Monday, July 25, 2016

Little ms. anxiety opens her proverbial closet...




One person I'm incredibly thankful for in my life is my longtime friend Cheryl. Cheryl has been a friend, mentor, and my wellness/nutrition coach for quite a few years. She has a true gift for helping me (and I have no doubt many, many others) through personal mental and emotional challenges. In my last post I wrote about how life happens in seasons. For me, tough seasons can also bring little ms. anxiety full swing back into my life.

Little ms. anxiety? 

Oh... you don't know her? 

I guess I haven't officially introduced you to her. I don't talk a lot about her...  as she is often an unwelcome guest in my life. I'm going to make a grand assumption and guess that many of you may also deal with your own versions of little ms. anxiety. If you don't have anxiety yourself, I can promise that someone in your circle of friends and family does.

During a recent conversation, with Cheryl's help, I realized that a current life situation was making me feel shameful, embarrassed, and kind of like a failure.  I had a hard time finding the words for how I was feeling and what was bothering me... but Cheryl was able to interpret my thoughts and get to the heart of what I was actually feeling. During the end of the conversation I mentioned that shame loves to take over my head when little ms. anxiety comes to visit. Cheryl responded, "It's like when BrenĂ© Brown talks about "shame" gremlins and how they can't thrive in the light..." and that evening, that particular little gem really stuck with me. (If you've never had the privilege of listening/watching one of Ms. Brown's epic and viral TED talks, please take 20 minutes and have a listen.

We don't talk enough about little ms. anxiety. While the stigma of mental illness has lessened dramatically over the years, it's still there. It's still VERY much there.

I had a doctor's appointment last week. It was a new, establishing appointment at the practice. This physician's office is close to my work and I knew it would make life easier in the future if I could become a patient at this location.

If you live with little ms. anxiety on your heels you probably have triggers. Triggers can be things, places, events, situations, or even people that send your anxiety into overdrive. One of my big triggers is a doctor's office. ANY doctor's office. I have terrible white coat syndrome. My blood pressure shoots through the roof when I simply try to call and make a doctor's appointment, let alone once I'm actually in the doctor's office for a checkup.

The Visit

But I bucked up, made my appointment, and showed up 20 minutes early. I knew that I would most likely be seeing an intern since this office was affiliated with our medical school. I was okay with that. No problem. Everybody needs experience... right? I even brought all my meds. Dude, I was on top of things. I was going to kick-ass this appointment.

Go in. Show the insurance cards and pay the co-pay. No problem... even laughed with the receptionist. Man, I can do this.

Get called back to the triage area. (For those of you who suffer from anxiety, please know, I'm feeling it rise as I'm writing this. Even remembering the stress of the experience is an anxiety trigger for me. I'm breathing deep and I do know I'll feel better once I can share my words since writing is one form of therapy for me... so let's keep going...)  I get my weight and height recorded... I gently remind myself that weight scales at MD offices ALWAYS read higher than my scale at home. No problem.

Next, the med tech sits me down to take my blood pressure. I place my things down, and immediately let her know that doctor's appointments make me very nervous. I have serious white coat syndrome, my blood pressure will be at least 20 points higher here than it is at home. One thing I have learned with Cheryl over the years is to own my story. That when I can, if I can put words to my feelings, speak my truth, and tell people what I need, it tampers down the anxiety. It helps me, it helps them. Practice when you can.

The med tech is kind, tells me I have nothing to be nervous about, to take deep breaths and she'll begin to take my blood pressure. As expected it's almost exactly 20 points higher than it reads at home. No worries. We're good. I follow her to the examination room. She tells me that my doctor will be in shortly.  Still good. No problem.

I wait patiently in the room. I took one of the chairs in the corner of the small room. I message Michael and tell him all is well, I'm at the doctor's office. I am nervous though. He texts back immediately letting me know it will be just fine. Soon after the doctor comes in. She's young. I know she's nervous, freshly out of med school, ready to take on the world. She kindly asks what I'd like to be called and then we review all the normal things: family medical history, medications you're on, are you having any new issues... etc.. etc... All good. A few nervous laughs. No problem.

She asks if there's anything new I would like to address today. Because life had been stressful the past few weeks, a friend recommended that I ask for something like Xanax to help me through really challenging situations. Honestly, I was nervous about asking for it. I don't like having to take medications in the first place, who does really? However, the medications I do take have made my life enormously better. The mood stabilizer that I've used for 10 years is clearly written in my medical history. Anxiety and panic disorder is also clearly noted. It's been relatively well managed with my medication.

One thing I know is that anxious people are anxious about asking for help. It's one more thing to make us look needy, weak, and powerless over our emotions and our life. But I asked. I could feel the sweat in my palms when I asked about it and I truly, I made it clear this was NOT something I needed all the time. I JUST needed it for occasional, very stressful moments in life. I just wanted a backup when I felt my anxiety getting out of control.

