Australian Doctors/Hormonal problem

I coudlnt decide how to name this entry because both components are factors which caused me a great deal of frustration. I will just get on with teh story

Since about July of 2007 or so, I had been losing an insane amount of weight (30lbs within half a year), involuntarily. I lost most of my energy and was constantly depressed. I had trouble getting out of my house todoing things and my quality of life declined.

Around xmas time, I was at my worst. My body shrank like a 90 year old and my stomach felt bloated and fat even though I was at a veryvery low bodyfat percentage. I also had constant runny noses.

My condition did not get better until I began weight training again. But I noticed that I coudlnt 'get big' at all, even though my strength was not bad. My symptoms stayed the same; lack of energy, easily depressed, great deal of tropuble conentrating in class, greatly reduced memory, decreased libido, increase in abdominal fat, increased pseudogynecomastia (nipples became droopy) and I looked pale constantly.

Around March, I decided that I had enough. I went to the doctor's clinic at the universsity (UQ).

Doctor #1. I told her of my symptoms and I suspected it to be due to low testsoterone levels caused by a decline in endocrine function. She examined teh size of my testicles and determined it was normal sized. She also commented that I have facial hair, which indicates my testsoterone is not low. I also told her I had bloating and when she asked me how big mmy meals were I said: 'abotu 600 calories, 400 from rice, 100 from shrimp and 100 frmo canola oil". She said: "dont talk to me about calories I dont know how that stuffworks". I sighed and dumbed msyelf down and told her: "a bowl of rice with some seafood." That was the langauge she understood. Nonetheless, I asked her for a blood test to check for hormones and she refused, insisting that it isnt due to hormones. My blood test consisted of checking for liver enzymes and blood counts.

Medical lab: the phlebotomist missed my vein and had to fish for it. It hurt me a lot.

Doctor #2. I saw teh doctor again after a rather nasty flare of depression that made me want to quit med school and return to canada. The results from my previous blood test came back and this doctor, reading my blood test results, determined that I was 'not anemic'. I told him I suspected I had low testsoterone, given the symptoms, and I brought up the issue about depression. He insisted that I may be feeling down because of depression, but I insisted my low testsoerone caused my depression because this depression came much later than the low testosterone symptoms.

This doctor did not heed my concerns and wrote me a prescription for Prozac, an antidepressant. Before he let me go, I forced him to check my hromoen levels and he did, reluctantly. He ordered LH, FSH, Total Testosterone, Estradiol and Progesterone. In addition, he asked me: 'so these symptoms started before you came here or?". It was clearly a leading question intended to trick me into saying it occurred before so I woudlnt be covered. I made the mistake of saying :'well I started noticing it in July or so 2007'. he then told me I will not be covered for this blood test. I was stupid, and he was unethical. From then on, I always lied and said the symptoms started after I came here.

Doctor #3. Results came back, indicating that I was borderline low on Total testosterone and 1 unit below normal for LH. This is very obviously a form of secondary hypogonadism, I told this doctor. This doctor insisted that my depressino was causing the secondary hypogondaism and that I shoudl take the anti depressant medication. I wanted another test but he refused, saying that I should wait at least 1 month and then repeat the test to see if my hormone levels rise. This time, I got him to test for Free testsoterone and Prolactin, as my personal research indicated hyperprolactemia may be a cause for low testsoetrone. Free testsoerone is the form of testosterone that is actually avaiable when teh body needs. He did not know a thing about what I was talking about when I explained it to him.

Doctor #4. So 1 month later, I take a blood test. My free testosterone levels were 39 (normal = 60-130) and my proklactin was 34 (normal < 15). He asked me if I had been taking any antidep[ressant medication because such medication raises prolactin levels. Thank god I did not listen to those other doctors and take Prozac or else this doctor would send me away again telling me its only the Prozac. Since I did not take the medication, he ordered a CT scan of my brain to see if there is a tumor in my pituitary. This doctor also told me my concerns weren't great. But the concern is great to me because 1) it decreases my mental capacity in school 2) decreases teh effectivenes sof my workouts. **back to medical school --> Never tell a pateint their concerns are invalid**. I went home thinking that he shoudl have referred me to an endocrinoligst at the same time because whether or not I had a tumor, i would still need treatment for my hormonal aimbalance.

CT scan clinic. The technician missed my vein completely and had to fish for it horizontally to get it right. It hurt me a lot.

Doctor #5.  The results show that I have a microadenoma in my anterior pituitary, which explains my elevated prolactin levels. This doctor said: "how did they get THAT?! what does this high prolactin mean  hmm...". I proceeded to teaach her about hyperprolactemia. She said "well I never seen it before". I said "it is quite common". I then asked her if she can give me a list of endocrinologists so I can pick the fastest available one. She said yes, and put the letter of referral inside an envelope. When I got home, I discovered she lied and only gave me 1 number. I call it and the soonest available date was July 10th. Angry, I hung up and googled for my own endocrinologist and managed to secure an appointment on May 19th, saving me 15 weeks. 

I am due to visit the endocrinologist on May 19th. Already expecting incompetance, I have already begun to seek my own treatment in case this endocrinologist simply gives me medication to lower the prolactin withotu giving me testosterone replacement therapy (TRT). To this end, I have begun researtching into anti aging clinics that give TRT as I will have blood tests to show I am low on test.

Summary: throughout this entire process of treatment, I have had to

1) Suffer 3 months longer than I should have, which has made my life a living hell in terms of physical and mental distress

2) I had to educate doctors about my illness (as they did not know how to deal with this type of situation)

3) I had to remind the doctors to heed my complaints (as they should have good communication skilsl and listent to me instead of going their own course of action and ignoring my reports)

4) I had to force doctors to give me blood tests which were crucial for detecting my adenoma. If those doctors had their way, I would be on anti depressant, suffering from its side effects, wioth that tumor in my head for teh rest of my life.

5) Had to put up with a misdiagnosis (telling me to take prozac that would obscure the reason behind my hyperprolactemia) resulting from not listening to my concerns. Can I say...'negligence'?

6) Had to refer msyelf to a specialist.

7) Made me lose trust in the medical system and steered me towards medical practices that are of a commercial nature (ie, antiagging clinics). Not that I trusted GPs much before, but this has made me conclude that GPs are useless.

***

The interesting thing is I will be a doctor in a few years. I already knew what kind of doctor I was going to be and this incident has reinforced my belief.

There are roughly 2 opposite extremes of doctors. 1 type is common in more socialized countries like canada and australia, where they like to 'sit back and wait' before giving treatment. Perhaps they do so to save health care  money, or perhaps they do so to avoid law suits.

The other type of doctor is more common in capitalistic countries such as USA and Hong Kong. These doctors will give you medication for any and everything. Although our 'australian and canadian' system may criticize them for being unethical for wanting money, their system does work, because only doctors who are good at diagnosis and quick treatment can survive in those places.

**

I was sitting in the clinic waiting for the 5th doctor and bumped into a fellow dorm mate. She told me the doctor did not give her any medication for her cough. I took at look at the doctor's notes and it said: 'get more rest'. I suspected it was a viral lung infection as thsoe are self limiting. However, I would not send the pateint away withotu medication. I would send her off writing a prescriptino for cough medicine (even though it is over the counter) and medicatino to relieve symptoms whether or not doing so will speed treatment. I do not see what the purpose of exposing patients to unnecessary suffering is, unless the symptom reliving medication has dire side effects, in which case I would tell the patient and let them make an informed decision about taking it.

I saw the doctor years before suspecting I had low testsoterone but each one laughed at me and told me to go home.

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