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Denied an increase in HRT because I'm a smoker! Denied an increase in HRT because I'm a smoker!

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  #1  
Unread 12-06-2010, 10:35 AM
Denied an increase in HRT because I'm a smoker!

Ok, so for a while now me and my dr haven't saw eye to eye on the whole HRT deal. He is in a very small office where its only him and I'm realising staying on with him is only hindering my options for HRT. He is all about oral hrt only. I tried Estrace first and had bad headaches with it. No patches because I'm allergic to the adhesive. Tried Vagifem and it didn't work out after a few months. I asked for the shot and he tells me its not available at his office. Creams? Not available either. Then we sgree on trying Premarin .3 and after 4 weeks on that he would add in T or P (oral only of course) because I had to be stable on E before adding another. OK, I was alright with that.
So I just returned from my 4 week appt and guess what? No T. No P. No increase in my Premarin like I asked. Now he is saying because I smoke (1/2 pack/day or about 10 cigarettes per day) he is refusing to give me anymore hormones! What really ticks me off is that I have been with him for almost 9 years and have always smoked and he has always known it. Actually I used to be a pack/day+ smoker and have finally got down to where I am at now. He gave me birth control pills with no problem, never held those back even though I smoked. Now he just flat out refused to up my premarin dose from .3 or give me P or T. Yes I know smoking is bad, I've heard it all before, but he acts like I'm just supposed to drop it like its oh so easy, and its not. I asked about taking a low dose asprin once a day to help thin my blood a little to help against blood clots and he basically told me that is cheating and I just have to quit or no more hormones. And he acted like he never said what he said the last appt about the P or T. He knew I smoked when he said that. And I'm not saying he is a bad dr for wanting me to stop smoking. Its just odd how he will tell me one thing then the next time its something different.
I don't know if he is getting too old or he is just so busy he forgets? IDK but I can't go through it anymore with him and I am on the hunt for a new GYN because I feel like he is set in his old ways and I need someone who is up to date on all the options out there. I'm a 33 year old single mom of 4 young kids, with anxiety, history of depression and anger issues, and no ovaries which has made everything worse. NO sex drive, insomnia, vaginal atrophy, low energy, increased anxiety, memory loss, INTENSE hot flashes and night sweats, back to back yeast infections. UGH. So being on the Premarin I have felt better than I have since experiencing surgical menopause, but I still have some nightly hot flashes, low energy, and a barely there libido, which is why I wanted an increase in my dosage and maybe P or T added.
I need to get this whole menopause thing under control before I can quit smoking all together. I tried since the last appt and its a no go. I was snapping at everyone and about to go crazy, and I don't need any other issues on top of the ones I already have. I know I can quit if my anxiety level was down to managable, but the way I am now I don't see it happening ATM. Yes, I do want to stop because its yucky and bad for you, but it takes time and has to be the right time. And its not like I smoke a whole lot, but when I'm frustrated or worrying I can't help it. Its a struggle to stay at only a half pack a day, sheesh!
Oh and don't let me mention anything about this site or the internet to my dr at all! He does not hide the fact that he does not like it. IDK, maybe he is sick of dealing with me and wants me to go somewhere else, lol. And if thats the case we'll both be happier now I guess.

Sooo, has anyone else been denied HRT because they smoke?
Anyone experienced blood clots from being on hrt and smoking?
What about any other side effects resulting from being a smoker?

Sorry this is so very long. I guess its half rant, half question, lol. Thanks in advance for any replies.
Have a great day!
Jessica
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  #2  
Unread 12-07-2010, 06:08 AM
Re: Denied an increase in HRT because I'm a smoker!

