Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: LadyT on July 02, 2015, 11:01:42 PM
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I have been on elleste conti duet 2mg for one month, I was finally seeing light at the end of a dark murky tunnel, after years of mis diagnosis.
I went for my pre arranged Doctors appointment today which was to see how i was doing on the HRT. I had been looking forward to this appointment as I hoped to discuss other menopause issues that may be helped too.
However the first thing I was asked was had I given up smoking, my reply was no, I have cut down lots and also taken up exercise and diet plans.
My talk was cut short as I was told I was no longer going to be prescribed HRT. :'(
I feel so hopeless now, I have found it so hard to give up smoking. It is such a comfort to me for anxiety and down days and i don't feel ready to give up yet, but cannot imagine living life as I have for the last eight years without HRT.
Is this common practice to be denied it as a smoker?
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I think it's a disgusting way to treat a patient :bang: :bang: :bang: medication isn't prescribed in the UK generally with 'conditions' attached :-\. Was this a GP appt., were you offered NHS support to quit smoking ……. at a time when you feel vulnerable I think this is appalling and quite frankly, un-ethical!
Are you able to change your Surgery? Have a chat with a Pharmacist in LLoyds/Boots - they have private rooms. Go along and ask how much smoking is likely to interfere with the up-take of HRT treatment and take it from there.
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Thank you for your support CLKD.
Yes it was a GP appointment, last month i thought she was a godsend after I had been listened to a prescribed the elleste conti, she did at the time say she didn't feel happy that I was a smoker and did recommend a support group, but I just don't feel ready for this yet. >:(
i felt so upset and then embarrassed for being so and was then offered CBT as i'm "not in a good place" no kidding :-\
I was thinking I may have to change surgery CKLD, but worry that my Doctors notes may make it hard to get prescribed HRT anywhere.
That is a good idea to chat to a pharmacist, I have a lovely local one, so will do that. Thank you x
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Hi LadyT
I was taking HRT & smoking for 5 years & did not have this issue.
So long as you do not have high BP, not too much overweight or have a history of breast cancer in the family & generally in good health you should not be denied HRT on the grounds of being a smoker, this is despicable (sp).
Go back & see another doctor.
This makes me so bl**dy angry.
I really hope you get your HRT back.
Good luck LadyT, & please let us know the outcome - you do not deserve to be treated like this.
Cazi x
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I think you need to go back to the GP and ask for HRT as it has helped thus far. Explain that you are already feeling in a 'better' place and that eventually you will consider a support group to stop smoking. That you were extremely disappointed in her comments and the shock caused you upset. Some GPs have no bedside manner :kick:
End of. We really shouldn't have to justify ourselves, treatment should be free at the point of delivery and the NHS is for all …… regardless!
I wonder what the waiting list for CBT is in your area, here it's 18 months :o ……….
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Hi Cazikins,
I am so pleased to know that you haven't had this problem and maybe I just got unlucky with a particular anti smoking doctor! That makes me feel more hopeful, Thank you very much.
I have normal range bp and not terribly overweight, gone up from a size 8 to a 12 though due to my thyroid problems and recent inactivity :( no family history of breast cancer either.
Thank you for your reply I will try and get it back and will definitely let you know how I get on. x
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Now that the shock to her response is dealt with you will be in a stronger emotional position to challenge her ideas! You could begin by asking what impact smoking/not has on HRT uptake ;)
"I was quite stunned by your refusal to prescribe HRT because I smoke and wonder why you are particularly concerned? Surely it is better that my intense menopause symptoms are sorted so that I am more emotionally secure in order to consider ways to quit ciggies. ……… "
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CLKD, apparently there isn't a long waiting list for CBT, according to my DR, but that can be relative.
I feel a little bit stronger for reading your comments, and now want to phone for an appt. tomorrow with another gp in the practice and get a second opinion!
You are so right! we shouldn't have to justify ourselves, I am annoyed with myself for getting upset instead of assertive :( i felt like I was a child being chastised! smh >:(
you have helped me no end tonight! thank you x
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Oh being shocked with an un-expected response is difficult to deal with ……… having the immediate bite back has never been my forte ::)
Is this particular GP younger …….. if so, her time will come :whist:
When I was 16 and wanted The Pill, the GP at the time asked "How would you feel if because of my Religious beliefs I was against prescribing The Pill?" - my retort was 'Your feelings shouldn't come into what you prescribe!' to which he replied, "You are so like your Father" - me: 'yep, and will remain so until someone proves that he isn't'.
I got my prescription ;D
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I think that was exactly what it was, the unexpected shock of her not allowing me something that I was so relieved and pleased to have had, I think I physically slumped in the chair!
