越过“一切都在你的脑海”
慢性背痛的妇女通常会被解雇，这些妇女经常被解雇。了解原因 - 以及该怎么办。
几个月来，您的背部最严重。您已经尝试了非处方止痛药，购买了一个新的枕头，跟随良好的睡眠卫生，甚至提高了您的运动商，但您仍然无法动摇这种可怕的痛苦。
根据您的研究，您想知道是否可能是强直性脊柱炎（AS）根据Mayo诊所的说法，一种主要影响脊柱的慢性自身免疫性炎症性疾病，导致慢性不适，但也可以针对其他关节，包括臀部，膝盖和肩膀，除了眼睛甚至心脏外。那么，您认为可以诊断出来，统治您的直觉要多长时间？
这可能完全取决于您是男人还是女人。
Until recently, doctors thought women rarely got AS. They believed that biological males were three times more likely to get the disease than females. Turns out, that’s simply not true. Newer research reveals that the actual difference in AS rates among men versus women is negligible—closer to 1:1,according to Arthritis Care and Research。
If you’re a woman with chronic or debilitating back pain that fails to respond to all the obvious remedies, and if you just know something more serious is going on, how do you get past the “it’s all in your head” syndrome, where doctors dismiss your concerns or misdiagnose your symptoms—an experience that, according to research, happens to a whopping 40% of all women with AS?
不同的身体，不同的症状
相信女性并不常见（并且深深地根深蒂固），因为这种疾病在男女身体中的表现不同。男人更有可能在脊柱中融合两个或更多的椎骨，这被认为是AS的标志。另一方面，妇女通常会出现更多无关症状的症状，例如肠炎，又称炎症，肌腱和韧带附着在骨骼上。妇女还倾向于产生更多的背痛，疲劳和晨毒。与男性的背部相比，女性的背痛通常是在上下后背部的，这可能是在下背部。当医生使用X射线评估AS的损害时女性的图像往往比男性表现出更少的疾病进展， 根据Current Rheumatology Reports。
由于这些差异，并且由于男性的症状长期以来一直被认为是常态研究表明，诊断可能需要大约两年的女性才能花费大约两年的时间than it does her male counterpart. During that journey, she may put a lot of time and energy into convincing doctors that there’s actually something wrong with her. In fact, if she’s like most women seeking a diagnosis of AS, research shows that she is two to three times more likely than a man to be misdiagnosed with other health problems, including fibromyalgia and—get this—psychosomatic disorders.
For these reasons, by the time a woman typically starts treatment for AS, her disease is often more advanced and has done more damage to her body than a man with a new AS diagnosis—and the harm done is not just to her spine.
“诊断的延迟与心理困扰有关”ANCA Askanase，医学博士说，，，，a rheumatologist at Columbia University Irving Medical Center in New York City. “Having to fight to be believed and feeling dismissed by health care professionals results in depression and anxiety. Earlier diagnosis can improve care, and early treatment with effective drugs can improve symptoms and health-related quality of life.”
妇女和慢性病
那么，什么给呢？不仅是有医疗机构感到震惊的女性，直到最近，这主要依赖于对男性身体进行疾病诊断的科学研究。传统上，研究人员更喜欢在临床试验中包括男性而不是女性，原因有两个。一方面，女性的激素比男性的激素波动更多，研究人员认为这些波动可能会偏向研究结果。而且，通常，研究人员将孕妇排除在临床试验之外，根据国家妇女健康网络。
这意味着许多医生在医学培训中学习了如何根据男性常见的症状来识别广泛的慢性疾病。实际上，男性的症状通常被认为是疾病的“经典”症状，而女性则可以归类为“非典型”。According to the book Gender Perspectives in Medicine，妇女在多达700种不同的情况下可能被诊断出来。
据CDC称，38％的美国妇女患有一种或多种慢性疾病，而只有30％的男性患有。这些疾病是美国妇女十大死亡原因中的七个。
这可能被忽略很多疾病。
女人做什么？
Whether you’ve been diagnosed with AS after months or years of trying to find a doctor who listened to you, or you’re still dealing with AS-like pain but haven’t been officially diagnosed, know that you are not alone, and you’re not wrong to feel dismissed. “Women’s health concerns are continually blamed on stress, hormones, and even [their] imaginations,” Dr. Askanase confirms.
Here’s some advice from patients, providers, and advocates on how to get the help you need if someone tells you, “It’s all in your head.”
