# Concern over approaching doctor



## lozonloz (Mar 8, 2011)

Hi!

Basically would like some advice as my menstrual cycle has gone to hell. well it's always been difficult, but more so than usual.

I just got off a 6 week long period. And I havent gone to the doctor. And yes, I know that's stupid.

The reason is as a student I'm registered at the university GP, and they give me a different doctor every time I go, and when I've brought up these sort of issues before I've been reminded that I'm fat and have PCOS, and sort of gently chided for wasting their time, and given a diabetes test. Again.

And each Doc will do the same thing, because they havent seen me and done it before.

I don't know how to make them take me seriously!

Any ideas?

(I'm not on the pill. I got taken off it about 2 years ago cos I'm fat. *makes face*)


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## Jes (Mar 8, 2011)

You're going to have to take a deep breath, put on your big girl panties, believe genuinely that you deserve answers to your questions and then walk into that office and ask them.

I'm fat, too, and I've never had doctors, etc., treat me the way I hear many of you being treated. I could be miraculously lucky, OR it could be my attitude from the word 'Hello.' 

Whoever is paying your way through school (assuming it's not all subsidized) is paying the doctor's salary. He or she is working for you. Remind yourself of that before you go in and while you're sitting on the table. 

Draft out (on paper if you need to) what questions you want answered, how you want the doctor to work on your problem with you and what you'll say if he or she goes off track. Make a list. Bring it with you if it helps. 

If you get the weight talk, wait a beat and say: we can address that later. I'm here b/c I've just had a 6-week long period. What can we do about that?

If weight comes up again, wait a beat and say: we can address that later. I'm here b/c I've just had a 6-week long period. What can we do about that? 

It takes 2 people to have a conversation. No matter what the doctor wants to talk about, if he or she is talking alone, then it's not a conversation. So just wait 'til there's silence, no matter how long it takes, and say your bit. Don't give anyone the permission to move you off of the topic that brought you into the ofc. in the first place. This takes some practice, but trust me--you'll get it down pat.

(maybe it's a plus that you don't see doctors a 2nd time--just tell them you've already had all the tests! they won't know!  )

At the end of the day, only you can make sure you're getting the health care you deserve, but you have to be your own best advocate.


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## annabellethecat (Mar 10, 2011)

If I were you I would fight to get back on the Pill. I am fat, have PCOS and was put ON the Pill the help with the symptoms. It is the only thing that controls my periods. I am very sorry about your six week long period. I know what that hell is like. I know doctors can be total jerks but keep insisting on proper treatment. If you have nurse practicioners in the UK you might get better treatment from one of them.


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## BeautifulPoeticDisaster (Mar 10, 2011)

ok dude. Im super duper fat! I have had a 6 month super heavy thought I was bleeding to death "period" before. I had the same issues and concerns as you. It was actually one of my women's studies professors who made me go. She encouraged me to be my own advocate and own my body...all of it..and to take care of it.

Now I am on the mini pill...also known as a pergesterone only pill. It's called femulin...dont know what its called over there, but my god...it's awesome! I get a period once every three months for 5-8 days...and its not full of fist sized blood clots, which is nice as I don't ruin my clothes now!

I also have PCOS. I have the beard to prove it  But seriously....I mean this with all the love in the world. GET OVER YOUR FEAR!!! Even if it is a new dr...start out something like "hi, I've seen other drs before and they didn't help, Im hoping you can. My issues are x,y and z and heres what Id like to do about it" and "yes I know Im fat, but as a dr I am sure you know losing weight with PCOS is extremely hard"

Just take the bull by the horns girl and get yourself sorted!!!!

EDIT! OHHHH I just saw you were in the UK! Go to a GP, you should be covered by NHS and get on FEMULIN!!!!!!!!! I take 2 a day as opposed to the normal 1 because of my size.


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## thatgirl08 (Mar 10, 2011)

Do you know if the risks are less with progesterone only pills? I'm curious specifically about blood clots & heart attacks. I'm too nervous to take birth control because I'm worried about those things but I'd like to be able to take something to help with my PCOS.