This GP is the same age as me 49, perhaps you are right, maybe it hasn't touched her yet, great doctors are the ones that have experienced some s*** lol i may return to her in a few years time!
Haha great response when you were only 16! I need a bit of that kind of attitude! well done you :)
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Difficult to quit. Have you tried the E cigs. They have really helped me to cut down drastically. I have never been denied HRT either despite my surgery knowing I am an off and on again smoker. It shouldn't be an issue really as its your choice to accept the SLIGHTLY increased risk.
Give the electronic ones a go, they work.
Honeyb
x
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Hi Honeybun,
Thanks for your reply :)
I have tried the Ecigs and found a good liquid vaper which I used when working long hours with no real breaks.I felt it pacified me for a short time, but just didn't take the real craving away. Since giving up work 2 months ago I haven't used it but I do smoke less now anyway perhaps as a result.
Did your Doctor explain the increased risk to you and ask if you accepted it?
Yes I think you are right, surely if I know the risk it is up to me if I accept it, but I never got a choice :o x
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I was on hrt/smoking for 13 years before I gave up 3 years ago. During those years I'd been at 3 surgeries due to moving and not one told me I couldn't have it, and a smoker needs the right time for them to give up
Annie xx
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Hello Lady T and welcome to the forum. As I am neither a smoker nor a user of HRT I am not qualified to give an opinion on your situation, but I just wanted to say that I think you were treated appallingly by that GP who was totally unhelpful to you and I urge you to get a second opinion from another partner in the practice and even maybe make a complaint when you feel in a stronger position.
From what I have seen these ladies here can offer a wealth of support and advice :)
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Hi Lady T
you could do one of two things:
1) lie - and tell her you have stopped?! There is no way they'd be able to tell if you go along on a morning that you dont partake of a ciggy.
2) go back as ask to be put on patches for giving up ciggy's (high cost items) and then promptly ask for your HRT back.
Either way, giving up the ciggies or at least cutting down might be better for you ;)
Also, given the dangers of smoking the damage is done to your body within a few years of smoking. It would take around 5 years smokeless to reduce the change of heart/stroke/breast cancer in relation to smoking too. So adding HRT is a bit of a flea on the bottom of an elephant sort of situation with you.
In terms of the attitude by doc, then perhaps we should do the same for alcohol as its much worse in combination with HRT than ladies think.
I'll leave you with those thoughts and hope your back to normal asap.
In the mean time I'll join the group FUME!
:hotflash:
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Love it ! Group FUME :hot flash:
I did wonder if I had over-reacted ……….. but surely under the Hypocratic Oath :-\
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Hi LadyT
I too am appalled at your doctor's refusal to prescribe HRT due to your smoking.
Aside from the risk info this site gives the contra-indications for HRT (smoking is not mentioned - nor in fact is age or length of time on HRT!):
http://www.menopausematters.co.uk/risks.php
Contraindications for HRT.
Pregnancy
Undiagnosed abnormal vaginal bleeding
Active or recent blood clot or myocardial infarction (heart attack)
Suspected or active breast or endometrial (womb) cancer
Active liver disease with abnormal liver function tests
Porphyria cutanea tarda
Under the lifestyle section it says this:
Smoking
Women who smoke have an earlier menopause than non-smokers, have worse flushes and often don't respond as well to tablet form of HRT. It's never too late to stop smoking!
Use this time in your life to start living a better healthier life.
It is undoubtedly better for your long term health to start the process of cutting down with a view to eventually giving up smoking - to redcue your risk of cardiovascular disease and cancer. However as you say - you know and understand the risks and your doctor should not refuse this!!
Is there another doctor in the same practice you can go to? Hopefully the doc has not put this in your notes but even so, it might be easier to explain to a different doc?
Good luck!
Hurdity x
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Hopefully the GP has put this into the notes, it will show other GPs in the Practice what patients may be 'up against'!
Do let us know how you get on and do have a chat with a Pharmacist too ;)
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I smoke and Dr knows this never been an issue ! This is really the thin edge of the wedge in NHS ,whilst I know it isn't healthy to smoke what next ! Oh we won't treat because you drink ,your too heavy,you have blue eyes !! Have brown hair,too old....really :hotflash:
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That is disgusting, absolutely outrageous. This holier than thou doctor should be struck off, they are not fit for purpose. Go back and tell them you have stopped smoking and get your HRT, in other words lie, they don't deserve anything better.
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Any news?
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Hi all,
Thank you for all your replies.
It has been a while since I posted,sorry
I am now no longer prescribed hrt :( I did see other Doctors at the practice and was told they were not able to change what the original Dr had decided. my pharmacy had also called me to say she had been refused a new prescription for me also but wouldn't give an opinion on the matter.
