Recurrent Vulvovaginal Thrush

Firstly, I think just like a bit of compassion, like if you feel like someone understands like where you're coming from, and what you're experiencing, it like... it creates like a whole different... I don't know, it... the experience is very different when you feel like someone’s listening to you versus when you don't really feel like you've been heard properly, I think that that is like a fundamental, basic thing that is... that it should happen anyway.

Being gentle, like kind. Recognising that it’s something that might not be easy to talk about and that someone might have had to overcome a lot, just like in themselves, to even get through the door, so there’s actually quite a lot riding on how this appointment goes. Because if you’re... if you don’t do a good job, it sounds like a lot of pressure, but I don’t think it’s hard to do a good job: if you don’t do a good job, like they might not come back, that might put them off. Like I think it can put you in an extremely vulnerable position, and if an appointment is triggering... or difficult, or unpleasant, like you are not going to want to go back, are you?

Listen to what we're saying. We're not saying this because it’s a mild inconvenience, we're saying it because it’s... it’s affecting a lot of things in our lives. Listen to what we're saying. If you can, try and be empathetic, but the key thing is to listen and take on board what is being said to you, and also to be mindful that it takes a lot for some people to come forward and say, ‘well, this is an issue,’ so when they come forward not to dismiss them, just listen, and like... the key... the one thing I'd say is to listen, listen and listen. Where possible probe as well, ask a bit more questions, I know that’s difficult for certain people because they don't want to explain... but go back to your training and like what... trying to get the root of the issue, and also please don't say, ‘well, what do you want us to do?’ or have... because we're coming to you asking you to help us: if we knew what we needed to get done, we would do it ourselves.

Yeah, I guess my... mine would probably be like to really look at like the bigger picture. You know, look at all of these reoccurring episodes, and whilst obviously I understand the importance of treating each case like in isolation just to like you know determine for example if it is actually thrush that you're experiencing on that specific time, to kind of like look at it as a whole and how you can sort of prevent things from getting worse for people, rather than just giving them the one-off treatments when the flare-ups come about, like finding ways to help people to prevent the flare-ups and to break the cycle; I think, yeah, that would be my kind of advice I guess.

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.

Just I guess the same thing with them is like looking at it as a zoomed out, but also about the person and their lifestyle and, yeah, like the other sorts of things, like the other medications they’re on and if that interacts with it, and just always I think with the more holistic viewpoint is and about somebody and their life and who they are, and probably just always being nice to people around these things too, because I think when you speak to GPs and they’re a bit like standoffish, or cold, or... you’d probably get on and off... like on the phone and off the phone so quickly, so then you might like hold back information or not be like as honest or as open, so, yeah, if there’s like a way for GPs to be a bit like softer maybe and non-judgemental, and yeah, very person-centred, but I think obviously that health care’s just so hard and difficult, isn’t it, like GPs have to do so much and are up against it, so I just think that level of care’s like a lot harder to want to say give to somebody or able to give.

I think if it’s an individual’s... you know, if an individual... whether they are young or whether they are old, if they’re coming in with their first sort of like bout of thrush, or it’s been years since they’ve had thrush, I think in those initial appointments being... sitting with them and giving the explanation of kind of like what it is, kind of like trying to get rid of some of that shame, allowing them to understand that it’s not a dirty thing, it’s not a shameful thing, giving them wider information kind of like on the treatment options and not just saying we’re going to prescribe you this, you know, giving them those options on kind of like do they want the pessary, do they want the tablet, do they want like the seven-week course, do they want the immediate one-off course, do they need the creams, and going through all those treatment options with them and helping them to understand how it works and what it is, and some information sort of on ways that it can be prevented without saying... without trying to pass the blame onto them whilst... you know... and if it’s someone who’s... you know, someone’s coming in and they can see on their records that they’ve been in three, four times over the last year or two, not just saying, ‘here’s some medication to treat it:’ at that point saying, ‘right, well, I can see on your records that you’ve had it quite a few times, would you like to go down the route of maybe trying to look at if there is an underlying cause for this so we can try and sort it out for you?’

I’d hope that they diagnose it quicker for people. Take it more seriously and understand that it’s a... it’s quite a traumatic like horrendous experience to have, and if they can't cure it, make a very clear treatment plan for the ongoing time with clear expectations and clear conversations around how it can... how it will affect you, what the side effects are in your body, what’s the implication of taking it long term, with the hope that we someday get to a cure would be my ultimate aim, and just don't just... and like for them to not just try something to see if it works, like as in don't go... if you know someone’s got recurrent thrush don't just go, ‘oh, just take it for a month and see what happens,’ because nine times out of ten it’s not going to work: just go in with a proper treatment plan, or if they know it might not work: give that expectation. I think just be clear, and be honest with it, because I think the most disappointing thing is knowing that there... at the moment there isn't much out there to cure it or to stop it. I think that would be... and educate more people on it, which is I suppose your aim is to educate more people on it.

Provide information about it in your GP surg... I'd love, you know, to see some leaflets. I mean this is something I really have had on my mind to do myself really and talk to my surgery about it, but I don't see any leaflets in my surgery about vulval pain or thrush: have something on... have something on the wall or something online on the website that you can access. It would be great if... if health professionals could refer to things like online support groups or research programmes or that sort of thing. I think... I think that’s a kind of a big shame as well, because me personally I would... I am always up for anything like that, but yet every time I go to my hospital appointment, it’s me telling my professionals what I'm doing, what I found. So I think a lot of people would actually be interested in doing studies like this one, but they don't know anything about it, they just don't know what’s out there, and it would be amazing if kind of health professionals could know more about that in order to kind of provide information really.

Well, I'm still going to... yeah, I mean if I could conduct research myself, I would love to do it. I think at the minute it is very short term, it’s trying to manage the symptoms every month. The long term is I'm going to keep trying looking out for studies and if there’s a research team that wants participants... you know... I said that to my partner and I was like, “If you ever see anything, sign me up,” you know like, “I'll go for it,” and I think it’s not just finding the cure and things like that, I do think that maybe the health system needs a bit of a change in direction and maybe had a look at prescribing things, maybe, I don't know, there’s... if I was in charge or if I had the resources, I would definitely put more research into this area.