The doctor actually seemed nervous, but also rather understanding of this. She seemed to think that since I had a long history with anxiety and I'd taken other medications for a long period of time, it really shouldn't be too big of a deal. She needed to run everything by her preceptor, but she didn't seem to think it would be an issue to get a prescription for some type of immediate-acting anxiety medication.

The Downward Spiral... 

Several minutes later after hearing the intern and the preceptor discussing my information right outside my door (seriously, do they not realize we can hear through those doors?)... the preceptor, who was CLEARLY in a hurry came bustling in. He quickly shook my hand. Introduced himself and then stated very quickly that we needed to do the blood work necessary for my other medications and that this practice was very conservative in the area of prescribing new medications.

Honestly, he was talking so fast, and I was so nervous at this point, I wasn't exactly sure what was being said. But somewhere in the midst of the conversation, he said that two psychologists were on there way down to talk to me about how to deal with my stress... you don't have to worry it's all covered, no extra cost... blah blah blah... and then he walked out of the room.

No double checking to make sure I understood what he said... no time for additional questions and answers... 

wait... what? annnndddd enter little ms. anxiety... making a HUGE appearance on stage right...

WAIT... You're sending TWO psychologists down to talk to me NOW? The intern and the preceptor were gone from the room and I was left waiting... I had no idea what was really going on. What had I done wrong? I was scared, my heart was racing, and I did NOT want to talk to anybody.

The intern came back into the room and my hands were shaking and I had started to cry and she handed me a box of tissues. "It's okay! It's okay!" she said several times, but at the moment I couldn't get any words to come. I was just completely in the midst of a panic attack not knowing what was happening and after she handed me the tissues, I think I may have mumbled out something like "I'm not comfortable with this..." and as soon as I said that the two psychologists walked in the room and the intern left.

Now let's set the scene. A patient who manages somewhat severe anxiety is literally sitting in the corner of a very small exam room. Without really understanding what's going on, two psychologists are sent into the room to talk to her. One of the psychologists is sitting up tall on the exam table and other is sitting on a stool. In the anxiety-riddled patient's mind, it feels as both these people are towering over her as if she's trapped in a literal corner, unable to escape. No one has made it entirely clear why the psychologists are here and why she has to talk to them. Does she have a choice? Why did all this happen so quickly? What the HELL is going on?

The psychologists were also probably twelve, cute as buttons, and excited about having a really crazy person who asked for drugs to analyze... at least that was the impression I got. Never mind HIPPA... I wondered what they'd be posting to their Facebook accounts once they were done with me.

These two young women shared the latest and greatest psychobabble I'd ever heard and said nice things like.. "If you're okay with this, we're going to sit down for some nice "TALK TIME"... so tell me what's bothering you and how you feel about that... when they were finally settled and in their seats and had explained their purpose, how we could schedule "talk time" any time I wanted, and how great of a service it is (I'm sure it is!).... they FINALLY got around to letting me actually talk.

But little ms. anxiety was so strongly reacting that the only things I could manage to say as FIRMLY as possible through tears and blubbering were, "I'M NOT OKAY WITH THIS. I ALREADY talk to someone on a regular basis, I told the intern that. I DO NOT FEEL COMFORTABLE talking to you. THIS IS NOT OKAY." Which seemed to have left both of the psychologists speechless, twiddling thumbs for a second or two... one of the two offered to leave the room... and then the other decided they both should... They left by saying they appreciated my honesty.

Once again I hear whispering and talking outside of the exam room door. I could hear bits and pieces, "maybe we handled this incorrectly.." I could hear the preceptor trying to tell the intern how to conduct herself for the rest of the visit (how to handle a crazy, crying patient?) And (apparently) offering immediate psychotherapy is just their plan of attack... it's what they have to do.

Honestly, I almost wanted to laugh at this point. I just wanted to tell them.. "Please JUST TALK to me, in front of me, face to face, like I'm a real person. Don't treat me like I'm breakable, just be up front and honest and stop making assumptions about who I am."

Shortly after the intern built up the courage to come back into the room. She sat down in front of the computer and she apologized. She said, they clearly didn't handle the situation correctly and that indeed when a patient asked for such a medication on a first visit red flags went up. That really, they would just prefer that I make a follow up appointment if I was still having problems with the serious anxiety in a few weeks to get that medication. To show I had a history with the practice. Also... she really felt I needed therapy on a weekly basis. Would I like to make an appointment with them now?

That's when I got angry. Through the entire visit, both doctors and the two psychiatrists had made assumptions about me, all because I asked for help. All I had done was ask for another medication to help me with my anxiety. My voice became clear and firm and I stated, "NO. Thank you. I know you don't believe this, but I have a good support system and I speak with someone at least once a month, more often when necessary. This visit hasn't helped me at all." She refilled the other prescriptions I needed and we wrapped up the appointment.

