Fear in the doctor's office
July 29, 2010 6:44 PM Subscribe
How do I deal with the fear of a painful medical test that I'm having in two weeks? The pain will be intense but short in duration, under 5 minutes. It's a simple procedure, done in the doctor's office, and afterwards I'll be able to do my normal activities and probably won't have any lingering sensations or discomfort. And yet, I'm having trouble summoning up the courage to go through with this, to the point where I'm becoming paralyzed with the fear. I would appreciate suggestions or anecdotes about how you overcame medical fear to do something you knew you had to do.
What I've already considered:
1. The doctor said if I can't do this, I can have the test under anesthesia at the hospital. This is what I'm trying to avoid, as it seems like the coward's way out for a test that is routinely done in the office. (not to mention the extra risk of anesthesia and the possibility that insurance won't cover it.)
2. I've told myself "millions" of women have had this or a similar procedure, and even if it's not quite millions, people every day have to undergo painful medical procedures of one sort or another. I am not alone in this experience; this is the human experience, and I can get through this. So far these thoughts aren't helping.
3. I've thought of just putting it out of my mind completely until an hour before the appointment but am worried that by doing this, I might panic at the last minute and cancel. Plus, I'm having a hard time not thinking about it.
4. I do a bit of meditation but don't have an established practice and am not sure how much help it would be in a two week period.
5. I asked the doctor if she could prescribe a drug for one-time use, to help me calm down. I was so nervous I don't think I made myself clear and she said no, she didn't want to do that.
So, help! What can I do? Not getting the test is not an option. Any advice to help me handle this with even a small amount of equanimity will be so much appreciated.
What I've already considered:
1. The doctor said if I can't do this, I can have the test under anesthesia at the hospital. This is what I'm trying to avoid, as it seems like the coward's way out for a test that is routinely done in the office. (not to mention the extra risk of anesthesia and the possibility that insurance won't cover it.)
2. I've told myself "millions" of women have had this or a similar procedure, and even if it's not quite millions, people every day have to undergo painful medical procedures of one sort or another. I am not alone in this experience; this is the human experience, and I can get through this. So far these thoughts aren't helping.
3. I've thought of just putting it out of my mind completely until an hour before the appointment but am worried that by doing this, I might panic at the last minute and cancel. Plus, I'm having a hard time not thinking about it.
4. I do a bit of meditation but don't have an established practice and am not sure how much help it would be in a two week period.
5. I asked the doctor if she could prescribe a drug for one-time use, to help me calm down. I was so nervous I don't think I made myself clear and she said no, she didn't want to do that.
So, help! What can I do? Not getting the test is not an option. Any advice to help me handle this with even a small amount of equanimity will be so much appreciated.
Best answer: If it were me, I'd be worrying like you. I'd find a song that was five minutes in length that I absolutely loved and put it on my ipod and listen to it over and over and over again thinking to myself "The pain won't last longer than this."
Other options:
- ask her to reconsider the one-time calm down drug when you know you are being clear in explaining it
- sign up a friend to go with you so that you don't cancel at the last minute
- plan something for afterwards that will be awesome [whatever that means to you] so you can look forward to it
Whatever it is, it will not kill you. Whatever it is will help make you healthier or learn more about your health. The pain is five minutes but the fear of the pain is also not that pleasant and is lasting forever. Try to make this as unpainful as possible with five minutes being your goal.
posted by jessamyn at 6:52 PM on July 29, 2010
Other options:
- ask her to reconsider the one-time calm down drug when you know you are being clear in explaining it
- sign up a friend to go with you so that you don't cancel at the last minute
- plan something for afterwards that will be awesome [whatever that means to you] so you can look forward to it
Whatever it is, it will not kill you. Whatever it is will help make you healthier or learn more about your health. The pain is five minutes but the fear of the pain is also not that pleasant and is lasting forever. Try to make this as unpainful as possible with five minutes being your goal.
posted by jessamyn at 6:52 PM on July 29, 2010
Ask for a Xanax prescription, be more insistent this time. Ask for whatever topical analgestics you can receive for or before the procedure (you mentioned that it's a women's doctor; there's always lidocaine spray for, ahem, girly bits up to the cervix – it works). If she still refuses, I recommend finding a doctor who actually listens to you.
posted by halogen at 6:54 PM on July 29, 2010 [8 favorites]
posted by halogen at 6:54 PM on July 29, 2010 [8 favorites]
Best answer: Talk to your doctor again about a one-time anti-anxiety medication. Write out what you need to say, or email if necessary. Please don't beat yourself up because "millions" of people have had similar experiences and gotten through them; this is your experience. It's not any less valid than anyone else's.
Nthing the idea of bringing a friend with you for moral support.
posted by corey flood at 6:54 PM on July 29, 2010 [2 favorites]
Nthing the idea of bringing a friend with you for moral support.
posted by corey flood at 6:54 PM on July 29, 2010 [2 favorites]
Wait...she'll do it under anesthesia, but not prescribe you a dose of Ativan? Ask her to explain her thinking to you.
Also, relaxation breathing and podcasts or music on headphones work, if it's not the kind of test where you feel comfortable having a friend in the room to talk to (also soothing).
posted by availablelight at 6:55 PM on July 29, 2010 [2 favorites]
Also, relaxation breathing and podcasts or music on headphones work, if it's not the kind of test where you feel comfortable having a friend in the room to talk to (also soothing).
posted by availablelight at 6:55 PM on July 29, 2010 [2 favorites]
I think that knowing what you're getting in to allows you to manage your expectations. Yes, this is going to be painful, but you can deal with it. You can get through it!
I went through something similar to this - I had cryosurgery to remove abnormal cells on my cervix. It was extremely painful. The doctors tried to make small talk to take my mind off of what was going on, but I was in so much pain I couldn't speak. I didn't take anyone into the room with me, but in retrospect, I wish I would have. Do you have anyone - a friend, relative, significant other - who would be available to be with you? Don't be afraid to ask! They can sit by your head, face away from the, er "business" side of things (if it's some kind of gyno test), and talk to you and hold your hand. Bring an iPod and listen to relaxing music. Don't be embarrassed if you cry.
