Today I’m taking a break from the on-going conversations with and about my emotional well-being. Today is a day for considering how I want to interact with the hospital.
After talking about it for months, I’m now just one week away from surgery–a hysterectomy and repair from pelvic organ prolapse. I’ve done a lot of reading and thinking to prepare myself, and I had extra meetings with both the surgeon and her nurse to make sure I’m prepared and that they are sensitive to my needs. My biggest need, of course, is to know what’s about to happen and to have it all happen with as much respect and dignity as possible. I don’t ever want a repeat of the humiliating, triggering test I had last fall.
One of the things I have worried about is what happens after the surgery, when I’m back in my hospital room. Will I have different nurses in and out, poking me in personal places, very nonchalant and possibly with the door open because, after all, they’re used to it? My doctor suggested weeks ago that I write a letter to go into my file that specifies how I want to be treated.
I still haven’t written that letter .
The reason I haven’t written it is that I can’t decide how much I should reveal. I could just keep it simple, with my basic request: Please don’t do anything to me without first telling me exactly what you are going to do. I would appreciate it if you would be particularly attentive to my concerns about privacy and dignity.
What I can’t decide is whether to add something like this: As a survivor of childhood sexual abuse, I am especially sensitive about the way gynecological exams and procedures are conducted.
To me the cases for not including the information about my background is 1) I should be able to make this kind of request regardless of the reason for it (i.e. why should I have to justify myself?); 2) it’s none of their business that I have a history of abuse; 3) I don’t know them and don’t know who I can reasonably trust or not trust with very personal information; 4) it seems kind of presumptuous–it’s as if I’m assuming that I am more sensitive than other women, and how would I know that? There are plenty of reasons to be sensitive about strangers poking around in your vagina, after all.
The case in favor of including it is 1) it might make them take the request more seriously and 2) it might make them think about other patients with a similar history who may or may not feel able to bring it up.
I’d better decide pretty soon or there won’t be any letter at all.
Sage Burning 
I think telling them about your trauma history is not trying to say you’re more sensitive than other women. Sometimes, it helps the caretaker to understand how important a request is when you tell them the reason, whate er the reason. People are not going to understand the longevity of the effects of childhood trauma without hearing about it and seeing it first hand. And having a face to put to that reason makes it more personal. I’ve never revealed details of my trauma to my primary care physician or the nurses when I just had surgery or my dentist or the physician’s assistant I saw at Urgent Care a few weeks ago. I’ve just said, you know, this is really difficult for me due to childhood trauma. So can I swab my own throat or can you put no more than two things in my mouth at a time or could you please find me a female specialist?
Other women may have other reasons for being sensitive and will need to advocate for their needs. You have the right to advocate for your needs. Personally, I think with the prevalence of childhood teauma, everybody should be treated as if they had that experience which simply means that people and their privacy and needs should be treated with the utmost respect and dignity. But needs differ, so I really think it’s okay and important to say that that you experienced childhood trauma.
You are in my thoughts.
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You could write them both so you’re prepared and just decide at the last minute what feels right?
I agree with Patty, though; they should be treating everyone with care, respect, and sensitivity. But that’s not the reality, and if you need to disclose in a non-specific way (as you described above), that seems like a really good middle ground that will still work to protect you.
Is your surgery next Thursday? If it’s okay, I’d like to know the date so I can make sure to keep you warmly and safely in my thoughts at that time. I’m not sure it does any good, but it certainly can’t do any harm. ❤
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Yes, next Thursday, April 7, 1pm Pacific time. Thank you, thank you, I would love to have you holding me in your thoughts. That’s a very caring thing to offer.
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It’s on my desk calendar at work and there’s a reminder in my phone in case I get distracted. 🙂 I’ll be turning the force of my will toward your successful surgery and your quick and complete recovery!
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I agree with the lovely ladies that commented:) Hope you are well, bella. I also wanted to stop by and let you know that I recently moved to a self-hosted site and the following is the latest post:
http://www.younfolded.com/2016/03/20/younfolded-temporary-maintenance/
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I like the idea of writing them both. I am in the middle of trying to write my own letter to my doctor, and failing miserably…..I’m having the same conflict you are having of how much to reveal. It’s so hard, and it’s unfair that we have to think about this. I have so much respect and admiration for you just for all the self advocating you have done through this process.