I don't smoke and never did but my Mom has been a lifelong smoker since the age of 17, she's 79 now. I can tell you what she's been through.
She could not have hrt because she smokes. Everything you read on hrt says if you smoke you cannot take it. It increases your risk of heart attack or stroke or blood clot add smoking to that which increases the risk even more. With four kids I don't think you want to increase that risk.
But the health problems my mom has experienced as a smoker is getting longer. She had to have leg surgery about six years ago because she had a blockage(Blood clot basiclly) and she could barely walk til it was fixed. She spent two weeks in the hospital for that. She developed macular degeneration and is now considered legally blind. It is a fact that smokers face a three times higher rate of acquiring that eye problem. She also just spent two weeks in the hospital in June for pneumonia. She had been off cigarettes for four weeks and as soon as the dr said the pneumonia was gone she started smoking again.
My mom believes that since she has no heart disease(she does have a small blockage in her heart though just diagnoised) and her lungs are clear(do you really think her lungs are clear after smoking for so many years? I don't) that smoking isn't harming her. Yeah right, tell me something I don't know.
The biggest thing I can tell you is that my father was also a smoker and he died from lung cancer when I was 17, my brother 15 and my sister 14.
I know quitting smoking is hard. It's addictive and I see how my mom is addicted to it. She has no will power or the desire to quit. She says she can't quit when really she just won't quit even as I see it taking it's tole on her body.
I have to think your dr. has your best interests at heart when he is saying no more hrt. You probably won't find any other dr. who will give it to you if you continue to smoke even just 10 cigarettes a day. So you have to decide what you want more. The hrt or the cigarettes.
I hope I'm not sounding too harsh as I don't mean to come across that way. I am just saying what has happened to my parents because they smoked. My brother, sister and I never smoked probably because of what we went through with our dad dying when we were so young.
Also remember the damage second hand smoke can be to your children as they breath it in too, if you smoke inside.
I hope you can quit smoking and there is all kinds of help out there if you choose to do that.
Good luck.
  #3  
Unread 12-07-2010, 06:38 AM
Re: Denied an increase in HRT because I'm a smoker!

This Post isnt to encourage people who smoke to stop Its more to help the ones who would love to stop
Ive smoked for most of my life a month ago i decided its time to stop
my husband decided to stop too
we got some tablets called champix from the doctor for the first 2 weeks you smoke while taking the tablets then you stop smoking
i didnt expect it to work but it has ive not even thought about having a cigarette since
even though ive had a stressful few weeks i had my TAH last week
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  #4  
Unread 12-07-2010, 08:40 AM
Re: Denied an increase in HRT because I'm a smoker!

Hi Jessica -

Until you finally do quit smoking, how about Estrogel or Evamist spray? They are both FDA approved pharmaceutical products. And, as you know, only the oral hrts are associated with clots. I think it's cruel to do what your Dr is doing, even though smoking is bad for you, etc. I don't see why, if you are willing to quit, that he can't work with you to ease the misery.

This wouldn't happen if you needed thyroid hormones or insulin! Estrogen is NOT OPTIONAL for women, no matter what these igmos think.

Maddie
  #5  
Unread 12-07-2010, 10:26 AM
Re: Denied an increase in HRT because I'm a smoker!

Hi jessberr, I was a smoker for many years myself. I actually quit once for 6 years and most recently have been off for over 8 years. I was also a single mom of 3 young kids with a history of anxiety and depression. I feel for you! I was on oral Estrace at 2mg for 17 years. A lot of that time I was also smoking. There will be a Dr out there who will help you. OF COURSE the risks are higher with the smoking. I'm sure you know that. I knew that too. We all have to assume responsibility for the risks we take. I think Dr.s have been put into the unfortunate position to protect themselves from those people who can't wait to sue them.

I do think Maddie is right that the risks may be less for transdermal methods of delivery. Maybe you could do some research and take it to your Dr, or at least a Dr who would be willing to listen to you and help you.

I don't think smoking is seen for what it really is...a coping mechanism not unlike love of jelly donuts, compulsive shopping, and alcoholism. Those things also hurt us as well as our family members in ways not always physically seen.

I hope you can find a way to get the estrogen that your body desperately needs. It absolutely magnifies the depression that was there before your surgery. I actually think the depression and anxiety are more immediately detrimental to you and your children than the second hand smoke!

BIG HUGS!!!!!
  #6  
Unread 12-07-2010, 07:35 PM
Re: Denied an increase in HRT because I'm a smoker!

Thank you for all your replies.

I have seen the ad on TV for that champix and I think when I get a new pcp I will see if its available. Thanks for the info! And congrats on quitting Mysterylady!

Anon, I totally agree. I swear my body felt like everything was shutting down when I started the premarin! Surgical menopause has took its toll on my body and mind and I don't know what will happen if I feel that bad again! Thought I was dying from a brain tumor at one point from the tension headaches, migraines, and neck spasms, but now everything but an occasional migraine are gone so I know it had to be from have 0 estrogen. Crazy how it all works....
  #7  
Unread 12-11-2010, 02:31 PM
Re: Denied an increase in HRT because I'm a smoker!

Just a little update.......

