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Opinions please re gynae appointment

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beaneeboo

MyPTSD Pro
I had a gynae appointment last week... I was triggered (more unusual for me actually as I've been ok in the past) and had to ground myself and manage the appointment on my own (without explaining anything to them). I was proud of that as it was unexpected to me that would happen and I got through it.

There was something small that happened which I'm likely making a big deal of as that's what my brain does. But thought I'd ask for others' opinions.

I was having an internal scan (with probe). It was a fairly hectic appointment (the curtain wasn't pulled back properly, the door to the main corridor was opening and closing quite a bit, some objects hadn't been organised properly before starting etc.)

The thing that got me was there were THREE people in the room present. All female. First the consultant (nice enough) second a junior doctor (seemed professional no idea why she needed to be there too) and a third technician. So they were all talking among themselves and addressed me occasionally but I was really aware there were THREE of them all looking together at EVERYTHING going on...

Consultant fine.

Junior doctor - not sure. Why are you there? To learn? Please not from me.

Technician? f*ck off!!! Why the f*ck are you looking over the doctor's shoulders at everything they are doing?

I've been trying to not let this thought grow but in all honesty I don't feel too good from it.
 
I'm sorry you had such a triggering experience.

At my last gynaecologist appointment the room was pretty full - all female, but they knew I had ptsd and why.

Telling them, without going into all of the details, helped because they knew why I could be triggered by anything they were doing.

They explained the role of each person in the room before hand and introduced them by name;
The consultant, fairly obvious. Junior doctors would be there to learn and you should have been asked if you objected to her presence.
Nurse 1, was there to assist the consultant with instruments, swabs etc. Sometimes this can be done by a technician, and are there in case anything is needed, and they make sure that you are the correct patient and everything is accurately labeled.
Nurse 2, was there for my benefit and to chat to me if I needed a distraction or to explain what they were doing and why at each stage so that I knew what was about to happen. She was great and held my hand if I needed it.
Nurse 3, was there to assist with everything technology based, such as moving monitors, cameras etc to where they needed to be and to make sure they were sterilised and working.

In the UK, by law, there has to be at least two people present with the patient during any examinations, so that one acts as a chaperone for the patient.

It may be worth asking for ptsd to be discretely put on your notes, not so they have to discuss it, but so they understand why and what can trigger you.

I hope this helps.
 
Hm...usually, if there is going to be an observer (which I'm guessing the "junior doctor" was) who is there to learn, they ask if it's ok. I'm sorry that didn't happen. If/when you go back, you might want to make it clear that you don't want a student in the room. Some facilities are consider "teaching" hospitals or offices, though, and we give consent (often without knowing) for students to observe when we consent to treatment.
 
That would be terrible! Here my doctors always ask if so and so can be in the room and I always say no. No to anyone at anytime, it’s my standard answer and it makes it easier for me because I’ve detached myself from thinking about it and therefore removed any guilt associated I’ve even coached myself to not check their reaction.

I’m not sure of the law in the US but I do know the rule at my doctors office and it is to always have two but my doctor lets me be the exception because though he is a man and that could be triggering and something could happen, for me I just want it over and the less people the faster he will go and therefore the less I have to dissociate through because that’s what I’ll be doing.

This rule came after I had to have an internal ultrasound and I got what seemed like 12 year olds one male and one female and it was the most triggering event I’ve had. When they called to find out where to send the bill as the billing had also been screwed up I told the lady as much and the hospital deleted the bill. She told me there’s be some education happening in the department too. I’m pretty strong on the phone. I have a much easier time standing up to anyone on the phone, in person I come across as one until you come at me and then you realize I’m all bravado and fear.

Reach out to the place and tell them or at the very least to ease your mind send an anonymous letter.
 
That sounds horrific!

For my last smear I went to a special clinic for survivors of sexual violence and it was soooo much better.
What they did was let me come up with a plan about how I wanted it to go, who would be where, what to look out for etc.
What I take from that is:
Can you form a plan of what you want and tell them.
I.e door not to open during it.
Curtain shut properly.
Limit number of people and be told what is happening when and why?

Whether you tell them about PTSD or your past , up to you, but expressing your plan for your treatment might help with putting you in control?
 
Oh wow so many useful and informed replies! Thank you and apologies if I do a general reply to everyone...

I'm sorry you had such a triggering experience.

At my last gynaecologist appointment the room was pretty full - all female, but they knew I had ptsd and why.