Having a simple "mantra" of sorts also really helped me. I just repeated to myself in my head, over and over, "I can get through this, I can get through this." And I did.
posted by pecanpies at 6:57 PM on July 29, 2010
I went through something similar to this - I had cryosurgery to remove abnormal cells on my cervix. It was extremely painful. The doctors tried to make small talk to take my mind off of what was going on, but I was in so much pain I couldn't speak. I didn't take anyone into the room with me, but in retrospect, I wish I would have. Do you have anyone - a friend, relative, significant other - who would be available to be with you? Don't be afraid to ask! They can sit by your head, face away from the, er "business" side of things (if it's some kind of gyno test), and talk to you and hold your hand. Bring an iPod and listen to relaxing music. Don't be embarrassed if you cry.
Having a simple "mantra" of sorts also really helped me. I just repeated to myself in my head, over and over, "I can get through this, I can get through this." And I did.
posted by pecanpies at 6:57 PM on July 29, 2010
Pain control is the responsibility of a medical provider. It is not a minor side thing that you should have to persuade your doctor is necessary. Ask for pain control short of "under anesthesia at the hospital" but that is effective, as suggested by halogen. If you don't get a satisfactory response, consider going elsewhere.
posted by werkzeuger at 6:58 PM on July 29, 2010 [4 favorites]
posted by werkzeuger at 6:58 PM on July 29, 2010 [4 favorites]
If I know the pain is finite, I'm okay. I had a spinal tap and a mileogram (the worst pain came later from that - and I'm still glad that no one properly warned me). I dont; remember the actual pain from those procedures. Just the recollection of it being "terrible".
I think you need to give yourself credit (you can handle it: if others have, then why not you?) and not give it as much thought (worrying about it might be worse than the actual pain - if only because it will lasts longer than the five minutes (or less) of the procedure.
Consider it a strange adventure (I'm going somewhere I've never been before) I did this before the spinal tap at the advice of someone else. She was smart to suggest this to me: it somehow put me squarely back in "control" and that helped make it more of a curiosity than something fearsome.
posted by marimeko at 7:00 PM on July 29, 2010
I think you need to give yourself credit (you can handle it: if others have, then why not you?) and not give it as much thought (worrying about it might be worse than the actual pain - if only because it will lasts longer than the five minutes (or less) of the procedure.
Consider it a strange adventure (I'm going somewhere I've never been before) I did this before the spinal tap at the advice of someone else. She was smart to suggest this to me: it somehow put me squarely back in "control" and that helped make it more of a curiosity than something fearsome.
posted by marimeko at 7:00 PM on July 29, 2010
Would you consider telling us what the procedure is? Some of us may have had it and could tell you what it's like.
posted by amro at 7:02 PM on July 29, 2010
posted by amro at 7:02 PM on July 29, 2010
I agree that you should ask her to reconsider prescribing you something to calm you down for this procedure. Maybe she doesn't understand the extent of your anxiety.
As someone who has been through some truly barbaric, painful medical procedures (spinal tap, myelogram, etc.), I can say that almost certainly the anticipation of the pain will be worse than the actual experience. If you can find comparisons in your life to other things that have turned out to be less awful than you feared, perhaps you can use those memories to mentally prepare yourself.
Still, the best approach I think is to press for an anti-anxiety drug, or at the very least an explanation of why she won't prescribe one in your situation.
I wish you the best.
posted by vincele at 7:06 PM on July 29, 2010
As someone who has been through some truly barbaric, painful medical procedures (spinal tap, myelogram, etc.), I can say that almost certainly the anticipation of the pain will be worse than the actual experience. If you can find comparisons in your life to other things that have turned out to be less awful than you feared, perhaps you can use those memories to mentally prepare yourself.
Still, the best approach I think is to press for an anti-anxiety drug, or at the very least an explanation of why she won't prescribe one in your situation.
I wish you the best.
posted by vincele at 7:06 PM on July 29, 2010
Wait...she'll do it under anesthesia, but not prescribe you a dose of Ativan? Ask her to explain her thinking to you.
^This. Ask your doctor again about an Ativan.
Also, the pain is never nearly as bad as you will work yourself up for it to be. Take deep breaths during it, if you are allowed. A relaxed (even a little!) body will make just about any test or procedure far more bearable than it would otherwise be. I've had a few such short/painful procedures, though not necessarily the one you're having of course, and my experience has always been that it was nowhere what I expected. And that has made me more confident about future tests and procedures ("If I can do that, I can do anything!").
If you can't have someone with you, can you have something with you? For dental procedures, for example, I have a little stuffed tooth I hold really tight in my hand. Concentrating on that can be a nice distraction.
Good luck to you!
posted by dayintoday at 7:08 PM on July 29, 2010 [1 favorite]
^This. Ask your doctor again about an Ativan.
Also, the pain is never nearly as bad as you will work yourself up for it to be. Take deep breaths during it, if you are allowed. A relaxed (even a little!) body will make just about any test or procedure far more bearable than it would otherwise be. I've had a few such short/painful procedures, though not necessarily the one you're having of course, and my experience has always been that it was nowhere what I expected. And that has made me more confident about future tests and procedures ("If I can do that, I can do anything!").
If you can't have someone with you, can you have something with you? For dental procedures, for example, I have a little stuffed tooth I hold really tight in my hand. Concentrating on that can be a nice distraction.
Good luck to you!
posted by dayintoday at 7:08 PM on July 29, 2010 [1 favorite]
I've gone through some painful procedures and have found that it really helps me to just consider that pain, in and of itself, is really nothing to be afraid of. It's so scary because usually pain means something has gone seriously, unexpectedly wrong, and there is the potential for real damage to your body. But situations like this are an opportunity to just experience the pain, knowing it is temporary and without having to worry about any of the things that really do make pain so terrifying.
posted by Balonious Assault at 7:15 PM on July 29, 2010 [4 favorites]
posted by Balonious Assault at 7:15 PM on July 29, 2010 [4 favorites]
I've gone through several procedures on my eyes. I have been stressed and upset prior to each procedures. And every time I have simply grit my teeth and bore the pain and discomfort. The last procedure was a vitrectomy on my right eye. The doc said that there was a sedative in the saline drip. If there was a sedative it was totally useless. If I have to have eye surgery again, which is likely, I'm insisting on being put under.
