Friday, April 23, 2010

A Successful Visit to the Doc for that Pesky Exam

Hello Friends:

I had my annual physical exam yesterday, and it actually went pretty well. This is in contrast to my physical last year, which ended up being something of a disaster. That situation was what motivated me to try harder to express my needs and get advocates for health care. I have too many CPTSD flashback triggers in doctor's offices and hospital settings. The environments are too threatening. And as you know I recently geared myself up to visit the obgyn for the first time in years. I used a lot of my tips and ideas (from post I and post II) to make that visit go better, and it worked pretty well.

So I went into my yearly physical a bit more prepared. I took my Ativan the night before to ensure a good night's sleep. And since it isn't fully out of the system in twelve hours, I had some left to help buffer the visit itself. I had my husband come with me, so that he could listen to the advice I was given, and make sure I didn't forget to mention anything important. He also gets to sign all the forms so I don't have to touch any contaminated pens and clipboards. Ewww. I wore comfortable, loose fitting clothes and a tank top. This turned out to be a big bonus since they didn't have to remove it to do the standard EKG test. (Having to take off clothes makes me feel shaky and vulnerable.)

Let's see ... I brought a food bar to scarf after the blood test, and asked right up front for juice. Last time I spent the visit in a state we call, "gone a$$hole from hunger induced madness of the brain." This time I got my blood sugar right back up. I also had made sure to drink lots and lots of water the night before and day of, so the tests were easier. Nothing like performance anxiety when you are trying to pee in a cup.

I told the nice nurse I wanted her to take my blood. She says the same thing every time, "There are others better at it than me.  It might hurt more if I do it." She still does not quite understand that it isn't about pain, it is about personal trust. The pain of the stick is not what bothers me, it is the feeling of helplessness, the loss of control, the sense of violation (along with the fear of contamination.) All of these things are much less of a problem if I know that the person I am working with sees me as a real person, respects my limits and boundaries, and will take me seriously when I say "There is one vein. One. Only one that will work. It is right here." And she does, and did. We hit it on the first try, and the rest was cake.

But most importantly, my doctor is finally catching on to what it means to have a patient with PTSD and very bad anxiety. I asked specifically for continuity with the staff. This is a trick in that practice since people are always coming and going. But she is going to try. She made of point of having me introduced to the new nurse I'll be working with (when the old nice nurse retires, boo hoo) and introduced me to the manager of the front office. I've also been told to ask specifically for the manager any time I have an issue. This "permission" will make it easier for me to feel like I have a right to stand up for myself. Even if they forget, and they often do, I'll remember.

And even if I get the run-around for something in the future, just having gone through this will make me feel better. I felt respected. I felt like people cared about my individual needs. They still don't really understand. For example, my doctor still has me on five different supplements (I do need them, I do have all the deficiencies they are supposed to fill.) But when I told her I couldn't take them consistently, there were just too many, she couldn't understand that. No matter how many times I tell her that every single pill is a struggle, vitamin or not, she doesn't get it. So I will probably remain semi-compliant with my meds. I will always try, but there is only so much of me.

However, they are trying. And I am trying. It all feels much better. Still very scary, but it has become something that can be managed, something that can be coped with.  I didn't dissociate once during the whole visit, even during the blood test. I was present in the moment, and had only a few episodes of hyper-aware anxiety. And then I got a french-toast breakfast. Oh yeah.

Your Hostess With Neuroses

Image credit/info: Photoxpress


Andy said...

I'm glad that went well, and I'm glad french toast was a reward. :)

Is it easier on you to have a whole bunch of things in one visit to get over with (or over a short time), or do you do better with things spread out over multiple short visits?

The Blue Morpho said...

Hey Andy - Interesting question. I hate to say it, but it probably is completely variable. Depending on how I feel, what my resources are, how things have been going, etc., it can be better to pile up or better to spread it out. Generally, though, having too much to handle at once can cause a big crash if it goes bad. So although spreading stuff out can be a pain, it might be the wiser approach.

expwoman said...

Yay for taking care of yourself! That is very cool. I freeze like a deer in headlights when talking to doctors, and have trouble remembering what they said or what I want to ask about, so I like your idea of bringing your husband.

The Blue Morpho said...

Expwoman - Exactly. I get freaked out and then I don't say what I wanted to, and don't remember everything they said, either. Barring recording the whole thing, taking an advocate along seems like the practical solution.

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