Recurrent Vulvovaginal Thrush

I think for the first time I think I wasn’t aware what was that. So, went to see the GP it helped me because you see if you have something that you... you don’t understand and you have a discomfort, it... you know, it’s there... what can I say, down there it’s really sensitive, so the moment you feel that something is not right, you won’t be well and you feel very stressed, so going to see a GP, it helped me to identify that it was thrush.

Yeah, so I think generally I'd say... generally I would say that the local doctors were more sort of, ‘oh, it’s just thrush,’ you know, ‘here’s the medication, go away,’ kind of thing, where I would have said that the nurses that I saw, usually within the doctor’s practice, seem to have more of a sympathetic attitude, and actually I think I've now come to realise that sympathy with something like... like recurrent thrush is actually really important for me, because apart from anything else I needed that validation that, ‘yes, I am actually suffering enough for it to need treatment and help,’ because there’s so much of the... in my experience, there’s so much of the female experience that is just, ‘get on with it,’ you know, ‘take some medication and get on with it.

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.

I think if it was a really big flare-up then I would absolutely go. I think but... I think because I’m just... be able to contain it myself, then I think, ‘why would I go to the... the GP?’ But now I’m starting to think now, ‘well, this has been nine months now, maybe having that... that time under my belt, I can sort of say... I can turn round and say, ‘listen, it’s not just been a couple of months,’ you know, I’m... I’ve got that longevity under my belt now, so I can say, you know, ‘this has been this amount of time, it’s obviously not disappearing, you know, it’s obviously not... there’s... there’s something there that needs... I probably need some help with,’ maybe, I don't know.

The thing is with the chemist, if you say to... if they say to you, “Oh, how many episodes of thrush have you had in past so many months?” and I’m honest – they won’t give it me, they’ll say, “Ouu no, you’ve got to go to your GP,” well then your GP will say to go to the pharmacy. And I understand where the GPs are coming from, because they’re very busy, and you should just be able to pick something up like that, do you know what I mean? But anyway, automatic... anyway I went to... so I went to... when... when I go to the pharmacy now to get the cream, I just lie, I just have to say... I lie... I just have to lie, and that’s how it’s got, because no one wants to help you.

I have to get... so I've got them from over the counter at pharmacies. Sometimes they just are like, “Have you had this in the past...” sort of they’d just be like, “Oh, have you had this in the past year or six months?” Me: “No,” is lying, and then they just believe me and give me it, but sometimes they're like... I've occasionally had people say, “No, we can't give you this because you don't have a prescription,” then I would just like, “OK,” and then I'd be like, “OK, that’s fair enough,” and me goes next door.

To go to a different pharmacy down the road because it’s just... I think once I get into a pharmacy, if I get denied it, I'm like the desperation kind of gets to me and I'm like, ‘I am so uncomfortable, I need this right now or I will scream and things,’ so I just kind of get more desperate and more willing to lie to pharmacists which is not a good practice to get into if you have other chronic illnesses.

I also think I slipped through the net because it’s so easy to buy over-the-counter treatment, and I wonder... I mean I’m... I’m pleased it’s easy to buy over-the-counter treatment but I am you know genuinely slightly horrified by the amount of over-the-counter treatment I’ve taken, because also the check is like... I lied constantly to people in Boots who were like, “Oh, have you taken this pill in the last six months?” “No.” I would have taken it like three weeks before, I just wanted to have it again, and I think I’ve probably [chuckles] taken that pill like way too many times, and that cream, and I’m not a doctor and I don’t understand what’s in those and I put those in my body probably upwards of thousands of times, so I wonder if there could be a way to catch... I mean I don’t know how you’d do this and you’d get into big brother territory, but like it would be great if somebody had noticed that a 23‑year‑old woman was going into Boots and spending all her money on... on thrush medication and like arguably taking way too [laughs] much of it. So yeah, I think there are definitely structures that could be built-in to help catch it sooner.

Yeah, it’s quite hard to remember exact because I have seen so many different people. Like I have... I've been to like my GP before, and that was probably the first interactions that I had a GP, and at the sexual health clinic. And yeah, the... I think the sexual health clinic were a lot better because they were more kind of thorough with their investigations, like they would do like a physical examination, they would go and send off tests, they would in the end start looking at like you know samples like under a microscope.

I went to... no, actually my consultant at the hospital does a... a joint clinic with the sexual health doctor and she happened to be in one of my appointments, and she said that you know if I ever wanted to go and get tested for thrush, or have a general check-up, I can contact the sexual health clinic at any time and pop down there, you know, they have appointments released daily, so if I was in a bad flare-up, I could just contact the sexual health clinic and pop down there and see one of the nurses and they would then do a swab and see how I was getting on and see if they could recommend anything more quickly than seeing my GP or waiting for the consultant.

