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Doctor's Appointment Anxiety

Ken

Well-Known Member
V.I.P Member
I am still suffering from traumatic anxiety following last year’s annual doctor’s visit. Now, my next visit is due on October 3, 2022 and I am extremely stressed and depressed with dread.

I would simply not go. I don’t think I really need annual exams, however, I am a type 1 diabetic and require insulin. I can’t get insulin without a prescription and I can’t get a prescription without the annual exam.

I have developed my own diabetic control method that I call the SPP method (Synchronous Push-Pull method) that keeps my blood sugar and all my bio markers in the non-diabetic normal range. My A1C is always 4.5 to 4.7 over the past several years and I never rely on any doctor for my control.

She is a good, kind doctor, but I am extremely sensitive to touch and the social aspect of such an intimate examination. I am also sensitive to being stereotyped. Many of the tests are based on stereotypes, which induces traumatic anxieties that never goes away.

Therefore, I have composed a letter to send to the doctor before my appointment. I have attached a PDF of the letter. What do you think? I have replaced any names, etc. with X’s for privacy concerns.
 

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  • Ken's Doctor's Appointment Anxiety.pdf
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Assuming some one actually reads it, I think sending a four
page letter would immediately alert the reader to the idea
that the sender has serious anxieties and concerns.

A1C of 4.5 to 4.7 is excellent. :cool:
 
you forgot to anonymize your name (if you forgot it) (in the end of your letter)

I think a therapist would maybe read it, but I don´t know if a medical doctor would read it. here most doctors are very busy and they wouldn´t even read letters from therapists.

so maybe summarize it and make it shorter? don´t know.
 
Oh I haaaaaate doctor's appointments. I will literally stay up all night in worry, the night before. It makes me physically ill.
 
Sorry you have to go through this, @Ken, I hope they would read your letter, but it might be best to shorten or summarise it if that's possible. Maybe you could just use the last part where you explain what's hard for you specifically? You should be able to take Yr own blood pressure at home, my mum had that problem of anxiety affecting it at the doctor's, and they gave her a kit and instructions which relieved their fears as well as hers!

It's fair to say most people wouldn't be able to treat and control their diabetes as superbly as you are doing, and that the system is designed for the majority. But this shouldn't stop them accommodating your needs. I would be inclined to cut some of the explanation of autism in the letter and add some bullet points stating briefly and clearly what I would prefer, after the part where you list what's hard for you. Then they have guidelines about your needs and preferences. The service is for you, you are the person who knows what you need, best.
 
I am still suffering from traumatic anxiety following last year’s annual doctor’s visit. Now, my next visit is due on October 3, 2022 and I am extremely stressed and depressed with dread.

I would simply not go. I don’t think I really need annual exams, however, I am a type 1 diabetic and require insulin. I can’t get insulin without a prescription and I can’t get a prescription without the annual exam.

I have developed my own diabetic control method that I call the SPP method (Synchronous Push-Pull method) that keeps my blood sugar and all my bio markers in the non-diabetic normal range. My A1C is always 4.5 to 4.7 over the past several years and I never rely on any doctor for my control.

She is a good, kind doctor, but I am extremely sensitive to touch and the social aspect of such an intimate examination. I am also sensitive to being stereotyped. Many of the tests are based on stereotypes, which induces traumatic anxieties that never goes away.

Therefore, I have composed a letter to send to the doctor before my appointment. I have attached a PDF of the letter. What do you think? I have replaced any names, etc. with X’s for privacy concerns.

Ken, I read the letter, and although I feel it was nicely worded, with lots of great details, I would have only resorted to that lengthy of an explanation about how Autism greatly impacts you if a much shorter version was not taken seriously by them. For instance, if it were me, and if I had the exact same situation, I would have said something like this:

"Dear Dr. ____

You seem like a very kind and considerate doctor. As you know I have Autism, but I failed to tell you that a small part of my condition is I am so extremely touch sensitive that having any touch on any part of my body much less pressure can cause extreme ___________ and _____________. I would go into more detail, but I want you to trust me there about that severe sensory issue. Therefore, I am politely requesting no unnecessary touch or testing as I know from all my life experiences that could severely trigger and harm me, and not just for short time periods.

