Medical Talking to your Doctor about Pelvic Exam

[piratelady]

I’ve been trying to get pregnant for about a year. With my PTSD, we aren’t doing everything perfectly (like we don’t have sex every day during my “fertile” time). Anyway, I haven’t been successful yet and I’m getting up there in age.

Last “month” I was spotting or bleeding for nearly 2 weeks. I went to my primary care doctors team, they did some blood work-which was all normal and ordered a transvaginal ultrasound, which I have on Wednesday. I totally spaced it out. Now that I remember I’m incredibly anxious.

After this, in a few more weeks, I’ll go back and see my doctor (rather than a doctor in his team) for a follow up.

I haven’t had my annual pelvic exam/pap smear in a year and a half. The doctor who was doing those has since retired. It would make sense to have my primary doctor do those since I would likely also use them if I got pregnant. I’m comfortable with my doctor, I think I could tolerate the exam, but not any of the other ones.

So, they don’t know that I have PTSD. I know I need to tell them that. Would it be weird to also tell them I’m only comfortable seeing my doctor for my well woman stuff or am I just asking for too much? I don’t want to be a burden. How do you tell them, just blurt it out? I don’t know why I’m so scared to disclose this.

Part of me is also thinking, I only bled abnormally one month, maybe I should cancel the ultrasound and the follow up appointment and just wait and see.

 

[scout86]

Would it be weird to also tell them I’m only comfortable seeing my doctor for my well woman stuff or am I just asking for too much?

I don't think that would be weird, and it's hard to see it as asking very much at all.

 

[bellbird]

Would it be weird to also tell them I’m only comfortable seeing my doctor for my well woman stuff or am I just asking for too much?

Seconding @scout86 . Not weird or too much at all.

I haven't been brave enough yet to have my smear test following my SA, but I have had the conversation with my GP where I asked if she could be the one to do it rather than a nurse.
She was totally cool about it and said yes straight away.

I would think that your doctor is likely to have the same response. You have a reasonable and rational plan (1 doctor doing all gyno related stuffs) to help you to overcome a challenge (PTSD related stuffs) to make sure you get all necessary medical tests done.
Nothing but commendable, really.

How do you tell them, just blurt it out?

Something like:
"Could I see you for my smear test as well? I have PTSD, and find it difficult to have gyno exams due to my trauma.
It would help me to feel more comfortable if I could see just one doctor for those exams."

Part of me is also thinking, I only bled abnormally one month, maybe I should cancel the ultrasound and the follow up appointment and just wait and see.

Do you think if you got over the above hurdle, that you'd feel better about the ultrasound?
I really want this to happen for you, and I feel like if you can put steps in place to make going to the appointment easier, it could be conducive to getting pregnant to get the tests your docs have ordered. They want to help you.

 

[piratelady]

Thank you both for the responses.

Could I see you for my smear test as well? I have PTSD, and find it difficult to have gyno exams due to my trauma.
It would help me to feel more comfortable if I could see just one doctor for those exams."

I’m going to try to remember/save this fir when I see my doctor in a few weeks. This is way more concise than what’s going through my head.

Do you think if you got over the above hurdle, that you'd feel better about the ultrasound?

well, the ultrasound is on Wednesday, I do t see my doctor until the 24th. The ultrasound is just with a technician. Maybe it will be fine. I told my husband today that I didn’t think I needed it and could just cancel. He asked what changed to make me think it wasn’t necessary... I didn’t have a real answer so I’ll be getting the ultrasound I guess.

Now it’s time to find a way to cope through that, then tackle the conversation and subsequent exams next. I feel like if I can’t get through this, I have no business having a baby since that’s way more invasive and a lot more exams.

 

[bellbird]

I’m going to try to remember/save this fir when I see my doctor in a few weeks

Maybe you could also have it/similar written down on a piece of paper that you put in your pocket before that appointment?

On instances where I've really struggled to tell a medical professional something, handing them it written down can be a helpful approach.

Now it’s time to find a way to cope through that,

How would you feel about telling the technician that you have PTSD?

I find that if I can mention my condition(s) upfront, it eases a lot of internal angst about but what if they notice symptom X...

Every time I had an xray while I was in hospital recovering from surgery, I'd tell the radiographer that I have a tremor (it tends to get worse when I'm focusing on being still).
It would make me cringe because I'm pretty ashamed of it, but every time I said it it got a little easier.

