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Second-Rate Care From a Primary Care Doc

“Getting Herself Back” After Suffering Needlessly For Two Years



 

One of the major responsibilities of your primary care physician is to refer you to appropriate medical specialists when necessary. So, if your blood sugar level is out of sight, a wise PCP with precious little education on diabetes will send you to an expert. Or to a urologist, if you spot blood in your urine, have abdominal pain, and feel fatigued.

 

Let’s say, however, you’re a mid-age woman with multiple bothersome symptoms that aren’t so well defined, yet your PCP - basically ignorant about the specific health and well-being of women like you - attempts treatment?

 

That’s precisely what’s happening throughout the country, often with unfortunate results. Until medical students and practicing physicians are properly educated about women’s bodies in midlife, you’d be wise to become informed yourself, ensuring that your symptoms will be satisfactorily diagnosed and treated.

 

 

Consider the experience of VJ, a 49-year-old patient of Dr. Tara K. Iyer,

associate physician, Menopause and Midlife Clinic, Division of Women’s Health, Brigham and Women’s Hospital, Boston, MA.


 

 

“OMG! Is This My New Normal?”

 

When VJ first saw Dr. Iyer in the clinic, she had been suffering with multiple symptoms for several years and wasn’t feeling so hot in general.

 

VJ had an IUD inserted at age 45 and no longer got her period. Describing herself as an “upbeat, energetic and take-charge person,” she started feeling low and unmotivated around the summer of 2020, when she was age 47.  

 

Initially attributing her mood to the COVID epidemic and subsequent changes in the world, VJ’s symptoms persisted and became more frequent. She also began to experience some new issues, including sleep disturbances, that began to impact her energy levels. She often felt fatigued, developed brain fog, and found it more difficult to recall words, which sparked her anxiety about dementia. What’s more, she developed sporadic heart palpitations.

 

VJ’s primary care doctor thought her symptoms were likely linked to stress about the country’s health crisis and prescribed an antidepressant. The medication’s side effects, however, forced her to stop taking it after only two weeks. Reluctant to try another medication, she began exercising more frequently and seeing a therapist.

 

Despite feeling mildly better and coping more easily, VJ thought her quality of life was significantly diminished, which she attributed to aging.

 

Her problems continued for the next two years, during which time she underwent a thorough cardiac workup to rule out heart disease, which could be causing her palpitations. 

 

When VJ started experiencing night sweats, she thought hormonal changes could be the culprits and turned to Dr. Iyer’s clinic.

 

After discussing her history and symptoms with the doctor, VJ was shocked to learn that her issues were likely due to the menopausal transition, often misdiagnosed by physicians inexperienced in the subject.

 

Dr. Iyer prescribed a trial of hormone therapy, which dramatically improved VJ’s sleep, mood, palpitations, vasomotor symptoms and cognitive function.

 

Looking back, VJ said she felt like she’d been living in a stranger's body for the last few years, stripped of her identity, which she had come to accept as her “new normal.” She likened her newfound well-being to “coming out of a fog,” and noted that the important people in her life also saw the difference.

 

So relieved to “have herself back” and to “stop feeling like it's only downhill from here,” VJ burst into tears in Dr. Iyer’s office. Her symptoms continue to be successfully treated.

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