Going to the doctor is stressful
This is me, before and after a doctor’s appointment that I was stressing about, and how I got myself through it. It’s totally unedited and raw, not showing me in my best light (but far from my worst) and probably annoying to watch, but maybe kinda helpful? I tried to talk through what I’m doing inside.
I thought I’d just be a little different today. I am in the parking lot outside my doctor’s building and getting ready to go into an appointment, and I’m not looking forward to this at all. I’ve been not looking forward to it for months, and I thought I might talk you through what I do to calm myself down. To see the anti-anxiety practices that I talk about in action.
So this is just a follow up appointment. It’s a fairly routine thing, not a big deal, except that doctor’s appointments or doctor’s offices (health care offices in general), tend to be kind of my perfect storm of sensory hell.
The fluorescent lights give me migraines, often within about 20 minutes, that could last for a couple of days. So I do a number of things to protect me from the fluorescent lights, but they still hurt, and I usually end up walking away with at least a headache. The temperature is often cold, and I’m very sensitive to temperature. I am fully supportive of COVID masking, but the feel of anything on my face is like an electric shock to my nervous system. It’s really really hard for me to keep a mask on my face for more than a couple of minutes, and even a few seconds contact is really hard for me and it works me up just thinking about it now. I’m getting a little bit worked up about it.
I have medical trauma in my history. I’ve worked through a lot of it and I am getting better, but it’s still there and I’m still dealing with the effects of it, and various other things (pointed questions, very personal stuff). And with this particular appointment, even though it’s theoretically a routine follow up, their instructions for it were rather vague.
They need to do some blood work and the instructions were to get here a few minutes early, go to the lab on the first floor and they’ll take some blood. Then the doctor can check it in the appointment. Those are both unclear instructions, and that was the clearest it got after I asked them three times to explain it.
What is a few minutes early? How long do they actually need for this blood test to be run, so the doctor can have the results? That is the second part that runs counter to everything that I know in my history of medical appointments, which are extensive about how long it takes for blood work to get done. So that conflict inside me is not helping my stress level.
Alright, so the thing is, I’ve already spent some time identifying what it is that’s stressing me out. It’s the sensory stuff. I have some things with me that can help to take care of the sensory stuff, or at least to reduce its impact. I have a hat and have fluorescent light filtering glasses. I have a mask that I can deal with better than other ones (still not great, but at least I can keep it on my face for a few minutes). I have some fidget toys and things that help me out.
So I can deal with that stuff, but also just the psychological part, the “what is going on here?” The vague instructions, and the conflict in my head between how my experience has shown that blood tests generally work and the short time span. Those are the two main sources of stress, apart from the sensory thing. Apart from just generally not liking most doctor’s appointments.
Identifying what it is that I have a problem with helps because then it’s not “everything is bad,” it’s “okay, there’s two things.”
I did talk to someone who has experience at this place and they said that the blood tests can actually come back in a few minutes. I looked up a map of the place to identify where the lab is, so that I will feel a little bit more confident coming here. I can’t make all of it perfect, but I can reduce these sources of my specific stress.
Also, I’ve been trying not to think about the appointment because I only want to live through it once, not 1000 times. Now, of course, I’m not entirely successful with only thinking about it when I’m actually there. But when it comes up, and I start ruminating, I’ve been talking myself through, “I’m having the thought that I can’t deal with this, but I can. I have dealt with lots of doctor’s appointments in the past, and I can get through this one too. It might be a little confusing, and I don’t like that, but I have dealt with lots of confusing things in the past and I can deal with this one too.” And I’ve talked to myself like that and just said, “Okay, when I get there, I will deal with it.”
Now, of course, it’s just before the appointment so it’s actually natural to think about it more often. And I listened to some music on the way here, Dr. Horrible’s Sing-Along Blog, which is kind of my go-to “set myself up for something that I don’t want to do” music. Also my go-to “set myself up for something that I’m really enjoying” music. Multipurpose! So it’s helped me kind of feel better in my nervous system, but as I’m talking you through this, I’m going through a whole range of stress reactions.
