Women’s Health Care: Your Health is your responsibility.
The medical History of individual women can vary from needing to see a doctor just once or twice in 20 years or so, to twice-weekly visits to the surgery.
Males and females on average have the same pattern of doctor attendance until they are about 12 years old, then women tend to visit their doctors far more often until their late forties.
At this stage, men start requiring treatment for stress-related, degenerative diseases: respiratory complaints, diabetes, digestive disorders, cancers, and so on.
The majority of women’s consultations are concerned with birth control, childbirth, and urogenital problems. Because of a woman’s physical and biological makeup, she is likely to fall ill or needs medical advice far more often than a man throughout her most active years.
Even the healthiest woman is likely to find that she suffers from the occasional minor ailment, such as dysmenorrheal or thrush, varying in degrees from the irritating to the seriously debilitating.
It is important, therefore, for every woman to be aware of this extra physical vulnerability and to know and understand her body fully, the way it functions, the risks she may run, the diseases she may catch, and, finally, the different positive choices in her health care.
Self-knowledge can enable her to practice preventative medicine in the sense that by being aware of her lifestyle choices she can do much to prevent serious diseases from ever developing.
This seems a self-evident truth but it is a point that needs reiterating. In this age of medical experts and high technology (eTech), we have lost a great deal of the basic knowledge previously passed down from one generation of women to the next, regarding daily health care and the home treatment of simpler ailments.
One of the aims of this blog – and, indeed, this eTechGuide.org Women’s Health Care– is to help you to care for yourself, treat basic disorders yourself, and decide when and if you need general medical or specialist assistance.
There are times for us all when we feel we cannot cope anymore, that we need help, either because we are ill, miserable, confused, or all three. At this point most women, if they do not have a close female friend or relative to advise and care for them, often turn instead to their doctor.
However, a doctor is often not the right person to help. Hindered by overwork and by his very training, which does not encourage an understanding of people on a mutually equal basis, his ability is principally that of diagnosing recognized diseases and prescribing the appropriate medication.
A survey carried out in the late 1970s in London showed that more than 75 percent of women every single day take some form of pill, either self-administered or prescribed by a doctor.
And on a national basis, recent figures record that 21 million pounds worth of mood-altering drugs, mostly tranquilizers, are prescribed yearly, three-quarters of them for women.
Why are so many women being given drugs to suppress and otherwise alter their moods and feelings – to make them sleep or to wake them up, to calm them down or cheer them up – when they go to their doctors with a wide range of complaints or disorders requiring more varied attention and care?
The present situation is his: women are taking their complaints to health care professionals who, under their very training, cannot understand them.
For instance, if a woman complains to her doctor about pre-menstrual fluid retention, irrational rages. Or recurring breast pain, unless her symptoms fit in with a textbook description of a disease recognized by Western science the woman is often told that it is all in her mind and that she will either ‘get over it’ or ‘it will pass’ or to ‘take some rest’, or whatever.
Alternatively, the doctor may prescribe a mood-altering drug. This last alternative is an attractive one for the busy doctor; he can send his patient away and both of them feel that something has been done, that the meeting was effective.
Furthermore, the doctor is not likely to be bothered by the woman again, at least until the prescription runs out. It makes good sense, therefore, to know what other choices there are.
The Choices in Women’s Health Care
Let us take the example of a woman with a vaginal discharge. There are many courses of action open to her – from exploring a whole range of alternative therapies to self-care:
Women’s Health Self Care:
- If you are doing nothing and hoping it will go away.
- Douching with either tap water or mild vinegar solution.
- Buying a pre-prepared cleansing douche from the chemist.
Professional Women’s Health Care:
- Consulting her doctor.
- Attending a women’s clinic, usually sited in a local community center.
- Asking for advice at a family planning clinic.
- Going to the local hospital’s department of sexually transmitted diseases (usually called Special Clinics).
- Choosing from the range of alternative therapies: homeopathy, aromatherapy, nutritional advice, naturopathy, and so on.
These choices apply to all minor ailments. If a woman chooses professional health care, of whatever kind. She will need to reassess her decision to continue this treatment according to whether or not she has been satisfied by her first visit.
This is very important. We all tend to be overawed by professionals, and this is particularly so for women.
Many women have been told when she presents her perception of what is wrong with her to the doctor: ‘I am the doctor around here!’ some doctors tend to separate patients into ‘good patients. Those who accept the diagnosis and treatment uncritically. And ‘bad’ patients – those who ask questions he or she cannot answer, or who present their diagnosis.
Many of us feel this instinctively when we visit them and behave accordingly, never daring to complain or argue.
Many women, therefore, come away greatly dissatisfied with the meeting, but do not like to question the doctor’s wisdom or go elsewhere for help for fear of offending someone they see as a superior, or because they do not want to jeopardize what is essentially an important relationship, or to be dismissed as ‘neurotic’.
Your Medical Record:
Many of us have in our personal files documents that chart various stages in our physical and intellectual development, but often there is no record of immunization, childhood ailments, or hospital admissions.
At a major London teaching hospital, patients are encouraged to keep their maternity records. This enables fathers-to-be and other members of the family to follow the progress of the pregnancy with the expectant mother.
It also follows that the pregnant woman will be better motivated towards taking iron tablets and following a sensible diet if she feels that she is responsible for her health.
When you have some spare time, sit down and fill out as much of your medical record as you can, starting at birth. Take stock of the contents and advice in this book and decide if there are any common tests that you need.
