Went to HRT specialist, am disappointed

I went to a doctor who specializes in hormone balance today and I left very disappointed. I was there because I was interested in getting my estrogen in compounded form, because so many women on this board have recommended this. However, before she gives me anything she wants me to have all kinds of lab work done. Pelvic ultra sound, complete X-ray type bone scan, mammogram, cholesterol screening, pap smear and she was even talking about a thyroid test. Well, this is all going to cost me about two thousand dollars. Then she said after I get all this stuff done, she MAY prescribe me compounded estrogen and progesterone, as I want. So, I am very upset. I do NOT believe in mammograms and do not want one for myself. This is just my personal choice. I told her so and she said she would not prescribe HRT without one. So now I'm out three hundred dollars and I don't know what to do. I'm wondering if every doctor I go to will have the same attitude. I'm only 46 and I don't see why I need all of these tests when I know I am perfectly fine. I have read on John Lee's web site that it is perfectly adequate to judge the condition of your bones by taking careful measurements of your height. Well, I have been doing this all along and since I've been taking progesterone my height increased by a sixteeth of an inch. Who needs doctors?? I am so sick of our medical system. My doctor took out both my ovaries though only one needed to be, and now it's like these doctors get to own me. I really resent this!

Lisa P

I am so sorry you're upset about your doctor's visit. I don't agree with everything in our medical system either.

I feel like this doctor is going to be okay. I like that she is checking your bones, cholesterol, thyroid, and pelvis. She seems to know what the impact of a hysterectomy is to cardiovascular and bone health.

Please hang on to this doctor especially since she'll write for the bio-identical (natural) hormones. I feel like she has the right attitude.

I had the same reaction as Lauren--wow, a doctor who takes all the ramifications of the hormone jungle seriously. What a find! I think you've found a woman interested in being a serious health partner. BUT I do know that I couldn't handle a $2000 bill right now. Or a lot more doctoring, so I do sympathize. I think doctors get used to people having health insurance and being able to afford things.

However, that "I feel great, I don't need this" argument was the one I was using a year and a half ago when my doctor was insisting that I needed a hysterectomy. It was true. I felt good. But his instincts were right. The mystery lump accidentally turned up during an intravaginal ultrasound was cancer. I was blessed. Because I had a thorough doctor willing to schedule tests, I didn't face chemo or radiation.

But a lot of people around here have found GPs they can convince to write a particular prescription or work with a compounding pharmacist. I know you have strong opinions about all this, Lisa, so that might work too, but I'd sure reconsider about passing up an opportunity a lot of us would love to have.

I agree with everyone else. If you found a doctor willing to do all these tests to make sure you are 100% I would hang on tight. It took me 4 months of looking to find one.

Also, I know you have strong feelings about mammograms - but you might want to think about why. My life was saved because of a mammogram - I was only 36 at the time - and I have a friend that had the same happen. I was lucky enough to catch it really early and didn't have to go through any furher treatment besides surgery, but my friend went through chemo, radiation, etc. Bottom line - both of us are alive because of a mammogram.

Just something to consider...

Ditto, ditto. I think you should hang on to a doctor willing to check you out so thoroughly. Likewise, though, I would not be able to handle the $2,000 bill. Did you explain to your doc. that you don't have insurance? Maybe if you did, she might pare down the tests to what she believes is the bare minimum. Good luck to you.

You are all making perfect sense, and I really do appreciate your points of view, but I guess I am just so jaded by the medical system at this point, I'm a lost cause. I really don't trust medical technicians to read ultra sounds right nor mammograms. I have been diagnosed with melanoma mistakenly and spent a year thinking I had a deadly form of cancer. On the other hand, my sister's cancer was missed as well as her opportunity to have it surgically cured at an early stage. My brother's doctor (who is one of the most prestigeious doctor's in the country) prescribed a lethal dose of drug combinations to him and he nearly died. In my case I had a perfectly good ovary removed because my surgeon thought it had a dermoid cyst on it and it had only a small functional cyst and was perfectly healthy. This was an inexcusible error. I also had a false positive on a pap smear once, which scared the hell out of me. So, this is where I'm coming from. I am so much more afraid of having tests than not having them. Also, so many needless hysterectomies are still being performed on women.
Why?

I was willing to compromise and get a bone scan and a pap smear and a pelvic ultra sound but not a mammogram. The doctor would not compromise with me. So I will get nothing. I'm not being irrational, I'm just trying to do what I truly feel is best for myself, based on my life experience. I cannot relinguish my control and my decision making over my own health to a stranger. No one should.

Lisa

hi lisa it does sound like she may have gone a little overboard with the tests!!! i would explain to her your insurance situation and see if she can narrow the tests down a little!!! however, at age 46, i would say you should be having a mamogram every yr now, and the minimum every two yrs.!!! that means you should have had at least 3 so far along with the base one!!!! that to me would be one of the most important tests before starting HRT. sometimes i wonder if doctors get a percentage of all those tests they order??? just a thought?? good luck
diane

Lisa-
I tend to agree with you. If all you want is natural compounded hormones then you should have that option. You are already on the non-compounded hormones arent you? If her reasoning is that compounded hormones are somehow less safe than non-compounded then I believe that she is mistaken.
Health care is OUR choice since it is OUR body and it is a fee for service business just like any other. We are the consumer and should not be forced to "purchase" more than we want. I could understand her view if you were requesting a prescription that might be harmful or that you were not already on. I was able to get natural compounded hormones from my gyno-AFTER a huge tug of war. But I did not have to go thru all of those tests.
I'd keep looking. Ask your local compounding pharmacy which doctors are most friendly toward using their services and try them.
Good luck
TAH/BSO 3/7/00

But I think we all need to understand that it is NOT the doctors that run our medical system... it is the insurance companies and attorneys.

Doctors have to charge a fortune for tests because the insurance companies (PPOs and HMOs) only pay a small percentage of what they do charge.

Also, this doctor is probably wanting to run a lot of tests not only for your safety but for her own. It seems that everyone is on the "I'll sue you" band wagon and doctors have to cover their behind. I'm sure this doctor is probably only looking out for your best interests (mammograms, pap smears, bone density tests) are only there to help us prevent disease.

Lisa,
If you are objecting to the mammogram because of the radiation, perhaps you could have a breast ultrasound. They are safer and actually more accurate. I think that the reasoning behind screening for breast cancer is that should you have a small tumor taking any estrogen compounded or otherwise could stimulate it to grow. I think this doctor is being responsible...I am looking for a doctor like this!