Tips to Minimize Stress at the Doctor

December 9, 2014 8:43 AM

I haven't been to the doctor in a long, long time. I am experiencing a rapid heartbeat and am making an appointment. I am pretty convinced I'm dying, and am sitting here crying while looking up doctors online. How can I make this process as painless as possible?

So my experience with doctors has never been pleasant. I haven't been to any sort of doctor since I broke my ankle in 2006, and that doctor was a dick. It was also extremely expensive and unpleasant all around. For a long time I didn't have insurance, which was a handy excuse for not visiting a doctor. Now my fear has taken complete hold of me and has made me extremely avoidant, especially because I have heard so many stories about having to shop around for the right doctor after bad experiences.

A complicating matter is that I'm fat. I don't want to lose weight, but from what I hear most doctors will focus on my weight and nothing else. I am particularly concerned about this since I am going in due to my heart--I am afraid a doctor will go, "well of course your heart is awful, you're fat." I don't know WHY this scares me so much, I guess because I feel like my identity is wrapped up in my appearance, which I take great pride in. I also worry that my weight is not the cause of any issues, but will be the thing the doctor focuses on since it's the most obvious. I am also scared of needles and I get stage fright when I have to pee in a cup.

And of course, my real fear is that something very serious is wrong with me. While I know it's better to have an answer than to live in fear, objectively, I don't FEEL that way. I feel like ignorance is bliss and we're all going to die anyway so I would rather have it surprise me, than learn I have cancer and have to go through all that entails. However, feeling anxious about my heart for the past few days has also been pretty shitty!

So! Please lay on me any and all tips. Should I go to Urgent Care or a PCP? How can I calm myself down? What should I expect at the doctor, and how can I make it not seem so scary? Did you ever get bad news that made you feel relieved anyway, since you got an answer? Please be gentle on me. I know this crowd shouts "go to a doctor" at nearly every problem like it's no big deal, and to me it's a HUGE FREAKIN' DEAL. I'd love it if the doctor felt like a necessary part of life, rather than the enemy.

posted by masquesoporfavor to Health & Fitness (22 answers total)

There are doctors who are dicks, but there are also doctors who specialize in health-at-any-size fat-positivity stuff. I googled "fat positive doctor atlanta" and came up with a ton of results. I don't have time to dog through them, but I'm sure you can find someone who will work with you and not against you.
posted by showbiz_liz at 8:46 AM on December 9, 2014 [4 favorites]

Can I just point out that if your heart is beating fast, feeling anxious is part of that?

That's what my anxiety meds do - slow my heart rate.

Your heart apparently isn't thinking straight right now, and it's trying to trick you into not giving it the tender loving care it needs. Sorry, but you have to be a little cruel to be kind right now and just firmly tell it you're taking it to the doctor and you'll both feel better soon.

I don't know your healthcare system so I don't know who you should call right now, but someone else will be along in a minute to tell you that.

In the meantime, you'll be fine! Even if the doctor is a dick to you, it'll be okay because you can come back here and tell us about it and we'll help you figure out what to do next. But, the doctor will probably give you the help you need.

You can do this.
posted by tel3path at 8:55 AM on December 9, 2014 [3 favorites]

Response by poster: Not to threadsit but I did mean to include that--I DEFINITELY have "white coat syndrome" and it extends beyond just the white coat. Even checking my own heart rate, I feel my heart start to beat faster and faster, so it's going to be so tough to get this addressed properly. Thank you for mentioning that!
posted by masquesoporfavor at 8:57 AM on December 9, 2014 [1 favorite]

I just sent you a memail with a recommendation for an Atlanta doctor.

Typically, when I go in for my PCP appointment, they check me in, and have me fill out information on a tablet. This tablet sometimes even takes my payment! Otherwise, the person behind the desk will you have you fill out paperwork, and will take your payment/copay.

Then they call me back with a nurse/assistant. That person goes over my medical information, takes my weight, blood pressure, etc, and sees why I am there - is it for prescription renewals, am I having another issue, is it just time for my annual exam?

At that point, they take me to an exam room, and leave me there to wait on the doctor. depending on the issue, I may need to change into a gown - usually not. I wait for the doctor, and then he comes in, and greets me, and talks to me about whatever reason I am there. He examines me, tells me what he thinks/the proposed solution, and we discuss. He asks if I have any questions or any other concerns, and then will give me a prescription or send me to the lab to have blood drawn (if my annual exam). He will then either give me prescriptions if needed, or send them to the pharmacy.