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## Miss Vickie (Mar 10, 2011)

Yes the risks are far less with the progesterone only pills. The problem with oral contraceptives with fat chicks is that we're at higher risks for heart problems and strokes because we usually have lots of extra endogenous estrogen which also makes us more at risk for certain cancers like breast and uterine. So using a progesterone only pill decreases that risk; it also lowers the risk of developing a thick endometrium which is usually what causes heavy bleeding, which many of us experience.

The problem with progesterone only pills in my experience is that they have slightly higher risks of pregnancy. We put our breast feeding moms on progesterone only pills and unless they take the pills at EXACTLY the same time every day they end up pregnant. Also, some of us get pretty wacky on progesterone (raises hand), so if you notice your mood getting erratic, definitely mention it to someone. Being fat isn't (in the US anyway) a total contraindication for getting the pill; it's something they prescribe cautiously, but if you're young and normotensive and don't smoke, most providers will give it because as risky as the pill may be, your risk of pregnancy is greater (or at least that's how they explain it to me).

However, what you asked about was help in talking to your doctor. I think Jes's advice was right on. This is YOUR body and you really need to put any shame or embarrassment you feel away, make eye contact and ask for what you need. Write a list of all your questions, concerns, and the things you need and don't leave until you feel that all of them have been answered. Bring a friend with you if you must to help remind you and give you moral support.

It is NOT normal to bleed that much. It could be hormonal, it could be an infection, and it could be cancer. You NEED to get properly evaluated. I don't say this to scare you or make you feel bad, but rather to light a fire under your butt to get it taken care of. You should also get your blood taken to see if you're anemic with all that bleeding. 

It's not uncommon to have a different doctor each time you go, and that's okay. Hopefully they write good notes in your chart but if not, that makes it more important for you to be your own advocate. When you go in, you can say, "Last time I was here in [insert month], Dr. So and So thought I had [insert diagnosis] and did [insert testing or treatment]." Then talk about how your body responded and ask what this doctor thinks and would like to try. They will have a LOT more respect for you and treat you a LOT better if you own your body and take responsibility for your health. Make eye contact, smile, don't apologize, don't call yourself names. But do talk about whatever positive lifestyle changes you're making (they like that).

Good luck, and please follow up with us!


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## lozonloz (Mar 11, 2011)

OK, got an appointment booked.

I shall try and get my points across, thanks for the advice!


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## BeautifulPoeticDisaster (Mar 11, 2011)

lozonloz said:


> OK, got an appointment booked.
> 
> I shall try and get my points across, thanks for the advice!



Thinking of you My experience here in England is that if you own your weight and talk about your health concerns like a educated person, they are pretty neutral about fat.


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## thatgirl08 (Mar 11, 2011)

Miss Vickie said:


> Yes the risks are far less with the progesterone only pills. The problem with oral contraceptives with fat chicks is that we're at higher risks for heart problems and strokes because we usually have lots of extra endogenous estrogen which also makes us more at risk for certain cancers like breast and uterine. So using a progesterone only pill decreases that risk; it also lowers the risk of developing a thick endometrium which is usually what causes heavy bleeding, which many of us experience.
> 
> The problem with progesterone only pills in my experience is that they have slightly higher risks of pregnancy. We put our breast feeding moms on progesterone only pills and unless they take the pills at EXACTLY the same time every day they end up pregnant. Also, some of us get pretty wacky on progesterone (raises hand), so if you notice your mood getting erratic, definitely mention it to someone. Being fat isn't (in the US anyway) a total contraindication for getting the pill; it's something they prescribe cautiously, but if you're young and normotensive and don't smoke, most providers will give it because as risky as the pill may be, your risk of pregnancy is greater (or at least that's how they explain it to me).



I appreciate your input on my question about birth control. My doctor is trying to push me into taking it (the estrogen & prog kind) but I really worry about the heart risks. I believe I have normal blood pressure.. I went to the doctors today and it was 112 over 77.. she acted like that was in the normal range. However, I know I have frequent surges in heart rate because I get anxiety attacks fairly frequently.. some days it doesn't happen but some days it'll happen 5 or 6 times if I'm stressed out. I don't know if that would make a difference or not, but I guess I just feel like I'm already putting strain on my heart because of that and because of my weight so it makes me iffy. I also was a smoker when she originally gave me the prescription for it so I was extra nervous but I've since quit. My doctor said at my age, even being fat and smoking wouldn't raise my risk that much but I just have weird anxieties about taking medication. I'm not really as worried about the pregnancy because even if I was taking b/c I would still use other contraceptive methods in addition to it. I really just want my bad periods to end. Mine don't seem to be as bad as the OP is describing but I still only get my period 3-4 times a year for about 3 weeks at a time and the bleeding can be pretty heavy. I've tried talking to my doctor about my concerns but she doesn't deal with my anxiety issues well which is frustrating.. but I'm in the process of getting a new doctor so I think I'll just wait until that goes through and then bring it up with the new person.


