March 15, 2011

Idiopathic Hirsutism and Defending Doctors

There is a certain amount of negativity attached to the diagnosis of idiopathic hirsutism. Even before I was diagnosed with this myself, I was aware that a prevailing opinion was that being told you had idiopathic hirsutism was the diplomatic equivalent having your condition swept under the rug. And I felt that way myself, early on in my quest to find out what was going on with my body. I imagined how I would feel if a doctor essentially said, "I don't know what it is," or even, "It's not important enough to investigate further." I decided I'd be pretty angry, and probably seek out a second opinion.

Yet here I am, content to know that what I have is idiopathic hirsutism. And I'm actually grateful that for once, most of the people around me are not educated in the world of extra body hair. To finally receive an answer, after years of wondering, is emotional in the extreme. If everyone I knew had come down on me with moues of disgust, saying, "Oh, your doctor's just writing you off," I would have felt pretty crappy. How easily others can turn your small triumph into defeat.

So, okay. Here's the thing. I read an article about the stress of a doctor's job, a long time ago, and it's always stuck with me. Sure, it's easy to nod and say, "Yeah, they've got a stressful job." But have you ever paused to really imagine it? The example that really wrenched things into perspective for me was from a doctor who recalled parents bringing their newborn baby to him for help, but he found there was nothing to be done, and he had to tell the parents that their child would be blind all his life. Before the doctor even had a chance to recover from the sorrow of the encounter, the next patient came in and expected to be cheerily welcomed. Often, we're so worried about our own symptoms that we don't even realize who our doctor might have seen before us.

And that stress starts early. They have to work hard to get into medical school. They're often confronted with cadavers pretty much right away. I've only seen a dead body once in my life, and it was thankfully not in a dissecting room. I can't imagine how awful that would be. When my art class planned to go down to the University to see corpses for anatomy studies, I flatly refused to go. And then, for medical students there's the hospital training. If I had to face fatal diseases and mortality every day when I was in college, I don't know how that could have changed me.

And with all that knowledge packed into their heads, they also have to figure out how to interact with people they help every day. Not everyone is a natural people person of course. And with all the natural fear and anxiety that comes with being ill, doctors often find themselves having to be counselors, too, as patients use them as a sounding board for their frustrations. And that's not even the difficult patients. And the longer a doctor practices, the more responsibility they have. It's a job where things never, ever get any easier with time.

Now, I've said before that it is everyone's right to choose their own treatments, get a second or third or fourth opinion, and to retain a doctor they feel confident in. We know I've had a doctor or two I've lost faith in thanks to a couple of errors in diagnosis. Most people have a story of misdiagnosis, or know of one. And I do feel neglected and overlooked that my most recent family physician did not call or send a note, or get her office staff to do so, to inform her patients that she was moving. But I don't know all the circumstances. I just have to take a deep breath and not take it personally. Because the inherent antagonism of doctors, the blind mistrust that sometimes colors peoples' attitudes, it makes me sad. It seems almost like a fashion to have a cynical opinion of the people responsible for our health. They are as human as we are. And they have chosen one of the most demanding jobs imaginable--but also one of the most rewarding.

So here are a few things I just want to emphasize, if you're searching for treatments for your hirsutism and are frustrated with your doctor.

  • There is no FDA-approved drug for hirsutism out there. None. There are drugs that have side-effects that help manage the hair, but there is no Pill For Hirsutism. Unless it's caused by hormonal reasons where the cause is actually removable (like a testosterone-secreting tumor), there is really no permanent cure for excess hair growth.
  • Your doctor has prescribed you a medication because the benefits outweigh the risks. This is written on practically every fact sheet I get with my prescriptions. Maybe the risks will be higher for you, but nobody knows until they try. If you are not comfortable with taking the drug, you can always refuse treatment and live with your hirsutism naturally. There's nothing wrong with that. (I can imagine myself doing that in the future.)
  • Idiopathic hirsutism does have a definition, even if some doctors use it as a blanket name for medical mysteries. It means that, rather than having hormonal abnormalities or other factors, your hair follicles are simply more sensitive to testosterone. Even among men, there is a vast difference in amount of body hair. Some people, and indeed some ethnicities, simply have it written into their genes that their hair follicles will be more sensitive to testosterone, and thus they'll have more and darker body hair.

If you don't feel that this is the cause of your hirsutism, is it because you haven't done enough tests to eliminate other causes? If that is the case, ask for them. You deserve to know, and have that peace of mind. I feel that everything that needs to be checked has been checked. I am satisfied with my endocrinologist's conclusion. She did a great job.

Read a little more about idiopathic hirsutism here.

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