Billie

Age at interview: 25

Brief Outline:

Billie has had suspected recurrent thrush since she was 18. She has seen over ten GPs and has not tried self-treating. Billie has found support online and plans to advocate for a long-term course of treatment at her next appointment. 

Background:

Billie (she/her) is a straight woman in a long-term relationship. She works as an accounts manager. Her background is white British. 

More about me...

Billie has had suspected recurrent thrush “on and off” since she was 18. She feels it has been “a long old road”.

Her symptoms include itching and pain with penetration. She does not always get an uncomfortable discharge. Over time, Billie says she has become “used” to being uncomfortable.

Recurrent thrush has impacted Billie’s mental health as she is exhausted from “constantly fighting” for her health. Her sex life has been impacted, but her partner is supportive.

While at University, Billie first visited the GP for recurrent thrush. The GP did a swab and provided one antifungal tablet. Since then, she has seen around ten different doctors. Billie found interactions with healthcare professionals frustrating as she was given “short courses” of treatment that did not stop what she thought was the thrush from returning. When Billie was younger, she found swabs embarrassing, but now she says that because of “going to the doctor’s loads”, she is more likely to ask for a swab to confirm that it is thrush.

Billie said the doctors always treated the thrush as “one-off cases” that were “minor”. She found the “constant back and forth” difficult when physicians did not consider all of the episodes together.

In terms of treatment, Billie has found relief in taking oral tablets and external steroid creams. However, she says she is unsure how well the pills work since she hasn’t had a long enough treatment course. She finds the pessaries uncomfortable. Billie has a medical exemption card but said recurrent thrush would cost “a fortune” without it. She has not tried self-treatment at the pharmacy. Most recently, Billie saw a consultant gynaecologist and said that her partner should also use the thrush cream. Billie was happy to get new advice and said the thrush cleared quicker than usual.

About three months ago, Billie was diagnosed with endometriosis. She recalls reading the back of her endometriosis medication and seeing it increased the risk of thrush. She was frustrated to be given medication with this side effect as her physician was aware of her history of recurrent thrush.

Billie said that she has had to research recurrent thrush, which has been “a lot of effort” from her side. She says that some of the advice on the NHS website doesn’t feel like medical advice, such as telling you what clothes to wear.

While Billie lives with other health conditions, such as inflammatory bowel disease and endometriosis, she finds recurrent thrush the most difficult to talk about. It takes Billie a few days to call the doctor as she feels “imposter syndrome” and worries her symptoms are all in her head. However, Billie has found support speaking with others on social media who have had similar experiences.

Moving forward, Billie has plans to see a GP, and she plans to ask for a longer-term treatment plan. Billie encourages patients not to avoid asking questions and advocate for themselves in doctor’s appointments. She advises GPs to review the patient’s entire thrush history, conduct swabs, and follow up.

Billie now asks for a swab to confirm the presence of thrush because she does not want to take unnecessary medication.

Yeah, when I was younger and constantly going back and I’d just describe my symptoms, and they’d be like, “Oh yeah, that’s probably thrush,” and there would be... and then that’s it, they'd write me a prescription and send me home, I'd take the meds, I'm like, ‘OK, it’s fine,’ but I think since I've got a bit more... like through the system, I understand how things work from a medical point of view a bit more just purely out of going to the doctor’s loads, I will more than likely ask for it now, to say like ‘I just want to confirm through some sort of swab because like I don't want to be taking these meds and it’s currently... you know it’s... it’s not thrush, you've given me it and then it actually it brings thrush on maybe further down the line’, so I’d always ask for it now.

Billie had not yet had success in having healthcare professionals “consider all the other episodes” of thrush together and continued to get short-term treatment.

But I would say it’s the constant going back and forth to a doctor where they only give you a week’s worth of treatment and they don't sort of consider all the other episodes you've had throughout your life and there’s no sort of, ‘well, why are you getting it so often?’ but I don't think anyone’s ever asked me like, ‘well, this is maybe the fifth or sixth time you've had it in 12 months, why is that, maybe is there something else going on?’