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## Miss Vickie (Mar 11, 2011)

lozonloz said:


> OK, got an appointment booked.
> 
> I shall try and get my points across, thanks for the advice!



Great! Just remember, we all turn into blithering idiots, so having it written down will help you feel in control. I'm a nurse, almost a nurse practitioner but when it's about my health I'm a patient and I forget everything I know. I recently had a big health scare and I am a TERRIBLE patient! So anything you can do to empower yourself will make the experience both more useful and more pleasant.



BeautifulPoeticDisaster said:


> Thinking of you My experience here in England is that if you own your weight and talk about your health concerns like a educated person, they are pretty neutral about fat.



Yeah I think that "owning" your stuff is enormously helpful when you see a health care provider. I feel I can do a lot more for a patient who's honest with me, "Hey, look, I have a problem, I did drugs during my pregnancy" or "hey, look, I have the best intentions to not have unprotected sex but get a couple of drinks into me and I forget to use condoms" or "I try to eat well but if I'm left alone in the house I can't stay away from the fridge". Those are things I can work with. But if you're refusing to take any responsibility or ownership of what you do, then I can't help you because I can't come home with you and do it FOR you.

Own it, baybee!



thatgirl08 said:


> I appreciate your input on my question about birth control. My doctor is trying to push me into taking it (the estrogen & prog kind) but I really worry about the heart risks. I believe I have normal blood pressure.. I went to the doctors today and it was 112 over 77..



Yes, that's a normal blood pressure. It's actually quite good. Especially since for most of us our blood pressure is higher at the doctor's office because we're anxious. Mine's about ten points lower at home, at least! Anything lower than 120/80 is good.



> However, I know I have frequent surges in heart rate because I get anxiety attacks fairly frequently..



Ohhh, okay. So you're getting some palpitations when you're anxious. Do you feel like your heart beats fast and kind of irregularly? Like maybe it's bumping around in your chest? I get that too, and it can be from lots of different things. Anemia. Thyroid disorders. Anxiety. Caffeine. If you google "PVC" or "PAC" or "arrhythmia" you'll see that most of the time these are benign. 

As long as you're not breathless and don't have long "runs" of them, you're probably okay, but if you're concerned, they should probably do an EKG (they hook you up to a machine with all these stickers and it looks at the electrical conduction of your heart). If you're not having them at the time it'll probably be normal. Sometimes they put you on a 24 hour monitor that looks at how many times it happens in 24 hours and they can sometimes see where they are originating from and if they're truly benign. Sometimes certain medications can cause you to have arrhythmias, too. (There was an inhaler I was on call Seravent that gave me nearly constant arrhythmias but it's since been taken off the market). But if you see your doctor and mention it to them they should be able to rule that out. I could see why you'd be concerned about being on birth control with this going on, so maybe you should wait until you feel sufficiently reassured. If it's going to add to your anxiety, and nothing they can say will reassure you, it seems like it would be good to wait, even if the statistical data is reassuring.

Have you considered an implantable device like an IUD? They have hormones but the vast majority of it stays put in the uterus and doesn't go in the bloodstream and none of it goes through the liver, making it much safer. IUD's also help get rid of periods, if you use the Mirena, which has hormone in it. The Paraguard, which is a copper IUD, doesn't help reduce periods, and in fact can make them worse. 



> Mine don't seem to be as bad as the OP is describing but I still only get my period 3-4 times a year for about 3 weeks at a time and the bleeding can be pretty heavy. I've tried talking to my doctor about my concerns but she doesn't deal with my anxiety issues well which is frustrating.. but I'm in the process of getting a new doctor so I think I'll just wait until that goes through and then bring it up with the new person.