"Also, as I currently have no pain, limitation or mobility issues that would require touch, I feel those testing and procedures would be up to the discretion of the doctor. I'd be glad to answer all your questions that you have, and with regards to the diabetes testing I did and prescription refill, and I realize you have typical protocols to follow, but I think you would agree that having severe longer term ___________ and _____________because of those touch and testing procedures is not the answer either. I just cannot risk severely worsening my health again, knowing last year's exam was so traumatizing to me, which I should have told you about but did not want to upset you.

"So, Dr. ______________I kindly ask you to refrain having any such contact and testing this visit which I feel would be very agonizing for me and _______________. Please let me know prior to the visit by portal, phone or letter if we can keep the visit to a non-contact only or extremely limited contact exam, with you specifying in advance what, if any physical contacts with me you'd need to refill my prescription. Otherwise, I will assume the same procedures will happen as before, and I would have to make other arrangements. Thank You. .....Sincerely, _____________."

If they did not reply back to me then and accept those terms or elaborate more to give me enough comfort level to show up to their office, only then would I have considered elaborating at lengths like you did and sending that much more personal information to them about the Autism hoping to sway them more, hoping for more understanding from them by seeing my many more details of what I and other Autistics can go through which the medical community and NT's do not understand, thinking touch and other sensory issues are minor and not triggered much by the basic things they do or by the basic things included in their environments.

Or instead, perhaps it could be better to find an online doctor who'd prescribe the insulin, as from what I just researched such can occur, and they have places that do such, if you have either an online doctor or one you saw in person diagnosed you as having diabetes. Whatever you choose Ken, your original longer letter way, or some other approach I am wishing you the best there. We certainly understand, as the last two annual exams for our thirteen-year-old son, we refused, for instance, the pediatrician to do the private part test on him, after our son said he no longer wanted that because of the puberty and extreme anxiety and touch sensitivities..

The doc wasn't happy about it, and he tried to convince our son the need for it, but that was BS, as the research I did prior said doctors do not have to do such unless some concerning signs and symptoms or per urgent need, and as the doctor should not say there was a need there otherwise, but just say they would like to perform that test. Well, regardless, we are proud of our son for standing firm, and saying no there, as he had no pain there, told the doctor also things were developing there fine according to his puberty research, and saying we would let the doctor know if he ever had issues there.

The more that doctor pushes him, the more we think he has some agenda, or is so rigid thinking there and unconcerned with our child's anxieties there, and the more we will find another doctor instead.
 
Keep it as short and simple as possible. You don't need to explain why, you just need to set the rules. The "why" of it only matters if the doctor asks. Also, your message/email will likely be first viewed by staff and not the doctor. They forward that which seems important. Doctors don't have time to look at all their mail or email.

Be prepared to tell the doctor your rules when you meet. Be firm (not angry) if the doctor doesn't agree right away.
 
I am still suffering from traumatic anxiety following last year’s annual doctor’s visit. Now, my next visit is due on October 3, 2022 and I am extremely stressed and depressed with dread.

I would simply not go. I don’t think I really need annual exams, however, I am a type 1 diabetic and require insulin. I can’t get insulin without a prescription and I can’t get a prescription without the annual exam.

I have developed my own diabetic control method that I call the SPP method (Synchronous Push-Pull method) that keeps my blood sugar and all my bio markers in the non-diabetic normal range. My A1C is always 4.5 to 4.7 over the past several years and I never rely on any doctor for my control.

She is a good, kind doctor, but I am extremely sensitive to touch and the social aspect of such an intimate examination. I am also sensitive to being stereotyped. Many of the tests are based on stereotypes, which induces traumatic anxieties that never goes away.