In short, go for the anaesthesia. There is no shame in opting out of pain.
posted by deborah at 7:18 PM on July 29, 2010 [1 favorite]
In short, go for the anaesthesia. There is no shame in opting out of pain.
posted by deborah at 7:18 PM on July 29, 2010 [1 favorite]
Insist on the anti-anxiety medication, get the EMLA (topical ointment, made of magic) or whatever, get whatever you need. Tell her you'll faint or cancel. I have to do a two day marathon of convincing and pampering to get myself near needles; the "fainting" thing is real in my case and it makes medical people solicitous because they hate it when people faint, as far as I can tell. Irony is being on a drug that's supposed to help with my anxiety, that requires regular blood tests. And I can beat you on guilt - my grandmother was a Type 1 diabetic who was finally no longer afraid of needles, fifty years after they first taught her to inject herself daily. I faint when I see the needle in the room, no pain needed. It took an enormous amount of convincing to get myself to go to the doctor for a set of numb arms, because I knew they'd either do blood tests or stick me with an IV (they did both.) My arms! Couldn't move them at all! Tiny, stupid needles. I feel queasy writing this out. Some people, they donate blood on purpose. Every month or so.
Anyway, millions of women give birth, too, and plenty of them get seriously drugged up for it. Pain is unpleasant, fear can be crippling, and your health is important enough to use crutches rather than not take the test. Do what it takes to get in there; if your doctor is an ally she'll help you out.
I find that visualization (not pretending I'm at a beach, but rather walking myself mentally through exactly what I'm going to do once it's done) is helpful, but you do need practice enough that it actually calms you down. I get the practice while lying on the table waiting for my sense of balance to come back after a blood draw, plus in other lower-pressure settings (like being stuck in crowds, which I like to think of as "not nearly as bad as needles.") Unfortunately for me a lot of the tricks mentioned above make me feel sick to my stomach when trying them in the needle/doctor situation; you ought to find some other thing that freaks you out and test a few techniques ahead of time.
Oh, and bribery is one of my favorite tools. Buy yourself an ice cream cone or go see a movie you're embarrassed you like, afterward. I'm partial to McDonald's breakfasts after a draw. It may also help to have someone take you, even if they can't come in. No "last minute" cancellations that way.
posted by SMPA at 7:18 PM on July 29, 2010
Anyway, millions of women give birth, too, and plenty of them get seriously drugged up for it. Pain is unpleasant, fear can be crippling, and your health is important enough to use crutches rather than not take the test. Do what it takes to get in there; if your doctor is an ally she'll help you out.
I find that visualization (not pretending I'm at a beach, but rather walking myself mentally through exactly what I'm going to do once it's done) is helpful, but you do need practice enough that it actually calms you down. I get the practice while lying on the table waiting for my sense of balance to come back after a blood draw, plus in other lower-pressure settings (like being stuck in crowds, which I like to think of as "not nearly as bad as needles.") Unfortunately for me a lot of the tricks mentioned above make me feel sick to my stomach when trying them in the needle/doctor situation; you ought to find some other thing that freaks you out and test a few techniques ahead of time.
Oh, and bribery is one of my favorite tools. Buy yourself an ice cream cone or go see a movie you're embarrassed you like, afterward. I'm partial to McDonald's breakfasts after a draw. It may also help to have someone take you, even if they can't come in. No "last minute" cancellations that way.
posted by SMPA at 7:18 PM on July 29, 2010
Millions of people get punched in the face every day. This does not wanting to get punched in the face cowardly, nor does it make wanting to lessen the pain of the blow -- if you must take it -- cowardly.
posted by griphus at 7:28 PM on July 29, 2010 [1 favorite]
posted by griphus at 7:28 PM on July 29, 2010 [1 favorite]
There is nothing, NOTHING inherently better, or ennobling, or any of that stuff, about enduring pain. It's okay to draw a line in the sand: no painkillers/Ativan/combo of both, no procedure.
I personally would go the general anesthesia route because I have issues around pain. If I can't be knocked out then Ativan is my friend. Your doc should be more understanding about prescribing you something to get through the procedure. If she's really adamant that you have to tough it out - and you don't think that an Ipod and sweet thoughts will get you through this (it never works for me) then find a different doctor, at least to do this procedure.
posted by Rosie M. Banks at 7:36 PM on July 29, 2010 [1 favorite]
I personally would go the general anesthesia route because I have issues around pain. If I can't be knocked out then Ativan is my friend. Your doc should be more understanding about prescribing you something to get through the procedure. If she's really adamant that you have to tough it out - and you don't think that an Ipod and sweet thoughts will get you through this (it never works for me) then find a different doctor, at least to do this procedure.
posted by Rosie M. Banks at 7:36 PM on July 29, 2010 [1 favorite]
I always think, "This will end. Only five more minutes and then it will end. This will be over and done with and I will forget about it."
Reminding myself that something painful is temporary helps a lot. Pain ends, and then you're through and out the other side. PAIN ENDS. Remember that.
posted by L'Estrange Fruit at 7:49 PM on July 29, 2010 [1 favorite]
Reminding myself that something painful is temporary helps a lot. Pain ends, and then you're through and out the other side. PAIN ENDS. Remember that.
posted by L'Estrange Fruit at 7:49 PM on July 29, 2010 [1 favorite]
I'd find a song that was five minutes in length that I absolutely loved and put it on my ipod and listen to it over and over and over again thinking to myself "The pain won't last longer than this."
Is it possible that you could bring an iPod with you into the exam room? When I got my tattoo, which I had similar fears about, I made a playlist of beautiful relaxing music that I love with the same length as my session. The needles really hurt, but when it got overwhelming I could just meditate on an Iron & Wine track for a moment and let it all go. Certain songs still remind me of the day I got my tattoo.
Similar not-medically-sanctioned advice: can you take a couple aspirin or drink a glass of wine before the procedure?
Earlier this year I had similar painful medical test drama (I'm actually wondering if we're not talking about the same thing) and rewarded myself afterwards with lunch at one of my favorite restaurants. That was a big help.
posted by Sara C. at 7:52 PM on July 29, 2010
Is it possible that you could bring an iPod with you into the exam room? When I got my tattoo, which I had similar fears about, I made a playlist of beautiful relaxing music that I love with the same length as my session. The needles really hurt, but when it got overwhelming I could just meditate on an Iron & Wine track for a moment and let it all go. Certain songs still remind me of the day I got my tattoo.
Similar not-medically-sanctioned advice: can you take a couple aspirin or drink a glass of wine before the procedure?
Earlier this year I had similar painful medical test drama (I'm actually wondering if we're not talking about the same thing) and rewarded myself afterwards with lunch at one of my favorite restaurants. That was a big help.
posted by Sara C. at 7:52 PM on July 29, 2010
Do have an absurdist sense of humor that you could call upon? Is there anything you can find funny or goofy about this? I'm not trying to be flip, I promise but absurd & sometimes gallows humor runs in my family and it actually can help a lot. Will anything about the procedure make a good story later (I can crack people up with an ER visit I had once).
My dad is & my late grandad was an OBGYN. Once during an uncomfortable procedure my mantra was thisputmethroughcollegethisputmethroughcollegedoctorgottamakealiving. Weird, but it helped
I also Nth the idea of asking for an anti-anxiety med. You are not a coward & your feelings are normal.
posted by pointystick at 7:53 PM on July 29, 2010
My dad is & my late grandad was an OBGYN. Once during an uncomfortable procedure my mantra was thisputmethroughcollegethisputmethroughcollegedoctorgottamakealiving. Weird, but it helped
I also Nth the idea of asking for an anti-anxiety med. You are not a coward & your feelings are normal.
posted by pointystick at 7:53 PM on July 29, 2010
I have a guess that this is an endometrial biopsy and I have to say that if it is that, for me it was seriously painful. I did take an oral valium-like drug beforehand and brought a friend with me to hold my hand. Both of those things did help-- they do reduce pain by reducing anxiety, especially a friendly presence.
But it still hurt badly enough that I cringe to remember it-- though the pain only lasted for about 1 minute or 2. If I ever have to have another one, I will have some form of IV anesthesia.
That said, people's experience varies incredibly wildly and the pain was just intense for a very short period of time. Some people don't have that bad a time of it. Afterwards, I was completely fine: no cramps or anything. But unfortunately, anxiety enhances pain and now that I know what it was like for me, I couldn't deal with the anticipation of it again. I would go somewhere else if they won't at least give you Ativan or something similar.
posted by Maias at 7:53 PM on July 29, 2010
But it still hurt badly enough that I cringe to remember it-- though the pain only lasted for about 1 minute or 2. If I ever have to have another one, I will have some form of IV anesthesia.
That said, people's experience varies incredibly wildly and the pain was just intense for a very short period of time. Some people don't have that bad a time of it. Afterwards, I was completely fine: no cramps or anything. But unfortunately, anxiety enhances pain and now that I know what it was like for me, I couldn't deal with the anticipation of it again. I would go somewhere else if they won't at least give you Ativan or something similar.
posted by Maias at 7:53 PM on July 29, 2010
A tranquilizer (both for the night before the procedure and for the procedure itself) is an eminently reasonable request, and you have the right to expect your doctor to respect it; moreover, it is not cowardly to opt for the anesthesia if that's what you really prefer. There is no reason to make it any more painful than it truly has to be. Ask again for the medication, and if your doctor truly won't give it to you, I would strongly suggest looking around for another doctor.
I've been through my share of not-fun procedures recently and over the years in general, and when I haven't been able to be knocked out, the things that have helped me have been: tranquilizers and/or painkillers as appropriate (see above); deep, steady, slow breaths through my nose (count each breath if it helps you); and a simple, comforting mantra to keep freaking out at bay, such "I am in control and able to handle this" or even the old standby "this, too, shall pass."
Because the thing to try to keep in mind is that it is temporary, and you will get through it, and it won't swallow you up or define you -- none of the things that we often secretly fear are ever really going to happen. The pain will pass, just as all things pass. (But try to get an Ativan in the meantime!)
My best to you.
posted by scody at 8:01 PM on July 29, 2010
I've been through my share of not-fun procedures recently and over the years in general, and when I haven't been able to be knocked out, the things that have helped me have been: tranquilizers and/or painkillers as appropriate (see above); deep, steady, slow breaths through my nose (count each breath if it helps you); and a simple, comforting mantra to keep freaking out at bay, such "I am in control and able to handle this" or even the old standby "this, too, shall pass."
Because the thing to try to keep in mind is that it is temporary, and you will get through it, and it won't swallow you up or define you -- none of the things that we often secretly fear are ever really going to happen. The pain will pass, just as all things pass. (But try to get an Ativan in the meantime!)
My best to you.
posted by scody at 8:01 PM on July 29, 2010
Seconding asking your doctor again for a painkiller/sedative during the procedure. Also, there is no shame in getting it done under anaesthesia if you can afford it. It's not cowardly!
A while ago, I had to have an uncomfortable gyno procedure done. I was extremely anxious and could not stop thinking about it, because I didn't know what to expect. If you can talk to someone who has had the same procedure, that could be helpful--they might have some tips on pain reduction, for example. In my case, I talked to a friend who had had the same procedure, and she gave me some advice to help make it more bearable--options that the med lab techs did not tell me about ahead of time. It's only because of my friend that I even knew what accommodations I could ask for (and once I asked, they were all granted!).
posted by hurdy gurdy girl at 8:05 PM on July 29, 2010
A while ago, I had to have an uncomfortable gyno procedure done. I was extremely anxious and could not stop thinking about it, because I didn't know what to expect. If you can talk to someone who has had the same procedure, that could be helpful--they might have some tips on pain reduction, for example. In my case, I talked to a friend who had had the same procedure, and she gave me some advice to help make it more bearable--options that the med lab techs did not tell me about ahead of time. It's only because of my friend that I even knew what accommodations I could ask for (and once I asked, they were all granted!).
posted by hurdy gurdy girl at 8:05 PM on July 29, 2010
I have had lots of gynecological procedures done, due to a big history with nasty cervical stuff. How is local anesthetic not an option? I was never in any pain with any of it, burning, punching, scraping... all that fun stuff.
posted by gaspode at 8:05 PM on July 29, 2010
posted by gaspode at 8:05 PM on July 29, 2010
To which I meant to add, please get her to clarify her position on pain relief. As said above, this should not be a grin and bear it situation. Pain relief is not a trivial part of medical care.
posted by gaspode at 8:06 PM on July 29, 2010 [1 favorite]
posted by gaspode at 8:06 PM on July 29, 2010 [1 favorite]
Similar not-medically-sanctioned advice: can you take a couple aspirin or drink a glass of wine before the procedure?
This is a really bad idea. Especially the aspirin, since aspirin can make you bleed more easily (which is why it's used in low doses to protect some people's hearts). Absolutely ask your doc again about a sedative or anti-anxiety pill; as others have said, I'm surprised your doc said no the first time, and hopefully it was just a miscommunication by one of you. But do not take anything they're not aware of, no matter how mundane and over the counter it is.
posted by spaceman_spiff at 8:17 PM on July 29, 2010 [2 favorites]
This is a really bad idea. Especially the aspirin, since aspirin can make you bleed more easily (which is why it's used in low doses to protect some people's hearts). Absolutely ask your doc again about a sedative or anti-anxiety pill; as others have said, I'm surprised your doc said no the first time, and hopefully it was just a miscommunication by one of you. But do not take anything they're not aware of, no matter how mundane and over the counter it is.
posted by spaceman_spiff at 8:17 PM on July 29, 2010 [2 favorites]
Are you certain she isn't giving you a local anesthetic?
posted by gillianr at 8:25 PM on July 29, 2010
posted by gillianr at 8:25 PM on July 29, 2010
People routinely get anti-anxiety and pain medications for painful in-office procedures. I don't understand why she wouldn't prescribe you something, as long as you don't have any pre-existing medical conditions that would exclude you from taking them. Ask her again and ask her why she won't. If she won't prescribe you something ask her what over-the-counter pain medications you can take before hand.
Bring a friend. You may not want him/her in the office with you but at least they will be there before and after. Also, it would be best if he/she drives you home, especially if you took something for the pain.
I've had to be present for many in-office painful gyn procedures (male doctor needed female attendant) and many women wanted me to explain what was going on in the procedure. They said it made them feel more prepared for the painful aspects. Anticipation can really increase fear/stress. I don't know if that would be helpful for you but it might and you can certainly ask the doctor to narrate what it is that she is doing.
(If this is some type of gyn procedure you will probably have some spotting so make sure they give you a pad afterward or just bring one with you.)
Also...I totally get the anxiety and fear associated with medical procedures. That doesn't make you a coward.
posted by teamnap at 8:30 PM on July 29, 2010
Bring a friend. You may not want him/her in the office with you but at least they will be there before and after. Also, it would be best if he/she drives you home, especially if you took something for the pain.
I've had to be present for many in-office painful gyn procedures (male doctor needed female attendant) and many women wanted me to explain what was going on in the procedure. They said it made them feel more prepared for the painful aspects. Anticipation can really increase fear/stress. I don't know if that would be helpful for you but it might and you can certainly ask the doctor to narrate what it is that she is doing.
(If this is some type of gyn procedure you will probably have some spotting so make sure they give you a pad afterward or just bring one with you.)
Also...I totally get the anxiety and fear associated with medical procedures. That doesn't make you a coward.
posted by teamnap at 8:30 PM on July 29, 2010
Response by poster: Thank you all for these great answers and suggestions. Maias has it right, this is an endometrial biopsy. The pain is intense cramping and so doesn't lend itself to topical painkillers, etc. From my own knowledge of my body, I know the pain will be bad. In this case, fear of the unknown would be better than this fear of the known. This is one time I wish I didn't have any idea what the experience will be like. I will definitely insist on anti-anxiety medication, which I did not clearly ask for during my visit. I'm also now considering the anesthesia option, cowardly or not. I plan to reread all the answers a couple more times and mark some as best - many have been very helpful already.
posted by daikon at 8:31 PM on July 29, 2010
posted by daikon at 8:31 PM on July 29, 2010
Response by poster: I also want to add, when I asked for anti-anxiety medication, it's possible she didn't even know what I was talking about, that's how nervous, and vague, I was. It has been helpful hearing people say things like "People routinely get anti-anxiety and pain medications for painful in-office procedures." This will help me insist on medication.
posted by daikon at 8:34 PM on July 29, 2010
posted by daikon at 8:34 PM on July 29, 2010
maias' statement that people's experience varies widely is true; i had an endometrial biopsy just a couple weeks ago, and my experience was very different from hers. my gyno, who is fantastic, had told me to take 600 to 800 mg of ibuprofen before i came in, but i overslept and ended up running out of the house with no meds in me. when i got there and told her about that, she asked if i wanted to take some right then let it get in my system, but i was not really wanting to lie around waiting for meds to kick in, so we went ahead without.
so. that's no meds at all. she put a clamp on the cervix to allow her to put the whatsis through, and that was like a menstrual cramp starting up. the dilation of the cervix and the biopsy itself were like an intense cramp, but weren't what i was expecting it to feel like--i guess i imagined it would be more sharp or burning or something--no, just like a bad cramp. if you've had intense menstrual cramps, that is what you can expect. in fact, my doc said "that's what labor feels like." (i've never had a baby).
if you are indeed going in for an endometrial biopsy, yes, it hurts. if you have had cramps or been in labor, that is the sort of thing you can expect. the intense crampage was over (for me) after about a minute when she finished the biopsy and withdrew the instruments, though there was residual pain until i took the damned ibuprofen i had forgotten and then been in too big of a hurry for.
for me, the fact that it was a pain i was familiar with really helped me deal with it. another thing that helped me deal was, before i even got to the office, looking beyond the biopsy--i was looking ahead to breakfast when i was done, since i hadn't had time for that, and to making grape jelly from the first harvest ever of my own grapes! so maybe having a cool thing planned to do afterward would help you. Also, it really helped me to talk to my doctor during the procedure, having her tell me what-all she was doing, but then, i'm always nosy--i mean, it's my body, right? what is she doing down there? i know some people would rather NOT know what's being done, but if you're one of the curious ones like me, feel free to ask her to tell you what she's doing as she's doing it. that also helps you (or me, anyway) be ready for what comes to pass.
there is no shame in flagging off now and opting for the knock-out. this is not a question of morality. whichever you choose, all this will come and go and hopefully everything will be fine with whatever the test is--that's the important thing, right?
posted by miss patrish at 8:37 PM on July 29, 2010 [2 favorites]
so. that's no meds at all. she put a clamp on the cervix to allow her to put the whatsis through, and that was like a menstrual cramp starting up. the dilation of the cervix and the biopsy itself were like an intense cramp, but weren't what i was expecting it to feel like--i guess i imagined it would be more sharp or burning or something--no, just like a bad cramp. if you've had intense menstrual cramps, that is what you can expect. in fact, my doc said "that's what labor feels like." (i've never had a baby).
if you are indeed going in for an endometrial biopsy, yes, it hurts. if you have had cramps or been in labor, that is the sort of thing you can expect. the intense crampage was over (for me) after about a minute when she finished the biopsy and withdrew the instruments, though there was residual pain until i took the damned ibuprofen i had forgotten and then been in too big of a hurry for.
for me, the fact that it was a pain i was familiar with really helped me deal with it. another thing that helped me deal was, before i even got to the office, looking beyond the biopsy--i was looking ahead to breakfast when i was done, since i hadn't had time for that, and to making grape jelly from the first harvest ever of my own grapes! so maybe having a cool thing planned to do afterward would help you. Also, it really helped me to talk to my doctor during the procedure, having her tell me what-all she was doing, but then, i'm always nosy--i mean, it's my body, right? what is she doing down there? i know some people would rather NOT know what's being done, but if you're one of the curious ones like me, feel free to ask her to tell you what she's doing as she's doing it. that also helps you (or me, anyway) be ready for what comes to pass.
there is no shame in flagging off now and opting for the knock-out. this is not a question of morality. whichever you choose, all this will come and go and hopefully everything will be fine with whatever the test is--that's the important thing, right?
posted by miss patrish at 8:37 PM on July 29, 2010 [2 favorites]
woops! guess i should have previewed, hm?
posted by miss patrish at 8:38 PM on July 29, 2010
posted by miss patrish at 8:38 PM on July 29, 2010
I have never had an endometrial biopsy, but anecdotally, a few months ago I had a hysterosalpingogram (HSG) where they shoot dye up into your fallopian tubes. Everything I read before the test told me it would feel like the worst cramps of my life. The woman who went in for it right before came out and told her husband it was terrible. I was totally worked up when I finally went in for the test, and it was a big fat nothing. It was over before I knew it.
I mean, I really don't know, an HSG could be a joke next to endometrial biopsy. But I just wanted to say that not everything you read or hear about pain from the procedure is going to be right, and every body is different.
posted by amro at 8:42 PM on July 29, 2010
I mean, I really don't know, an HSG could be a joke next to endometrial biopsy. But I just wanted to say that not everything you read or hear about pain from the procedure is going to be right, and every body is different.
posted by amro at 8:42 PM on July 29, 2010
I had an IUD placed which also requires the dilation of your cervix and the uterine cramp bit. I took 975mg of Tylenol prior to going. I am terrible with pain, generally I get really bothered by even stupid levels of pain.
The actual procedure with the dilation and placement was REALLY short. I mean it probably only took 1-2 minutes. I had this pain with it and thought "wow, I never want to experience THAT again!" but to be honest, it was so short, that now when I think back, I actually would go through it again for the benefits of the IUD. It was well worth it. I've just decided that I can never allow myself to go through labor because I can't imagine feeling that feeling for hours on end!
I had my husband there and squeezed the hand hard. Afterwards I had ice cream. I guess many of us are comforted by the same things. I am also a doctor so I see a lot of people going through this same situation, but everyone is different regarding what they want from the physician. Some like everything narrated and explained. Some hate that and don't want to see or hear anything about what's going on, so they can focus on something else. This seems like one of those situations where you need to think about how you deal best with things and what will make you happy, and then try to do that.
As side notes, one tactic that doctors frequently use that I've seen (that I myself use) is that when people ask for medications that you don't think will be necessary, let's say narcotics for an ankle sprain for the sake of argument, you at first tell them "I'd rather not do that" and sort of gauge how they handle that. (some physicians I know are much more adamant that certain things do not require such medications and will outright refuse to give them) Sometimes then people sort of face up to things and do better with them. A lot of us are sort of softies at heart and if we see that the person truly can't deal with pain, we will give in and let them have something in the end, even though 99% of other folks don't require it - I'll give like one or two Vicodins or something. No one wants to be seen as 'the candyman' particularly in this age of prescription drug abuse that we are always being confronted with. It can be very hard to walk the line.
p.s., I've done tons of spinal taps and they are not always horribly painful. Depending on anatomy, they can be just 'funny feeling' or 'somewhat uncomfortable' - I swear. I've done them on babies and toddlers who don't even make a peep. I just don't want people to needlessly fear spinal taps because sometimes they are a very important medical procedure to have done.
posted by treehorn+bunny at 9:04 PM on July 29, 2010
The actual procedure with the dilation and placement was REALLY short. I mean it probably only took 1-2 minutes. I had this pain with it and thought "wow, I never want to experience THAT again!" but to be honest, it was so short, that now when I think back, I actually would go through it again for the benefits of the IUD. It was well worth it. I've just decided that I can never allow myself to go through labor because I can't imagine feeling that feeling for hours on end!
I had my husband there and squeezed the hand hard. Afterwards I had ice cream. I guess many of us are comforted by the same things. I am also a doctor so I see a lot of people going through this same situation, but everyone is different regarding what they want from the physician. Some like everything narrated and explained. Some hate that and don't want to see or hear anything about what's going on, so they can focus on something else. This seems like one of those situations where you need to think about how you deal best with things and what will make you happy, and then try to do that.
As side notes, one tactic that doctors frequently use that I've seen (that I myself use) is that when people ask for medications that you don't think will be necessary, let's say narcotics for an ankle sprain for the sake of argument, you at first tell them "I'd rather not do that" and sort of gauge how they handle that. (some physicians I know are much more adamant that certain things do not require such medications and will outright refuse to give them) Sometimes then people sort of face up to things and do better with them. A lot of us are sort of softies at heart and if we see that the person truly can't deal with pain, we will give in and let them have something in the end, even though 99% of other folks don't require it - I'll give like one or two Vicodins or something. No one wants to be seen as 'the candyman' particularly in this age of prescription drug abuse that we are always being confronted with. It can be very hard to walk the line.
p.s., I've done tons of spinal taps and they are not always horribly painful. Depending on anatomy, they can be just 'funny feeling' or 'somewhat uncomfortable' - I swear. I've done them on babies and toddlers who don't even make a peep. I just don't want people to needlessly fear spinal taps because sometimes they are a very important medical procedure to have done.
posted by treehorn+bunny at 9:04 PM on July 29, 2010
I had that done. Yes, it hurt a heck of a lot. My doc didn't offer alternatives, said it would hurt, but didn't say how much. It was a very unpleasant experience. But until this question, I had kind of forgotten I ever had that procedure. Which says to me that it was really unpleasant, but not genuinely traumatic.
You need to have the test. The office visit is way less dangerous than anesthesia. I recommend you focus on the fact that you're having a painful procedure that is important to your health. Reminding yourself of the benefit and distract yourself from anticipating the discomfort.
posted by theora55 at 9:16 PM on July 29, 2010
You need to have the test. The office visit is way less dangerous than anesthesia. I recommend you focus on the fact that you're having a painful procedure that is important to your health. Reminding yourself of the benefit and distract yourself from anticipating the discomfort.
posted by theora55 at 9:16 PM on July 29, 2010
When I was in high school I had to have two wisdom teeth removed. My mom got the oral surgeon to prescribe a couple of valiums for me for me to take an hour or so before the appointment, and that really did the trick. I was so stoned he could have removed my jaw and I wouldn't have cared.
You should be able to get your doctor to prescribe something like that to get you through. It isn't a pain reliever, but it makes you not care much about the pain.
posted by Chocolate Pickle at 9:23 PM on July 29, 2010
You should be able to get your doctor to prescribe something like that to get you through. It isn't a pain reliever, but it makes you not care much about the pain.
posted by Chocolate Pickle at 9:23 PM on July 29, 2010
when I asked for anti-anxiety medication, it's possible she didn't even know what I was talking about, that's how nervous, and vague, I was. It has been helpful hearing people say things like "People routinely get anti-anxiety and pain medications for painful in-office procedures." This will help me insist on medication.
Good for you. Just a heads-up -- and this may be stating the obvious -- but if you do take an anti-anxiety med before your procedure, you will need to arrange for a ride to and from your appointment.
posted by scody at 10:05 PM on July 29, 2010
Good for you. Just a heads-up -- and this may be stating the obvious -- but if you do take an anti-anxiety med before your procedure, you will need to arrange for a ride to and from your appointment.
posted by scody at 10:05 PM on July 29, 2010
Best answer: I don't think you're cowardly at all for considering anesthesia. I wanted all my life to be a doula or a midwife and yet childbirth pain terrifies me so much that if I were inclined to have children, I'd be tempted to ask for a c-section with no labor! I'm not having kids so it's a moot point.
If you do decide to go without anesthesia, here's something that's always helped me. I had severe stomach aches as a child and even still get one every now and then, and I just repeat "this too shall pass" in a whisper over and over again. It combines the idea that the pain will be over soon with the added benefit of steadying my breathing, forcing me to exhale long and slow.
posted by IndigoRain at 12:33 AM on July 30, 2010
If you do decide to go without anesthesia, here's something that's always helped me. I had severe stomach aches as a child and even still get one every now and then, and I just repeat "this too shall pass" in a whisper over and over again. It combines the idea that the pain will be over soon with the added benefit of steadying my breathing, forcing me to exhale long and slow.
posted by IndigoRain at 12:33 AM on July 30, 2010
I had a similiar experience although I think my test was maybe longer but less painful.
The doctor offered IV sedation (relaxed and painless but not unconscious), and I eagerly took it.
posted by curious_yellow at 5:55 AM on July 30, 2010
The doctor offered IV sedation (relaxed and painless but not unconscious), and I eagerly took it.
posted by curious_yellow at 5:55 AM on July 30, 2010
Definitely call and ask again, more specifically, about a) what they can do as far as your anxiety, b) prophylactic pain management. I've almost always been advised before similar procedures to do a course of prescription-dosage ibuprofen beforehand (sometimes a few hours before, sometimes for 24 hours) - ASK the office specifically about this.