Then, he says to come back around my birthday for my yearly exam, unless I have another issue.
posted by needlegrrl at 8:58 AM on December 9, 2014 [4 favorites]

Can someone go with you? If you're anxious, it will be hard to focus on what the doctor says and the other person can help you remember to ask questions & take notes for you.
posted by desjardins at 8:58 AM on December 9, 2014 [9 favorites]

Fwiw, I have stents and I am overweight. My cardiologist is also a realist. He certainly has suggested losing weight, but he told me that the best thing I could do for my heart was do build it up by doing cardio. I asked if I was better off losing weight or something else, He said, "Take your prescribed medication, exercise and eat a healthy well balanced diet. Your weight will gravitate to whatever it naturally should be."

Go to the doctor (PCP). Get a diagnosis. Work on correcting whatever is wrong. Your weight is a by product of your genes and what you eat. It is not the cause, it is a symptom.
posted by 724A at 8:58 AM on December 9, 2014 [1 favorite]

Can you have someone go with you to the doctor? A trusted friend or family member? Invite them to distract you with fun conversation while you wait, and then be there by your side and hold your hand while the doctor says whatever they're going to say. I bet the doctor won't be cruel when there is a witness. Or even if the doctor is a dick, your friend can say "Excuse me, that is not appropriate. My friend is here for health care, not to be treated that way." Then you and your friend go out to do something fun right afterward.
posted by Bentobox Humperdinck at 8:59 AM on December 9, 2014 [5 favorites]

Oh - I would also let the intake nurse know that you're anxious - sometimes they will take your blood pressure multiple times during an appointment, if you think it will change for the better at the end instead of right when you get there.
posted by needlegrrl at 8:59 AM on December 9, 2014 [5 favorites]

There are many horror stories about doctors prescribing weight loss, but there are also tons of great doctors out there who don't take that approach. Looking for Health-At-Every-Size doctors or fat-positive doctors is one great way to weed them out.

Do you have insurance right now? Does your insurance provider have a nurse line? They may be able to advise you on whether you should go to an urgent care provider right now or wait until you can see a Primary Care physician. Personally I am a big fan of Urgent Care - I've always had great experiences with the speed and quality of care at Urgent Care clinics.

Whether you go to urgent care or a regular doctor's office, here's what will happen.
(1) You will check in at the front desk and receive some medical history forms to fill out. They will ask for your insurance card to photocopy.
(2) After you return the forms, you will wait to be called back by a nurse.
(3) The nurse will take your vitals - temperature, blood pressure, heart rate, height, and weight. If you prefer not to be weighed, you can say that you don't want to be weighed. Or if you are OK with being weighed but don't want to know the number, you can say that too. This is a great time to tell them that you are nervous about going to the doctor - they will have techniques to try and get more accurate "resting" and calm readings.
(4) They will want to know the purpose of your visit and ask you more questions about your health history and symptoms.
(5) You will be taken to an exam room to wait for the doctor.
(6) When the doctor arrives, he or she may ask you the same questions as the nurse. It's possible that they will take your vitals again. A good doctor will give you a quick physical to check your abdomen and lungs.
(7) The doctor will make a preliminary diagnosis that they should discuss thoroughly with you, and talk about what the next steps are. That could include further tests if they think it's necessary, or a prescription, or making a follow-on appointment..

Ragen at Dances with Fat has a really good guide to dealing with health care professionals who overlook fat patients.
posted by muddgirl at 9:01 AM on December 9, 2014 [3 favorites]

You can also do some google searching for doctors in your area. If you go to a site like Vitals, I think you can search for docs who've gotten "compassionate care" awards by their patients, or "patient's choice" awards. You'll be able to see doctors who excel in being kind and friendly rather than intimidating.
posted by swheatie at 9:06 AM on December 9, 2014 [2 favorites]

Sent you my recommendation for both a GP and a GYN.

Love my docs, and they're both perfectly cool with the fat thing.
posted by Ruthless Bunny at 9:09 AM on December 9, 2014 [1 favorite]

I don't FEEL that way. I feel like ignorance is bliss and we're all going to die anyway so I would rather have it surprise me, than learn I have cancer and have to go through all that entails.

