advice please

advice please

this is a letter I have drafted to the practice manager at my surgery .anyones advice on construction of letter would be welcome.i am not good at letter writing and don't know if I should say certain things or not.

I have spoken with Dr W______ about some of the issues but it still leaves the issues of symptoms/weight issues not being recognized.I have obtained copies of my latest blood results and see they are within range but it is still a concern that actual symptoms are not taken into consideration ,therefore diagnoses are not being made.i clearly have symptoms of thyroidism(including hair loss and weight loss could be attributed to this )and have noticed more eyebrow hairloss today and possible lupus(including characteristic skin rashes and nasal problems).my CA125 results although slightly elevated are above range and because of other symptoms- principally unaccountable abdominal weight gain, -is why I believe it is ovarian cancer.also because my dogs have being picking up on it for the last year.

I told DR W______ that I had lost more weight for the third time suddenly on my hips and legs and that I had gained weight on my abdomen.i was weighed and DR W______said I had gained weight(now 87 kgs)but the scales do not show specific areas of weight loss/gain.i still don't have any idea as to what is causing my abdominal swelling if not OC.

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  • my instinct would be to prioritise your concerns about possible ovarian cancer, and directly ask for a referral. I would be reluctant to bring in too many issues at one time, as there is more chance of you being dismissed .as just being over-worried about health in general. IF they do find a cancer then the other symptoms would be investigated as they might impact on treatment. Prioritise the condition which you are most worried about....

  • I agree with gardengnome that it would be good to be clear about what your concerns are.

    What do you want the letter to achieve? and clearly state that.

    You don't have to write in sentences - you can use bullet points to help give clarity on particular points.

    I personally wouldn't mention the dogs.

    It sounds like, in terms of the symptoms you probably want to focus on the fact that you are concerned about your abdominal swelling/changes in your body shape. Good to mention that you were weighed and the result was that you had put on weight rather than lost weight. Are there other details of the conversation that you could record.

  • My letter would be on the lines of the following.

    Dear XXXX

    During recent visits to my doctor, I have expressed concerns that symptoms I am having are typical of those associated with ovarian cancer.

    Research shows that this disease often lies undetected for a long time, as symptoms can mimic several other conditions.

    I would like to be referred for an investigative scan to rule out the possibility that I have ovarian cancer.

    I would be grateful if you could take an independent look at my notes and make a decision as to whether you feel a referral should be made.

    I look forward to your response

    Name

  • Hi Lucy

    That is a good letter as it sticks to the most important point.

    When you mention too many things it loses it's impact , so

    That letter is unemotional and factual.

    Hannah x

  • thank you fro your response.as I have had scan before tho sometime ago should I jsut ask fro a referral to gynae?ahve done so recently in writing no action taken?

  • No! A referral to gynae is not appropriate if you suspect you have ovarian cancer! You'll wait months! You need a scan for goodness sake. I'll pay for it for you if your GP won't refer you.

  • Hi Anbuma

    I feel your letter should follow along Gambits , Gardengnome's and

    Lucy's excellent letter.

    I would stick to one point your worry about Ovarian Cancer.

    Have any of your Drs. Ever mentioned to you that you might benefit from

    Counselling.

    This might help you to deal with all your health worries.

    Good luck and your Dogs are lovely . They give so much love.

    Hannah x

  • thank you everyone fro your replies .greatly appreciated and so much help to an indecisive me.i will incorporate them in my letter to the p.m.my main concern is the pelvic pain which is quite disabling.have meds for a month to see if they help.

  • Hi,

    You clearly have a lot of worrying symptoms and your letter clearly expresses your concerns but how about making them as very separate points and say you are concerned that it may be such and such a diagnosis rather than what it is - that way you will undermine their sense of having learned things you may not have done. I agree about prioritising the most worrying possible diagnosis, but if you do want to include all your worries you could list your symptoms first and then say you are concerned about each possible diagnosis in turn, numbering them as separate points and linking them to particular symptoms. I would also leave out the bit about the dogs even though it may have relevance.

    I think the paragraph on weight gain and loss is complicated and not clear. What about asking for a lengthy appointment or to be referred to a specialist who deals with endocrinology (I think that's the right branch of medicine but may be wrong so check first). If you are concerned about serious health problems you have the right to be referred for specialist opinions and deserve to make sure you are.

    I hope you manage to get some more helpful response.

    Suex

  • I would be getting referral to gynaecologist ASAP at least that is relevent to their area.I have had one hell of a journey too.the trouble is drs aren't taught how to diagnose from symptons.they look at blood tests & reply normal range then if Scans,MRI,u/s are clear than its in your head.Im in Australia & its taken 6 mths to find I have b12 deficiency initially overmedicated on thyroxine.Dont give up be persistent Good luck.

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