For most of my life, like most people my age in the US, all my doctors were men. And for the most part they have been good doctors, taken good care of me. Only a couple of doctors have made serious mistakes, and that wasn’t because of their gender. But I had heard anecdotally from many women over the years that as they grew older, male doctors frequently stopped LISTENING to them.
Twenty-five years ago, if you’d asked me if I would have a problem like that, I would have said no. Unfortunately the truth was, I did. It happened gradually, nonetheless it was real. And it had very damaging outcomes. Now I have four special female physicians that rode to assist me when I needed it. I think of them not as my Four Horsewomen of the Apocalypse, but of the Rebirth.
My First Female Doctor is Dr. JVL, who happened to be the one adding to her practice at GW when I needed a new allergist. And what a gift she has been!
She’s been the most critical to my care – not just for asthma and eosinophilia, but overall. She has a particular talent for putting pieces together, even outside her specialty, and a genius for building a great medical team for me. I have had plenty of sleepless nights to wonder what would have happened to me if she hadn’t seen and worried about the eosinophil results for so long. And then campaigned so hard to get an accurate diagnosis of a disorder that still doesn’t have a diagnosis code.
The Second one comes with a story. At first, I didn’t really think anything of the fact that it seemed each new male specialist I saw would discount my problems. One notable example were the reactions to the horrible diarrhea I had for years. Referred by my old internist to a colleague at first, I was given a tremendous battery of tests. The ultimate diagnosis? Insufficient fiber in my diet.
I added yet more fiber to an already high-fiber diet, resulting in cramping and even worse diarrhea. My internist said to cut out the fiber supplements and just take more anti-diarrheal medication. That was barely tolerable, if I didn’t leave home – but after a year or so, it had become even worse, so I asked friends for references, and got a referral to the chief of gastroenterology at one of the big hospitals in town.
Once again, there was a battery of tests. This time the result was: more fiber in my diet. Oh, and hormone replacement therapy. You see, I had started menopause early because of all the prednisone, and this gentleman was convinced that my “problem” was really more a problem of being a “temperamental” woman and what I really needed was more estrogen. When I asked how estrogen would help the explosive diarrhea I suffered with, he said it was “common” for women “of a certain age” (his age, mind you) to have gastrointestinal problems as they went through menopause and HRT would help. He also didn’t address my question about how additional fiber was going to help. He handed me the prescription and left the room.
I filled the prescription, took the pills for six months – and it did help. My night sweats. Nothing else.
Over time I gradually learned how to cope, somewhat. There were still plenty of times when it would strike at the most inopportune moments, and the only thing I could do was return home, or take clean clothes with me just in case. But one of the areas that concerned my allergist, as she worried about the eosinophils in 2012, was that they frequently caused eosinophilic gastroenteritis. Dr VL approached one of the women in GE, Dr AnS, who also performed a battery of tests – this time figuring out a lot, quickly.
-
-
- There was no evidence of eosinophilic gastroenteritis, or eosinophilic esophagitis. (Whoosh, that was a relief! There’s a family history of stomach and esophageal cancers.)
- There was evidence of intestinal bacterial overgrowth. I’d been prescribed so many courses of antibiotics over the years for my chronic sinus and upper respiratory infections, they eventually killed off almost all the “good” bacteria/flora in my intestines. (Dr. AnS put me on two two-week courses of rifaximin, which did the trick. I now rarely have a problem, and then it only lasts two or three days.)
- In addition to the diarrhea, I had developed a chronic problem absorbing certain nutrients (notably electrolytes like magnesium, calcium, iron …). That problem has persisted – we’re afraid it is permanent. There is a chance that many of my problems relate to the destruction of my intestinal biome, caused in large part by those antibiotics.
- I had been prescribed proton-pump inhibitors (PPIs) for more than 20 years to address the bad acid reflux I had, which can trigger asthma. Not one of the various other GE specialists, or the internists, had done a solid, in-depth, medical history until Dr. AnS. She took me back in time, asking when they started prescribing it, which different drugs had I been given. And that was another important piece: turns out you aren’t supposed to take PPIs for years on end, and certainly not for 20 years+! (Now I take ranitidine daily, and up to two TUMS per day. I also am careful about eating dinner early, and try not to eat spicy food in the evening.)
-
The Third Female Doctor is a rheumatologist, Dr. MH. She diagnosed me with fibromyalgia, but also said definitively that I had a non-specific autoimmune disease, and that we might never be able to give it a proper name. She monitored a lot of the moving pieces of my care until she left MFA in 2018, checking all the different blood tests for various centromeres and antibodies, making certain that nothing was being overlooked as we coped with my everyday problems, juggling 60 medical conditions. Dr. H was also willing to take on another physician when she thought I wasn’t getting what I needed when I needed it – that is a rare quality indeed.
The Fourth Female Doctor came in later, Dr. SL, the nephrologist who kept me from killing myself by diagnosing the critically low level of magnesium in my body that had not been properly understood by my other doctors for some time. I had reached my limit in suffering excruciating pain and not one of my physicians had been able to find a single causal link, much less respite from the pain. Making one final trip to the GW Hospital ER in a last attempt to get help, I planned to return home and kill myself – all my preparations were ready.
But that day, Dr. L happened to walk out of the hospital through the ER, and overheard the attending physicians discussing my symptoms – including the uncontrollable muscle spasms and jerking that had just ripped the IV out of my arm. She looked at my CBC results, pulled up my historical results – and found many months of “critically low” magnesium levels recorded. She couldn’t snap her fingers and fix me, but she gave me hope. And she demonstrated clearly she was right, by adding some magnesium to the saline IV they had reestablished, and in only a couple of minutes, the jerking stopped. She patiently taught me how to calibrate my intake of magnesium in cooked form (the most accessible), and how to not take too much in supplements (it causes your body to spill out what you’ve painstakingly been building up) or raw vegetables. She also taught me how to monitor my level with monthly blood tests, so that I wasn’t dependent on an overburdened physician to read the results and tell me what to do.
Each one of these women has looked at me as more than a few symptoms in their area of expertise. They see me as a whole, and they take the time to dig into my past to tease out causes, interrelationships. I have some excellent male physicians, too, and I am grateful to all of them. But as a woman “of a certain age,” I also find it a little amusing and occasionally frustrating that it took other women to not just reach for an easy answer, but to find the correct answer for me.