A basic check-up by a doctor should cover such things as a breast examination, blood pressure, cervical smear, and testing of the heart and other major organs.
Most family planning clinics and health centers are very helpful with check-ups and they are keen to promote preventive medicine. Once you have established a personal health record, you can log the results of tests and X-rays and details of vaccinations.
A personal health record is confidential and should only be shown to those people with whom you have complete trust.
How to Manage Your Doctor:
Women have been brought up to be ’good girls’: if they are good they will be given the sweetie, do well, be beloved, attract a husband, or, in this case, get better.
The doctor is the Western equivalent of the primitive wise-man-cum-witch-doctor, and to offend him will, women instinctively feel, bring his wrath down upon them.
That is, to go against the doctor’s prescriptions will automatically result in their illness getting worse, or, at the very least, not clearing up or getting better.
None of this is intended to suggest that doctors are consciously power-seekers, malicious, uncaring, or even unsympathetic.
The relationship is one of collusion: the patient wants the doctor to be all-powerful and all-knowing just as much as the doctor may need to assume this role.
And just as many women are today challenging this state of affairs, so many doctors, too, are wary of being set on the pedestal, always having to know the answers.
It must also be said, that when the relationship works and both patient and doctor cooperate towards a happy conclusion, it can be very satisfying to both of them.
Both feel that they have fulfilled their roles well: the patient feels cared for by someone who knows more than she does and the doctor feels the satisfaction of having been cared for and cured.
Your first Visit
In every human interaction, each of us brings, as it were, a portfolio of gifts and a portfolio of needs to the meeting. Both portfolios of each person must be recognized.
So, just as the doctor needs to recognize what his patient has to offer in the way of knowledge and insight (because each woman is the expert on her own body), the patient must be aware of the doctor’s need to practice the skills he or she possesses, and to be verbally supported in his or her effectiveness.
Doctors must learn to listen and patients must learn to give appropriate information on their condition so that they may have an informed say in whatever treatment is prescribed and undergone.
This is the most important factor in a good patient/doctor relationship and lays the foundation for future consultations no matter how serious or life-threatening the disease process is.
As the patient, your first meeting with your doctor or other health care professional you choose to visit with your problem will be much more satisfying if you state exactly what is troubling you, clearly and directly.
Think about this beforehand and make a note of any points, dates, and symptoms that are (or maybe) relevant. If, for example, you have abdominal pain, it is useful to be able to state quite clearly:
- When you first became aware of it.
- Exactly where it is.
- The things that make it better and the things that make it worse.
The doctor may then ask if you have ever had a similar condition before and, if so, what sort of treatment was helpful then.
If it is a recurrence and treatment was by the same doctor, he may simply refer to your medical record – but be prepared for such questions if you can, and have dates and details of treatment ready.
If this line of questioning leads the doctor to a working diagnosis, he will then ask you about certain other elements in your life, such as appetite and sleep, and examine you to try to rule out the possible serious causes of pain.
He will then tell you what the likely diagnosis is, and which specific form of treatment he feels will be of help to you.
Alternatively, if his examination finds a condition that needs further investigation he will ask you to undergo X-rays or blood tests, as appropriate.
At this point, you need to understand clearly what these tests are for. Ask your doctor for a clear description of the tests and their implications.
You need this information to be suggested to you, so do persist until you are completely clear about the issue.
If, after you meet with the doctor, you have other questions or worries, either go back a second time or write your doctor a brief letter setting them out clearly; enclose a stamped, self-address envelope and ask him to provide the information you require.
If you do not receive a reply within a reasonable time, phone the surgery or call there. Do not be discouraged or give up. It is your health that is involved and it is in your best interests to persist.
After your first visit, you will either come away from the meeting satisfied and decide to follow the treatment prescribed until your problem clears up, or you will come away feeling dissatisfied with the meeting and/or the treatment suggested.
If further communication by letter or telephone does not help, then you must decide how and where you wish to seek a second opinion.
Most doctors intuitively realize when they have failed to communicate adequately with a patient and at this point are often happy to suggest to the patient that she receive a second opinion.
In general practice, a doctor may suggest that one of his partners see the patient or that she have an extended interview with a health visitor or the practice nurse.
Alternatively, if it is a single-handed practice, the patient may be referred to the local hospital, or she may visit another doctor and ask to be transferred.
Recent legislation has set up several bodies in the health care field to which patients have recourse if they are unhappy with their treatment – among them the Patients Association. If you are not treated with respect and compassion by your physician, you are entitled to make a change.
It is wise to do this in a calm, sensible atmosphere and is often best done by letter. Your relationship with your doctor is not binding, you can opt-out of it at any time, and if you are unhappy with your doctor it is better to seek out another practitioner rather than live with your doubts and dissatisfaction.
A local post office normally has a list of all doctors in practice in its area, but this is a rather hit-or-miss method of selecting alternative help in that the list gives no guidance on what individual doctors are like.
Ask women friends and acquaintances for their recommendations, just as you might when seeking professional help of any kind.
If on a visit to your prospective new doctor, he or she agrees to accept you as a patient, any necessary transfer of documents such as medical records can be arranged by post, without the need for a further visit to your former doctor.
A Further option is to seek alternative health care. This may be in the form of any one of some therapies outlined in the next etechguide.org blog posts, or with routine disorders, self-treatment.