Straight from the Doctor: It’s Not in Your Head.
I was asked to write about the top things that women should bring up with their doctor. Besides the usual health maintenance things – your regular physical, blood work, female tests – what kind of signs and symptoms should you share with your physician?
I thought about it, and thought about it . . . started writing a top ten list, moving symptoms around . . . .
And then I saw a patient, a 42 year old woman who had concerns about her left arm feeling heavy and swollen. There are certain symptoms, when matched with a certain age, that make my hair stand on end. My spider sense was tingling.
Jane Doe, as I’ll refer to her here, realized she had been having this arm swelling for over a month and half, only after I pressed the issue and she really thought about it. She was usually a very healthy person, rarely came to see me at the office. A wife, mother of two, didn’t smoke, was a little over weight, but handled most of the minor colds and illnesses on her own. She probably wouldn’t have come in if her husband hadn’t been nagging her and her armpit hadn’t started hurting this week.
After various questions, with my spider sense going haywire, I examined her. Her arm was considerably swollen; I found a lump in her armpit . . . and above her collar bone . . . and in her left breast. Jane had never had a mammogram, she sort of neglected the female stuff after her last child over a decade ago. Now I had to tell her my worst fears about what I’ve discovered.
My mind flash-backed to another patient, a 51 year old female who didn’t like a scar on her elbow, that I agreed to remove, but I also convinced her to let me take off a mole on her other arm that I didn’t like . . . turned out to be a malignant melanoma.
So, I’ve thrown out my top ten list.
What’s my advice about what you should tell your doctor? Whatever it is about your health that makes you concerned or uncomfortable. Of course, you need to have confidence in your doctor, and trust me, I’ve been the victim of TMI on more occasions than I can mentally suppress.
But I’m also aware of the mothers, wives, sisters, daughters, etc that have been so grateful to feel better, to have had someone that listened to them, gave a name to their ailment, reassured and validated their feelings. I can recall the countless stories from colleagues about a pain, a lump, weight loss, weight gain, poor sleep, bleeding, that we turned into peace of mind for that individual . . . for that family.
So don’t let anyone tell you its in your head, you’re being a baby, suck it up, you’re worrying over nothing.
What can we do for you today? We are listening.
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I am a family doc practicing in the midwest. Married with 8 kids, no typo here, 8. I love singing, dancing, reading, cooking, playing all sorts of sports, doing outdoorsy things, being artistic and creative. Every day I try to learn or do something different to make myself a better person for others, and for myself. 
I’m guilty of neglecting myself. It’s so easy to do with the ever growing list of other things to do each day. I’ve started this year right with putting me higher on the list and taking better care of myself.
This is fantastic advice. I always put off going to the doctor because I don’t want to seem like I’m complaining or overreacting. In the end he usually gets upset with me for waiting too long to come in, not because I’m there with a problem/question.
What do you do about being refused healthcare?? I have experienced this so many times over my life that I have lost trust in the medical system. When I was younger, so many times doctors would pull my mother to the side and tell her that I was just faking stomach pains and headaches to get attention or get out of school or whatever other reason. I wasn’t and we still don’t know what causes my severe migraines, but I suspect it has something to do w/my “mysterious” (as my last neurologist stated) seizure disorder, another non-diagnosis. Flash-forward to today and you find a woman who is at least 12wks pregnant with her second child but has yet to be seen by a doctor, despite reports of health concerns; all because I don’t have insurance and can’t pay anything BEFORE I’m even seen. I commend you and other medical personnel who are so dedicated to their patients. I also know how few and far between you truly are. It is this life-long experience with uncaring “professionals” which I believe leads so many to keeping their health concerns to themselves until maybe it’s too late.
So sorry to hear about your bad run with my colleagues . . . but now you have another life relying on you so I would urge you to get the care you need for your unborn baby. . . . sometimes the way to find a compassionate doctor is by word of mouth. Being pregnant should allow you to get some medical coverage.
Believe me, I’ve tried. I FINALLY have gotten someone to listen to me and am now covered by state government medical for pregnant women, but there are no doctors in my town that will accept this form of insurance as it doesn’t pay enough for them (was told this directly from my elder sister’s OB/GYN just today). I have been able to find a clinic that will accept my insurance in another town but am unable to receive care from them for two more weeks as they are terribly full at the moment. I will, or course, call every day to see if there is an earlier availability or cancellation and have already utilized the local ER for issues that have come up in the last month or so. I am FULLY aware of the importance of medical care for myself and my unborn child, most especially with the plethora of medical issues in both my and my husband’s family histories. This awareness is just one reason for my intense frustration and anxiety over the whole medical system right now. I just don’t understand how so many doctors can turn away patients in need, especially expecting mothers, just because they can’t pay up-front. I completely understand that they are working professionals as well, relying on their careers to provide for their own families, but it seem contradictory to their oaths to take care of the needy and sick. It makes me not really wonder how, even though the US is one of the leading industrialized countries in the world, we still have one of the highest newborn death rates at about 12%.
Thank you, though, for your reply and listening to my complaints. I apologize for my negatively-vibed posting. Also, thank you for your diligence and caring toward your own patients.
We just had an argument over this with my husband last week. I’ve been feeling weird lately. Never hungry, and the thought of every imaginable food makes me want to puke. I drink gallons of water every day (literally), because I’m always thirsty. I have weird pains in my body etc. I don’t know what it is, I just know it’s somehow “off” and not how I would normally feel. I was really worried, and I did what any woman would do – I cried. My husband shot down every symptom with “it’s probably just this and that” and “I think that’s normal”. I got really sad and angry that he wouldn’t take any of this seriously and felt that I didn’t need a doctor (other than for head check).
