June 16, 2009

We have a possible answer!

A quick recap: I met a candidate for our new family doctor at the beginning of the new year, liked her, and went back for a long-awaited physical in April. At that time, I told her about my hirsutism and that I was eager to find out what was causing it. (I've read a lot of trepidation and embarrassment ladies have about seeing their doctor for this kind of matter, so I detailed that discussion in this entry.) My new doctor sent me for blood tests, some to measure routine things with a few additions to investigate my hormone levels. After some shuffling around with my appointment, we finally settled on June 11 to discuss the results.

I wasn't too nervous before I left for the appointment. Usually I get really jittery when I'm expecting something big in the afternoon, and can't focus on anything. I was doing okay until I got there. The clinic waiting area was abnormally quiet and I had forgotten my book, so I sat there clasping and unclasping my hands, tucking them under my elbows, and listening to the office staff rescheduling appointments and booking referrals. Even then, I couldn't focus on my worry. After twenty minutes, they called my name and put me in an examination room, where I waited for fifteen more. In that silent space, facing the bio hazard box of syringes on the wall above the little sink, I managed to tackle what was bothering me.

I wanted something to be wrong. Twisted, but true. It had to be better than hearing, "There's no reason for your excess hair." And since I have hardly had a thing wrong with me my whole life, this seemed the most likely answer. But on the other hand, I didn't want anything to be too wrong with me. What if, despite my regular cycles and other lack of symptoms, the tests indicated a possibility of Polycystic Ovarian Syndrome? I do have a family history of ovarian problems. Something that affects your fertility, your weight, your insulin as well as the hair--if that was the answer, so be it, I would work through it, but it was not news I wanted to hear either.

Basically, some kind of answer had to be better than no answer at all. But maybe there had been no telling results from that blood test years ago, and that's why no one was bothered about helping me find it and telling me what was on it. Maybe my dermatologist at the time really had known what he was doing when he sent me off for laser hair removal without investigating whether or not I was a good candidate. Maybe there was no other answer than, "It just is." And I tried for those fifteen minutes of silence to prepare myself for that.

My doctor came in and took me to another room, almost like a closet, where her computer was tucked away. We went through the results together. I had never seen the results of a blood test with my own eyes before. The things that were too high or too low in my blood were bolded and in red, and next to them were the normal ranges. There were some things unrelated to the hirsutism that needed to be addressed with a daily supplement; nothing serious. My thyroid is slightly overactive, explaining my revved up metabolism, so I have to go for another blood test in a few months so she can monitor what it's doing. I noticed she wrote down another androgen test on the requisition form.

What was most relevant was my androgen levels. Both testosterone and other androgens were elevated--not overly so, but noticeably enough to show up big and bold and red on the screen. I was so flustered that this might actually be the answer that I didn't retain the exact numbers she showed me. She says this is a possible explanation for the hirsutism, and when she decides which specialist to refer me to, she will let me know. She touched my arm, looking truly sympathetic as she made sure this was okay with me.

I don't mind waiting. Seeing a possible answer makes me feel so much better. I was a little stunned, and wandered through the next door drug store in a haze. I couldn't remember enough of my reading and research to recall exactly what was done for high levels of androgens, or a sensitivity of hair to those androgens, both of which can cause the excess dark hair. So I just floated through the store, picking up the recommended vitamins and few beauty tidbits I needed. I vaguely recall nearly breaking down into tears in front of the lotions. This sales clerk asked me if she could help me and I felt so self conscious that I probably acted very guilty--like she wanted me out of the store.

In the mean time, I have another blood test (ugh) on my horizon. Then goodness knows what the specialist might want to do to me. I may find myself becoming good at being poked by needles to the point where I won't have to lie down anymore. Knowing that it is all to find an answer certainly helps. I also have a lot of reading up on anti-androgens to do, so I have good questions to ask in the future. The Hairtell forum has been quite interesting in that regard.

I want to encourage whoever may read this to be assertive in finding out why they have excess hair, especially before investing in expensive treatments. Doctors have one of the toughest jobs out there and they went through years of research and training to get where they are, so of course you should respect their expertise. But they are also human. They are busy and stressed, so you might happen to slip through the cracks. Your condition may not seem as important to them as someone with a life endangering health issue. People often say "Be your own advocate" but I never would have thought much about it until I found myself at a loose end, personally. Perhaps I was too young, not ready (I left it for years, for goodness sake), or hadn't done enough of my own research to be aware of what the dermatologist was doing and not doing when referring me to a laser clinic before doing any tests. I could have been better equipped to ask him questions or insist on tests, instead of nodding meekly and shelling out college money on a procedure that did not work well for me and taught me very little.

So, yes. Be your own advocate. Research is the best tool to have in your arsenal. Temper it with respect for the professionals. Getting answers, even possible ones, feels so good.

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