I’m about to go in…
I don’t know if this is even helpful. Maybe it’s just watching someone get psyched out? But anyway…
I’m about to go in, and this is gonna sound totally corny, but this is literally what I do before any kind of doctor’s visits, or anything that I have to deal with that’s really unpleasant: I close my eyes, and I kind of just shut down. I can’t look at the video screen much anymore. When I go in, I’m probably gonna be walking with my head down and staring at the floor, and…
Okay, I’m feeling my heart beat getting faster. I’m feeling my chest feeling tighter and my shoulders are hunched. My jaw is really tight. I’m noticing these sensations. My hands want to clench and want to rub things, rub different parts of my legs or my face, and scratch my head. I’m just noticing what’s going on in my physical reactions to this. And I’m actually trying to key into that more, not push it away. Get grounded into it. Just notice.
Yep, my shoulders are really tight. Yep, I’m rubbing things. Yep, I’m breathing a little more shallowly. Okay, just notice that there’s nothing wrong with it. This is simply a stress reaction, and my body is trying to take care of me. It’s trying to prepare me for something that I’m anticipating to be unpleasant. But yeah, that’s another thing. This kind of pain (not like the pain that’s in my knee right now, that is physically hurting), any kind of stress pain or psychological pain, it’s all either anticipated pain or remembered pain, and I’m remembering lots of pain right now. But that’s in the past, it’s over with right now. I am safe.
I’m anticipating that this will be unpleasant, but right now I am safe. Right now I am just sitting in the car, and nothing is happening to me. Right now nothing bad is happening. I might be talking to some people in a few minutes. That will be confusing and might be a little bit stressful, but right now: I am just sitting in a car and nothing bad is happening to me, I am safe. In a few minutes, when that happens, I will deal with it. But right now I am safe. Right now nothing is happening to me.
I’m noticing that my breathing is getting a little bit slower, a little bit deeper on its own. I’m not trying to make it do anything, it’s just happening. Because right now I am safe. Right now I’m just sitting in a car and nothing bad is happening to me.
Right now I’m safe.
In a minute, I’m going to get out of the car. I’m going to walk over there and I’m just going to be walking. Nothing bad is going to happen to me. I’m just going to be walking, it’s about a half a block to the building. I’m gonna go, and I’m going to walk around the first floor, and find the lab that will get the frickin’ lab done. I’ve had lots of labs done before, it’s unpleasant, but I can get through it.
Right now I am safe. Right now nothing is happening to me, I’m just sitting in a car. Right now I am safe.
It sounds totally cheesy but I literally talk to myself like this sometimes in my head, sometimes even out loud, and it just helps me get through it. It doesn’t make everything “poof, better!” But it helps me get through it.
I will talk to myself this way the entire time, “Right now this is all that’s happening, and I am safe right now. I am safe in a few minutes. I’ll deal with whatever comes, but right now I am safe. Right now nothing is happening to me. I’m just walking, I’m just sitting, I’m just standing here, I’m just stimming.” (And yes, I will stim publicly. That is not an endorsement, that is not a “you should”. This is simply what I do, and this is how I get through it.)
Alright, I’m gonna go now, and I will hopefully remember to check in with you afterwards and just say that it all went okay. Okay, I’m gonna go now. Bye-Bye.
I need a few minutes to decompress… It was not too terrible. Not great but not too terrible…
They did not, in fact, have the bloodwork done. I went in half an hour early and they said “Oh yeah, that’s fine. Plenty of time.” And when I got up to the doctor’s office, they did not have the bloodwork done. Even after the whole appointment was over, it still wasn’t back. At least that wasn’t the main thing.
So got the rest of the appointment done, which was the much more important part.
Oh, I can scoot my seat back! I didn’t think about that earlier… Okay… this is clearly a totally unfiltered unedited thing.
Also, when I’m in a mild or moderate stress mode, I notice that I get chatty and tend to smile a lot, even though I’m not happy. But when it gets really intensely stressful, I go complete flat affect and shut down. So noticing that I’m not completely shutting down, that I’m able to talk to you, that my weird thing where I smile when I’m unhappy…
(I get bad news and I smile. That’s just my reaction, I don’t know why. It’s not a happy smile, I do know the difference. It feels different, it’s like a nervous thing. I don’t know.)
Anyway, yeah, so I get chatty when I’m in moderate stress. Noticing that is a good sign that I am not in complete shutdown. So I’m just reminding myself, I’m actually saying that aloud in order to remind myself, that it is not as bad as it could be. I am handling it. This is not pleasant, but I am handling it.
Okay… Noticing my body… There’s a lot of tension in my entire upper torso… In my entire upper body, I’m conflating words again. Again, a sign of stress and it’s okay, because I’m dealing with it. I am still here.
