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Other Finding a primary care Dr that's good with PTSD and physical issues

Thread starter #1
So, I moved from the city to the country a couple of years ago and have to find a new GP (general practitioner) / primary care Dr that's good with PTSD.

I've always found this challenging, but in the city there was a big range of Dr's so I eventually found one I felt comfortable with. (He's retired now tho).

For a while I've been muddling through without a proper primary care Dr now, and this year I've had one that I picked randomly but am not happy with.

I interviewed a new potential GP this morning... Talked about PTSD and how it impacts my primary care stuff (for example: dissociating, and hence not feeling symptoms well or at all and hence answering weirdly when I'm asked about symptoms).

I want a GP that's "aware" of PTSD and that can accomodate that it's an issue for me... But that also doesn't "overdo" it and treat me like I'm made of glass or am a "psychology patient".

We had a bit of to-ing and fro-ing in the conversation today and I was a bit sceptical at first, but I think we both (patient and Dr) managed to muddle through in the end and kinda agree to try it and see if it works.

I googled his name when I got home (it's a GP practice with multiple Dr's and I was given a random Dr today at my first appt) and he's Iranian and he spoke the local language where I live well, but with a strong accent.

At first, I wasn't sure whether that would be a hinderance, because I've noticed that while our cultures in the West struggle to accept mental health issues as normal and not as a "taboo", in other cultures around the world, this is often even more the case.

So there was a phase in the conversation where I thought "Hmm, if he's from a culture that finds talking about mental health even more challenging than my own culture does, it could be an additional hurdle that makes it too hard."

But on the way home I thought about the fact that there are so many traumatised refugees from the Middle East atm, and I've had a primary care Dr with a Middle Eastern background before who was really good at dealing with PTSD for exactly that reason - he had lots of Middle Eastern patients come and see him and a significant proportion had PTSD.

So, I'm going to (gently/ respectfully) ask him about that, next time I see him. I'll work out some non-awkward way of asking if he has treated patients with PTSD that have a refugee background and how PTSD from that background and from a childhood trauma background are similar and different. That might help us be on the same page about how trauma affects patients mentally and physically and how to find a good balance in primary care medical treatment.

I'd like to try and think of other ways PTSD impacts my primary medical care, so that a) I can be more aware and conscious of it myself and b) so I can communicate it to him in an easy to understand way.

1) I've already mentioned how dissociation makes it hard for me to assess symptoms properly.

2) There's so much cross-over between psycho-somatic stuff for me... My body affects my brain massively and my brain affects my body massively, and almost every ailment I have has got both psychological and somatic components. It's so hard for me to work out which symptoms are "just" stress based and hence should be ignored, and which symptoms are signs of physical illness and need to be acted upon. I need a Dr that doesn't outright dismiss my symptoms as "just psychological" but that also doesn't run a thousand tests everytime my body produces some new random symptom.

3) My body is screwed from a childhood of stress, abuse, trauma and neglect and from the post-trauma years where I had to focus on survival and neglected my own health too. It's embarrassing how long the list is of stuff that's wrong with my body and ways that it's broken. I need a Dr who's comfortable with my body being a medium-level disaster zone of chronic illnesses and chronic pain, who just helps me manage it as best as possible and helps me attain the quality of life that's possible for me.

4) As regards medical (and life) issues, there's 2 main modes that my brain goes into. One is a sort of survival-soldier mode of I WILL TAKE CARE OF MYSELF AND DON'T NEED ANYONE ELSE SO BACK THE F*CK OFF. The other is traumatised child mode where I'm scared of and overwhelmed by everything, even the simplest things and can be a crying, clingy, panicked mess. It's not easy for me to deal with the polarity/ difference of those two brain modes, and I know it's not easy for others, like primary care Dr's either.

5) Sometimes I'm actually scared of medical treatments themselves, which can even include just talking to a Dr. So sometimes PTSD gets in the way of health care. So when my PTSD symptoms spike, sometimes I'm not able to focus on my physical health at all for a while.

6) I can occasionally get quite panicked/ obsessive/ OCD/ hypochondriac about health scares/ worrying symptoms. In those situations I need a GP to help remind me to just calm the f*ck down, that the chances of developing a terminal illness over night are low and that we'll take the usual steps to see if we can work out what's going on and neither over-do it nor ignore it.

7) I want a GP who treats PTSD as a "normal and unfortunate thing that can happen in life" and realises that yes, it impacts me as a person and as a patient, but who doesn't treat it as "Okay, so this patient is crazy... Let's humour her... Hopefully she doesn't have a panic attack..."

How do others deal with the issue of getting primary medical care in combination with PTSD?

Any ideas/ advice about issues I've missed and that I should add to my list?
 

scout86

MyPTSD Pro
#3
First, good luck!

You mentioned that you previously had a doctor who was a good fit. Can you think of specific examples of how he handled things well (or not so well), and what made him a good fit? Specific examples might give the new doctor a better idea of what to expect. One other thought, depending on his previous work experience, he might have worked with clients who had PTSD but were never officially diagnosed with it. It wouldn't surprise me to find that having some level of PTSD is "normal" in a lot of parts of the world. If you live somewhere like that, you might learn to deal with the mindset without the label.
 
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