I had something wrong with me that would have killed me at 25 if it hadn't been diagnosed. It was diagnosed, and I went through "all that entails," which was kind of shitty, but now I'm 27 and in great health and my life expectancy is basically unaffected by what I went through earlier in my 20s.

Would you really choose to miss out on decades of the rest of your life rather than possibly suffer through a few months of treatment? Certainly there are still things that modern medicine can't cure, but many things can be addressed and if you don't get medical care you'll never get the chance to do that.

That's what gets me to the doctor even if I'm scared of the unknown. Everyone dies someday, but you have a tremendous amount of power to delay that by being proactive about your health.
posted by telegraph at 9:39 AM on December 9, 2014 [5 favorites]

There are a lot of things that cause a racing heartbeat. Some are benign. Some are things that can easily be dealt with (e.g. hyperthyroidism). Some are potentially serious, but of those serious things, I'm going to guess that NONE of them will be better off not being diagnosed or treated.

I also have white coat hypertension. I explain this to doctors and they are generally OK with that. (They're doctors -- they see a lot of people with that, or with fears of needles, etc.) Sometimes they tell me to go check out my blood pressure at the pharmacy to confirm that it goes down after I see them (it does), or they measure again at the end of the appointment.

I also try to reward myself after doctor's appointments with something I like. (OK, it's bribery. But it works.) Is there some little treat you look forward to, like a special coffee or a magazine, or new socks, or some activity you like doing? If so, plan to treat yourself after you get out of the visit. If you start spiraling during the visit, try to refocus and think about how nice the treat will be.

You can totally do this! It might suck, but you will get through it.
posted by pie ninja at 9:39 AM on December 9, 2014 [3 favorites]

I just want to tell you, you're not alone in being anxious about going to the doctor, or about preferring not to know if there's bad news about your health. I'm crying just thinking about this stuff right now. Are you afraid to hear bad news because it might mean you would have to make a lifestyle change that you really wouldn't like, or couldn't do? That and feeling like I'm being judged on how well I take care of my health are what I'm so scared of. If you ask not to be told what your weight is, you won't be the first or last person to do that, either.

Would taking someone with you make things better, or worse? For me, the answer is definitely worse. I do NOT want my friends or family members seeing if something is wrong with me, or how upset I might get. I would rather post my social security number and all my credit card numbers on a hacker site than let my husband come to a doctor's appointment with me. (I would tell him later if there were something seriously wrong, but I'd make sure there was no one else there to hear the conversation) If that sounds like you, don't bring someone with you. If having someone there with you would help, you can do that.

I'm not a morning person. But that also means my emotional responses tend not to be as extreme early in the morning. I almost always schedule my doctor appointments for first thing in the day for that reason. If your anxiety has a schedule like that, take advantage of it. I would normally never leave the house without having had some caffeine, but I don't have any before going to the doctor, because I know that might make my anxiety worse.

If they want to draw blood, tell them beforehand that you are scared of needles. You're not alone there: Wikipedia says at least 10% of American adults have a needle phobia. Drink lots of water and don't go to the bathroom before you go in case they want a urine sample.
posted by Anne Neville at 9:44 AM on December 9, 2014 [1 favorite]

Response by poster: Thanks all for being so compassionate. I'm going to have my husband call a couple of the recommendations and see about getting an appt when he gets home this afternoon. I'll start with a regular ol' doctor and see if they think I need an ER or a specialist or something. I think having my husband with me will be good--he's seen me at my worst before, and if I have a freakout in the office I'd rather have him there looking sane to counter my behavior. :)

Re: decades of my life being saved--I am very much of the "well I could die in a car wreck on the way to the doctor's so might as well eat the bacon" kind of person. There were a lot of deaths in my young life that kind of ruined my perspective for this, I think. It's hard for me to think about being 50, 60, or 80, because 1) it might not happen regardless of my health and 2) those ages don't sound super cool anyway.

Thank you, thank you, thank you.
posted by masquesoporfavor at 10:06 AM on December 9, 2014

I mean this in the most supportive way possible: For me, depression and anxiety go hand in hand. Like, anxiety and fear are the tools that my depressed mind use to keep me from seeking help. For me, the #1 sign that I am slipping into a depressed state is a lack of self-care and a disregard for my future. If you get a good feeling for your primary care doc, you might want to talk about these feelings with him and see if your insurance covers a psychiatrist as well.

