One appointment with doctor - which of these issues takes priority?

[DoctorDoctorWho]

So i have an appointment with the doctor but have a list of things (minor) wrong with me and i am not sure which to prioritise. If I list them out would you be able to advise?

1. I have a (naturally) large thyroid and notice swallowing and occasionally choke a little. Seen by a specialist in the past and all fine - just large thyroids! I have lost a little weight recently and I am finding the swallowing more noticeable.

2. Anxiety - I have always had it (and probably depressed as well tbh) - was really bad after babies but manage to contain it. it manifests as intrusive thoughts and a fear of vomiting in front of people. I control it by always having an escape route (end of row at theatre etc) but lately I have feigned sickness to avoid a 3 hr meeting, nearly missed ds' school play and have needed to do breathing exercises when waiting for show etc to begin. I was very close to having a panic attack when on a crowded train alone with the kids. Never seen a doctor about this before and i'm scared of being given pills.

3. A physical one! I have a terribly itchy perineum but no obvious spots/rash etc. Had it about a year.

4. This could well be linked to any of the above but i have lost my ability to orgasm. As this is impacting my relationship dh is keen for this to be the one I talk to the doctor about.

I am tired all of the time and find it hard to sleep (1 & 2 probably!).

I have always just plodded on and hoped the next day would be better but it hasn't and I'm not really sure what to do.

Thank you if you have read all this and thank you for any advice!

I'd prioritise the anxiety tomorrow as it sounds like it's impacting your day to day life the most and, as you say, could well be the route cause of the insomnia and the inability to orgasm. Then I'd ask for a double appointment to sweep up the rest whenever you can get one.

Hi, if it was me I'd see about the anxiety/ depression first. That's the thing that could spiral and life could become very difficult. I'm on meds and they really help, but you could also go the therapy route. Mention along with that, your thyroid, as depression can be linked with that. A good gp will do a blood test to rule that out before coming up with a diagnosis as such. The itch issue could be dealt with by pharmacist maybe? Good luck!

Mention the lot. Anxiety can be a thyroid symptom, itching can be related to high thyroid hormones too, as can the sex bits. Not saying it is for you, but would reccomend you lead with thyroid and mention the lot in your intro. Gp will help prioritise from there but there may well be links

(gp)

thanks - you both seem in agreement!

my thyroid is fine - all blood tests normal (had some as part of work medical 6m ago)

deep down i know i should but i'm terrified of either being laughed out the surgery or having mental health issues on my notes. i also know i'm being irrational!!!

xpost Knotty!

My GP is extremely strict on one appointment per issue but it is almost impossible to book a double appointment.

Maybe i have a fear of my GP. She is very nice but I have taken DS for 3 separate things that have turned out to be nothing (after blood tests or swabs) and she must think i'm totally neurotic

maybe i should change GP surgery first!

When I saw gp last week about my enlarged thyroid and said "oh it can't be that as I had thyroid bloods done in April". He told me it could have changed a lot in 12 weeks.

If you feel as crap as me (waiting for blood results) then I say mention thyroid. Explain oyher symptoms and say you understand they could all be connected.

He is a twat if he argues with that!

Sorry! Assumed a man....

Anxiety because it undermines your ability to cope all the others.

Thyroid could be the cause of everything that follows in the rest of the list, so do mention it.

What about writing it all down, as you have in your OP, and giving the list to the doctor and asking her to prioritise? As mentioned, she might be able to make some links between the various issues. Might also stop her intimidating you into missing any of them out!

that's probably a good idea molly. i'm feeling a bit tearful and panicky just thinking of the appointment!

I've been seeing specialists about my thyroid for over a decade and have always had normal blood tests and ultrasound fine. It is just on the large side of normal and my neck on the slim side of normal!! I don't know if the weight loss has caused it to be more noticeable or not though. I suppose i worry she will focus on the thyroid.

do you think what i have written above is ok?

appointment is in a week and a half so lots of time to get wound up!!!

I am a GP and would really appreciate you printing off your original message and letting me read it if I was your doctor. I may not be able to deal with all of it but we could make a plan and your OP is very clear, particularly about the fact you aren't keen on meds.

Thanks Caravan. I will do that then.

I've thought of something else - I have TMJ in my jaw which gets worse with stress and could also explain the tiredness.

Should I put that on the list? I don't want her to think i'm just a big hypochondriac!!

(and thank you everyone for taking the time - i don't have anyone to talk to in real life and have been bottling this all up for a while)

Do change GP at some point. They vary - mine don't mind you taking in a list of issues as long as you talk quickly! It is an odd rule I think, as seemingly disparate symptoms can be connected.

Thyroids can be funny things. I agree, after dealing with lots of issues for a couple of years I'd write your op down and hand it over. It took a minute to read it and a GP could pick out red flags and /or arrange a second later double appointment if they felt nec and have the list if they wanted to ponder on it.

Thanks

I feel a bit paranoid about writing it down and it being 'on record'

I don't know anymore. I've always been an unhappy person overall and think i'm probably too old to be 'fixed'

One issue per appointment is a ridiculous idea. They could all be related. I had a whole host of seemingly unrelated issues which turned out to be caused by a single problem. I wrote a list and gave it to the GP.

I will do that too Best. I just need to get it written down and hope i get to see the GP and not a locum who i've never met

Good luck.

A locum might be better as you don't appear to trust your own GP. When is the appointment? Good luck!

Just to update - i have made an appointment after getting some strength from this thread (I hadn't before as I was scared!)

Thank you for all your help