Telling them, without going into all of the details, helped because they knew why I could be triggered by anything they were doing.

They explained the role of each person in the room before hand and introduced them by name;
The consultant, fairly obvious. Junior doctors would be there to learn and you should have been asked if you objected to her presence.
Nurse 1, was there to assist the consultant with instruments, swabs etc. Sometimes this can be done by a technician, and are there in case anything is needed, and they make sure that you are the correct patient and everything is accurately labeled.
Nurse 2, was there for my benefit and to chat to me if I needed a distraction or to explain what they were doing and why at each stage so that I knew what was about to happen. She was great and held my hand if I needed it.
Nurse 3, was there to assist with everything technology based, such as moving monitors, cameras etc to where they needed to be and to make sure they were sterilised and working.

In the UK, by law, there has to be at least two people present with the patient during any examinations, so that one acts as a chaperone for the patient.

It may be worth asking for ptsd to be discretely put on your notes, not so they have to discuss it, but so they understand why and what can trigger you.

I hope this helps.

Hm...usually, if there is going to be an observer (which I'm guessing the "junior doctor" was) who is there to learn, they ask if it's ok. I'm sorry that didn't happen. If/when you go back, you might want to make it clear that you don't want a student in the room. Some facilities are consider "teaching" hospitals or offices, though, and we give consent (often without knowing) for students to observe when we consent to treatment.

That would be terrible! Here my doctors always ask if so and so can be in the room and I always say no. No to anyone at anytime, it’s my standard answer and it makes it easier for me because I’ve detached myself from thinking about it and therefore removed any guilt associated I’ve even coached myself to not check their reaction.

I’m not sure of the law in the US but I do know the rule at my doctors office and it is to always have two but my doctor lets me be the exception because though he is a man and that could be triggering and something could happen, for me I just want it over and the less people the faster he will go and therefore the less I have to dissociate through because that’s what I’ll be doing.

This rule came after I had to have an internal ultrasound and I got what seemed like 12 year olds one male and one female and it was the most triggering event I’ve had. When they called to find out where to send the bill as the billing had also been screwed up I told the lady as much and the hospital deleted the bill. She told me there’s be some education happening in the department too. I’m pretty strong on the phone. I have a much easier time standing up to anyone on the phone, in person I come across as one until you come at me and then you realize I’m all bravado and fear.

Reach out to the place and tell them or at the very least to ease your mind send an anonymous letter.

That sounds horrific!

For my last smear I went to a special clinic for survivors of sexual violence and it was soooo much better.
What they did was let me come up with a plan about how I wanted it to go, who would be where, what to look out for etc.
What I take from that is:
Can you form a plan of what you want and tell them.
I.e door not to open during it.
Curtain shut properly.
Limit number of people and be told what is happening when and why?

Whether you tell them about PTSD or your past , up to you, but expressing your plan for your treatment might help with putting you in control?
Firstly thank you for giving me so much info to put parts of my experience into context of the NHS health care system... all info which I should have been provided with before going in BY THEM i think!

Nope, wasn't asked about the junior doctor... no consent asked.

Good to know re 2 people needing to be present. I still can't see what the job of the technician was. I know I wasn't fully present so may not have seen what she did in the room. All I was aware of was that she was just looking at the most intimate (?) part of the assessment- literally full view. All 3 of them looking. If she had been with me talking to me. Or stayed behind the curtain. Or stayed in the room but on the other side only handing things out or moving equipment- fine. But just staring at the whole procedure almost as close as the doc and consultant just felt really wrong

So, I think the fact I wasn't expecting to have a reaction at doing the appointment was part of the issue... I had become desensitised over the years to gynae appointments mainly through having a vagianl birth and pregnacy check ups etc.. there have been times it's been absolutely fine for me...The way my reaction happened to the appointment was unusual (again a resurgence of trauma sypmtoms and parts since therapy) left me ZERO time to prepare in my head now to deal with the reaction...

I was amazed in my head I managed to talk through what I would say when I got in there and planned out how to communicate what I needed to (whilst I was waiting). But when I actually got in there, I saw the junior doc (who I thought actually was the consultant initially) made a spilt second decision, this is not a person who i can relate to in that way. And she also didn't provide any way for me to communicate about something so difficult. I just shut up and said everything was fine... my bad 🙄

I had NO idea that a plan of any such sort could be made. Or that centres exist for people who've experienced sexual trauma (I'm going to look into that).

I'm considering writing them an email. @Charbella good idea to do this anonymously if I can't send it from me ..
 