So now I don’t talk about it, and I didn’t go to the doctor. And I don’t know what to do about it.
Unless your husband is an MD then his advice is not that of a professional. Let your doctor check you out, run some tests, rule out the most serious concerns. Hopefully they can help with some of your symptoms and then the two of you can muddle through the weird stuff if your tests are all normal, but you can’t get any peace of mind if you don’t seek advice.
My issues are (a) that I don’t want to be a bother (silly, I know), and (b) I have no idea which doctor to see for which affliction!
For instance, my back was hurting, so I went to the chiropractor and even got a massage. Pain continued and moved/radiated. Figured it was probably another ovarian cyst, but happened over New Year’s and by the time the OBGYN office opened on Tuesday, the pain had lessened dramatically. Now I have a slight twinge pain in my leg, near where I had lymph nodes removed. So now, do I call my oncologist or PCP? And what about the nausea that I’ve got going on? Is it all related or separate things? And how do I explain it?
I’m not really asking, but just giving you an idea of my thought processes. I think we, as women, tend to worry and over-think. Over the course of the past few days, I’ve, in my head, had a cyst, slipped discs, pinched nerves, ovarian cancer, reoccurrence of melanoma and more. But by the time my doctor sees me, it’ll all seem to be in my head.
This.
I do the same thing. I HATE going in because I feel like a pain, and by the time I finally talk myself into going in, it seems foolish because I’ve built it up so much in my head.
Why haven’t they invented computers that sit in our bodies, and then when something is wrong, it can light up, and then we can just plug in to find the issue, like on cars.
I can so relate to this. I am 46 and did not get my first mammogram until this past summer. And they called me back for an ultrasound. I tried really hard not to freak out, and everything was fine, but let’s just say I’ve learned my lesson!
On the other hand, my husband suffered and survived a brain aneurysm 3 years ago. If I get a weird pain in my head, I tell my husband “If I pass out in a minute, just so you know, I am having this killer pain in my head right here!” He had a brief moment of pain before he passed out. I know it is one way of dealing in humor manner something that scares me to death.
Thank you for giving us permission to talk to our doctors. I drive and hour each way to see my doctor because I have such a great relationship with him. Hmmm, wonder if he would scan my brain…
Bernice
Thanks for the post! I’m as guilty as others about this – there are things I know to go for (dentist, yearly check-ups, etc) but the rest? Please, I don’t even have a regular doctor! I wouldn’t know where to start. I’ve had so many problems through the years (and I’m not even 30 yet) that doctors diagnose but can’t treat (those IBS type of diagnoses – a name, but no cause/cure), that I feel like a hypochondriac if I complain and try to piece it all together. So, instead of feeling ridiculos, I put off getting things checked on altogether. My problem too is that a lot of doctors want to treat the symptoms, not diagnose the problem (in part, I think, due to patients wanting a cure so often). Personally, I would rather know what’s wrong rather than medicate.
I think part of the problem is that we, as women, are “programmed”, either by society or genetics (or both?); to take care of others first, at the expense of ourselves. I know I do this constantly, as I sit here with an Ace bandage on my wrist because there’s an obscure discomfort from my elbow to wrist. I would make sure my son got off to school, the husband off to work and even myself off to work (because the company will fall to pieces without me), in all stages of sickness.
Our aunt though, paid the ultimate price, for putting everyone and everything before herself. She raised two kids, including a special needs one, worked 40+ hour weeks as and LVN, took care of her parents and siblings as needed, went back to school for her RN – so she could work half the amount of time for the same amount of pay. She graduated with her RN, a few months later, she had that “ongoing pain” checked out, it’d been bugging her for almost a year; Breast Cancer. Suz fought the battle for over three years, before losing it; her message. loud and long, to the rest of us, was to make sure we got our mammograms done on a regular basis.
When I was about 14 or so, I started having pain in my joints and odd periods of fatigue. At first it was my mother telling me that “it was all in my head”, then her docs diagnosing me as having tendonitis or the like before telling us that my pain (that didn’t go away after taking aspirin and icing) was “all in my head”. Years later, as an adult – with worse, more widespread pain, my docs started telling me that my pain and discomfort “was all in my head”. This went on until I was 28, I was being treated for planter fasciitis that wouldn’t go away and my podiatrist said “You know, this just isn’t right, something else is going on. I would like you to see a Rheumatologist to rule out any other problems before we even think about surgical options”. Two weeks later I was finally diagnosed with Rheumatoid Arthritis. I don’t have to tell you all that I wept the day that I was diagnosed, finally there was a reason and it wasn’t that I was crazy or crying out for attention. I’d had symptoms for half my life and it never occurred to my parents or my previous HMO medical staff that “something else {was} going on”.
I realize it’s partially my fault; I wasn’t an advocate for myself. I accepted the “all in my head” theories without comment, rarely getting angry about the lack of answers or support. That has changed. I am now an advocate for my own – and my family’s healthcare. I refuse to accept medical staff that marginalizes my fears or feelings.
i agree with your post, however, it has back fired on me.
recently, i saw a doc due to frequent (but mild) sore throats. before even looking at my throat she dramatically brought up HIV testing…without any background on my lifestyle or health history. later, she noticed i had a killer case of post nasal drip and never thought to mention that this was probably the cause of my sore throats. sometimes, with the wrong doctor, concerns can be completely blown out of proportion… but for the most part, better safe than sorry. yes, i have a new doctor now.
Peach, Val Payne – I think that you two have helped emphasize the importance of having a doctor that you can trust and have confidence in their plan. Unfortunately personality is not a part of the medical board exam – I’ll refrain from making a surgeon joke here – but nonetheless your doctor has to be a good pairing with you in order for you the get the most from your health care.