent Bane Of My Loins ended by telling me she still didn’t know what to do about my pelvic pain (the reason I saw her in the first place) because the PCOS “Wouldn’t be causing any pain.”
I think this is when my eyes started tearing up. The H&IBOML looked at me incredulously and said:
“Are you going to cry?”
I reached for a tissue and she said, annoyed:
“What are you crying about?”
I should have said “I am crying because you are an ugly, stupid cunt and the money you wasted on medical school could have saved dozens of starving children,” but I didn’t.
“Look,” said the H&IBOML, “I am giving you my opinion, I thought that is why you came to see me in the first place. Do you want me to write you a birth control prescription or not?”
In my car, in the parking ramp, I checked to make sure my windows were tightly rolled up and there was no one around before I screamed. I grabbed things out of my purse and flung them at the dashboard. Then I picked everything back up, smoothed my hair, and drove out of the ramp, smiling at the parking attendant and chirping at her to Have A Nice Afternoon!
I held myself together until I got into my apartment, when I started sobbing and choking and crumpled onto the floor in front of the doorway curling myself as tightly as possible into the corner. The Nearly rushed over to put his arms around me and ask what had happened, but all I could say was “I hate her I hate her I hate her.”
And so I called the Fancy RE’s clinic, and then the H&IBOML to have my records transferred, and now am waiting for the Fancy RE to send me my intake paperwork.
Yesterday evening, at a bookstore, I found a book on insulin resistance. In the diagnosis section, it recommended having a fasting glucose and insulin level drawn. Fasting insulin levels over 10, it said, are indicative of insulin resistance. Perhaps I will photocopy the page, highlight that paragraph, and send it to the H&IBOML along with a tersely worded note:
Dear Hateful & Incompetent Bane Of My Loins,
Please refer to highlighted portion.
Suck my cock,
Alexa

{ 7 comments… read them below or add one }
Oh crap, honey. It sucks to know more than the doctors. Makes the whole thing feel like a pointless exercise. I am glad that you’re going to see an RE, who will hopefully have a clue about such things. And I think a letter to the nasty doctor would be in order, though you may want to wait for further fodder from the RE to really flesh out the letter (though “I told you so, you brainless nincompoop” is pretty good in its own right!). It’s not that going on the pill is an absurd suggestion for the PCOS if you’re not currently TTC (though the migraine issue is highly relevant and any doctor who says, “Well, let’s just hope you don’t get them” is an ignorant twat who has never watched someone she loves writhe around in agony) but the overall response is sorely lacking.
Now for the pep talk: Metformin helps. Monitoring from a doctor with a clue helps. Sometimes adjusting your diet helps. Lots of PCOS women manage to get pregnant – and carry to term – with just a little bit of medical help. The 50% miscarriage statistic is a weird beast – but in any case the rates are vastly improved with the Met (I think Dr. Glueck has suggested the Met reduces the 50% miscarriage rate back to average, non-PCOS levels). And baby aspirin helps too, they think. So please don’t despair about your chances. Yes, it may be hard. But in the care of a competent RE, you have lots of chances. This was just not the right doctor. At all.
Oh, Alexa. What a nightmare. At times like this, I just wonder about all the hundreds of patients who don’t take the initiative. A doctor like that can do a lot of harm. Onward and upward to the RE, I say. And if that fails, you’ve always got Cass.
Hell, maybe I should go into business. I don’t know as what, but you all seem to think I’m really good at it. Think of me as the PCOS cheerleader. No, that doesn’t sound right. The anti-PCOS cheerleader? The dorky-but-cool librarian? I don’t know. But if it helps, I’m happy to do it.
Let me just reiterate that H&IBOML sounds like pure evil. I’m glad you are going elswhere, because she sounds horrible. All the other shit aside, her statement regarding you not having PCOS because you don’t have “hair sprouting out everywhere” is so immensely ignorant you’d think she was practicing medicine 40 years ago rather than currently. First of all, not every woman diagnosed with PCOS exhibits all of the symptoms. Second, even if you do have issues with hirsuitism, there are ways around it so that people wouldn’t suspect that you are hairier than normal. Duh. I speak from experience. Stupid bitch.
Brief aside, just so you don’t feel so alone in the dumbass gyn stakes, here is my contribution. I started going to the gyno at 19, which is when I was diagnosed with PCOS. I made occasional visits for the smear and PCOS-related consultations. I saw the same doctor each and every time, yet this did not preclude her from being a forgetful, sinister bitch. I went for one appointment right after I got married, and enquired how hard she thought it would be for me to conceive. She gleefully said, “Oh, no harder than normal I don’t think!” , which I was so relieved to hear given all the PCOS horror-stories I acquainted myself with by that point. 10 minutes later we went to her office from the exam room where she looked at my chart and said, “Oops, forget I said that. I didn’t realise your case was so bad. Yeah, you will definitely have trouble conceiving and will probably require medical assistance. Sorry about that!” Pfft…no big deal, right? Just a slight mix-up!
I hope the new RE listens to what you have to say and actually knows of what he/she speaks.
Heavens what a horrible experience. I think a letter is well in order, particularly if you can fill it with lots of evidence of her ignorance. So glad you’re going to an RE.
I like the letter – clear and to the point. God I hate doctors.
Hi, I am 22 and have pcos as well. I was just recently diagnosed about three months ago. It took about six months before I got the diagnosis. I definently believe I have pcos but the doctors never explained jack shit to me. They seem so useless. Right now I am on 2250 mg of glucopahge a day. I had one doctor i was refered to for high blood preasure tell me I was taking up too much of her time because I was asking her questions and trying to get a scipt for my acne because no one else would give me one. I feel your pain. It is so nice to know that there are other people who understand what I am going through. You are in my thoughts and please know that I can relate. Trust me.