I had my hat, I had my fidgets, and I calmed down a little bit. I was able to advocate for my needs, to ask for the lights to be off, and the nurse didn’t give me too much of a hassle. Actually, rephrasing that, reframing it. Not just words, but actually reframing it in my head… She did not actually give me a hassle at all, she was questioning and trying to figure out what combination of lights. Then, because there were two different lights in the room, what combination could let her see enough to write her notes, but be as low as possible.
So she was troubleshooting in order to meet my requests, which took several trial and errors. That was an unpleasant experience, but she was not actually giving me a hard time about it. I know what that looks like, what a genuine giving me a hard time about it is, and that was not it. So it’s good to differentiate for myself, and my own mental health, that she was trying to accommodate and still meet her needs because she needed to be able to see her paper. We did get a compromise worked out. That worked. I just put my head down lower to help, and that worked.
The doctor was very pleasant. In fact, he let me turn off all the lights except for his computer light. He was able to do that and it worked out just fine for him. He was quite pleasant, and basically said that the results have not changed much and he’d like to follow up again in six months.
He’ll give me a call, or the nurse will give me a call, when the blood test has come back, because they still weren’t back. And I have a slight feeling of vindication, of, “See? I was right, it’s gonna take more than a few minutes!” That’s probably not a very helpful feeling, but that’s my feeling anyway. At least it didn’t ruin the appointment, the fact that the labs weren’t back yet, which was part of my concern.
Okay, stretching out, noticing my insight and assessing my body feelings. Just getting grounded in the moment, in the present. Reviewing a little bit of what happened does help me, that way I can kind of cycle it through my system and be present in the moment.
Okay, so right now I am just sitting in a car and nothing bad is happening to me. I’m just sitting in the car, I am doing what I need to do to calm down and I’m rubbing my legs. I find that putting some pressure on my thighs, rubbing from the top to the bottom… Sometimes the bottom to the top, but I find more the top to the bottom works… Well it’s a little muscle massage, I guess I don’t know exactly why it works, but it does seem to.
I cross my arms. Left hand on the right thigh, and right hand on the left thigh. That gives a different sensation. I go back and forth sometimes, and the combination does help…
Shaking it out…
There’s a very interesting thing that happens… Most animals do not do this rumination, by the way. Something scary happens, a predator comes, scares them, and they run away. Fight or flight saves their life, hopefully, (or it doesn’t and then they don’t have worries anymore) but they get away. Then they physically shake it off, and they just go back to grazing or doing whatever they were going to do.
They don’t ruminate on it, but that physical shaking… you’ll see dogs do this, you’ll see deer do this in the woods… It helps the blood, it helps the nervous system release the cortisol out of the bloodstream. In our society, we people do this too. Like when you’ve just been in a near accident in the car or something, a few minutes later you might start shaking.
Our society teaches us that that’s a bad thing, that we’re supposed to control and not shake. But it’s actually the inherent response to our nervous system, to help us release the cortisol so that it doesn’t last as long. The experience completes.
We can use that intentionally. To just shake, physically shake, get up and jump around, or move in some way. Physical movement in general, but for some reason shaking works really well… and my brain is not fully online, otherwise, I could probably explain why I do know this information. But right now, I don’t really have access to all of that… but maybe another video sometime? Anyway, it helps to complete the experience.
I’m actually noticing that my breathing is slowing, my nervous system is calming, my arms are moving a little bit more easily, a little more smoothly. I don’t feel as rigid and… I don’t know how to describe it. The only image I’m getting is a robot that has joints that need to be oiled or something. When I’m really stressed, I feel like that robot that needs to be oiled or my movements are very jerky and stiff, but I’m moving a little bit more easily now. Feeling like I can handle it.
I’m going to do this for a few more minutes, let myself wind down, relax in the car on my own, and turn the video off in a second… You don’t need to watch that for another 10 minutes or so… But then I’m going to go ahead and drive because I’m feeling like I’ll be able to drive safely in a few.
For now, I’m just sitting in a parking lot and I am okay. I’m just sitting here, and I am safe, and I’m taking care of myself. At this moment I am safe. Other things will happen later and I will deal with them then, but right now I am safe.
Right now, I am okay.
Alright, I have no idea if any of this is helpful, or if it’s just working you up watching someone get stressed out (if that’s all it’s happening, I hope that you turned it off ages ago). Anyway, I’m gonna say goodbye now. Take care.