Dr. DebateTeam

So.  Dr. DebateTeam.

I wasn't crazy about her.  She kept saying that I didn't necessarily have PCOS and that it was a diagnosis of exclusion and that one bad ultrasound didn't really mean anything, and maybe it was done on the wrong day, and oh my God, I just wanted to scream.

"I want to see someone about my recent diagnosis of PCOS because we're pursuing IVF, and I'd really like to try to avoid complications of PCOS if I get pregnant."

"Like, what kind of complications?"

"Gestational Diabetes, pre-term labor...you know, complications."

"Well, we really can't do anything to prevent theoretical complications.  I mean, you're not even pregnant yet, and we don't know that you have PCOS."

What I didn't say: "Preventative medicine is quackery, eh?  Then why the fuck have I been choking down prenatal vitamins since the beginning of the year on the advice of one of your doctors?  Why bother with vaccines or pre-natal care or even eating a healthy diet?  Why do you even exist, Dr. DebateTeam?"

What I did say: "I had thirtyfour follicles on a Day Three ultrasound."

"Well...you can have that from annovulatory cycles."

I guess her theory was that the Easter Bunny was responsible for my annovulatory cycles.  Later on she said "Well, the annovulatory cycles were just because you recently went off the pill."  So...I have Polycystic Ovaries (and whether or not she believes that I have Polycystic Ovarian Syndrome, the Polycystic Ovaries part is really not up for debate) because I was on the patch?  So...every woman who takes birth control pills ends up with thirtyfour follicles?  I find that really hard to believe, how about you?

According to Dr. Debate Team, women with PCOS are overweight and I'm "obviously not overweight."  Boy, that was worth the $20 co-pay right there.

"I'd like to see a Reproductive Endocrinologist," I said, since Dr. DebateTeam had just told me that the only treatments for PCOS were diet, exercise, and metformin, and I already know that's not true, thanks.

"Evil Insurance Company, Inc. doesn't have any."

"Any at all?  So how do I see one?"

"Well, you said you're seeing Dr. BrightEyes..."

"Right.  For IVF.  And I'd like to see someone under Evil Insurance Company, Inc. and have it covered.  We just spent two grand getting diagnosed with something that Evil Insurance Company, Inc. told me I didn't even have in June.  I'd like to see someone for the PCOS regardless of fertility issues."

"Well, we have Endocrinologists."

"I want to see a Reproductive Endocrinologist."

"But you might not even have PCOS."

"Okay, look, so far I've gotten one 'yes,' one 'no,' and one 'maybe.'  Who do I have to see to get a definitive diagnosis?"

"Well, it's kind of subjective...it's really an opinion..."

Oh, for fuck's sake.  So clearly I can't get treated without a diagnosis, I can't get a diagnosis without seeing a qualified doctor, and I can't see a qualified doctor unless I have a diagnosis?

Also, ladies with PCOS, take note!  Apparently the problem is that PCOS doesn't actually exist!  Those classic string-of-pearls cystic ovaries of mine are just a matter of opinion.  Now that I think about it, the Endo's probably all in my head, too.  "Nurse, this woman is very ill."  "What's wrong with her, doctor?"  "She has...an opinion."  "Heavens to Betsy, doctor, not that!  Anything but that!"

"...but there are, um, lab tests that we can run," Dr. DebateTeam admitted.

"Great.  Then let's do those." 

As she was entering orders for a fasting glucose test into the computer (completely skipping over the FSH/LH ratio, because why start being thorough and competent this late in the game?) (and believe me, I'm already wondering how much credibility to give their labs, what with their history of 'lots of follicles' caliber fuckups work), I opened my big fat "not overweight" mouth and prompted Dr. DebateTeam's next Cavalcade of Assvice.

...to be continued...

Comments

[Katie]

That's almost as bad as the one RE who told me that I must have PCOS because I am overweight. Nevermind that I had NONE of the other issues. Quacks!

[Tiffanni]

I think maybe you should rename her Dr. Doesn'tknowherheadfromherass. Damn!

