Help me be OK with saying what I need for a health procedure
January 20, 2020 8:07 PM   Subscribe

I need to have a certain health procedure done several times per year. Due to the pain, I want to change to a more involved and costly approach. Help me to be OK with this.

I have an ongoing medical issue that requires examination around four times per year. For many people (perhaps even most people) this procedure is uncomfortable; but is short (~ 5 to 10 minutes) and the pain can be addressed using a large dose of advil. On the other hand, there are a few people that describe intense pain, with a few even saying it was worse pain than unmedicated childbirth.

I have had the procedure done many times. In the beginning, it was uncomfortable but completely tolerable. Recently however, I have been in so much pain, I have been moaning, crying, and yelling out during the appointments. In the past I think that I remember my doctor mentioning that general sedation was an option. I thought that I did not need this since the first few times were not so bad. But now, I am starting to reconsider. I feel a bit guilty since this seems like a waste of resources for something that could be taken care of during a quick office visit. I feel wimpy and embarrassed since I used to be somewhat tough and a have decent pain tolerance. I feel guilty asking my husband to take a day off of work to take care of me for something that is not medically required.

More specifically, I am asking for: 1) Is it reasonable to move forward with a day long procedure when it could be handled in 20 minutes at the doctor's office? 2) what to say to request a change in approach when I call the doctor's office 3) what to say to talk to my husband about why the old approach is no longer working and I'll need him to take off 4-5 times per year.
posted by seesom to Health & Fitness (18 answers total) 1 user marked this as a favorite
There's nothing noble about enduring pain. This is your body telling you it's time to take that day to recover from this procedure. It doesn't matter that you used to be tougher. It doesn't matter at all. You deserve to be free of suffering if can be avoided. The procedure can't, but the pain can be.

It is now medically required. You deserve as a person to be able to care for your health without pain. Your husband is probably fine with taking that time, and frankly may well be relieved that you aren't subjecting yourself to torture any more.

It is absolutely reasonable to not want to be in pain. If your doctor has already tabled the idea of general sedation, they're probably going to be fine with not torturing you. Doctors are people. They don't want to hurt you. They mentioned it as a option because they wanted you to think about it. All you need to say is "I remember you mentioning some time ago sedation is an option and given the pain levels of the procedure I'd like to consider it- how does that work? What's the effects? What do I need to do to prepare?"

It's not superfluous. You are in pain. You don't need to be.

Tell your husband that it is now too excruciating to deal with. Show him this if you want - you very articulately list why you don't want to suffer any more.
posted by Jilder at 8:39 PM on January 20, 2020 [17 favorites]

1) Is it reasonable to move forward with a day long procedure when it could be handled in 20 minutes at the doctor's office?

Yes. No one should suffer excruciating pain if they don't want to and it can be safely avoided.

2) what to say to request a change in approach when I call the doctor's office

"Hi, I want to have general sedation for my procedures going forward. Please confirm and let me know how to prepare before my next visit."

3) what to say to talk to my husband about why the old approach is no longer working and I'll need him to take off 4-5 times per year."

"Hey, I can't take the pain of this procedure any more without sedation. Can you commit to helping me [get home/other care needed] on my appointment days?"

Ideally your husband is your person, and he loves you and will do anything in his power to help you, his spouse, avoid enduring unnecessary torturous pain. And hopefully you feel the same way about him if the tables were turned! If it's a hardship for him to take the time off work, you could ask a friend or relative to do a couple of days with you. But no one, including yourself, should ever make you feel bad for choosing not to hurt. Seriously, fuck pain.
posted by prewar lemonade at 8:44 PM on January 20, 2020 [2 favorites]

1) This IS MEDICALLY REQUIRED. Just because someone else could tough it out, or you could in the past, doesn't mean you can now.

There is nothing wrong with wanting sedation, pain management, or anxiety management even for simple procedures. I am chronically ill. I have a lot of medical trauma. I'm getting sedated in a week for a tooth extraction. Specifically, my regular dentist said it would be more...difficult due to root. But the oral surgeon said they could do it without sedation. And I said, "Put me to sleep."

Plenty of people can get a tooth pulled, even a difficult one, and be fine. My body cannot tolerate that.

2) "Hello, my pain has become intolerable during [procedure]. What pain management and sedation options do I have?" For example, they could give you a medication to calm you down with pain before hand, rather than sedation. They may have a local numbing agent. Or you can do sedation. See what they offer and recommend. State it as a fact that you NEED something. If you know you want the sedation, state that. "I need sedation for these going forward. What do I need to do to prepare for that? How much will it be?"

3) Part of being a spouse is dealing with medical shit. Look, it sucks. And it sucks to have to ask for help. But this is part of marriage - helping. Do you have anyone else that can go with you, and drive you home? Can your spouse work extra to make up for time off? Can he file for FMLA *if you're in the US* coverage for that time off?

