Thursday, March 25, 2010

Going to the Doctor Part II of II - The Visit (or More Tips for Dealing with White Coat Anxiety)

 Hello Friends:

Well, today I go to the doctor for my 'yearly' check of my womanly bits, as I noted yesterday in my post Going to the Doctor Part I of II.  I can't tell you how very badly I do not want to do this.  I really don't want to go.  But I am going.  I am going to put on my brave persona, and I'm going to do this.  First of all, because I need to get this done.  Second of all, because if I let myself be frightened away I won't be able to test how well my suggestions worked.

And then I won't be able to post about it.  Blog as motivation.  Whatever works.

Anyway, here are my tips for the day of the doctor visit. Assume you already did what you could from my list of tips on yesterday's post, and now you have an actual appointment to go to.  (Like, say, I do.)  Again, all of these tips might not work for you, but some might be of use.

Some preparation the day of the visit:
  • If you are, in fact, experiencing anxiety about the visit (har) try to put your finger on exactly what you are concerned about.  Claustrophobia from the small rooms?  Afraid of needles, contamination, germs?  Maybe it is a sense of violation or that someone will take advantage of you.  Some people are afraid they will get bad news about their health.  One of my fears based in past trauma and PTSD is the fear of being yelled at, put down, told I am irresponsible and such.  If you can identify the things that are causing your anxiety, you can work to try to accommodate them yourself, or to get the doctor's staff to do so.  You can also be proactive simply by naming your fears and doing some cognitive self talk to mitigate them before you go.
  • Do you have a med you can take as needed for anxiety?  If so, take it.  In my case I have a prescription for Ativan to take when I travel, to deal with crowds, and in case of a sudden panic situation.  If you don't have a med like this, you can always talk to your doctor about getting something to help you through tough situations.  I will be taking my Ativan an hour before I go.
  • If you know you need to have a blood test done, drink water.  Dehydration makes it more difficult to spot those hidden veins, and water will increase your overall blood mass.  Naturally, you'll need some water for that urine test, too, huh?
  • If there are specific issues you want to bring up with your doctor, write them all out ahead of time.  I can't think in that office with my anxiety running so high.  If your support person will be in the exam room with you, give them a copy, too, so they can help keep the visit on track for you.
What to wear:
  • Comfortable clothes that are easy to get on and off.  
  • Short sleeves in case of blood pressure test, etc.
  • Socks to keep feet away from cold floors and cold, ahem, stirrups.  
  • Shoes that slip on and off (in my case that is critical since I can't tie shoelaces that have touched the floor of a doctor's office.)
  • A sweater to keep warm in chilly examination rooms.
  • I'll note that sometimes I wear something very specific to make me feel safer or more powerful.  I have a necklace with a dragon on it that I use for 'protection'.  Sometimes I will wear a suit jacket to the doctor because it makes me feel like people take me more seriously.  Consider what might make you feel more at ease, or more in control.
  • Also in my case, I don't wear anything that can't immediately be stuffed into the washing machine when I get home.  Doctor's offices feel contaminated to me, and I want those things off and washed as soon as possible.
What to bring:
  • Bring spouse/friend.  My hubby will be driving me there, sitting with me in the waiting room, and will probably be in the exam room with me, depending on how I feel.
  • Bring bottled water and a protein bar to munch immediately after the visit, especially if you had to fast beforehand.  My blood sugar plummets in stress situations as adrenaline spikes and then wanes.  A little food and water help me a lot.
  • Bring your OCD coping items.  Normally I try hard to keep from overusing things like disposable hand towels, but a doctor's visit is not the time to be stingy with coping mechanisms.  So I bring my own towelettes, hand sanitizer, pen, and even tissues.
  • Take a really engrossing book for the wait around.  
  • Take a purse or bag that you can wash.  This is a big one for me.  I put my things into the bag, and then when I get home I dump them out.  My book is 'clean' and I put the bag into the washer along with all my 'contaminated' clothes.  Whew.
  • Do you need a comfort object?  They do it for kids, and really, all of us have wounded inner children.  Kids might bring a favorite toy, story book, or stuffed animal.  Treat yourself the way you would have wanted to be treated as a child in this position, and bring a symbol of comfort.  I'm taking my stuffed Stitch 'animal'!  (He'll bite the bad guys.)
At the visit:
  • Ask for the accommodations you need from the staff.  They might not be able to do everything, but sometimes a little is all you need to know that people are looking out for you.
  • Stay as relaxed as possible by distracting yourself with your book, talking with your friend, meditating, listening to ipod, whatever.
  • Keep reminding yourself that you are at the doctor for very good reasons.  Tell yourself about how the tests are a necessary part of health care, and that doing them is important.  You are taking control of your own life, health, and well being.
  • Remind the staff and doctor about your mental health issues.
  • Ask the doctor what to expect during any procedure.  How long will it last?  Will it hurt -  how much and how long?  Where will you have to touch me?  Will I be in this room alone with stuff attached to me?  Will anything like alcohol or another substance be spread on my skin?  Ask about anything that concerns you.
  • Refer to your list of questions, and have your friend help make sure you get all of your issues addressed.  Don't let yourself be rushed.  You are paying for this visit.
  • If necessary, have you or your friend write down comments and suggestions from the doctor so you can refer to them later.  This takes the pressure off of having to remember the whole conversation while trying to ignore that small drop on the floor that might be ... who knows what.
After the visit:
  • Give yourself a big cheer, you deserve it!
  • Reward yourself.  If you had to fast for a test, maybe a great breakfast or lunch would be a good reward.  Personally, I like flowers and chocolate.  Anytime.
  • Be especially gentle with yourself for the rest of the day.  The visit might have been tough, no matter how well you prepared.  Give yourself the slack to relax, take a nap or a hot bath, read a book, play video games, have a glass of wine in front of the fire, or whatever works for you. 
And that's what I have to offer, today.  I'll be doing a lot of this myself, obviously, and I'll let you know how it went.  Please send comments on this list, or more suggestions for stuff I might have missed.

Your Hostess With Neuroses

Image credit/info: Photoxpress


Amy said...

That is some good advice. I have a blood disorder and have been getting regular CBC's for years. Drinking lots of water right before a blood test is a good idea, and if it's not a fasting test, it's good to have a meal beforehand. That always helps me.

Bringing someone along can make a difficult doctor visit a lot easier. I go to many of mine by myself, so I've learned to have my cell phone to text my husband, a good book, and a little spare cash for a treat after the appointment.

Andy said...

Again, a lot of good suggestions there in general. I think people expect to just kind of go in there and take it, the idea of trying to make things easier on themselves doesn't necessarily cross their mind. I wonder why that is?

The Blue Morpho said...

Hey there Amy - Regular blood tests would probably make me lose my mind. You are brave! Nothing like a good book to keep a person distracted ...

The Blue Morpho said...

Hello Andy - I suppose if people are only mildly inconvenienced, then they simply push through. It's different if you have an anxiety disorder and find the thing so scary you don't go, and therefore don't take care of your health. Most people don't find standing in line at the grocery store to be anything other than annoying, but it makes me very anxious.

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