Find the right Gynecologist

Find the right Gynecologist

I am going to transcribe the recent course of my daughter, who began to be followed for the mutation Brca1 18 months ago. The protocol given at the time of the announcement by the onco-geneticist, is as follows:

  • From 20 to 30 years: appointment gynecologist every 6 months
  • From 30 years old, mammo echo MRI annually

These are the recommendations on breast cancer screening among "women with risks".

She has had 3 appointments since her announcement at age 20. The 3 times were pitiful. She knew more than them.

I could have called this post "A hen with a knife"...

First time
I had referred to a small hospital, the one where we live. I knew that the gynecologists worked there part of the week, and the other in a larger hospital. It seemed safer that they were not just in a small structure.

She took at random, confidently, the one that was offered to her by phone. The quarantine, sympathetic, he held a speech she found later: it was not necessary she worried, it was extremely rare to have breast cancer so young, he showed him how it is self-fulfilling while telling him that it was not useful at his age, and that it was enough (attention, it's heavy!) that she looks at her breasts in the ice from time to time and that she checks that they are symmetrical.

She came out disappointed. It was going to be so that the follow-up for 10 years? Do not be taken seriously...

Second time
Six months later, it was out of the question for her to return to see this guy. So she chooses via a website that "grade" physicians, an e city gynecologist, Marseilles, well marked. A woman of a certain age, who found herself a little disoriented by this follow-up. She (the gynecologist) asked her what she should do as a follow-up, what was recommended to her (to my daughter). "Do you want me to have a mammogram? ... or an echo? " My daughter had to then explain what the protocol itself. And the other gave him a bed at his age, blah, blah ... Basically, my daughter really did not need to be followed so young.

Third time
Convinced of having fallen ill the first time, and regretting having chosen a city gynecologist the second time, she chose a hospital gynecologist more important than the first, hoping this time to have a real consultation where we would not tell her that she is wasting her time following a protocol that is currently useless.

First, he had trouble writing in his file "Brca1", hesitated, my daughter gave him the acronym he spelled with difficulty... glups... bad pickaxe... Then the type came out the same sentences "comforting" : we are too young to... etc. He asked her twice during the consultation, if she did not want to take the pill. Which showed if it was necessary, that he did not know the Brca1. She stammered that not because she had the mutation.

As she was asking him for advice against the very painful rules, he wanted to prescribe a progestogen treatment ... Er ... my daughter reminded her that she should not take any hormone given her mutation. She came out groggy. A little amused by the ridiculousness of the situation. And especially discouraged by so much misunderstanding. Why systematically discredit the monitoring so young, deny the risk?

It's quite disturbing to be in a high-risk woman's consultation and to be told that you have no risk. The lesson to be learned is simple. Go to a big hospital to see a specialist, and no longer a lambda gynecologist. One who has the habit of consulting young women with change, and without a priority.

It's stupid, I know. Why not do it from the start? No doubt to try to play down this appointment. Immersion in a big CHU for someone who is in surveillance of a possible cancer is pretty scary. Even (and especially) if my daughter has been around the disease for so long through me.

And why not advise her own gynecologist? Because she is totally void humanly speaking. And even if she knows the mutation Brca, she told me last time, never had a consultation with someone 20 years.

The problem is here. Oncogenetics consultations began timidly in 2003, when the criteria for accessing them were limited. (Thus, in 2008, I was not entitled to it, and in 2016, if they had evolved.)

So gynecos are rarely found in front of young people who have this  monitoring of high-risk woman . And suddenly, they are not up to par, considering the patient as a poor girl who needs to be  comforted. (FYI, she has a bachelor's degree in organic medicine, she is quite capable of understanding the statistics.)

In short, the fourth consultation this winter will hopefully be good. Finished the approximation. She will now knock on the door of a real specialist. In a big CHU. Hope that the gynecologist who will receive it will simply take into account the national recommendations.

1 comment: