Why is there so much....anxiety?
--Former Clinton Cabinet Member Robert Reich
One of the things that always gets my goat in the health care setting is when doctors--usually male--ask this patient (a female) lots of questions about anxiety.
Now, this is a legit question. I've been on anti-anxiety medication since I was about sixteen years old and I was diagnosed with a type of tuberculosis (TB). I would think that most 16 year olds, after having a near-death experience (and that's not an exaggeration--if we hadn't caught it when we did, I probably wouldn't have seen Christmas that year), would be a bit anxious. My doctor, who is Godlike in All Things, tactfully and gently suggested that perhaps I would feel better with some medication, and also a therapist.
She was right on both counts. I love my therapist, and I've seen her since I was 16.Other than family and a few friends, that's the longest continuous relationship in my life. Not only is she extremely good at her job, but she's also a very nice person, and I have found her invaluable.
So, it does make sense, when doing a differential diagnosis on me, to ask about anxiety. There's a history, there. I may be on a low dose of an anti-anxiety med, but I am on one. I've tried to go off it a few times, but thus far it just hasn't worked. So I keep it, and life is better.
But.
(You knew that was coming, right?)
Sometimes, this note in my chart becomes something that doctors use as a crutch to dismiss my concerns. This isn't relegated to just doctors, and it isn't relegated to just men. A memorable incident was back in 2011, when I was on beta blockers in an attempt to stop my atrial flutter. It wasn't working, and my HR was doing its merry near 200 BPM dance. In the ER triage area, the nurse taking my vitals asked me if I was "nervous about anything." She asked the question like I was a very small, very silly girl-child that needed to be soothed and pacified.
Trying very valiantly not to roll my eyes, I said, "I'm on beta-blockers. I physically cannot get nervous."
"Oh. OK!"
I have been asked this questions, repeatedly, many times over the years, in a tone of voice that suggests I am either: 1) not-too-bright, 2) five years old, or 3) both. This is insupportable. Yes, ask me if there's any stress triggers or anxiety-inducing events coming up. That's fine. But don't make it sound like you think it's the reason I'm here, and not because of any physical issues that might require your attention.
Like I said, it's men who primarily do this, and I wonder--do they do this to other men? I can't imagine the condescending mask covering their faces, the simpering smiles, if they were talking to a 33 year old man. But they see me, and they see anxiety, and they go, oh, she's a little touched.
This is especially true when it comes to pain. Guys. I know pain. I've had pancreatitis eight times. That's generally considered to be really painful. I've had collapsed lungs (although the Queen of Collapsed Lung heroism is my friend Sage, who has had chest tubes put in without sedation--a feat I cannot even imagine. She is the Toughest Person I Know, Bar None.) I have basically been cut in half and put back together!
I don't write this to be all I AM AWESOME, but to show you that I know what pain is. When I say my pain is a seven or higher, it's legit. It's not Tylenol pain. IT IS PAIN. I'm not making it up. It's not in my head. My pain is real, and it deserves to be treated as such.
This last time, this was a consideration. Pain halts healing. After transplant, a certain amount of pain is expected, but if it's too much, you can't get better. That's not good. It has to be managed appropriately. There's a reason there's a whole branch of medicine devoted to pain care! I had a doctor tell me that pain isn't something that happens with pneumonia. (Read: It's in my head!)
It's not? Actually, it is. Google it, people.
Just because I am a girl, and I am on anti-anxiety meds, does not mean I am "drug seeking." It doesn't mean that it's in my head. I have a very good imagination, but come on. Pain is real. Pain is a symptom of a problem. It deserves to be treated, not just brushed off. There are many ways to treat pain, but the point is to treat it.
This is where my psychologist rises above the rest. Not only does she treat CF and post-transplant folk, but she also does a lot of work with people with sickle cell trait, which is exceedingly painful (so I'm told. I don't know, although I do have thalessimia, which is sort of related to sickle cell disease as a genetic level). She--and her other patients--deal with this all the time. Over the years we've done lots of non-med relaxation techniques--tapes, visualization, even hypnosis once (that didn't work. I threw up all over myself.) We've tried bio-feedback, yoga (which does work, for some things), and other methods. It's very all -inclusive. But sometimes--we need the medication.
What I do not need to be told is that it's in my head.