While I'm waiting to get in to a new pcp to try the Champix I decided to do the best I can on my own and smoke as little as possible. So yesterday I only had 5 cigarettes, and only had one today so far. I feel mean and evil, but I am going to try my hardest to stop. Actually I don't even have any left and I'm fighting the urge at this moment to go buy another pack! I feel like I am in some sick competition with myself, lol.
But I've decided that I'm going to look for another GYN anyway. My bestfriend just reminded me about when she was pg with my goddaughter how he forgot to do her glucose check, and she even tried to tell him she didn't do it yet and he said "no, no, you already did that test.", but she really didn't. By the time he figured it out himself she was almost due and it was too late or whatever. Well, she swears she had gestational diabetes, and her baby was too big and she ended up having a c-section. Then my goddaughter was diagnosed with cancer in her adrenial gland and liver, called neuroblastoma which is a very aggressive type of child cancer, at 4 mo old. They said that it had started in utero, and I think she feels like our dr should have caught it in an u/s. Who knows if he could or couldn't of have, but she feels like he either has too many patients and is too busy or is getting senile. Which either of those would fit in to why he would tell me one thing one day, then something totally different the next appt.
So I think I want a female dr this time. I have always had a male gyn.
In the meantime I have a 4 month supply of my Premarin .3 so I guess I'll just focus on quitting smoking and be happy that I have all of the more severe issues fixed with the .3 premarin.
  #8  
Unread 12-11-2010, 05:13 PM
Re: Denied an increase in HRT because I'm a smoker!

  Quote:
Originally Posted by jessberr31 View Post
Just a little update.......

While I'm waiting to get in to a new pcp to try the Champix I decided to do the best I can on my own and smoke as little as possible. So yesterday I only had 5 cigarettes, and only had one today so far. I feel mean and evil, but I am going to try my hardest to stop. Actually I don't even have any left and I'm fighting the urge at this moment to go buy another pack! I feel like I am in some sick competition with myself, lol.
But I've decided that I'm going to look for another GYN anyway. My bestfriend just reminded me about when she was pg with my goddaughter how he forgot to do her glucose check, and she even tried to tell him she didn't do it yet and he said "no, no, you already did that test.", but she really didn't. By the time he figured it out himself she was almost due and it was too late or whatever. Well, she swears she had gestational diabetes, and her baby was too big and she ended up having a c-section. Then my goddaughter was diagnosed with cancer in her adrenial gland and liver, called neuroblastoma which is a very aggressive type of child cancer, at 4 mo old. They said that it had started in utero, and I think she feels like our dr should have caught it in an u/s. Who knows if he could or couldn't of have, but she feels like he either has too many patients and is too busy or is getting senile. Which either of those would fit in to why he would tell me one thing one day, then something totally different the next appt.
So I think I want a female dr this time. I have always had a male gyn.
In the meantime I have a 4 month supply of my Premarin .3 so I guess I'll just focus on quitting smoking and be happy that I have all of the more severe issues fixed with the .3 premarin.
I really wish you good luck in trying to quit. I know it is going to be hard. I hope my previous reply didn't sound too harsh or scare you but you asked about long term smoking effects and I just wanted to tell you my experience with my parents.
Good luck.
  #9  
Unread 12-11-2010, 05:55 PM
Re: Denied an increase in HRT because I'm a smoker!

Marcat, thanks, and no, I already know about that very nasty side to smoking so nothing was offensive or anything.
My grandmother died from the effects of smoking, and I know several others. I know that even when I do stop the damage may already done if I'm one of those who are unfortunate to die because of smoking. My grandmother stopped when she was 40 and she ended up developing emphezema (sp?) and dying from it in her 70's anyways. I know lung cancer is very aggrssive and has low survival rates. My daughter's great-grandmother just died of lung cancer at 67 on Nov 30, 2010. A great women if I ever met one too. Sooooooo, I need to quit and hope I haven't ruined my lungs. I have quit before when I was pg and I know I felt better and saved $. Looking forward to that, lol. I am just really grouchy, the cravings are hard. I've only had 3 and its 8pm so I'm aiming for 5 like yesterday......
  #10  
Unread 12-12-2010, 02:10 PM
Re: Denied an increase in HRT because I'm a smoker!

I wish you lots of luck on the tough road of quiting smoking. I am not a smoker now but was years ago. I just wanted to chime in & say, if you are not happy with your Dr definately find a new one. Since you are asking for help with your hormones also, consider an endocrinologist. Do some research yourself also if you can. Are all the patch adhesives the same? Have you tried any of the over-the-counter menopause suppliments? I don't know if you can take both but if you can maybe that would help balance things. I hope you are able to balance everything & get back to your normal self or even better.
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