Consulting with the experts for your health – including yourself!
Adho Mukha Virasana, “Child’s Pose” with support for my nervous system and low back.
Thanks to Koren Paalman for the pose instructions and the photo.
When dealing with a health issue, or just focusing on our overall health and well-being, it can mean we have well-trained health/body experts around us giving us advice, telling us what’s good for us and what’s not good for us, or simply teaching their wisdom. Those experts can include doctors, nurse practitioners, dietitians, physical therapists, yoga teachers, chiropractors, bodyworkers, and an array of health/wellness practitioners. Whomever you’re turning to for consultation, prescriptions, advice, treatments, classes, or any kind of care, of course it’s important to make sure that they are properly skilled, educated, knowledgeable, and have your best interests in mind. It’s not always easy to discern if a caregiver is looking out for you in the ways you need, but we do the best we can to find practitioners we feel comfortable with and trust enough to provide us with care.
Whatever your own background or career may be, the list of experts must include you. Whichever treatment has been prescribed for you, whichever advice someone has given you based on their years of education or experience, however a trained person puts their hands on your body, you are the expert of your own body. No one else can tell you how something feels for you. That is especially true about people who seem to think they are experts all of a sudden (i.e. influencers or random people on Instagram) in subjects like nutrition just because they tried that one diet and it worked so well for them so surely it is the diet for all humans, including you, and you just haven’t watched the right YouTube videos to learn the truth! (Oh boy).
Pain is the 5th vital sign!
In nursing, we are taught and reminded over and over again that our patients’ pain or discomfort is subjective. We’re taught that assessing pain is so important that it’s considered the 5th vital sign with temperature, heart rate, respiration rate, and blood pressure. Only the person experiencing the pain can tell you how strong the pain is, and what qualities the pain has for them (throbbing, aching, sharp, pressure, etc.). Sometimes a patient’s description of their pain clues us into unexpected outcomes like internal bleeding, an adverse reaction to a medication, injury, ineffective medication, or even an incorrect diagnosis.
Pain is a clue that should always be followed with questions. Even a mild headache can give us a clue into something relevant for our wellbeing. Why do I have a headache? Oh, I’ve been staring at my phone for too long and need to give my eyes a break. Or, oh, this thing I’m working on is causing stress, so I’m going to take a walk or meditate or listen to soothing music for a bit.
In healthcare, although pain and discomfort are supposed to be major clues into a patient’s health status, women’s symptoms (especially Black women) are sometimes ignored or brushed off. Serena Williams (one of the best tennis players ever) experienced a pulmonary embolism after childbirth and recognized her own symptoms, but caregivers “dismissed her concerns” initially. This happened to a famous, wealthy woman who was likely receiving the “best” healthcare available. Physicians and nurses have shown to have the awful misconception that Black people don’t feel pain as much as Whites, an attitude with roots in slavery. Women reporting chest pain in outpatient centers were much less likely to be referred to a cardiologist. Although 20 years old, the still-relevant article “The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain” reviewed studies of women reporting pain but receiving less pain medicine in relation to surgeries, metastatic cancer, and AIDS. For women after coronary artery surgery, men were given narcotic pain medicine more often, and women were given sedatives (for anxiety) more often.
One of the “endo sisters” profiled on Buzzfeed. “My doctor believed that I was lying about the pain for years, just to get drugs.”
© 2015 Corrine Mihailovic
Women with endometriosis can experience chronic pain for years before finally being properly diagnosed. These young women are often told their pain is due to emotional issues or anxiety, they are not taken seriously, accused of imagining it, and misdiagnosed by their doctors. It is estimated that only 4 in 10 women with endometriosis are properly diagnosed. These images of “endo sisters” from Buzzfeed are heart-breaking, and I hope these young women finally received the care they needed.
Advocating for yourself or your family in healthcare, however excellent your caregiver, is extremely important.
Only you know you feel on the inside.