That is a lot of bleeding. Has anyone checked your levels to see if you're anemic? Anemia itself can cause palpitations and rapid heart rate, even if you're not anxious. I felt a lot more anxious when I was anemic, too. 

Best of luck with your new doctor (nurse practitioners are great, too, and are SUPER about dealing with anxieties!!!!) I hope they help. And as I told the other poster, please check back in with us and let us know how you are.


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## thatgirl08 (Mar 11, 2011)

Miss Vickie said:


> Ohhh, okay. So you're getting some palpitations when you're anxious. Do you feel like your heart beats fast and kind of irregularly? Like maybe it's bumping around in your chest? I get that too, and it can be from lots of different things. Anemia. Thyroid disorders. Anxiety. Caffeine. If you google "PVC" or "PAC" or "arrhythmia" you'll see that most of the time these are benign.
> 
> As long as you're not breathless and don't have long "runs" of them, you're probably okay, but if you're concerned, they should probably do an EKG (they hook you up to a machine with all these stickers and it looks at the electrical conduction of your heart). If you're not having them at the time it'll probably be normal. Sometimes they put you on a 24 hour monitor that looks at how many times it happens in 24 hours and they can sometimes see where they are originating from and if they're truly benign. Sometimes certain medications can cause you to have arrhythmias, too. (There was an inhaler I was on call Seravent that gave me nearly constant arrhythmias but it's since been taken off the market). But if you see your doctor and mention it to them they should be able to rule that out. I could see why you'd be concerned about being on birth control with this going on, so maybe you should wait until you feel sufficiently reassured. If it's going to add to your anxiety, and nothing they can say will reassure you, it seems like it would be good to wait, even if the statistical data is reassuring.
> 
> ...



Hm, I'm not sure if it's irregular.. not usually at least. It's definitely faster though, and harder. I just notice it more.. if that makes sense. I'm almost positive it has to do with my anxiety because it seems to get faster/harder as I get more anxious.. like, it might be a little raised if I'm just uneasy but if I'm full out having a panic attack it feels like it's going to beat out of my chest. They say panic attacks aren't dangerous for your heart, and I guess I can see that being true if they're occasional but I can't imagine that prolonged levels of high anxiety & frequent panic attacks could be good for me. I've taken my heart rate and it's usually in the upper 90's, lower 100's (which I know is too high for a resting heart rate as it is) but when I'm anxious it can easily jump up to 130, 140, even higher on occasion. I don't know .. it just makes me uneasy I guess (ironically making me more anxious.. vicious cycle.) I've had a few EKGs done because I've gone into ER a few times thinking I was having a heart attack (this was shortly after the panic disorder first set in) and it always was normal. It's difficult because panic attacks can make you feel like you're choking/can't breathe and also a little lightheaded from hyperventilating.. sometimes I even get back and chest pains, so it can be hard to differentiate between what is anxiety and what might be another problem. I've gotten pretty used to recognizing my usual anxiety symptoms though and can pretty much separate them from sensations that are new to my body. The obvious answer is to lower stress and anxiety which I'm certainly trying to do, and I'm making pretty good headway but it's a long process.

I'm not sure if I'm anemic or not. I certainly would think my iron levels would be low during my period just because of the sheer amount of blood loss. I remember when I donated blood they checked my iron and it was too low to donate, but then they waited 5 minutes, checked it again and it was at the very lowest you could have to donate blood. I'm not sure what that says exactly, but I thought then that I should probably start taking iron pills. I did start taking a multivitamin but then kind of freaked out over the whole medication thing again .. I know it's silly because taking a vitamin isn't really like taking meds, they don't have side effects or anything.. but I've just been really sensitized to pretty much anything medical related because of a few bad experiences. 

I didn't know that about the IUD but I'm definitely going to look into that. One of my friends had that put in and I know she loves it because she doesn't have to worry about taking the pill everyday. Thanks again so much for the information, I really appreciate it! I'll keep everyone updated!