And these are so routine things, like a doctor should be able to say like, oh OK, we're clearly looking at the amount of times that I've been given the medicine or prescribed or the... the appointment notes and things, but they just don't bother, and I think that’s really sad. Then also it’s not even like I've been to the same GP every single time, I've been to probably a collective of maybe 10 different doctors and none of them have ever considered to say, ‘well actually, maybe we need to do a bit more of a full sweep on you to see why you're still getting it and why it’s been so... so sort of like regular,’ I guess as well.

Billie said that difficulties around accessing healthcare and advocating for herself added to the mental health burden of recurrent thrush.

I think my... my mental health around the whole thing is more the exhaustion I'm having to constantly fight for your health and advocate for your health, I would say that’s probably more the side of it. And having like the anxiety of having to ring the GP and try and get an appointment is something I've always experienced for a long time, it’s kind of sitting on hold for like 25 minutes and then they finally answer and it’s like, ‘ouu, ha...’ and I like lose my words, so that’s probably one of the only like mental side of things that it would affect me. But work: not... not necessarily. I guess the booking of hospital appoint... doctors’ appointments and things like that is where it kind of can sometimes infringe on the work I do, but I work in health care so they're all pretty comfortable and pretty open about the whole thing, so yeah, not... not so much on that side.

Billie said that if she did not have a medical exemption card, recurrent thrush medication would “cost a fortune”.

Yeah, I mean it was... I could say financially if I didn't have my medical exemption card it would cost a fortune to go and get prescriptions, alongside all the other medications I'm on as well, you know, and I can imagine that that really stacks up for a lot of people if they are constantly getting... like you're always having to go back to a GP, and especially with the hikes in prescription charges, and the assumption that just because it’s something that when... well, some people get on kind of a short-term basis, there’s no allowances for recurrent thrush in terms of the prescription charges, so like you'll just have to pay whatever it is now, like £9.85, every single time you go, and if like you say you know if you're getting anything between five and 10 times in 12 months, I mean like it’s so much money, so yeah, if I didn't have a medical exemption card it would cost me a fortune, and especially in a current you know cost of living crisis, I imagine that they may make some people choose between being able to afford a prescription and being able to afford food, which should not be... that should not happen.

Billie found that healthcare professionals did not always look at her medical history to understand recurrent thrush.

And these are so routine things, like a doctor should be able to say like, oh OK, we're clearly looking at the amount of times that I've been given the medicine or prescribed or the... the appointment notes and things, but they just don't bother, and I think that’s really sad. Then also it’s not even like I've been to the same GP every single time, I've been to probably a collective of maybe 10 different doctors and none of them have ever considered to say, ‘well actually, maybe we need to do a bit more of a full sweep on you to see why you're still getting it and why it’s been so... so sort of like regular,’ I guess as well.

Billie hesitated to call her GP due to concerns that others had “worse” health conditions to book appointments for.

It takes me like three days to ring them: one) because I know I'm going to be sat on hold for so long and partly because it’s like ‘uhh, again,’ like they're going to be like, ‘you keep coming back.’ [chuckles] I think that... I don't know what it is, I think because it’s difficult to get a doctor’s appointment at the moment, I think that Covid has really had a massive impact and I think that if you turn up to a doctor and be like, “Oh, I think I have thrush again,” again it comes back to the dismissive point of view where it’s like, ‘well, I've got so many other patients that have got worse things than you do,’ like, ‘why are you wasting my time?’ I never ever want to waste a doctor’s time, and I think that sometimes I talk myself out of saying I need to go to see the... see a doctor because I feel like I might be wasting their time, which I know is not true, but I think that that can sometimes be the reason why it takes me three days to call them.

Billie expressed frustration that clothing recommendations did not feel like “medical advice”.

I also find the NHS and some medical advice, for me, doesn't feel like medical advice: like on the NHS website it says that you should not wear tight clothes, I'm like, ‘well, that doesn't feel like medical advice,’ and I also don't think that’s appropriate to start telling people what... to an extent, start telling people what they should wear when they're not actually then equipped with maybe the right research or the right resources to solve the root of the problem, it’s almost like you're putting the onus on the patient to be like, ‘well, you're wearing tight jeans so it’s your fault,’ and I feel like that isn't medical advice.

Billie was “constantly” given short-term treatments by healthcare professionals.