[Emily]

Oh for fuck's sake. Even though you told me about this, I still had to comment because it just grates me. PCOS is just a subjective 'opinion'? Forget about a day three u/s or the FSH/LH ratio which um, according to just about every source I've ever consulted, CONFIRMS PCOS. Your glucose may or may not be out of whack by the way with your PCOS. Since your weight is within normal range, you may not have that issue (because yes Virginia, you CAN have PCOS and not be overweight). Where did she go to medical school? Even Google University teaches more. I want to smack her. Why can't she just admit that they royally screwed up? Stop arguing with you when you have a CONFIRMED diagnosis from one of the best RE's in the STATE. Grrr.

[Jen/Chew]

oh, my GOD! How fucking annoying!!!

[Cat]

Your OB and my old OB went to the same medical school it seems. Why is it that we seem to know more than these fuckwads? They went to med school for christs sake. Can you leave this OB or does evil insurance company have you by the er... *cough* balls?

[elle]

That is INSANE!!!!!!

[Rooshie]

Ugh, been down that road myself. Having a new opinion from every doctor just sucks- and they all seem offended when you're reluctant to swallow their diagnosis with no questions. Like there is something about their aura that should make it undeniable that they have the answer, while the last 32 specialists have each had their own unique opinion. Whatever.

For what it is worth, I have also been called PCOS, not possibly PCOS (since I'm not overweight), someone with polycyctic ovaries, but likely due to a pituitary tumor and therefore not PCOS, ah, wait, there is no pituitary tumor, so maybe it is PCOS, but 'it doesn't matter, it wouldn't change our treatment plan', and finally a 'well, who knows?' I don't think that doctors realize that when you are this far into the game, there is no compelling reason to accept their diagnosis over the diagnosis of other doctors. I feel like taking my magic 8 ball in with me to consult after they offer their diagnosis. Or flip a coin.

Looking forward to part 2.

[Lyss]

What a joke. I hate HMO doctors (except for my former PCP love love love her). When I was in grad school and thought I had PCOS, my doctor ran all the diagnostics for IR - fasting blood sugar and something else.

Can you get a diabetes/insulin resistance screening through your PCP without messing around with these jerkoffs anymore?

P.S. having a crappy HMO doctor sucks balls when you're pregnant too. We went out of pocket quite a bit until I got my ppo.

[cass]

Do you have the same insurance I have? Because this is all sounding eerily familiar.

So, um, did she tell you to just relax?

[erinberry]

Well THAT sounds like an enjoyable, confidence-boosting appointment!

[B]

WTF. Just WTF. Fucking incompetent moron.

[Susan]

She actually said that 34 follicles could be due to an anovulatory cycle?
How do you ever keep your cool? I'd be strangling her with her stethoscope after an appointment like that!

[akeeyu]

Yeah, see? It didn't sound plausible coming out of her mouth, and it still doesn't.

If my polycystic ovaries were caused by annovulatory cycles caused by birth control hormones, why aren't birth control pills listed as a primary cause of polycystic ovaries anywhere on the Internet?

How can polycystic ovaries be both a cause AND an effect of annovulatory cycles?

Also, if birth control pills cause freaky-high numbers of antral follicles, why don't they just put women with diminished ovarian reserve on birth control pills until they have whole cartons full of eggs? According to Dr. DebateTeam's logic, that would work.

That woman just didn't make any damned sense.

[Blue]

That is exactly the diagnosis I was given the THREE times I asked about PCOS. "Well, it is a diagnosis of exclusion, hard to pin down, blah, blah, blah." I still suspect I have it, but I can't get anyone to actually diagnose it for me.

Anyone know someone out there with an opinion I could submit to my insurance?

[erin]

I sure wish I had duct taped my head before I read your post. At lease then, after my head exploded, I'd still have all the pieces.

[erin]

see! my head really did exploded. I spelled "least" wrong. Whatever.

[Alexa]

Am...grinding...teeth...
Anovulatory cylces are from polycystic ovaries which are from anovulatory cycles which are from polycystic ovaries which are from anovulatory cycles...
I'm going to lie down, now.

[T]

"I wasn't crazy about her" - either the understatement of the century or you have more patience than a - uh - really patient person. Annoying!

[laura]

Holy Crap! I can't believe the incredible run around you're getting. HMOs are such a total pain, but it seems like Dr. Debate Team needs to go back to school!!

