Is it worth going to the GP about this?

[vegetariandumpling]

I have several symptoms that I've had for my whole life but have definately got worse in the last year. I'm really not sure if they're just normal things that everyone gets and I'm just a wuss.

The worst one is definately the tiredness. I feel tired all the time, and everyday when I wake up I feel like I haven't gone to bed. I also can't stay awake by 9pm although I'd go to bed at 8pm if I could. If I go out during the day I just want to sleep and sometimes it feels like my brain isn't working and I can't really think, probably because I'm tired. I'm taking iron tablets but no improvement after 3 months.

The second worst one is the pain in my abdomen, in line with my belly button but just above my bikini line. I get it once or twice most days and it lasts for maybe 5 or 10 minutes before it gradually eases. It might be constipation but (sorry if TMI) I'm going pretty regularly, which is annoying because I get the pain when I poo as well.

Those are the symptoms I'm worried about but other things which might be relevant are: bleeding on an almost daily basis, painful and heavy periods with vomiting, bloating, weight gain and depression (but those two might just be because of the tiredness).

My GP seems really laid back and everytime I go he doesn't really do anything (I've been asking for years for help with my dry skin but he just says 'use aqueous cream' even though it doesn't work) and it seems like I'm just worrying about nothing. So I want to make sure that this isn't just stuff that everyone gets.

Sorry this was so long. So is this just normal? If I do go how can I persuade the GP to do something?

Can you another GP at your practice? I would go and get repeat bloods done, get them to check your thyroid function as well as an underactive thyroid can cause tiredness as well as anemia. Depression and weight gain can also be signs of an underactive thyroid. I would also ask for a gynae review if you are having problematic periods, especially with any breaththrough bleeding. Good luck.

Thanks for the advice. Unfortunately the other GP is even worse so wouldn't bother with him. I saw a locum once and she seemed the same as my normal GP so I am quite worried I'm just over thinking it. Should I mention all the symptoms? Or shoudl I just say I'm feeling tired and see if they ask about any of the other stuff?

I was going to say thyroid as well. Insist on a blood test.

All of your symptoms. Then the GP gets a full picture.

Ok well that's at least two people that think it might not be normal so I will go. Don't know how I'm going to insist he does something thought [wimp]

I would be tempted to change practice if that's at all possible - I'm guessing you live somewhere quite remote if there are only two GPs at the practice?

Alternatively, if you can afford it, I would be tempted to go for a Bupa or similar wellness checkup type thing.

It sounds like your GP isn't openly fobbing you off but rather just breezing through the appointment making you feel as if you can't ask any questions? You may need to be quite direct and say "I'd like to be seen at the hospital, what do you recommend?" so at the very least he has to say 'I do not recommend a referral because of x, y or z'. I would definitely want to see a gynae if I were you, and if he says no, I would write down (in front of him) exactly why not - not in order to try and intimidate him into referring you, but just to make the point that you're taking this seriously and you'll be exploring your options.

Keep pushing - here is the NICE guidance on heavy periods and what you should expect your doctor to do. There are also some useful links at the end.

Tiredness can be due to a lot of things. Low thyroid function and anaemia as mentioned are 2 very common ones. Combined with your bleeding daily (is that vaginally or rectally I wasn't too clear on which it was?) anaemia should definitely be checked for.

Other tiredness causes that I was tested for were sleep apnoea (I went for a sleep study) and post viral fatigue syndrome (specifically I was checked for glandular fever which is what it turned out to be)

It's hard to be assertive with GP's sometimes. I'm lucky and have some lovely open to suggestions ones. I suppose you have to really emphasise how much this is all affecting your quality of life and go from there. Try and insist on getting referred for bloods if nothing else. And if it was me I would probably start with the extreme tiredness. I went in saying how difficult I was finding it to get through the day. Don't down play it as 'just' tiredness. Then start to add in the other symptoms you're experiencing.

Hope you get things sorted

See another GP?
FWIW Aqueous cream is to be used as a soap not applied to cream as a moisturiser. Try diprobase or similar.

Btw this has a decision tree from the Royal College of Gynaes about breakthrough bleeding for women on hormonal contraceptives. This is from patient.co.uk (GP colleagues of mine recommend either NHS Choices or patient.co.uk to their patients). Patient.co.uk on intermenstrual bleeding. I won't bombard you with any more information but I would read up so you feel empowered to ask questions you want to - whether the GP is running late, whether you feel flustered: sod it. Just ask.

Keep a diary, especially of the blood loss etc..
Keeping a diary of my DDs lack of sleep really helped get our GP to take me seriously when I was being fobbed off.

Also, is there a practice nurse you could see? Sometimes, they can be better than the GP.

Thanks for the advice and the link. I didn't realise they actually do anything for heavy periods, never mind have a whole guildline on it! I've been telling him about my periods for years but when I told him that basically every woman in my family is the same he basically said 'well its probably hereditary' and left it at that.

I could change GP I guess, not really in a remote location, I've just never really thought about it before. I might give it one more go and then change if I don't get anywhere.

Thanks for the tip on writing down why he won't refer me tribpot . I've never even thought of that, I guess when I'm in there I never think to question if what he's saying is right or not.

wolfie that's probably why it got so much better when I stopped using it. He did prescribe diprobase once but then went back to 'now just keep using aqueous cream until it heals'

Are you on the mini pill? I seemed to bleed almost constantly when I was on that. Always had break through bleeding.

Just occurred to me whilst reading this.

Can you change GP practise?

No I'm on the combined pill, marvelon. I could change GP practice I suppose, I've just never done it before. I'll definately change if he still tells me not to worry about this.

vegetarian - you should find there is another practice that covers your address - you can look them up by distance from your postcode on NHS Choices although this doesn't guarantee they cover your 'catchment area'. However, catchment areas are being phased out, so that you can register (in theory) with any GP. One step at a time, though - see if you can get any sense out of this one, then see if you can register under the 'old rules' with another one nearby.

All you have to do is call them and ask if they're accepting new patients - they will then probably ask for your postcode. If they say yes, you just pop down to fill in a form (our practice asks for some evidence of ID now as well) and they'll probably book you a new patient appointment to get some basic info updated (height, weight etc). Your medical records will then follow you to the new practice.

Btw whilst you're in there, request some more diprobase. Alternatively, you can buy it on Amazon!