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## Miss Vickie (Mar 11, 2011)

thatgirl08 said:


> Hm, I'm not sure if it's irregular.. not usually at least. It's definitely faster though, and harder. I just notice it more.. if that makes sense. I'm almost positive it has to do with my anxiety because it seems to get faster/harder as I get more anxious.. like, it might be a little raised if I'm just uneasy but if I'm full out having a panic attack it feels like it's going to beat out of my chest. They say panic attacks aren't dangerous for your heart, and I guess I can see that being true if they're occasional but I can't imagine that prolonged levels of high anxiety & frequent panic attacks could be good for me. I've taken my heart rate and it's usually in the upper 90's, lower 100's (which I know is too high for a resting heart rate as it is) but when I'm anxious it can easily jump up to 130, 140, even higher on occasion. I don't know .. it just makes me uneasy I guess (ironically making me more anxious.. vicious cycle.) I've had a few EKGs done because I've gone into ER a few times thinking I was having a heart attack (this was shortly after the panic disorder first set in) and it always was normal. It's difficult because panic attacks can make you feel like you're choking/can't breathe and also a little lightheaded from hyperventilating.. sometimes I even get back and chest pains, so it can be hard to differentiate between what is anxiety and what might be another problem. I've gotten pretty used to recognizing my usual anxiety symptoms though and can pretty much separate them from sensations that are new to my body. The obvious answer is to lower stress and anxiety which I'm certainly trying to do, and I'm making pretty good headway but it's a long process.



I think you're on the right track, being able to recognize the symptoms and differentiate them from new symptoms. I understand your concern about stressing your body and if you think about how our bodies were created, with the ability to handle being chased by bears, chasing down prey animals, they were meant to handle that kind of stress so I don't think you're stressing your heart. You may be stressing your adrenals but they, too, are used to this kind of 'exercise'. And if you're doing what you can to mitigate your stress, you're doing all you can. Are you working with someone, in a therapeutic environment? For some people, cognitive behavioral therapy works, for others EMDR is better, for others the more traditional psychotherapeutic model works best. 

I'm more of a cognitive girl myself, because I live so much in my head, I need cognitive, rational thoughts to battle the crazy irrational ideas that try to crop up. I wonder if biofeedback or acupuncture would help you. Are those things you might consider? I'm never so relaxed as when I've got my needles in, lights low, music on, lying on a heated table, totally relaxed. (sigh) Being able to remember being that relaxed helps me during my more anxious moments get back to a semblance of that feeling when things are going to hell around me. 



> I'm not sure if I'm anemic or not. I certainly would think my iron levels would be low during my period just because of the sheer amount of blood loss.



And it takes 120 days to make a red blood cell so you can see how it would carry forward from heavy period to heavy period. Your body needs sufficient iron and protein to make red blood cells, and most women who have normal periods are anemic.



> I'm not sure what that says exactly, but I thought then that I should probably start taking iron pills.



I don't know what the minimum is for blood donation, but a total CBC (complete blood count) would tell how many red blood cells you have, their size, their color, how oxygenated they are, etc. It's a good basic test, and probably where your doc should start.



> I did start taking a multivitamin but then kind of freaked out over the whole medication thing again .. I know it's silly because taking a vitamin isn't really like taking meds, they don't have side effects or anything.. but I've just been really sensitized to pretty much anything medical related because of a few bad experiences.



Well maybe an iron pill would be better than a multivitamin because it just has one thing in it -- iron. Multivitamins are great but they usually just have a bunch of little things, and depending on the brand, often not the highest quality of those little things. They're okay but I'm a bigger fan of taking individually the things I know I need (which obviously varies from person to person). In your case, you could wait until you get your lab work done and then take iron and maybe Vitamin D too, because most people are Vitamin D deficient. My D has fish oil in it which is good for your heart, which I know you're worried about, so you'd be doing something good for your heart, too!

I'm sorry you had bad experiences with meds. I think we often underestimate how bad they can be, and how serious the side effects are. It's good to take them seriously, but also to recognize that they also have their role and most of us can't get through life without taking them sometimes. That being said, we probably take more than we need. 



> I didn't know that about the IUD but I'm definitely going to look into that. One of my friends had that put in and I know she loves it because she doesn't have to worry about taking the pill everyday. Thanks again so much for the information, I really appreciate it! I'll keep everyone updated!