So, I’ve been back to lots of different doctors. So, it’s been like my... when I was sort of... up until my early 20s it was the same GP and they were the ones that were constantly just giving me pessaries all the time and creams and all these different kinds of pills, and it would be the same thing. You know, I would go, they’d put mean me on a course for a week, I’d come back and they’d be like, “Oh OK, well, we’ll put you on for two weeks,” and that was it, that’s all they gave me, and I was going back probably once every three, six... three to six months, and nothing changed.

Billie said that getting used to recurrent thrush was a “double-edged sword”.

I’m partly used to it now, which obviously you shouldn’t have to be used to anything that’s uncomfortable, and... but I think that being used to it, in a way, is a bit of a double-edged sword because I’m like, OK, I’m used to the symptoms, I know what I’m looking out for and I think that that can be... like there is a lot of power in knowledge for sure, in really knowing what you’re looking out for, but at the same time it’s like that, [sighs] ‘how annoying,’ when I do get it again.

Billie considers that there needs to be more information, training and research on women’s health.

I would say... I mean I know that the Government’s just appointed... I can't remember her name, just appointed someone that’s essentially going to manage women’s health for the NHS and for UK, which... or it might just be England, which is something that it’s a bit closing the door after the horse has bolted, you know we've got an enormous issue with women’s health and understanding women’s health, there needs to be better understanding, there needs to be more research, there needs to be more understanding and available information about women’s health and hopefully that’s something that you can see that is happening.

Online conversations helped Billie to gain confidence before seeing her doctor.

But I do find that since I've been chatting about it more online and chatting to people that I know that have it, that’s been actually quite nice and being open about it because I do think that things like... like bacterial vaginosis, thrush, cystitis, they're all the things that you're just kind of expected to just get and get on with and go to a GP and sort it out and never talk about it, and I think it... you know, studies like this, and then talking about it with other people, it stops like vaginal thrush being so scary or so kind of hush-hush. So yeah, that’s kind of more of... I guess a silver lining to the itch [chuckles].

I found that speaking to girls through social media and people who have had it, like from experience, has been much more helpful, and especially it kind of almost gives you the confidence when you're speaking to someone that’s like, ‘no, keep going back to the doctor, keep telling them what you want, keep trying to advocate for yourself,’ that is much more helpful.

Billie encouraged patients to have the confidence to question clinicians if they feel something is wrong or they are not confident about a decision.

I think for patients, it’s you know your own body, I wouldn’t... like don’t let a healthcare professional tell you what’s wrong with you if you don’t feel like that’s right, like don’t walk out of a doctor’s appointment going, ‘mm, I’m not sure about that,’ I think that it’s... it’s really, really hard to sit in front of a doctor and go, ‘I don’t agree with you,’ that’s so difficult and it’s something that is equally brave and scary to do at the same time, but it might be the one thing that makes them question it and go, ‘oh right, OK, if you don’t agree, you don’t think this is right, how can we work together to sort it out?’ I think that’s really important. It’s not easy, it’s really tough.

Billie felt that sometimes healthcare professionals “treat the issue but they don’t treat you as a person”.

I think for providers it’s looking at someone as a whole, you're not just treating a prob... you're not just... they're not just sat there in front of you with recurrent thrush potentially once, you know it’s a case to be treating someone as a... as a whole person rather than just that one thing they're there to see you in. You know is it that they've had thrush and you can see on their records they've had it four times before? Well, don't just give them treatment for a week and tell them to go home, right, obviously is there something else, do they need blood tests, is there something in their diet they can be doing to try and support that, what else can they do? I think that there’s a case to be made that a lot doctors, and I'm not saying this is blanket across the NHS, because I'm sure some don't do this, but from my experience there is the case you may be... you go to the doctor for an issue, they try and treat the issue but they don't treat you as a person, and I think that that’s something that’s really important.

Billie planned to re-engage with her GP about recurrent thrush

I am very much going to go in and say that this is the fifth time I've had it so what are you going to do, and I don't think that two weeks of treatment’s going to cut it, so I think I'm going to treat it more as a conversation rather than them telling me what I should have, which I think is quite a good... good way of going about it.  I've only ever... the current GP I'm going to go and see is relatively new, so I've only recently been a patient at this practice, and my experience with them so far’s been brilliant, so I have hope.