Why physicians must have enough time to listen to their patients?
A story for every woman
A 32-year-old lady once walked into my office having tried many hospitals and physicians without finding any relief to her complaints. I was surprised that she chose to visit me although her problem was just constipation. Women often visit physicians or gastroenterologists when they consider their constipation as a chronic issue. But I believe this 32-year-old was tired, frustrated and at a point where she could not find any solution for her problem so she decided to visit me on a friend’s recommendation
Women with chronic pelvic pain benefit if we ask them to relate their history as anamnesis. So my interview for her began from the time she started her menarche. I believe it is important for Gynecologist to take a detailed history especially when women with chronic problem arrive without having an idea of why they’re facing these issues. Such recollection of events gives subtle clues to her present suffering. I figured that she had painful periods since menarche. Pain that she felt in periods was quickly brushed aside by her mother and grandmother saying this is all part of growing up, part of being a woman and will go away once you get married or have children. So she took it in her stride and never spoke about it to anybody. She did not feel the need to mention this when she was moving from clinic to clinic to solve her constipation problem as she did not realize that they could be associated. So what happened in the subsequent years?
This painful period slowly became intractable, requiring medication as she reached college, and often had to miss her college because of this pain and heavy bleeding in menstrual cycles. When I enquired further, she confirmed associated nausea, loss of appetite, menstrual headache, bloating around the menstrual cycle. I was dissapointing to know that although she visited for constipation no one ever asked her about these menstrual related symptoms. With her anamnesis, all were beginning to paint a larger picture of an underlying disorder called endometriosis. These subtle clinical clues were begging to be heard provided we had time to listen to our patients! Once clinical suspicion was confirmed, she underwent detailed evaluation followed by laparoscopic surgery for clearance of endometriosis involving her rectum causing her chronic constipation. To cut the story short, her painful periods became more tolerable, constipation improved. Married a year later and today has a beautiful daughter which is 3 months old.
The right step
Gone are the days when women suffer in silence and few days in a month remain in suspended animation due to pain or heavy bleeding. It’s time to discuss, find solutions and reclaim your life.