Yep, the Mirena IUD is pretty darn cool. A little tricky to place if you haven't had kids before -- you'll want Motrin for sure to make it more comfortable, and some people choose to take something called misoprostol which is a medicine that softens the cervix to make it easier -- but you won't have to take birth control pills for *FIVE YEARS*!!! What's not to like about that?

And yes, please let us know how things go for you.


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## thatgirl08 (Mar 11, 2011)

Miss Vickie said:


> I think you're on the right track, being able to recognize the symptoms and differentiate them from new symptoms. I understand your concern about stressing your body and if you think about how our bodies were created, with the ability to handle being chased by bears, chasing down prey animals, they were meant to handle that kind of stress so I don't think you're stressing your heart. You may be stressing your adrenals but they, too, are used to this kind of 'exercise'. And if you're doing what you can to mitigate your stress, you're doing all you can. Are you working with someone, in a therapeutic environment? For some people, cognitive behavioral therapy works, for others EMDR is better, for others the more traditional psychotherapeutic model works best.
> 
> I'm more of a cognitive girl myself, because I live so much in my head, I need cognitive, rational thoughts to battle the crazy irrational ideas that try to crop up. I wonder if biofeedback or acupuncture would help you. Are those things you might consider? I'm never so relaxed as when I've got my needles in, lights low, music on, lying on a heated table, totally relaxed. (sigh) Being able to remember being that relaxed helps me during my more anxious moments get back to a semblance of that feeling when things are going to hell around me.
> 
> ...



Thank you again for everything.. lots of things to think about.. I really, really appreciate it! :]


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## lozonloz (Mar 20, 2011)

Hi!

Thanks for the advice about writing it down, it wasnt actually too bad this time, the doc was another new one, who was very considerate and only mentioned my weight once before talking about the problem at hand, which was nice.

She didnt send me for any tests at all either, she thinks I have erm...I think its disfunctional uterine bleeding? Due to stress.

So I have a pack of hormone tabs to take to stop the bleeding and instructions to go to the doc or the hospital if i gets painful. But still, a relitively non worrying visit.

Thanks again!


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## moore2me (Mar 20, 2011)

Dear Lozonloz,

After reading your story theres a few things Id like to add to what youve accomplished. First, congrads on being brave and going to another strange gyno. This in itself is a courageous feat that some fat girls have lots of trouble with. 

I have been in the exact same situation you describe  University Gynos, different docs, bunches of tests, fat lectures, long menstrual periods that started to become painful. Some things that helped me deal with our University system -( I am just on the other side of the pond) . . . .

 Keep a written log of your visits for your own records. Put this on your computer. Write the date, the doctor(s) you consulted with, your symptoms, what happened  tests & diagnosis, any medications prescribed and followups?

 Do this every time you go back to the doctors and update your notes. Best to type for neatness.

 Bring an updated copy with you and hand it to the doctor(s) you are assigned that day. Also, bring a single page with your medications, allergies and a brief health history.

I know this sounds tedious, but it shows you are serious about your healthcare and are keeping track of who is taking care of you and what they are doing. This business like approach gets the attention of most professionals. 

*I don't know how the University healthcare system works in the UK, but here's how it works in the US. (Maybe there's a few things in common.)*

A US University hospital is a teaching hospital. There are baby docs that are supervised by a full time doctor. You will meet the boss after the baby docs make their diagnosis. Get all their names and cards if possible. It is not unusual for the trainees and their boss to disagree. The boss rules. There is also a department chair that rules everyone. The baby docs rotate, the bosses usually stay for years  they also may teach classes.
*
Make special friends with the nurses on the staff too*. Write down their names and talk to them. If you need to call the doctor  your easiest route is to call the receptionist and ask for the doctors nurse(s).
--------------------------------------------------------------------------------- 
As far as tests go, find out how often the one in question needs to be repeated. If you are having heavy periods and are becoming anemic, blood tests may need to be done frequently. The more you bleed, the more frequent. It helps to take slow iron pills (over the counter), eat spinach, eat liver and other iron rich food, low calorie Boost or Ensure. Note  No, No if taking Coumadin blood thinner.

I hope you do well and your bleeding problem straightens out with the hormone tabs. (My issue turned out to be benign tumors in my ovaries and uterus.)


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