保留出色的记录。触手可及的所有测试结果，图像和其他病历。在与新医生的约会中露面，并没有等待医生要求他们要求，宾夕法尼亚州费城的医生Marta Becker和M.D.日记我的健康，一个可帮助用户跟踪健康信息的应用程序。
这可能意味着在与新文档预约之前，您致电过去的提供商，并要求他们发送这些记录。或者，您可能必须在线填写一两个表格。或者，也许您已经可以访问患者门户网站，该门户可让您轻松地与其他提供商共享记录。无论对您而言是正确的，都可以在预约之前很好地排列所有这些。
Having your records, images, and test results ready before you’re asked for them may not only save the time it would take for your last doctor to send them to the current one, but it can also save your new doctor from re-ordering tests you’ve already taken, saving you from getting those tests again.
跟踪症状。你可以帮助医生很多if you keep meticulous track of your AS symptoms. Logging everything in real time helps because your doctor might pick up patterns or notice worrisome signs that you possibly ignored, or even assumed were benign.
问问自己的问题：
你感觉怎么样？
你什么时候感觉到的？
有多严重？
它持续多长时间？
Does movement help or make it worse?
症状爆发时发生了什么？你有月经吗？
你那天吃了什么？
你锻炼了吗？
你怎么睡觉？
天气怎么样？
然后写下来。“您的医生和其他医疗保健提供者是侦探，您可以给他们的线索越多，” Journal My Health的创始人兼首席执行官Tracey Welson-Rossman说。韦尔森·罗斯曼（Welson-Rossman）在诊断出反射性交感神经营养不良综合征和胸腔出口综合症之前，患有15年的慢性疼痛，并有适当的护理来控制自己的症状。她于2021年启动了自己的应用程序，以帮助其他患者避免该问题。
某些应用程序将与手机上的其他应用程序（例如锻炼应用程序或天气应用程序）同步，以帮助您将最准确的数据添加到AS症状日志中。
Other apps track symptoms, too. A few of them include:flaredown，，，，Symple，，，，andCareClinic。When you choose a symptom-tracking app, you want to make sure that it protects your private data and all sensitive health information while making it easy to share that info with your providers. You may have to read a lot of fine print to figure out what an app does with your information and how your privacy is protected. Before blindly clicking “I accept” on the terms and conditions, read it (or at least scan it) for details on how the app uses and guards your health info.
找到合适的提供商。您的感觉就是您的感受。您的症状是真实的，您最了解自己的身体。如果医生不愿意作为可能的诊断，则可以得到第二意见。和三分之一。您并不疯狂，您会像应该做的那样提倡自己的需求。
If you get the unmistakable message that the doctor thinks your AS symptoms (including all-over body pain that you just can’t shake) are just a figment of your imagination, it’s time to move on. “Find someone who will listen to you,” says Dr. Becker. We know—that means其他医生，其他一组形式，其他afternoon of missed work. But this is your health—so prioritize yourself, she adds.
相信你的肠子，然后迈出信仰的飞跃。贝克尔博士说：“一旦找到了值得信赖的医生，请相信他们。”如果您花了数年的时间从医生到医生来解决腰痛而没有结果，那么您可能会产生一些怀疑和不信任。但是，一旦您与一家医学博士联系，后者听到您的声音并认真对待您的症状，请与他们一起工作。
最后，提醒自己：即使是最有爱心，直觉，善解人意的医生也可能不知道发生了什么。强直性脊柱炎是臭名昭著的诊断疾病。Be collaborative and flexible and understand that it may take some time to solve your problem. So don’t give up.
强硬性脊椎炎和性别差异：MDEDGE风湿病学。（2021.）“在强直性脊柱炎中没有性别差异，患病率研究发现。”https://www.mdedge.com/rheumatology/article/245809/ankylosing-spondylitis/no-gender-gender-gap-seen-ankylosing-spondylis
强硬性脊椎炎和性别差异：Current Rheumatology Reports。（2018年。）“轴向脊椎关节炎的性别差异：女性不是那么幸运。”https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5949138/
Chronic Diseases in Women:全国州议会会议。（2015年。）“改善妇女健康，国家政策选择。”https://www.ncsl.org/portals/1/documents/health/whchecklist12-15.pdf
Autoimmune Diseases in Women:新兴的传染病。(2004.) “Women and Autoimmune Disease.”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3328995/
Long COVID in Women:Clinical Microbiology and Infection。（2021年。）“女性与长期共同综合征：一项前瞻性队列研究有关。”https://pubmed.ncbi.nlm.nih.gov/34763058/
