Reproductive Endocrinologist: The First Visit (LONG)

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Myrtle9e6 wrote:

>Hi all,

I'm going to see my RE for the first time on Monday morning >and I was

>wondering what types of questions I should ask him >regarding my

>fibroids.

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Hi-

Just a few thoughts for you:

First of all, I think ANYtime ANY OF US go to see ANY new doctor, we should

heed the wise words of

English writer/poet Donne who wrote:

" I observe the physician-- with the same diligence as the disease. "

So, observe, observe, observe this new-candidate-to-be- your-doctor. He/She

will not automatically get the job--he/she will have to be worthy of the honor!

Yup, at that very first meeting, we all should really be " checking out " the

doctor, at the same time he/she checks us out!

Remember: this may (or MAY NOT) be the doctor who eventually performs your

surgery, may help you make critical decisions about your health care. This

person may be the doctor you call in an emergency. Therefore, he should inspire

a

great deal of confidence, not only in his surgical expertise and knowledge, but

his demeanor, his listening/communication skills and yes, even his " niceness. "

By " niceness " I don't mean he has to be oozing charm from every pore; his

jokes just leaving you in stitches.

NO, I just mean that he has to seem caring and kind to you--and not be the

embodiment of a " smirk in a white coat. "

Trust me, I've met my share of " Smirks in white coats. " You realllllly don't

want one of them.

As for advice-

If I were you, I would try to TAKE CONTROL of the course of the appointment

at the OUTSET. (After all, it's YOUR appointment--you're paying the doctor for

it!).

Therefore, don't have him/her squander your precious appointment time

reiterating general information and statistics about uterine fibroids--all the

general background information THAT YOU ALREADY KNOW from having done the

requisite

reading, from having read this list, etc.

With first-time specialists, in order to maximize the value of the

appointment, I like to cut to the chase and start out with my own prepared

" personal

summary statement. " If you hone in on your specific complaint/situation,

he’s less apt to provide irrelevant information or reach a premature

conclusion.

You might start out with.....

" Doctor, I'm here today to ask your advice about my uterine fibroids. Since I’

ve already read a great deal about fibroids, it’s very specific information

about MY particular case that I’m seeking from you. "

" I was diagnosed with uterine fibroids X years ago, when I was seeing Dr.

XHFGDFHD. Aside from the fibroids, I am in excellent health........(If you

aren’

t, briefly mention other conditions, without getting sidetracked.)

" Currently, my main fibroid SYMPTOMS are.........whereas I have NOT been

bothered with......bleeding or x, y, z.. "

[it’s IMPERATIVE that you mention the symptoms you have and those that you DON

’T have, since in large part, this will dictate his responses for treatment

and testing.]

(If bleeding is a complaint, be sure to hand him copies of your latest blood

work.)

Then, it's time to hand him the documentation.

" My most recent ultrasound done on X---ary, xx, 20004 showed that .......

(then hand him a copy of the report)that my ..... and my...... "

" Could you comment on my necrotic fibroid? What should I be aware of with

respect to that? "

" I'm very interested in preserving my uterus and my fertility. "

" Have you treated many patients my same age with similar presentation of

fibroids? How have they fared? "

" Could you outline treatment options (including watchful waiting) that would

be appropriate for ME? Pros and cons? "

" Are there any further studies I should be having at this time? If so, WHY do

I think I should I have this study? Is it important to have that study

NOW---or later, when I am actively trying to conceive? "

(REMEMBER: it's NOT necessarily true that the more competent a doctor is the

more MORE tests he orders.--some docs just have a CYA fear of litigation

mentality. )

Be wary of-- and question-- any blanket statements that don't sound right or

ones that strike you as unnecessarily dramatic.

Such as: " You could bleed to death if you don't act NOW. "

" Wellllllll, Doctor, anything is possible--but just HOW LIKELY IS THAT to

happen in MY particular circumstances? "

If he confirms that watchful waiting is a possible option, ask him--- WHEN

(how will you know?) should you intervene?

You might raise the question of Uterine Artery Embolization (UAE) whether you

have any interest in pursuing this option or not--just to determine how much

interest and familiarity he has of ALL treatments for fibroids; not just the

ones he practices.

Also: find out:

1-How long has this doctor been practicing in his specialty?

2-How many myomectomies has he performed in his entire career, and how many

does he routinely do each year?

3-How many lap myos has he done?

4-How many myos have had to be converted to hysterectomy AND WHY DID HE HAVE

TO RESORT TO HYSTERECTOMY in those cases?

Before he orders any tests, ask him the REASON WHY--i.e. what additional

diagnostive/prognostic value will they provide to him?

Also make sure:

-the doctor devotes sufficient time to conducting his interview of you, after

you've made YOUR summary statement.

-Make sure you tell him all medicines/supplements(and dosages) you are

currently taking--and ask him about possible interactions.

Finally,(if you feel positive about the doctor) ask him when you should have

a follow-up visit and when should you have your next imaging study/

ultrasound.

Ask him if you were to have further questions BEFORE THE NEXT SCHEDULED

APPOINTMENT how HE--(that is, the doctor sitting before you)-- NOT his nurse,

his

receptionist or the janitor!!!!!!- can be contacted for answers.

I'm sure I've probably overlooked some other important questions, but I'm

confidant the other LOLs here can fill in any gaps for you.

Good luck ! Hope it's a good appointment for you, and do let us know how it

goes.

-Roma