Last edited:
This is the clinic:


they only have two sites: London and Glasgow. And you need to book well in advance for the smear. But you can live anywhere in the country and go there, if you have the means to travel. they also do maternity care.
when They do the smear, you meet with a psychologist and the nurse and talk through what you need. They ask what disassociation looks like for you and how they can help you express yourself if you are distressed. If you can’t go through with it all on one day, you don’t need to. The appointment is an hour and they let you decide when you want to start the procedure. No rush. It was really good,
the time before I went to my gp, had to stop half way through as very distressed and freaked out, then found this clinic, booked for 5months time, and now will always go there.
 
This is the clinic:


they only have two sites: London and Glasgow. And you need to book well in advance for the smear. But you can live anywhere in the country and go there, if you have the means to travel. they also do maternity care.
when They do the smear, you meet with a psychologist and the nurse and talk through what you need. They ask what disassociation looks like for you and how they can help you express yourself if you are distressed. If you can’t go through with it all on one day, you don’t need to. The appointment is an hour and they let you decide when you want to start the procedure. No rush. It was really good,
the time before I went to my gp, had to stop half way through as very distressed and freaked out, then found this clinic, booked for 5months time, and now will always go there.
This is an incredible resource. Thanks so much for sharing this. I will look into it. I'm glad you found it and it's been so helpful for you @Movingforward10
 
I had a look at the website and it does look really good!

But this is a good example of the hurdles I need to get over in order to move forward.

The language they use is very difficult for me to relate to. Because they stipulate that 'sexual violence is the key factor to be able to apply to use the service.

Well, in my consciousv memory violence has nothing to do with my experiences. I don't remember violence. I remember violation but not violence.

So not sure if I am allowed to use the service.

I do find this with 90% of services the words sexual violence are used to describe sexual trauma. It feels limiting for those of us who don't relate to the word violence as part of their trauma.

Still a fab resource though @Movingforward10 ...I may just contact them and ask them what other criteria arev involved for accessing the service are... is non- violent sexual trauma enough..
 
I had a look at the website and it does look really good!

But this is a good example of the hurdles I need to get over in order to move forward.

The language they use is very difficult for me to relate to. Because they stipulate that 'sexual violence is the key factor to be able to apply to use the service.

Well, in my consciousv memory violence has nothing to do with my experiences. I don't remember violence. I remember violation but not violence.

So not sure if I am allowed to use the service.

I do find this with 90% of services the words sexual violence are used to describe sexual trauma. It feels limiting for those of us who don't relate to the word violence as part of their trauma.

Still a fab resource though @Movingforward10 ...I may just contact them and ask them what other criteria arev involved for accessing the service are... is non- violent sexual trauma enough..
I completely relate to this notion that I wouldn’t call my violence per se. I’m getting closer to it because mini me is terrified sometimes.

If it helps though I live in the US I just remind my brain that though YOU don’t see it as violence, the rest of society DOES. So I remind myself of this when I need a resource that fits the category. If you ask me I was not raped but the law says I was. So my therapist recommended a group at the Rape Crisis Center, at least my one 20 years ago did.

Try to remember that if you have reprocessed the trauma you have no idea what you were feeling at the time. When I do EMDR that’s when I see the situation differently. I’m still not completely on board but baby steps. If you have sexual trauma you can check the sexual violence box.
 
I do find this with 90% of services the words sexual violence are used to describe sexual trauma. It feels limiting for those of us who don't relate to the word violence as part of their trauma.
You're eligible.
Your word of sexual trauma is their word sexual violence.
You don't need to have been restrained or pushed or threatened with psychical violence to have experienced sexual violence. For me the word sexual violence and sexual trauma are interchangeable.
So the only hurdle is the one in your mind and how you see the words, as opposed to their criteria.
They also don't ask questions about whether you are or are not eligible. You don't need to say what has happened to you.
 
Thanks @Charbella and @Movingforward10 ... that's very validating...

Yes I think the word sexual 'trauma' should be used as the 'umbrella' term /description when talking about sexual violation, or at least along side the word violence...

I searched for years to find a description of my remembered experiences and time and time again I read 'sexual violence' which meant for years I actually didn't consider my experience as trauma or even valid at all...

You're right, it starts with me and my understanding and validation of my experience and not how society decides to describe it... thank you for the reminder...

I'm considering writing to my local service who i saw first and seeing what response I get and use the other centre you posted about @Movingforward10 depending on how I feel after that...
 
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