Talking with your doctor

by Ellen T Johnson

It is vitally important for a woman with endometriosis to be able to communicate effectively with her doctor. Of course, this is a two-way street. The doctor should also be able to communicate effectively with his or her patient as well.

Fortunately, there are some things you can do to encourage a positive outcome!

Before the appointment

Take a few minutes before every doctor’s appointment to set an objective and make a list of appropriate questions.

For example, you might want to come away from the appointment with a treatment plan to try for the next month. You may want to schedule a surgery date or discuss alternative treatments. Or you may be having a new, bothersome symptom that you would like to discuss.

It’s helpful to put your objective in writing and go over it several times before your appointment.

Write down all your symptoms and questions, all the medications you’re currently taking (including supplements), and gather all recent medical records and lab results.

See also: Questions your doctor may want to ask you in order to help prepare.

Questions you may want to ask

Women with endometriosis may want to ask their physicians some very specific questions about diagnosis and treatment, including:

• What is your treatment plan for me?
• How will we know if this treatment is working?
• What are the benefits? What are the risks?
• How long is this treatment?
• Are there other alternatives?
• Will I need additional treatments or procedures in the future?
• What would happen if I did nothing?
• What is your approach for pain relief?

In the waiting room

As you wait for your appointment, go over your questions and your objective instead of reading a magazine. That way, you’ll be focused when the doctor is ready to see you.

During the appointment

After you greet the doctor, state the purpose of your visit clearly and concisely. For example:

“I am here today because I have been having pelvic pain for two weeks every month. I’ve taken over-the-counter analgesics, but that doesn’t help. I’d like to discover the reason for this continued pain and find some way to deal with it.”

It’s important not to minimize your symptoms or be vague in any way. Don’t ever say, “It’s probably nothing.” Women often under-report pain. As a result, we may not get the care we desperately need.

Be specific about your symptoms. It’s helpful to chart your pain symptoms on a daily basis, so you can see how often you’re in pain. Keep a Pain Diary which describes all your symptoms, when they occur, how long they last, and the intensity of the pain. Sketching a pain map of your body which shows the doctor the exact location of the pain is also helpful in diagnosing and treating endometriosis.

With specific information, you can accurately inform your doctor of your symptoms. For example, you might say:

“Two months ago, I began having pain with sex. I have a deep pulling pain and burning sensations with deep penetration, sometimes for up to two hours afterwards. It happens most often during the middle of my cycle.”

Don’t be embarrassed about your symptoms. Talk in straightforward language that makes your symptoms clear to your doctor.

Simply saying you have “cramps” usually doesn’t raise a red flag in the doctor’s mind. But telling the doctor you have sharp, knife-like pain in your lower pelvis for five days each month does. By providing specific descriptions, you can play an important role in obtaining a correct diagnosis and treatment plan.

If your doctor doesn’t listen

If your doctor minimises your symptoms, tells you it’s all in your head, to “just relax,” recommends pregnancy as a treatment, or gives you medication without a thorough physical exam, you would be well-advised to consider finding another doctor who listens and understands. Women with endometriosis often endure years of misdiagnosis because no one ever listened to them.

You may have to be persistent to find a doctor who will work with you.

Get a referral

If it’s clear your doctor cannot provide the degree of care you need (or the two of you simply do not get along), ask for a referral to someone else. You might say something like, “I’m not comfortable with the treatment plan you have outlined. I would like a referral to another gynaecologist.”

Summary

Developing a good doctor-patient relationship takes some time, but is worth it when you find someone you can trust. The best way to get good care is to:

• be persistent
• don’t downplay your symptoms
• search until you find the answers you need
• research, read, and talk with other women with endometriosis