Ugh, Medical Examination & Tips

Recently I've had the "great joy" of experiencing many medical issues and have been prodded, looked over, and have experienced trigger after trigger.  Sitting in a doctors office, stripped down and only covered by a thin paper gown is not a favorite for most of us.  As I've needed medical attention I've had to fight the fears and uncomfortable feelings that come along with it.
 

Feeling so vulnerable, having people touch me everywhere and needing to look and study my body has been extremely triggering to say the least as I'm sure it is for many survivors of childhood sexual abuse.  The medical professionals can easily direct and take over the exam and the feelings of a abuser/victim relationship can resurface.  It can be a difficult and traumatizing experience just to get the medical help you need.  I often find myself waiting as long as I possibly can, sometimes even putting myself in more danger, to get the medical help needed.

There are a few things I've found to be helpful.  Sometimes they work and sometime I still want to run out of the examination room screaming and punch the doctor on the way out but...I'm working on that.  A few months ago I found this book, When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbearing Women that has MANY great tips in working with medical professionals if you are a survivor of sexual abuse.

Another place with great information is The Canadian Women's Health Network.  Some of these tips are focused on female survivors but many of them are universal principles we've already discussed on this blog such as finding ways to stay in the present instead of disassociating.  I have used many of these tips.  Not all of them work for me and honestly depending on why I'm visiting the doctor the only way for me to get through it is to disassociate during the exam and then comfort myself every way I know possible afterwards. 

In a similar vein I also found an article written by a survivor of sexual abuse and having fears and triggers with visiting the dentist.  The article can be found at Dental Fear Central. 

This list is from The Canadian Women's Health Network.

 

What survivors can do to prepare themselves for medical examination:

 

Find a health care provider with whom you feel comfortable and trust. Many women survivors prefer female providers, especially for reproductive health care and where invasive procedures are involved like ultrasound that may require an instrument placed in the vagina and any breast procedures. 

Knowing your rights and your needs will help you be more assertive and confident. For instance, you have a right to refuse or stop a procedure or examination. Often a women's healthcare center may be useful in helping you learn about your rights.

Make an initial appointment to talk with the doctor about the procedure or examination, your concerns and difficulties, and what will help you get through it. You can ask questions ahead of time about procedures that will be performed (like what will be done, what you will see, feel, and smell). If you do not have an opportunity to have a talking appointment before your examination, tell your doctor that you find these examinations difficult. You do not have to disclose that you have a history of abuse. 

Learn some stress-reduction techniques and coping strategies like deep breathing. As one woman said, "I try to relax… I look around the room a lot. If something does catch my eye…it will keep my focus there. It will help me relax…make things go a lot easier." 

Wearing something that has pleasant associations for you such as your favorite scent or outfit may be helpful. Carrying something comforting, like a Walkman with music you like, may be helpful. 

Before you get undressed, talk with your doctor about what you need to make the examination easier for you. Make an agreement beforehand that if you are too uncomfortable at any time you will ask, or give a signal to stop and the doctor or nurse will stop. 

Here are some suggestions that may help during pelvic (or other) examinations:

• Ask to have the top of the exam table up so you can see the doctor or nurse. This may give you more of a feeling of empowerment.
• Keep your eyes open. This will help keep you in the present.
• Ask the doctor to drape you so you can see her or him during the examination. Maintaining visual contact also helps keep you in the present.
• Ask the doctor to explain what she or he is doing and why both BEFORE and DURING each part of the exam.
• Use self-talk like "I can get through this. I trust this person".
• You have the right to have a support person with you during the exam, if that is helpful. You may have to arrange this ahead of time with your care provider. 

After your appointment, plan something pleasant for yourself such as meeting with a friend, counselor, or support person. One woman stated, " I needed to take really good care of myself afterwards, do a lot of self-comforting. " Another said, " We have coffee after…[that] brings me back to reality and that helps."

If you are having surgery, visit the hospital or operating room before being admitted. Do not be afraid to tell the nurses looking after you that you find some of the procedures difficult. You do not have to disclose that you have a history of abuse.

Finally, keep in mind that these are only suggestions based on what has helped other women survivors get through medical examinations or procedures. What works for one person may not work for another. There is no right way of doing this. You are the best judge of what will be useful to you.

Remember, clearly discussing concerns you have about procedures with your health care provider should help ensure that you feel more comfortable and gain some sense of control over what happens to your body.