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I’ll be a dissenting opinion then. If it was me, I would not disclose like that, on a chart for anyone to read. It would feel to me as if I were giving away private and vulnerable information to people who may not deserve to have it. And I think you have enough to deal with without needing to be a trail blazer for other possible survivors in this way – there are other ways to do that. Your simple plea that they pay extra attention to your privacy and need for respect should do the trick. If it doesn’t, hard to see how more information would help much. They shouldn’t need details of your reasons. If you do feel you want to disclose, I’d make it maybe more vague – past trauma, something like that. But then, we are all different, and you must do what you feel is best for you. For me, disclosure brings up so much vulnerability, and I don’t want to deal with that while trying to deal with a surgery.
I had surgery three years ago. The whole process triggered me, especially diagnosis and then recovery. Having things done to me, physically, is simply a trigger, regardless what. But no one was unkind – in fact one of the doctors was extremely kind and seemed caring. Disclosing just would have made me feel bad and not helped. I even switched entirely at one point, but luckily, no one ever realizes what they’re seeing.
I’m not explaining my opinion that well, but wanted to provide another point of view.
Good luck!
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You are actually explaining your opinion well. The part that really speaks to me is “giving away private and vulnerable information to people who may not deserve to have it.” I struggle with that and make mistakes sometimes sharing too much with people I shouldn’t really trust–while at the same time hiding things from people I can trust (I know, makes no sense). It’s may be a good idea to err on the side of too little rather than too much info.
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I am so hoping that this goes as smoothly as it can and you are treated with the dignity you deserve – but even so, it’s such a hard thing to go through. The one thing I would add to the other comments is that this letter is a really important part of advocating for yourself within the process as a whole, but it’s still only one part. My understanding is that your husband is very supportive, and my hope is that he will be aware in advance of what things you are not okay with and will be able to advocate on your behalf if staff behave inappropriately and you’re not able to. Perhaps you could write a second letter for him to provide only if you’re not happy with the level of care you’re getting, so you’re able to disclose the minimum in the first letter. Or perhaps you could request that your doctor specifically check with you and/or him whether you are being treated appropriately each time she visits so she can speak to the staff if you’re not. I don’t in any way mean to minimize the letter, just would like to take a little of the pressure off it if possible.
You are amazing for facing this head on and not burying your face in the sand the way many people would undoubtedly do. Totally amazing.
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I don’t think there is a wrong way to do it, and I think you’ve done a good job already advocating for yourself and planning for good care. Whatever is going to make you feel safer and protected is good. Personally I am private and so would not provide information for the requests other then to ensure they are followed. I think what you are asking should be a standard of care for every person!
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I feel like people tend to be more sympathetic and more inclined to do what you request of them if they knew why. Otherwise, they might think that you’re just being difficult. I don’t know why people are that way but it seems like that’s usually the case with people in general. You don’t have to tell them everything – I think just that one line you suggested might be enough for them to be more careful of your condition. It’s definitely not an easy thing to experience. I’ve only been to the gynecologist maybe 5 times in my life – and all of them have been traumatic for me (hence why it’s only been 5 times – I just refuse to go…). I can’t imagine what you’re going to have to go through but my thoughts are with you always!
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I will also be thinking of you next Thursday. Glad to know the date and time.
I think going with your instinct will make it as comfortable as possible – if there are reservations about anything you’re considering sharing, I would give pause and ask what that is about. Because I would want for you to be as comfortable and stress-free as possible, and sharing very personal information can be really unsettling even if for a good reason. I know you can do this, I know you can find that discernment.
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This is exactly what I am thinking about these days. I vacillate between sharing very little and sharing too much, and I have often regretted sharing too much with people who aren’t really trustworthy. But when I don’t share anything, I feel alone, or at least I feel superficial and inauthentic. I am carrying this issue to therapy tomorrow, to talk about how/where I find the right balance. Thanks for the vote of confidence that I can find it.
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Hope therapy helps further deepen your insight around this before Thursday. It is a hard balance to find and I think it is one that flexes with each situation, making it even more nuanced! But I think continuing to practice and reflect will make it quite possible to feel grounded with whatever decision is made.
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❤ just wanted you to know I'm reading and that I care.
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Thanks, AG. I’m very glad to know you are there.
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I’m curious reading his after the fact how this turned out for you? This is something I have been thinking about…
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I ended up keeping it kind of simple, no particular explanations of the backstory but just saying what I wanted. The nurses were great about it, very respectful, and I ended up so glad I had written the letter (I wrote another post about this called “At The Hospital,” from April 10.
Also you know what was good: when I was checking out of the hospital, the nurse gave me the letter back to keep so it wouldn’t be in my medical file. I appreciated that, and if I ever have a situation like this again, I will make that part of my request.
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How smart and respectful of her to do that! Thanks for responding back! I’m so glad it worked to your benefit. It’s great you talk about this because I think its really important to advocate for ourselves in these situations to reduce any potential stress or trauma.
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