"Spouse, I need [sedation / a ride / whatever ] for these procedures. What should we do so we can get that handled?"
posted by Crystalinne at 8:45 PM on January 20, 2020 [2 favorites]

Regarding #1, you are absolutely reasonable to ask for it. To me, 5-10 minutes is sufficiently long to be in severe pain that it is not even a question. I can imagine types of pain only lasting that long that would keep me up nights knowing I had to do it 4 times a year. (For example, a tooth can be yanked in about 30 seconds or less, I imagine.) I think the duration doesn't have much to do with it. Regarding #2, let the doctor know that you have been seriously considered what he suggested before, as the pain is just too much. You decided to follow his advice. Regarding #3, it's hard to know what you should say, but I do know what he should do. He should help as much as possible, and it's okay to ask. Pain sucks so bad, and it's not how things are "supposed to be." You are not being wimpy. If you are like me, I find it hard to put people out with big requests. But in my mind, this is certainly an okay thing to have a "big ask" for without feeling at all guilty. Also, feel free to ask without thinking that there needs to be a sort of quid-pro-quo (don't know if that's how you feel at times, but I do). It's okay to have someone be there for you in a big way without thinking (necessarily right now) about reciprocity in the relationship. Although thinking about the logistics of how it would work, or could work best, is definitely the right thing.
posted by SpacemanStix at 8:47 PM on January 20, 2020

Best answer: 1) I think it is important to listen to your body, especially because experiencing the level of traumatic pain you describe can have other negative effects on your health and well-being. My own pain tolerance has changed and varied as I have more medical procedures, and I get general sedation for some procedures that might not otherwise require it because my doctors recommend it to protect my overall health.

2) I think you can explain to your doctor that you are following up on what you recall as their mention of general sedation as an option, and that you would like to discuss it, due to the increased pain and discomfort that you have been experiencing. In my experience, doctors do not want to cause patients unnecessary pain, so you are appealing to their role as your care provider.

3) As to your husband, you may be able to rely on your doctor's recommendation, and your doctor may also be able to explain why your pain tolerance is changing, as well as the potentially unhealthy consequences of untreated pain. I seriously doubt that you are alone in experiencing this, and I think that protecting yourself from unhealthy levels of pain is nothing to be embarrassed about.
posted by katra at 8:48 PM on January 20, 2020 [2 favorites]

I need sedation just for tooth cleanings and I don't feel even a little bad about it, even though it takes months to pay for it. And my husband does have to drive me somewhere and bring me a tray for once - he's fine with it. It's either that or not have teeth so. It's just the cost of doing business.

The severity of the pain is going to keep ramping up until you're going to feel like you can't tolerate the procedure at all. Why put yourself through all that to get to that point and then need the sedation anyway?
posted by bleep at 8:53 PM on January 20, 2020 [4 favorites]

This is a totally reasonable request! And it's nothing you need to be embarrassed about.

My boyfriend has to take off work every time I get blood work done or when I get a shot or when I go to the dentist. Fainting in medical settings is my super power. I can't help that I faint and you can't help that the procedure has gotten more painful.
posted by ilovewinter at 9:01 PM on January 20, 2020

There are always services you can pay to escort you to and from the procedure - you can do this without expecting your husband to take time off work. I'm coming at this from a different perspective, but you don't need him to cosign your desire to protect yourself from unmanageable levels of pain. If he wants to and is able to move his schedule around to accommodate you, cool, but if not, know you always have other options.
posted by blerghamot at 9:09 PM on January 20, 2020 [3 favorites]

1) Is it reasonable to move forward with a day long procedure when it could be handled in 20 minutes at the doctor's office?

If the latter option involves severe pain? Yes.

2) what to say to request a change in approach when I call the doctor's office

"This procedure has become very painful for me and I'd like to approach it that way."

3) what to say to talk to my husband about why the old approach is no longer working and I'll need him to take off 4-5 times per year.

That depends on the husband, but I would suggest "this procedure is now extremely painful for me. I dunno why."

I'd repeat that a lot to yourself as well. Figuring out the why is all very well, but it is totally immaterial to the fact that you need to take care of yourself right now.
posted by Tell Me No Lies at 9:42 PM on January 20, 2020

Best answer: The sedation is for the doctor's benefit more than yours. You are doing them a favor by not forcing them to knowingly inflict pain on someone. Your procedure will probably be easier and faster if you are not reacting to pain, also.
posted by amtho at 9:52 PM on January 20, 2020 [8 favorites]

In your explanation you say that with this procedure most people experience a tolerable level of pain, but a few people experience extreme pain. You have, very unfortunately, become one of the few. From your doctor's comments it appears that general sedation is suggested or recommended if you are one of those few. So, it's more than reasonable for you to go for general sedation.