My husband was diagnosed with cancer at the age of 30. We thought it was something else and ignored the symptoms for a long while before finally seeking help. Not knowing wasn't any better than knowing - both are suffuse with tension and fear for the future. It turns out that a cancer diagnosis is no more certain than a lack of one - as he reminds me, he could still be hit by a bus on the way to the doctor's office.
posted by muddgirl at 10:33 AM on December 9, 2014 [6 favorites]

Hi, I'm you. My motto for a long time was "Eat right, exercise daily, and die anyway." Then I started making good friends. Then I had kids. Then I wanted to stay FOREVER upon this earth. I currently have one living grandparent, going strong at 89. Her husband died at 87 of cancer that he chose not to treat. My other grandparents died well into their 90s.

I'm fat. And I hate doctors. And I'm scared of them. Well, I'm scared of people in general, but I'm especially scared of doctors. They always tend to have bad news, don't they? I also have chronic idiopathic sinus tacchycardia. That's doctor speak for long-term we don't know why it's happening high heart rate. I've seen my PCP for it, along with a cardiologist, a pulmonologist, and an electrophysiologist. Not one of them has mentioned my weight. My EP told me this week that he wants me to start walking every day, to strengthen my heart so I can get off the meds I'm currently taking for the tacchycardia. But that's it. No mentions of diet. No mentions of "well of course you're screwed up, you're fat."
posted by The Almighty Mommy Goddess at 2:20 PM on December 9, 2014 [2 favorites]

It sounds like you have medical anxiety. I hadn't been to a non urgent care doctor since high school because of mine. I got a prescription for Lorazapam and take one before doctor's appointments and am fine and finally getting caught up on my medical care.
posted by mermily at 2:35 PM on December 9, 2014 [3 favorites]

I always bring a little notebook to the appointment and write down everything I can ahead of time - all symptoms, when they started, etc., as well as any questions I have.

When the doctor talks, take notes. If they go to fast, ask them to slow down and then repeat back what you wrote down.

If you can bring a friend or family member, they can be a great advocate.
posted by radioamy at 4:05 PM on December 9, 2014 [1 favorite]

I once discovered the most hideous-looking skin condition on my inner thigh that had all the earmarks of advanced skin cancer according to the internet. I made an emergency appointment for the next day and barely slept a wink that night. The next day in the office, I was prepped on the table and the doctor came in. She asked me a few questions and then said, "Okay, let's have a look." She lifted the sheet and... smiled. "What you have is a yeast infection. We'll get that cleared up in no time."

Which is only to suggest, it doesn't pay to imagine the worst ahead of time.

I also have a congenital heart defect that I only learned about three years ago. The above experience helped me not freak out when my doctor noticed a heart murmur and referred me to a cardiologist. The cardiologist ordered tests and then more tests and then more tests still. And what I now know is that my heart condition may never require surgical intervention and only needs to be monitored once a year. Well, and I needed to get walking for 30 minutes a day and make some not-onerous dietary changes.

Let me add here parenthetically that I have grown to love walking and am out an hour. We have two dogs. I used to walk them because they needed exercise, but now they get to accompany me on MY walk, and we're marching four miles today so you better keep up. They have never been happier.

Anyhow, knowing is better than not knowing. Can you maybe say that to yourself as a mantra when anxiety strikes?

And allow me to second mermily's excellent suggestion to pop an Ativan/lorazapam beforehand. It's kind of a wonder drug as far as I'm concerned. If you don't have that, ask for a prescription on your first visit. (It can be habit forming, so your doctor will limit its availability; you'll only want to use it for "special occasions.")

Best wishes to you!
posted by Short Attention Sp at 4:12 PM on December 9, 2014 [2 favorites]

Response by poster: Ok in case anyone is interested--called a million places and couldn't get a "real" doctor to see me for a few weeks, so we went to the Urgent Care. The doctor there was super nice, and did an EKG. He said my heart sounds great, but I may have high blood pressure. I'll keep calling the docs recommended by Ruthless Bunny and needlegrrl but for now I'm not dying. Yayyy!!
posted by masquesoporfavor at 10:31 AM on December 10, 2014 [2 favorites]

Just checked back and am very glad to learn that you are not dying (spoiler: I didn't think you were :-))
posted by tel3path at 5:01 AM on December 17, 2014