I also suffer with a thyroid and have been increasingly unwell and yet have been refused blood tests for thyroid panel, had only the basic TSH which has now returned to borderline with levothyroxine, but I am not any better. I requested tests for antibodies, to ascertain whether it was caused by Hashimotos (which my symptoms would suggest I do), and was told those tests are nothing to do with thyroid! I have also noticed a swelling in my throat area, was told that on palpating (?) it was not felt, even though she could see it, so didn't think it was worth sending me to a specialist. Hashimotos left untreated can lead to mental health issues,heart failure and even coma! More risk than prescribing hrt it would seem?
I therefore do not think that any decision this surgery has made was anything to do with the risks of smoking with hrt or looking after my health.
I feel so so down, I just want to feel normal, but have given up :'(
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Can you change practice as it seems to me your health issues are not being taken seriously at all.
Do you feel as if it's down to budget....whatever the reason it's absolutely shocking you are being treated this way.
Is their a patients forum at your surgery where you could read if others experiences.
I'm so shocked I don't even know what to suggest.
Honeybun
X
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Hi Honeybun,
Thanks for your understanding reply.X
Yes I do think it is down to budget and have also thought they think I am a hypochondriac! :/ but Unfortunately hormones do cause so many symptoms and I do have a lot of them.
I know I should register at a different practice but have been afraid of what will be put in my notes as the other GP's seemed to only go by what the first Dr had written.
My GP was right about one thing, I am not in a good place! :/
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You have the right to be referred to an endocrinologist for your thyroid. A GP can only request a TSH test and only if it is out of the reference range will a Free T4 and Free T3 test be done. A consultant can request a full Thyroid function test and they don't have the right to refuse you (unless I am very much mistaken). Do you have a history of Hashimoto's (which I have)
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LadyT, I'm so sorry that you have been treated so badly. My advice would be to buy HRT online, it would appear to be your only option. Your surgery sounds completely clueless anyway so they are obviously incapable of giving you any decent advice so you might as well do your own thing.
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Do you have anyone in the area who can recommend a nice GP? I moved from the practice with the naff GP only to find he had moved too, to mine >:( I have only been once since, but on advice here I visited the practice nurse and I told her about the obnoxious GP, even though he is still at the surgery, she did not seem in the least surprised and informed he is leaving next month, hurray. She has been appauled at my length of symptoms and the fact he did nothing and has left me like this for 3 years.
Point is, a decent GP just see's his/her patient, not the cr*p written on your file by an idiot. I do think it is worth a try moving elsewhere in order to receive the help you so deserve. Remember you do not deserve to be treated this way.
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You need to change Surgeries. This is un-acceptable - not treating symptoms because someone smokes is not giving support nor dealing with un-related conditions!
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Hi Babyjane , Thanks for your reply
I have been treated for an underactive thyroid for around 4 years now, yet have never felt well, the only tests that have been offered are the basic tsh, I have family history of thyroid cancer and hashimotos and do feel worried as I do have the symptoms, or at the very least a non converting T4. It would be just reassuring to know one way or another.
Thank you MaryG, you are right they are pretty clueless, but I know I won't get anywhere arguing with them, I guess some doctors don't like you to know too much. Where can I buy hrt online Mary? I may have to look into that.
SadLynda, oh no, what are the odds of him moving too!? that's great you had an understanding practice nurse, I hope you now are getting the treatment you needed years ago! You are probably right I should find a more sympathetic surgery, thank you.
Thank you CLKD, I really do need to change, the only reason I had tried and tried with this one was I felt a different doctor, same practice could have a different view (they didn't) also I may have got the same elsewhere.
The next nearest surgery is miles away, but I have just read you don't need to be the catchment anymore, or tell them reasons for wanting to change, so i'm a little hopeful again.
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I would ring the Secretary who works for the Endocrinologist at your local Hospital and ask advice. Find out how long the waiting list is for first consultations, explain that you have had problems with the GP referring you (they may have had other complaints ;)) and check with her if you can insist on a referral. If so, ring your current Surgery and ask them to send a referral letter!
The details of the various Consultants is usually listed on each Hospital web-site, if it isn't obvious then ring the Hospital switch board and ask for assistance.
You could also ask advise from a Pharmacist. Most have private rooms so you could ask whether people have problems with your current medication dosage and what is usually suggested.
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In my opinion you need a referral so you can get a full thyroid function test done to get a fullmpicture. I urge you tonpush for this. Good luck.
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LadyT, I have never bought HRT online but I know you can. I have Googled it and there are plenty of places that do next day delivery. I always stock up in either Gibraltar (UK products) or Spain in the pharmacy where you can buy HRT over the counter.