I walked back to my office, edgy, wishing I could go home... knowing I had to put my best face on and get through the rest of the day at work.

So I did... but instead of hiding my anger, frustration, and anxiety... I met little ms. anxiety full on and immediately reached out to my support system -- to my husband, to my coach, to my furry family members when I got home, to my online anxiety support group, and to friends who struggle with similar issues.. and it helped. It helped a lot.

3 years ago, I would have buried my feelings and emotions and struggled for days, if not weeks, from the actions of that one event. 

What Can We Do? 

With the help I've received over the past few years, most of the time, I can now face my anxiety. I can step back from the present, use the tools I've learned, and work through it.  I had NO REASON to feel ashamed about asking for additional medical help and yet sadly, the medical community made me feel that way. No one should ever feel that way. The medical community MUST change how they work with patients who have mental health disorders like anxiety. 

Thankfully by the next day, I could laugh about the situation. In the past, I would not have been able to do that. I was able to talk freely about it to my coach, to co-workers, and to a friend who is affiliated with that medical office. And I felt empowered. I may live with little ms. anxiety on a daily basis... but I will not allow her to rule my life. And honestly, I wish that's what the intern could see (and why I'm writing this post)...the intern and preceptor who probably saw me for a total of 20 minutes were unable to see how far I've come and how much I have accomplished in managing my anxiety and panic disorder. The fact that I was asking for help, was a big step of acceptance and owning my story in my life.

And with this post... I'm opening up the closet of anxiety. It's time to talk about it. It's time to continue to fight against the stigma of mental health disorders which affects at least 1 in 5 Americans to some degree, most untreated. 

So let's open this discussion and talk about it on a regular basis. No one should be ashamed or embarrassed about living with mental health disorders and ASKING for help when they need it. I hope if this is something you've struggled with in your life, you'll join me in demanding better care, options, and treatment. 




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3 comments:

  1. Dear Carrie, Great article and congrats on how you handled these people who mishandled you and your request. As I was reading and recognizing the situation, I could feel my own anxiety rise along with my pulse rate. One good outcome is that you will be able to use this as an ace-up-your-sleeve the next time you have to encounter either that same intern or a new one. You will know that you have a history of putting youngsters, with a false sense of their own superiority, into their places. I had thought that medical personnel were now required to take courses on the psychology of dealing with their patients but it seems they still haven't understood that many patients know themselves better than anyone else could, particularly in an introductory situation. I hope you find a more sympathetic and helpful doctor in the future. Best wishes to you!

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  2. Hi Carrie,
    Wow, I just cringed reading your post. Not a good experience at all. It might help in some way to understand what triggered the poor patient care you received and so I am sharing what I know based on my experience and online research.

    The government is trying very hard to reduce deaths from drug abuse. They have a number of drugs which now must be reported to the government when a physician prescribes them. If they don't like the way the doctors are writing script for those medicines they can take their license to practice medicine away. Obviously that is pretty scary for a doctor.

    So all that said Xanax is one of the medicines which must be reported when prescribed. This has made doctors and clinics afraid to treat people who ask for this care.

    I am in no way suggesting you are doing anything wrong! It hurts to be treated like a drug abuser. It hurts not to have your medical needs respected. It might have been helpful if the intern or others at the clinic explained the situation but maybe not. It just pissed me off when I learned about it.

    If you want to check a bit of what I have written out here ask the next doctor or intern you deal with about it.

    I'm so sorry you had this horrible experience on top of the intense anxiety you deal with. Wishing you relief.

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  3. I wish I had managed my own visits with as much grace - the last time I saw someone, not only did it go completely and totally straight to hell... the therapist put my PHOTO ~AND~ ADDRESS (email too) on her linked in page as "as satisfied customer". Which was odd, as I had told her hell was gonna freeze solid before I came back she was so unprofessional. Took me three months to get my photo off her page, and never DID get an apology. I know my stressers. I know my tics. I usually can, granted, sometimes white knuckle gripping to do so, manage. But when I've gone for some supplemental help, it seems like its a "Let's see what it takes to reduce this person to shaking tears and tell her she can't manage her life. The last doctor I saw actually said "There is no way you are handling what you say you are, as you are. I couldn't. And if a trained professional couldn't manage, if it would make even ~ME~ suicidal, someone like YOU can't possibly be as okay as you claim." Someone.... like.... me. What the frilly heck does THAT mean? You either learn to get up again or you lay there and die. And while I have issues - I always always ALWAYS have dragged myself upright again. Reading your own experience makes me wish I could just print it out and the next time I try and get some help, make them read it first. Or find out how much it would cost to have you yell it at them for me.

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