If you do get ativan/valium/etc, make sure you have a designated driver and tell them when you call that you will. I think this is one of the reasons that medical practices are hesitant to provide medication like this, whereas dental practices (for example) are more used to telling people to bring a sober escort.
posted by Lyn Never at 6:10 AM on July 30, 2010
If you do get ativan/valium/etc, make sure you have a designated driver and tell them when you call that you will. I think this is one of the reasons that medical practices are hesitant to provide medication like this, whereas dental practices (for example) are more used to telling people to bring a sober escort.
posted by Lyn Never at 6:10 AM on July 30, 2010
Best answer: I've had a uterine biopsy, a colposcopy, and am having a LEEP for cervical dysplasia next week. I psyched myself out each time, and while the pain was there, it was nowhere near as bad as I anticipated. Having been through labor and delivery helped me with perspective, as NOTHING I've experienced compared to that.
Procedures on the ladyparts are daunting, for sure. Go with the pain-lesseners and anti-anxiety meds. Be kind to yourself.
posted by sundrop at 7:46 AM on July 30, 2010
Procedures on the ladyparts are daunting, for sure. Go with the pain-lesseners and anti-anxiety meds. Be kind to yourself.
posted by sundrop at 7:46 AM on July 30, 2010
Write down ahead of time what you want to say to the doctor when you ask for anti-anxiety medication, to help with nervous blathering. If your doctor is like mine, you'll be leaving a message with the receptionist anyway. Something along the lines of "I'm very nervous about the procedure next week, and would like Dr. Smith to call in a prescription for a single dose of an anti-anxiety medication like Xanax or Valium." Have your pharmacy's phone number on hand. I've done exactly that and nobody -- as far as I know -- blinked an eye.
posted by The corpse in the library at 8:47 AM on July 30, 2010
posted by The corpse in the library at 8:47 AM on July 30, 2010
YMMV, but here are a few quotes that have worked wonders in helping me to overcome fears:
"Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure or nothing." - Helen Keller
"It was a high counsel that I once heard given to a young person, 'Always do what you are afraid to do.'" -Ralph Waldo Emerson
"It is not death or pain that is to be dreaded, but the fear of pain or death." - Epictetus
You might also consider looking into mindfulness teachings, such as those in The Power of Now by Eckhart Tolle. Our minds have the bad habit of wandering to terrifying outcomes, many of which never actually end up being nearly as horrifying in reality as we thought they would. I remember how frightened of needles I was as a kid, and how miserable I was in anticipation of a scheduled shot for school; when the time came and I got the shot, I didn't feel a thing. Yet in my mind, I had built it up to be an awful experience. The only suffering that I experienced was that which I created for myself in my own mind.
posted by Ryogen at 7:43 PM on July 30, 2010
"Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure or nothing." - Helen Keller
"It was a high counsel that I once heard given to a young person, 'Always do what you are afraid to do.'" -Ralph Waldo Emerson
"It is not death or pain that is to be dreaded, but the fear of pain or death." - Epictetus
You might also consider looking into mindfulness teachings, such as those in The Power of Now by Eckhart Tolle. Our minds have the bad habit of wandering to terrifying outcomes, many of which never actually end up being nearly as horrifying in reality as we thought they would. I remember how frightened of needles I was as a kid, and how miserable I was in anticipation of a scheduled shot for school; when the time came and I got the shot, I didn't feel a thing. Yet in my mind, I had built it up to be an awful experience. The only suffering that I experienced was that which I created for myself in my own mind.
posted by Ryogen at 7:43 PM on July 30, 2010
Response by poster: Here's an update: I had the procedure done this week and I went into the hospital under anesthesia. When I asked this question, my hope was that I could find the courage to do this in the office. I could walk the three blocks from my house to the doctor's office and be home in less than an hour. And in the process I would learn to face my fears. But as helpful as the answers were, they didn't even make a dent in my fear. There was something about this particular procedure that terrified me. If it were a different test, even a more painful one (I told myself), I might have faced it more easily. Of course I don't know if that's true or not. But in the end I gravitated to the answers that said things like be kind to yourself, and this is not a question of morality, and that everyone's body is different. Everytime I read sio32's answer, "anathesia was the most awesome thing ever and I will never be ashamed to request it ...", I smiled. In the end I was fine with my decision.
It turns out it was the right decision. The doctor said that when my cervix was dilated, my blood pressure dropped and heart rate went way up. She said in the hospital this was handled easily, but in the office it could have presented some problems. My non-medical interpretation is that even under anesthesia, my body did not like this procedure. The lesson I learned is that there are times to face your fears and times when it's okay to go with the easier route. My fear was off the charts, and so I think I did the right thing, for me. Thanks to all who answered so thoughtfully.
posted by daikon at 4:02 PM on August 13, 2010 [7 favorites]
It turns out it was the right decision. The doctor said that when my cervix was dilated, my blood pressure dropped and heart rate went way up. She said in the hospital this was handled easily, but in the office it could have presented some problems. My non-medical interpretation is that even under anesthesia, my body did not like this procedure. The lesson I learned is that there are times to face your fears and times when it's okay to go with the easier route. My fear was off the charts, and so I think I did the right thing, for me. Thanks to all who answered so thoughtfully.
posted by daikon at 4:02 PM on August 13, 2010 [7 favorites]
The lesson I learned is that there are times to face your fears and times when it's okay to go with the easier route.
My feeling is that you did the right thing for yourself and you faced your fears. The really easy route would have been to ignore the situation and decline to have the procedure done entirely.
posted by scody at 6:13 PM on August 13, 2010
My feeling is that you did the right thing for yourself and you faced your fears. The really easy route would have been to ignore the situation and decline to have the procedure done entirely.
posted by scody at 6:13 PM on August 13, 2010
Exactly. You handled the problem maturely. Good for you.
posted by jessamyn at 7:11 PM on August 13, 2010
posted by jessamyn at 7:11 PM on August 13, 2010
Good for you for making the decision that was best for you. I am glad it went well in the hospital.
posted by hurdy gurdy girl at 1:20 PM on August 14, 2010
posted by hurdy gurdy girl at 1:20 PM on August 14, 2010
This thread is closed to new comments.
posted by Faint of Butt at 6:47 PM on July 29, 2010