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PTSD triggered by exams

I have PTSD from physical and sexual child abuse and also being raped as an adult. Years ago, when I sought help for bloody diarrhea (I suspected cancer—didn’t know anything about Crohns then) my usual GP had left on maternity leave and I was stuck with a male doctor I had never seen before. Both he and his nurse were really weird. They cracked jokes during the entire exam. The doctor was really rough and didn’t use lubricant. He dismissed my symptoms and told me everything was normal. The exam made me feel so violated that I actually ran to another room and sobbed on the floor until someone told me I needed to leave. I reported the incident to my insurance company and never went anywhere near that place again. I wouldn’t even drive past it for a long time.

A couple of other GPs before this had told me nothing was wrong. One said I had fissures because of constipation. I was constipated. I’ve only been constipated a few time as a child. Almost never as an adult. Another diagnosed me with IBS and told me to limit my stress.

After the horrible exam, I decided trying to figure out what was going on wasn’t worth it. But now I’ve also been having absolutely horrendous heartburn. I was hospitalized because I couldn’t swallow without unbearable pain and was diagnosed with esophageal ulcers following an endoscopy. When asked if I had any lower GI problems, I said no because I didn’t think they were related and didn’t want to be examined.

My dermatologist wanted me to get tested for Crohns because she believes that might be why my heartburn and HS occur around the same time. She didn’t know I also have bleeding, urgent BMs, and diarrhea when I have those episodes.

I told my GP, who referred me to a GE. I’m going because, although I work from home and can manage the lower GI symptoms, the heartburn is killing me.It doesn’t respond to medication and I can’t escape the pain.

I’m terrified of being examined, though. I don’t want any part of it. I’m not suicidal, but I would almost rather die.

Any suggestions on how to deal with this fear would be welcome. I have panic attack and am worried I will have one during my appointment. I know and accept that I need to do whatever is necessary to find out what’s happening, but I can’t stop worrying about it.
 
Hello

You poor thing. I'm sorry to hear what you've been through.
A few thoughts.
You do need to get checked out. If it's crohns it needs addressing as it can get very serious. Crohns can affect the whole digestive tract from mouth to bum so could explain your symptoms.
In the first instance there are tests they can do that don't involve doctors going anywhere near your private bits, I.e. blood tests for inflammation, stool tests for intestinal inflammation, scans.

I think in terms of anything more invasive, you would benefit from some help, ideally a counsellor or psychologist who can teach you some grounding and relaxation strategies and coping strategies for any physical exam or scopes. I would strongly encourage thinking about taking a friend with you who can help you throughout any procedure and provide distraction or help you implement coping strategies and also telling the hospital that you have been an abuse victim so they can be mindful during the procedure. You won't be the first, or last I'm afraid, and there are things they can do to help (explain clearly what is happening, go at your pace, pause as needed to check in with you, gain and keep checking consent, stop if needed, be extra patient and kind, discuss with you if/ what sedatives might help). Also, if they know in advance, they will be able to get advice from colleagues in gynae who will have a lot of experience of this kind of thing. Would it make a difference if you could have a female doctor, or if they don't have one a female nurse in the room with you?

You are in control of this, it's your body, there is a lot can be done to help you access these medical tests if you need to and less scary stuff could be done first to check if they're necessary.

Good luck.
 
Thank you so much! I’ll definitely look into grounding techniques, etc. I do have a friend who might be able to go to some appointments with me, and my first appointment is actually with the GE’s nurse practitioner, who is female. I think it’s just a consultation, but maybe that would be a good time to tell her I’m an abuse survivor. I was afraid to tell them, but what you said makes sense. The GE is male, but maybe if they work with me, it’ll be okay.

It’s also good to know that they might be able to start with some less invasive tests.
 

Maya142

Moderator
Staff member
Tell your GI - explain your experience, if you can. If you can't, do you have someone you can take with you? A boyfriend/girlfriend/partner, parent, sibling - anyone you trust and are close to. They can explain your issues to the doctor.
Also remember that an exam isn't always done at first by GIs. They'll probably do blood work and stool tests first and if they see certain red flags in the results, then they'll do further testing.

Blood work is to see if you have high inflammatory markers (CRP and ESR) and to check your hemoglobin and make sure you're not anemic from the bleeding. Fecal Calprotectin is a stool test which will tell them if there is inflammation in your gut. If it's high and there is inflammation, then they'll likely want to scope. They'll also do other stool tests to check and make sure you don't have any infections, since those can make Fecal Calprotectin appear high too.

Can I ask where you are located? Because in the US, they will make sure you are asleep before doing a colonoscopy. It's deep sedation - you will still be breathing on your own, but you'll be asleep. In other countries, I know the practice varies. But if you tell your GI about your issues in the past, I'm SURE they will make sure the scope is with some kind of sedation.

If they are going to do a scope, a rectal exam shouldn't even really be absolutely necessary - they can do it once you're sedated. They do this routinely for kids, and I'm sure they would do it for someone who has PTSD from medical trauma.
I would definitely suggest seeing a psychologist given all you have gone through - I'm really sorry you've had to deal with so much.
 
Tell your GI - explain your experience, if you can. If you can't, do you have someone you can take with you? A boyfriend/girlfriend/partner, parent, sibling - anyone you trust and are close to. They can explain your issues to the doctor.
Also remember that an exam isn't always done at first by GIs. They'll probably do blood work and stool tests first and if they see certain red flags in the results, then they'll do further testing.

Blood work is to see if you have high inflammatory markers (CRP and ESR) and to check your hemoglobin and make sure you're not anemic from the bleeding. Fecal Calprotectin is a stool test which will tell them if there is inflammation in your gut. If it's high and there is inflammation, then they'll likely want to scope. They'll also do other stool tests to check and make sure you don't have any infections, since those can make Fecal Calprotectin appear high too.

Can I ask where you are located? Because in the US, they will make sure you are asleep before doing a colonoscopy. It's deep sedation - you will still be breathing on your own, but you'll be asleep. In other countries, I know the practice varies. But if you tell your GI about your issues in the past, I'm SURE they will make sure the scope is with some kind of sedation.

If they are going to do a scope, a rectal exam shouldn't even really be absolutely necessary - they can do it once you're sedated. They do this routinely for kids, and I'm sure they would do it for someone who has PTSD from medical trauma.
I would definitely suggest seeing a psychologist given all you have gone through - I'm really sorry you've had to deal with so much.
Thank you for the advice! I’m in the US. That’s wonderful about being asleep for the colonoscopy and possible rectal exam!

I’ve never done a stool test, but my CRP has been elevated for about a year whenever my former GP performed blood tests. I don’t think it was exceptionally high, though. I have no idea about my ESR. I know a blood test for autoimmune diseases that was normal.

I have a therapist who’s really wonderful. I’m sure I wouldn’t be here without her. This week was the first time I’ve mentioned what happened with the doctor and my fears about my symptoms. She has taught me how to meditate and to become more aware of my triggers, but she can only help me with what I tell her, and I have trouble opening up in person.
 
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