[KH]

The overweight things is BS. The weight thing stems from insulin resistance (common part of PCOS). You should be able to get your regular doctor to do a 2 hour glucose tolerance/insulin test. My 1 hour was fine but it def. got whacky on the 2 hour, so it's worth doing the longer test. And you can be insulin resistant and THIN or normal weight. Whine to your doctor that you are always hungry, thirsty a lot, and dizzy if you don't eat often, tell them you want to be checked for insulin resistance with a 2 hour fasting test. They will take your blood, give you the icky glucose drink, then take blood at 1 and 2 hours. HTH! And Dr DebateTeam is an idiot.

[Lola]

"Why start being thorough this late in the game..." Oh how I sympathise... It really is something when you know more than the freaking doctors.

So sorry you had to deal with that. What a crock!!!!

[Jenn]

There are TONS of people who have PCOS that aren't overweight. I'm just not one of them :)

I do see a regular endocrinologist for my PCOS in addition to the RE though.

[Debe]

I feel like slapping that woman now, how did you manage to refrain?

[Jen P]

Still a lurker but wanted to let you know how I was diagnosed with PCOS -- which has never been 'offically' confirmed, by anyone basically.

I read about PCOS in a 17 magazine about a decade ago. It was hot off the press stuff and a girl in my social sphere was diagnosed with it. She was largely overweight, lots of facial hair, no periods like ever, etc, etc.

When I started having trouble getting pregnant, I saw my good ol RE who immediately said, endo no ifs ands or buts. Day 3 only showed a slightly elevated LH but my ratio was out of whack (Signal 1), my testosterone was 'mildly elevated' (Signal 2), my 'fasting' glucose showed nothing abnormal and my first ultrasound actually showed quite a few 'cysts' but no string of pearls. So he said, hey no way, just endo and you know the speel.

When I had my laparoscopy he found not only the growths, etc but he could actually see the ovaries and that's when he announced that there were more tests to run. I guess I did 3 fasting glucose tests and finally a 1hour GTT (which I did again for Gestational Diabetes). The 1 hour GTT was what finally showed something abnormal. The fasting ones were just useless and truly a waste of time for us all.

Finally he said PCOS with growths and dysfunctional ovary because my right ovary just doesn't ovulate at all. Nadda, Zip, Zilch but my left one has the possibility, IF stimulated adequately enough. (Which Clomid didn't do.)

I asked 4 or 5 other doctors if they'd agree with the PCOS diagnosis and they all just stammer and shift their weight -- they don't know. Hell, do I even believe it any more? Not really.

I am overweight by a smidge, but I blame that on stress eating, depression (another pcos quality if you believe it) and the general 'why me fuck the world' shit. And sister-in-laws. What caused a few other doctors to agree with PCOS as a diagnosis was: my hair quota (apparently, those of us with Mediterranean descent automatically get called 'hairy'), acne, skin tags, my cystic ovary, depression and infertility.

I look at it now and go WTF?? because it doesn't make sense to me. It was something thrown at me and I guess I took it because it was just something. I understand PCOS is a metabolic disorder, and as a disorder, a whole bunch of symptoms can be lumped together and given a name -- sort of a pin the tail on the randomly changing donkey.

I was never offered Met because I made some dietary changes (more meat, which is hard for me) and even in pregnancy didn't fail the 1 hour GTT again. So I dunno. It's hard to say.

I have had miscarriages, pcos 'thing', and I was red flagged and high risk during my 2T.

I was advised by the blogger Lia (don't know where she went) to get a real blood insulin test done, as her doctor father said that was one of the easiest ways to know if you would/could ever have a blood sugar problem and whether or not Met would even help.

I had mine done and it revealed I was perfectly normal. Who knows?

It's such a horrible time to go through a PCOS diagnosis. I kept thinking everyone was losing their minds, myself included, because no one could agree, people kept arguing over symptoms, no one wanted to 'treat' it, etc, etc. All I wanted was a baby and everyone was delaying that.

I don't know what to say, and can hope the madness I experienced gives relief that it is a maddening trial that no one help to relieve. They're going to fight one another, contradict, etc.

Go for more blood tests. Go for repeat blood tests. Ask for MORE scans at different times because cysts can be functional or not, they can resolve or not, and often they will be different within days.

I know how hard it is with shit insurance and it made me want to rip the hairs from obviously 'over hairy' body one by one.

Just sending love and hoping someone gives a damn and helps you to a real, honest diagnosis and not just panders you off.