Disappointing menopause appointment

[SpamhappyTootsie]

I follow the threads on here and I thought I was all prepared for an appointment with the Nurse Practitioner this morning (my first).
Had the usual gatekeeping oh you need a smear…..hmm, you haven’t had your bloods done for a while……blood pressure a bit high, buy a monitor to use at home and come back in a week or so
She would not listen to anything I said so now I’m a menopausal sobbing mess at home because I can see my 50s just vanishing in a fog of forgetfulness and joint pain. I’ve already turned down a fantastic job because of my energy levels. I have to choose what social and leisure activities I do because of the joint pain and fatigue.

Give me a kick up the arse, please. I’ve just spent £62 on a blood pressure monitor so I can play along with her stupid game, but I feel like next time I go there will be some other hoop to jump through.
Do I go private? Change GP ? How to combat the White Coat Hypertension because if HRT is riding on some magic number in her office then how will I ever get past that? HRT is proven to lower blood pressure ffs!

@JinglingSpringbells thanks for that advice on choosing a specialist.

Thanks to all who’ve replied too. I do appreciate it and have learnt a lot from this Board. Just not enough to get past my particular practice gatekeeping, apparently

My surgery accepts home readings. Take it 3x with 5mins between each one and take the lowest reading. Do it 4x a day and then work out the average reading.

I had a phone appointment with a GP who had menopause training so no bp was taken or asked for as a gatekeeping measure, though she did say I'd need to keep an eye on it.

Sorry to hear about your disappointing experience OP. It took years and many appointments (including appointments to discuss with a nurse which were then cancelled with no explanation) before I was referred. I had a phone appointment with a locum about a completely different matter and hrt came up and she referred me.

I'm not in the habit of wishing bad things on anyone so I won't tell you my thoughts about the young female GP who told me menopause was 'natural' (no shit Sherlock) and I could have antidepressants if I liked. She'll get there too.

That’s really helpful @MrsPelligrinoPetrichor . I wouldn’t have thought to have done 3x and taken lowest, or thought to average it out.

GP refusing to prescribe HRT www.mumsnet.com/Talk/menopause/4706088-gp-refusing-to-prescribe-hrt

My thread on a similar issue may help.

We took along a printed menopause checklist and the NICE guidance. GP prescribed HRT on the spot!

Sorry, just to be clear I meant that the first time I spoke with the meno GP she prescribed without taking my bp, just said to keep an eye on it.

You need to see a GP not a nurse practitioner, OP.

Fingers crossed you can get on HRT soon op. I found the brain fog, aches pains, low mood. etc all are greatly reduced now I've found the right dose for me. Good luck.

So it is possible to prescribe HRT with high blood pressure (well, one high reading under stress) or no BP record at all? That must be how Boots do it then. I’ll try and get the HRT started from somewhere then see how my BP goes. If it remains high I will go to the GP.

See, this is what confuses me. I phoned the GP to ask which one, if any, specialises in menopause. The receptionist said the Nurse Practitioner was responsible for menopause related stuff, “they don’t go off blood tests these days…..you’ll always get to see a woman….” She (receptionist ) couldn’t have been more reassuring or informative. In fact, she listened to me outlining my symptoms and self help I’ve tried much, much better than the actual NP!

You need to be firmer, and stand up for yourself. If you don't want to see the nurse practitioner again, phone again and say you asked which GP specialised but you were told nurse, but you don't want to see the nurse. Ask again which GP. Then make some notes, take a picture of the NICE guidelines. Drop them into conversation. Tell them you feel fobbed off. Stand up for yourself. Be firm. Say, I'm not leaving until we agree on my HRT medication.

They are obsessed about BP, cholesterol and smears (even when you are 61) - I'm sure they get paid bonuses based on these !! You could have a multitude of other things, and they bring it back to Bp and cholesterol every time. I had to have full bloods done a few months ago and when they called me the first things were my cholesterol and pre diabetes issues- I also had a few other deficiencies but had to push to ask about these things . I'm not saying those things aren't mega important- they are, but if someone is having other stuff be it menopausal or musician skeletal issues or dizzy spells or whatever they want to discuss those aspects too

OP you need to educate yourself. Mn has great threads on this. And there is a lot of info online, because if Davina programmes etc. Read up on it, and then when they give a reason why you can't, your'll be able to challenge it with medical evidence.
Ask your Dh to go with you. Or your mum. They won't fob you off with another person in the room.

I did think I was being assertive, @Oblomov23 but the smear thing blindsided me.
They do have targets @Crikeyalmighty for those things. DH works in a related field. Might ask him the jargon so I can throw that in . Funnily enough, if he goes to the GP he gets gold standard treatment, scans, the lot. Maybe I should take him in to sit at the back twirling his NHS badge . But then he’s a Man and therefore worth the NHS’s time.

@SpamhappyTootsie

how many times dis your blood pressure get taken at the surgery? Was it twice? the second reading is almost always the more accurate reading, especially with regards of WCS

go to a private menopause specialist or clinic

Nearly every thing you've told us they said can be disputed. Book a smear. Or if you don't want to tell her that. Say : is that a prerequisite, because I was under the impression it wasn't. Go in informed, Grow a pair of bollocks woman! Stand up for yourself. Argue the case and tell her what you want.

Do you want patches, gel? Progesterone. Tell her what you want. Do you struggle to stand up for yourself generally?

I'm sorry you've had this experience OP.

I had an appointment this morning to discuss HRT. It couldn't have been easier, I am astounded.
I listed my symptoms and she practically prescribed on the spot. I'm having a blood test anyway to rule out iron/B12 deficiency, but she's made a diary note to follow up my results in 10 days, and if there's no issues, she'll prescribe without me even having to go back in again.
She did take my BP but no issues.
I hope you get sorted soon

@Oblomov23

I reckon the OP felt overwhelmed and vulnerable this morning, and that can sometimes stop you feeling like you are able to control a situation.

I saw a uro-gynae a few months ago and I slightly went to pieces and I'm still annoyed about the way I handled it. (submissive). But I was so overwhelmed and upset before I even got in there, i was rubbish.

And of course you can't go off to the car park, have a think and then go back in ready to stand your ground!

The more I think about your appointment, the more cross it makes me. You arranged an appointment to discuss menopause and the nurse wouldn't let you talk about it, lectured you about smears and blood pressure and sent you away. It's not acceptable.

In your position I would re book an appointment with a gp to enquire about taking about what you want to do and if you don't have success then think about private or changing doctor.

I changed doctor after I got better treatment after taking my father with me on one occasion and realised that was the reason - a 40 something woman shouldn't have to take her father to the gp to get better treatment.

@SpamhappyTootsie with Boots, you have to say if your home BP was low/normal/high and if you've had a smear test. But certainly like the breast screening one it just says 'its important to do this, think about it'.
You can select just a consultation from the list of services, then fill out the thing about your symptoms and they will email you with advice as to what might suit - then they followup and ask how its going and say if you want to add more and so on

Are you overweight?

Have you been sexually active in the last 15 years?

I get that @Dogsgottabone. We can all be caught off guard. Wished we'd said something. Later feel fobbed off. But now we are all trying to help her. So she is better prepared. She can go in, to the next appointment, informed and firm. Get what she wants.

I did suggest that very same thing to you @SpamhappyTootsie about 2 hours ago, around 10am, before Mrs P!

My mum has had to monitor her BP under a consultant for a while, and I'm party to what they ask you to do.

What is your BP? How high is high?
It should be under 120/80

Take it twice a day at home.
You can take it 3 times each time (leave about 5 mins between each reading) and use the lowest reading as your record

Posted by me at 11.06