I think I just wanted to know whether there was anything else I could do to try and stop it coming back all the time, so I basically just went to the doctor and said, “I’ve had this many episodes of thrush and, you know, I think that this is... I’m having this... getting this more than normal, what can I do about it?” and was sort of why I went in the first place, and yeah, and then that was when I tried the sort of longer course of medication. Yeah, I think I was quite comfortable with doing that, like by that point I’d already been to see the same doctor about a UTI and got thrush as a result of that, and then I’d already been to see the same doctor about the discomfort I was experiencing having sex after having thrush, so I kind of was quite comfortable with then going and saying, “Actually I think I’ve got this thrush thing recurring like quite... you know, more than... more than most people... is there anything we can do about that?” I think I just wanted to try and sort it out, so... yeah.

I mean I think on the whole I’ve had quite a good experience. I would say that it was like really important to me that I didn’t feel like... like judged or ashamed, or like it was anything that I was doing that was making this happen, and that was quite a relief and quite important that I got that from the people that... like the doctors that I saw.

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.

I wasn’t able to get in with my GP because of the... the situation with, you know, staff shortages, Covid, and everything like that, so it was a massive challenge, so this time I was self-medicating and paying for it myself for probably three months before I actually managed to speak with the doctor properly, and even then I was having to use... it’s called ‘Push Doctor’, which is like an app, so there wasn’t enough GPs in my practice, so I was only doing it through like video calls, which was quite frustrating because no one could actually test me or do anything about it, and it was only when I’d seen by accident, say, a Push Doctor a couple of times and he was just like, “We can’t go on like this,” so he sent a special request to my GP, which kind of prompted them to see me, and he also put a referral into gynae, so he really got the ball rolling for me.

And also you know they ask for photographs or imagery of the relevant area, and obviously when it’s genital stuff, you can't send that, and yet at the same time that’s pretty crucial for appropriate diagnosis, and I understand why we can't send it, and I don't particularly want to send it, but at the same time it’s a bit like, ‘OK, so you're giving me the stuff and you haven't got a clue what’s going on, you haven't actually seen what the state of my skin or whatever,’ so yeah, it’s a mixed bag I'd say, but I understand, and I've got lots of friends who are GPs here and I understand why they've gone down that route and you know it’s... it’s kind of OK.

I think I was probably... you know I was taught to respect authority and I was a very well-behaved sort of docile young woman, and I wasn't particularly pushy and so I think... I think there’s another factor which is that as I grew up, I became more like cognisant of... of systems of power but also of like... I think I gained confidence, and so I think there’s probably another reason that I got referred is that I went, ‘this is not OK, this has to stop;’ whereas I reckon when I was 22, I just went, ‘oh OK, well, the doctor said this, and this is what the doctor said.’

Yeah, I’m at a different hospital, but I... I had to keep going back to my ANP because she was the only one that seemed to listen and understand. I think... [sighs] I don’t want to sound like I’m needy, it wasn’t that... it was just that you get to a point where you’re just so frustrated because you’re trying to do all the right things and no one is explaining anything to you, and it’s just... I’m just like, ‘can you just tell me what we can do,’ and I don’t mind taking ownership of my health, that’s not a problem, ‘but what I need you to do, as the professional, is explain and try and help me get to that point where I don’t have to keep coming back to you for the... for the same thing.’

I was only going to the pharmacy in that like initial time between first going to the GP, when I hadn’t quite figured out that it was like an ongoing thing and I thought I was just kind of having these discrete episodes, and so as soon as it became more recurrent then I kept... I went back to the GP, because when I went to the GP I wasn’t just getting like a one-off... like a single-dose treatment, I was getting like a... a slightly longer-term treatment that would then keep it like at bay for a little bit longer.

They don’t ask you how it affects your life, or they don't really comment on it, like they don't even say like, ‘oh, that must be difficult,’ and just the fact that they weren't doing anything and weren't... there was no, like pro-activeness and there’s no, ‘I don't know I'll go and find out,’ or like, ‘this is what helps my other patients,’ because they're not asking their other patients what helps, things like that.

Yeah, it was just a lot of feel... feeling like... I felt stupid a lot of the time, like I was being over the top about it, but you know, trying to do your job while you’ve got... you’re getting driven insane by the itching and you know it is something that’s not going away, it just kind of felt like the buck was getting each time, then: “Oh, well come back in a couple of weeks’ time.”

I really remember having one appointment with the nurse the first time I had it, and it was really like she was just kind of suggest... made me feel like I was overreacting, and then having the multiple appointments where I wasn’t getting anywhere, that’s... so it made me feel like I was overreacting.

I was saying that in terms of me going to the pharmacist instead of the doctor: the first issue is I we tend, or rather I tend to see that... I thought oh this illness is not really... so something I can call a doctor about, I seemed to downplay it, most women that I can’t really calling the doctor to say, ‘I’ve got a yeast infection,’ and when there are people, you know, serious condition that should be calling the doctor, I might be wasting the doctor’s time, so rather let me just go and get the medication for myself instead of wasting the doctor’s time. But obviously this is motivated by the fact that I’m really shy to be bringing this up, because the receptionist will be asking me at the beginning, “What is your problem?” and then I say, “Yeast infection,” so it’s something that I’m really, I’m shy about, so my motivation would be go to the pharmacy and avoid having to have the pertinent conversations with the doctor.

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.