My daughter’s appendicitis wasn’t diagnosed for 4 days partly because she was menstruating, which was creating confusion about her symptoms. After the second doctor’s visit (we were sent home the first time and told she had a “stomach bug”), she was in such excruciating pain (I gently touched her abdomen and she screamed) that they took her seriously. They pumped her with fluids and gave her pain meds to stabilize her in the ER, but the radiologist said the CT scan showed no appendicitis. They couldn’t figure out what was wrong even though her white blood cells were high (indicating infection), so they focused on keeping her as comfortable as possible. After 12 hours of no answers, they walked into our ER bay with discharge papers! My brilliant then-16-year old daughter said, “You can’t send me home! You don’t know what’s wrong with me!” The next radiologist looked at her CT scan and saw that her appendicitis had perforated and was leaking pus all through her abdomen! She had surgery a few hours later. I can only imagine what could have happened if she didn’t speak up — not that I would have let them discharge her either! But she didn’t need me to be a mama lion — she did it all by herself. :)
Will I ever tear up the dancefloor again?
I’ve been working on healing from a back injury that occurred at work almost 2 months ago. It has been humbling and challenging, with some feelings of depression and anxiety thrown in — “Will I ever get better?” “Will I ever tear up the dancefloor again?” “Will I be able to sit/stand/bend/twist/move without pain again?” But I’m grateful to have this time off work to focus on healing, and I’m grateful for the resources available to me. I’m seeing the doctor every 2 weeks, going to Physical Therapy (“PT”) twice per week, taking my dear friend Koren’s Iyengar yoga classes online, and I’m adding in a therapy when I can — either massage or acupuncture, and trying to be patient with the healing process. I’m also grateful to have another nurse friend who experienced a workplace injury who has provided emotional support.
This experience has taught me a few things, sometimes the hard way. I am learning what it feels like to be a patient, and having to push for what I need. I know from being a nurse that doctors (even with the best intentions) don’t always think of all the things that would make things better for their patients, and I’m learning that first-hand now. And I learned that I should speak up when someone is touching my body in a way that doesn’t feel right. The first physical therapist I was assigned massaged my spine firmly in the area of injury and compression and asked me to bend this way and that, saying, “Tell me when it hurts.” Well, it really hurt and it set me back in my healing for about a week, with re-inflammation and increased pain and tenderness. I advocated for myself and asked for a new therapist with more experience and understanding of scoliosis. I am now with a therapist who is more knowledgeable, and he altered my prescribed exercises to help the healing progress. I’ve made sure he knows to work around the injured area, and on days when the exercises cause increased pain, I hold off.
PTs and physicians have doctorates — which of course is impressive. But does that mean that someone with more years of schooling than me is going to know how my body feels more than me? No. Only I know.
Even my amazing Iyengar yoga teacher friend, who encourages her students’ autonomy to enter poses wisely and whose knowledge of the structures of the human body is remarkable, doesn’t know how my body feels inside. No one except me knows the quality of the pain, what makes it feel worse, what makes it feel better, what just feels “weird.” Only I can tune into my body and my intuition and do what feels right, and advocate for myself. Advocating doesn’t necessarily mean being against someone else’s knowledge, like a fight — it can just mean that you are supplementing their knowledge of how to care for you properly, or you choose to do things differently than is recommended because you know it’s not right for you (such as certain yoga poses or PT exercises or eating certain foods).
I hope it doesn’t need to be said that I am not telling you to go against your physician’s medical advice. I am not suggesting that you stop taking your blood pressure medication, for instance, because they make you feel weird or you have side effects you don’t like. But you can absolutely let your physician know if you are experiencing something unexpected or undesirable, so they can work with you to adjust your plan of care. You should always speak up for your body and your health. If your doctor doesn’t seem to listen to your concerns, continue to speak up or seek counsel elsewhere. If that means finding a doctor of a different gender, race, size, orientation or ethnicity, then do it. Only you know how your body feels on the inside, and only you can trust your own intuition. Having to advocate in a situation where you are not being honored or listened to can add unneeded stress. When you’re sick or injured, that is the last thing you need.