Issue 34

10 Professional articles
participants will generally have a much
lower score than the women, even in a
situation where the physical conditions
are matched between genders. One of
my colleagues recently observed that he
thought that this was because women
complain more (thanks!). However, if
you read Brene Brown’s book “Daring
Greatly”, towards the end she talks about
the strait jackets that both genders wear
in relation to social functioning. Men are
generally encouraged to be tough and to
endure without complaining, and talking
about their problems is considered a sign
of weakness. I think this has a knockon
effect in terms of how men access
and experience healthcare. This is not
to blame the men! I think as healthcare
professionals we need to get better
at understanding the very real gender
differences associated with accessing
healthcare, and improve how we elicit
information from our male patients about
what is happening with them.
While it should be possible for
patients to have a reasonable discussion
about their monitoring and treatment,
in reality it can be very difficult. If your
basic relationship with your body is one
of distrust, and you have a whole lot
of feelings of various kinds that you
don’t know how to interpret, the levels
of anxiety you experience are likely to
affect any communication you have with
healthcare professionals. Anxiety can be
related to control; the less control you
feel you have, the greater the anxiety
and this can lead to a strong feeling of
frustration (especially if you feel you’re
not being heard and/or supported)
which can eventually end up with a
patient feeling very angry and let down.
I think that’s one of the things that really
troubles me about Peter’s story; the
lack of dignity and respect with which
he seems to have been treated. For a
healthcare professional to refuse to order
a test “because it’s complicated” can be
experienced by a patients as being told
“it (you) aren’t important enough”. I
shouldn’t need to comment on just how
unacceptable it was to be made a source
of amusement when he was scared and
in pain.
Finally, remember The Pituitary
Foundation has many different ways of
offering support. For a start there is the
“Wellbeing Series” of booklets focussed
on coping with the psychosocial aspects of
pituitary conditions. There are also many
other leaflets aimed at helping patients to
deal with different aspects of life with a
pituitary condition. The Foundation also
has a telephone Helpline, Local Support
Groups, National Conferences, and webbased
services, too ■
Endocrinologist’s view
Professor John Wass
Patients and doctors are equal.
Only the patient knows the
symptoms and the doctor knows
about endocrinology - and so can the
patient know about endocrinology.
Going to outpatients is like preparing
for a meeting. You need to prioritise
the symptoms that are topmost and
make sure these come out first. Chest
pain is obviously important but loss of
the outer third of the eyebrows is not
going to affect quality of life or lifeexpectancy.
Take a list if necessary.
You should know what you want to get
out of the meeting with your doctor. It
also helps to take a relative or a friend.
All patients are different. If you are
organised about the outpatient clinic
appointment, they are more likely to be.
You need to feel empowered. I think
taking an interest in your condition is
important. You should check your doses
and your results. You should probably
see your results and make sure they are
satisfactory. You can get copies of them
together with the copies of the letter your
consultant has written; there should be a
clear plan with your consultant of what
you are going to do, and what the plan
for monitoring treatment is. This should
be clear to you, as well as to the person
looking after you.
If you are not happy, then you can
politely but firmly do something about
this. The consultant or registrar should
listen and act. If you are seeing the
registrar you can ask to see the consultant
or you can see another consultant. This is
all within your rights. This can all be done
non-aggressively.
These are some of the ways in which
you can ensure that there is a satisfactory
outcome to your consultation and your
satisfactory progress generally ■
Pituitary life | autumn 2016