Things change, and it's not that you can't cope with a small amount of pain that other people can. It's that you are experiencing a different and much higher level of pain than other people are. Because I am very confident that "I have been in so much pain, I have been moaning, crying, and yelling out" is not something most people would endure if they could get some relief from it.
posted by plonkee at 4:42 AM on January 21, 2020 [1 favorite]

I've had general sedation for a necessary and urgent procedure that doesn't much hurt anyone and that people are typically fully awake for, just because I had been so medically traumatized by a related procedure that I couldn't deal with the idea of being conscious for it. I would have felt the first numbing injection but realistically nothing after that, yet I was so scared of the procedure itself that came after that shot that I couldn't cope with the plan to sit there not-sobbing for 15 minutes. Delaying the whole thing for therapy and so on was not an option, and the surgeon wasn't willing to try twilight anesthesia because holding still was essential. It was either fully conscious or completely offline. My partner hates the idea of general anesthesia and definitely would have preferred that I remain awake, but I couldn't do it that way. I needed to choose the option that let me have my necessary procedure in a way that didn't add to my trauma, instead of waiting until things progressed to a stage where general would be mandatory anyway. I explained it to the surgeon, he ran it past anesthesiology, they asked if I understood the relative risks, and we did it. It was completely and entirely the correct choice for me and my body. Please, please make the correct choice for you and your body, whatever it may be, without regard to what hypothetical others can or cannot tolerate or what might be the most convenient.
posted by teremala at 6:20 AM on January 21, 2020 [2 favorites]

The anticipation of the pain and the pain over the period of the process, and the recovery from the pain totally and unequivocally require whatever can be done to reduce this for you.

If there is a good pain specialist in your area, talk to them about hypnosis or other treatment for dealing with the anticipation. There's a gap between Extra-strength Advil and General anesthesia, see what options exist, but if you need and/or want sedation, insist on it. Don't feel bad or shameful about needing assistance from your spouse or additional care. You've been tolerating this painful event for a while and you deserve a respite from pain. I'll reiterate that my suggestion that you consider alternatives does not mean you shouldn't insist on what you need, just that ypour doc may not have mentioned all options.
posted by theora55 at 6:44 AM on January 21, 2020

How to request a change? Call the office, explain that the procedure gotten increasingly and intolerably painful and that you need to talk to the doctor about options.
posted by theora55 at 6:45 AM on January 21, 2020

I periodically need a painful diagnostic procedure, and I'm adamant that I won't do it without sedation. The very first time I needed it (in the ER), the doctor told me I couldn't have sedation, and I just said that in that case, I would not be having the procedure. The doctor gave in.

Lots of people get this test without sedation, but that doesn't matter to me at all. You need some kind of sedation. I get that it's hard to ask for it the first time, but it will be fine. I doubt they'll push back, but even if they do, you can still say you need sedation until they agree to it. There's no reason to live with unnecessary pain.
posted by FencingGal at 7:12 AM on January 21, 2020

Best answer: Another person who's gotten many a procedure that she could be awake for with sedation instead. I have flat out told them, "I don't want to be around for this," and everyone has been very understanding and I've gotten no negative feedback about it.

It sounds like it would really settle your mind to do sedation from now on. Go for it!
posted by fiercecupcake at 9:55 AM on January 21, 2020 [3 favorites]

IANYD. I do several bone marrow biopsies per week. As much as possible, I try to offer them in the office for convenience and cost sake (as sedation and outpatient hospital stuff adds a layer of cost to the patient, and I also lose some control over things like where the pathology specimen goes). I offer pain medication, but it is oral and not always effective.

If I have any concern about safety of an office procedure (limited mobility, difficulty getting on exam table), or if I have a patient who has chronic pain, I will typically offer outright to send them for outpatient procedure at the hospital, with sedation if desired. I also offer this to anyone who asks as a rule, especially if they have had difficult-to-manage pain after an office-based procedure - the patient knows better what level of pain they are comfortable with and can tolerate.

Absolutely request that your doctor set up your procedure in a facility that can use sedation and/or higher-dose pain medication.
posted by honeybee413 at 10:04 AM on January 21, 2020 [4 favorites]

A script for your husband: "I need to start being sedated for this procedure, and as a result, I need you to schedule time off every few months. It would be best if you took me in, waited for me, then drove me home and stayed with me the rest of the day. Can you do that? I know it's an inconvenience for you, I know you have responsibilities during the day, I know that I've been able to take care of myself in the past, but this procedure has started becoming very painful and I can't do it anymore. I know there are alternative medical transportation services, but I need you, my husband, to be there for me, because I'm scared and upset that I can't deal with it like I used to, and I need your support and physical presence."

This is a thing that husbands do for their wives. And I recommend asking directly for what you want: you don't want a warm body to take you back and forth, you want HIM, and you want him to support you even though you could probably take care of yourself. Whatever you've got going on that requires such close medical attention is probably enough to weigh heavily on your mind, and it's a lot to deal with.
posted by disconnect at 11:10 AM on January 21, 2020 [3 favorites]

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