They were always so lovely about it, and said that they have patients with severe Parkinson's and they're still able to take an xray image.

It's easy to get caught up in our own anxieties, but we forget that these technicians/radiographers/doctors/etc are so familiar with patients that present with different health conditions.

Once the radiographers knew about my tremor, they were only too keen to make me as comfortable as possible in the situation.

The same with my surgical team knowing about my PTSD. It meant I got to have a say about certain things, like having general anaesthetic administered through an IV rather than a mask.

I would imagine it would be similar with the ultrasound technician you see. I'm guessing they would be able to talk to you about some sort of signal (hand gesture/etc) you could use during the procedure if it is getting too much and need a time out.

They use that as common practice in many procedures in general actually. I've never had a transvaginal ultrasound, but dentistry is one area I can think of where they use patient-signalling; PTSD or not.

I really do think you will get through this :)

 

[blackemerald1]

Oh congratulations on deciding to have a child @piratelady!! :)

Just on the haven't got pregnant yet and not doing it right comments you made. Relax... make the baby when you feel like it. Don't make it a high expectation encounter..

It will happen. If you have a normal history and are healthy - it's quite normal for it to take a little time. I've heard many ladies saying they expected to get pregnant immediately. Not so, but they did get pregnant. Sometimes it can take up to twelve months or more.

Most women who are deemed to be in the 'mature' age bracket... ugh... that sounds awful... but you know what I mean.. take a while to become pregnant. Stressing about it is the absolute worst thing you can do for yourself, partner, the experience and well, everything else too. So.. again... relax - you will be a wonderful mother.

I feel like if I can’t get through this, I have no business having a baby since that’s way more invasive and a lot more exams.

^ No.. look there are very few invasive examinations that are required during a normal pregnancy. Most are ultra-sounds done on the bump. Too easy... pull up shirt and watch on the screen. :)

You have every right to have a child and ok you have ptsd but that's not your fault. Having the examination's done from the one doctor, your usual doctor not only makes sense in terms of your emotional well being but also it's practical and common sense. No point having a different doctor who then only has to report back to your own doctor or incurring extra expenses by seeing additional doctors if not necessary.

I'd just say, 'Hey doc is it ok if you do all that stuff?' No massive explanations necessary unless he/she asks why you would prefer them to do it. Then the response is, 'I have anxiety about those types of procedures and I'd feel better if you did it.

Remember, this is all bread and butter stuff for almost every doctor who does general practice. You're certainly not the first who has anxiety about this and just letting him/her know will help a lot.

And, finally - yes - get the ultra-sound done and I hope it is ok. :hug:

Best of luck and again, congratulations on such a wonderful decision. :)

 

[Bristol]

Ive just had a baby after going through IVF and know how hard the struggle is to face all of this with history of CSA myself. What helped me was passing notes to doctors which either directly said the trauma i was facing or just said things like “i had a difficult childhood” they always know what you mean and whilst they cant change what they do they can make it better. For the ultrasounds i always found it better if i wore a really long skirt, i felt far safer and less exposured and it made them bearable as had to have a lot of them. Still by far the hardest thing i have ever done but i survived it and im sure you can too ?

 

[blackemerald1]

Congratulations @Bristol - I hope all is going very well for you. :)

 

[Bristol]

Thanks @blackemerald1 getting used to it all slowly ?

 

[piratelady]

Maybe you could also have it/similar written down on a piece of paper that you put in your pocket before that appointment?

I’ll do this too. I’m terrible about verbalizing that I have PTSD or even anxiety. I hate to say this, but I’m kind of ashamed.

How would you feel about telling the technician that you have PTSD?

I doubt I’ll be able to, but I will try. It’s a good idea, the technician should probably know in case I start to have a panic attack.

Thank you @blackemerald1 and @Bristol for the encouragement :hug:.

 

[bellbird]

I doubt I’ll be able to, but I will try.

:) maybe another note in your pocket? "PTSD"
They will understand. And you're doing a great thing for yourself by starting this thread to prepare in advance :hug:

 

[piratelady]

I had my massage today from someone who is also kind of my PTSD guru. He reminded me of my the breathing techniques he taught me and might message me beforehand to remind me. I feel a lot more prepared now :)

Thanks for all the tools everyone!