Therefore, I have composed a letter to send to the doctor before my appointment. I have attached a PDF of the letter. What do you think? I have replaced any names, etc. with X’s for privacy concerns.
Wow. Your SPP method is something else. I watched diabetes eat my mother alive and eventually kill her. That's such an impossible thing that you've managed to do. You've done this and you have anxiety about the doctor? You're amazing and can handle this. If anything you should be strutting in there. Have some faith in yourself.

Cheers and congrats again.
 
Many of you have advised that a 4 page letter was too much and unlikely to be read and that I should summarize and leave out all the details.

Sorry, I am a detailed person. I am not a Readers Digest person.

Through all my years, I have learned to never sell anyone short or to stereotype anyone. That is, pre-assuming that a doctor does not have the capacity or interest to read a 4 page letter - even if it is for the benefit of their patient.

Late yesterday, I received a message from my doctors office stating that the letter had been received and that it had been read by my doctor along with the three other doctors at the same clinic.

I guess I'll see how it goes on the third of October...
 
Keep it as short and simple as possible. You don't need to explain why, you just need to set the rules. The "why" of it only matters if the doctor asks. Also, your message/email will likely be first viewed by staff and not the doctor. They forward that which seems important. Doctors don't have time to look at all their mail or email.

A doctor that doesn't have time to understand their patients, in my opinion, is a bad doctor.

Be prepared to tell the doctor your rules when you meet. Be firm (not angry) if the doctor doesn't agree right away.
This is the sort of advice I have been receiving all my life. Unfortunately, I have never been able to do that. My social anxiety locks me down and I am mostly unable to speak. I am usually able to answer questions, but I certainly cannot set any rules.

Also, as I have mentioned earlier, I am not a "summary" person. I have learned by experience that everyone is much better at any job or task when they understand the details of what they are doing and dealing with. Just following rules would be like someone claiming to be an artist when their work is a paint-by-numbers set. I would not want a doctor that does not have any mentality beyond a check list.

My doctor is a good doctor. She listens and respects very well. The issue is all with me. I can't tell her about my sensitivities in person, because I'm too "locked-up". That is the reason for the letter, but I want her to know why instead of it just being a blind request.

I also sent her a letter previously regarding my SPP type 1 diabetes control method. It was also a long detailed letter. With that, however, she stopped trying to control my diabetes and extended my appointment schedules from every three months to once a year. This doctor is not a "system" doctor that was assigned to me. I chose the clinic and the doctor. My letter to her regarding my SPP T1D control method has helped her with other patients. I'm hoping this letter will help her with any other autistic patients as well.
 
OK. I just got back from my dreaded doctor's appointment!

I am very happy to report that the letter was a total, resounding success! I was informed that everyone in the clinic read the letter. Everyone. All four pages. All the doctors, nurses, physician assistants, office staff - everyone. They thanked me for the education and information regarding autism. They expressed that is was very illuminating, eliminating many of the mysteries they had about autism. Now, they explained, they will be more comfortable, understanding and better able to communicate when working with autistics.

My exam went far better also. The doctor explained each examination procedure and asked if any of it was uncomfortable for me. This is a key thing because I am unable to express anything that is uncomfortable unless asked. Knowing the doctor read my letter made me fell more comfortable discussing the subject. And I was so relieved to know she actually read it instead of just saying she did, because I could reference any part of the letter and she knew it all.

This goes a long way in proving my belief; one should never short change anyone. Never presume anyone cannot or will not do anything. If given the chance, people will surprise you.
 
I'm glad that went so well for you.

And an irrelevant little side story:

My grandmother got type 1 diabetes after the birth of her first child, but back then we didn't have insulin shots. The only known source of insulin was from liver, but cooking the liver destroyed the insulin so my grandmother used to eat raw liver.

By the time I came along she could have had insulin shots but by that time she'd grown to like eating liver, she got me to try it one time. I most certainly did not like it.
 

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