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Ah what a good idea CKLD!, Thank you so much for this advice, I will see if I can speak to the secretary tomorrow, I hope they will talk with me. x
Babyjane, I wonder why they have refused so far, I would have thought anyone with an elevated TSH result would have had a full function test, how did you manage to get your tests? and thank you x
Thank you MaryG I will google it, although would be a good excuse to take a holiday! :) x
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I was referred to a consultant endocrinologist some years ago when my levels would not stabilise and I was always ill. Because I am now on T3/T4 combination therapy and my levels can still be erratic I am on 6 monthly reviews at the endocrine clinic.
It is also important to try and stay on the same brand of thyroxine if your GP will do this, as if you are very sensitive the minute differences in manufacturing can upset your levels.
I was changed from a branded thyroxine to a generic last September and my levels went haywire. They have only started to stabilise in the last couple of months and my consultant and GP have both put instructions on my records that I remain on the same brand that I was changed to at every repeat.
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Did you get on OK today?
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Hi LadyT
So sorry to hear about your problems and especially with thyroid. Hashimoto's thyroiditis is the most common form of underactive thyroid and I understand is likely to be the cause for most women who begin to suffer this in middle age. I have a good friend with this problem and also the T4 conversion problem but the GPs would not entertain the idea of this and in the end she had to go privately and now takes NDT (natural dessicated thyroid - from pigs) in order to give her the T3 and enable her to function normally.
Like babyjane I would definitely insist on a referral to an endocrinologist if you can - sadly I think thyroid issues are one of those conditions that is not only not fully understood, but there is a blinkered approach by doctors and too rigid adherence to whatever tick system they have for referral.
I also have another friend (male) who had the same problem with the thyroxine brands - one was OK and the other totally wrong. You will know more babyjane. One was Eltroxine I think or similar - can't remember if that was the good one or the bad one!
By the way I wouldn't buy HRT online. If you need it you are entitled to be prescribed it you have symptoms that indicate it can help. The contra-indications are listed on this site: http://www.menopausematters.co.uk/contraindications.php
Pregnancy
Undiagnosed abnormal vaginal bleeding
Active or recent blood clot or myocardial infarction (heart attack)
Suspected or active breast or endometrial (womb) cancer
Active liver disease with abnormal liver function tests
Porphyria cutanea tarda
Another possibility is e-mailing Dr Currie (costs £25) and taking the print-out of her recommendations to your doctor.
Hurdity x
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:thankyou:
I have begun a thread about how we might encourage GPs to be more au fait with menopause …… a copy of this comment Hurdity might go well there ;)
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CLKD I rang the secretary at the hospital and she told me I would have to get a referral as I wasn't a patient she couldn't answer questions regarding the length of the waiting list, i asked if there was a private clinic too and no there isn't.
I then went on to look for a new surgery and have found one not too far away, their reviews were only average but I couldn't find one that had good reviews to be honest, but I have to give it a try, it should be better than the terrible treatment I have received. x
Thank you very much Hurdity, it was the NDT (Armour) that I particularly would have liked to try, testimonials for it have been so good, unfortunately National Health Doctors do not seem to prescribe it and like to stick with the T4 only, but if it isn't converting to T3 it is like having a warehouse full of stock (T4) but no vans to take it where it's needed (T3).
The TSH results will seem normal but it is just masking the bigger problem. I am sure the doctors know this but T4 only med is what they will dish out whether it makes one well or not. I have been on Levothyroxine. I am glad your friend got a good result going privately, shame that she was left with no choice, The NHS should be there to help us get well :/
As I now will be going to a new surgery I will try again to get my HRT and I will lie if I have to! so maybe I won't need to get it online. x
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What rubbish :bang: :bang: :bang: …….. maybe try the records/appts office next?
>sigh<
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You won't get an appointement without a referral unfortunately no matter how many people you call and ask.
I guess I agree otherwise the whole system would melt down. Once you have been referred you can ring and say you will take a cancellation.
Hopefully your new surgery will be much better and you will get to see a consultant.
Honeybun
X
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Yes Hurdity, Eltroxin was the brand that was discontinued. I took it for many years and remained stable. When I was migrated onto a generic my levels went haywire. At the instruction of my endo I now receive the same brand, albeit generic, at each repeat and the levels have settled but I am not as well as I was on Eltroxin. There are a lot of patients who found the same thing happened to them.
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LadyT you can get T4/T3 combination therapy on the NHS, I have it, but you need an understanding and supportive endo and GP. I realise how fortunate I am to have both.
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You are probably right Honeybun, if everyone called there would be a meltdown, oh well worth a try. :-\ Thank you,Yes hopefully my new surgery will be better and refer me to an endo and give me my HRT back x
That is good news BabyJane, I had heard a lot of NHS patients were in the same boat as me, I imagined it was to do with the Surgeries budgets or lack of. You are very fortunate, that's great, there is hope for me yet :) x