Coping with meltdowns at clinic visits

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Simon01
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24 Mar 2017, 2:31 pm

I'm not sure if my reaction to sensory overload or stress fits the exact definition of a meltdown because my reactions are more internal, but very, very exhausting. I sort of shut down and it's very difficult to communicate clearly. For a long time I didn't really understand the basis for it, so I got by just by forcing myself to "ride out" stressful situations or pretend to be unfazed but I'd be mentally drained and feeling like I had to recover after those situations.

More recently, since I've learned more about my own situation and what causes me to react like that in certain situations, I've started telling clinic staff about it at appointments and so far they've been very helpful, and I end up feeling better and much less drained than when I was trying to act like I wasn't bothered.

Basically, I have to go in for a monthly checkup and a procedure that I've had done many times and should be used to, but the sensory overload causes me to process it like it's a new experience, so what the clinic staff has been doing is talking me through everything as if it's the first time I've been through it.

One thing I'm concerned about is that when I've having those meltdowns I feel like a very nervous child, so I'm basically asking the clinic staff to treat me like one when I'm there- I know what's going on, but I can only process things in simple terms, and I can barely talk, and I need to be reminded that I'll be fine afterwards. They've been really great about it and totally understand, but I'm concerned that I'm going to get myself into trouble later on, perhaps someone higher up thinking I'm just acting weird to get attention and having to go elsewhere for the treatment. That happened years ago when I was first getting used to being in a wheelchair- for me adjusting wasn't the dramatic display that everyone expects, but rather was one long meltdown and constant stress and depression because I was having to adapt and put on an act and pretend to be stoic and adapting far better than I was really was, because persons with disabilities apparently aren't allowed to be too emotional, never mind being very emotional and not having an outlet for it. When I was younger, before I was disabled, I was running into similar problems, trying to deal with health issues on my terms only to get into trouble for supposed attention seeking.

So basically, I want to be sure that I'm not giving the impression that I'm secretly enjoying the attention, because that's not it. It's embarrassing that my brain goes into child-mode when I'm really stressed or upset, and frustrating that I've never gotten used to certain aspects of my disability, such as the monthly clinic visit. At the same time though, I feel a little better knowing that just being honest about what I need to handle those visits better has helped, and knowing the clinic staff understands and is ok with talking to me like I'm a child has made the recent clinic appointments go much better than they did before. It's one less thing to worry about. I've even given them permission to decide for me about what needs to be done because when I'm stressed like that, I know I might try to avoid something that's necessary.

I'm hoping I'm just worrying a bit too much and that I won't run into problems later on.



BeggingTurtle
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25 Mar 2017, 1:46 am

I have a meltdown as soon as my doctor tries the abdominal exam parts. Literally a stimming mess most doctors' visits.


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Chronos
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25 Mar 2017, 2:39 am

Simon01 wrote:
I'm not sure if my reaction to sensory overload or stress fits the exact definition of a meltdown because my reactions are more internal, but very, very exhausting. I sort of shut down and it's very difficult to communicate clearly. For a long time I didn't really understand the basis for it, so I got by just by forcing myself to "ride out" stressful situations or pretend to be unfazed but I'd be mentally drained and feeling like I had to recover after those situations.

More recently, since I've learned more about my own situation and what causes me to react like that in certain situations, I've started telling clinic staff about it at appointments and so far they've been very helpful, and I end up feeling better and much less drained than when I was trying to act like I wasn't bothered.

Basically, I have to go in for a monthly checkup and a procedure that I've had done many times and should be used to, but the sensory overload causes me to process it like it's a new experience, so what the clinic staff has been doing is talking me through everything as if it's the first time I've been through it.

One thing I'm concerned about is that when I've having those meltdowns I feel like a very nervous child, so I'm basically asking the clinic staff to treat me like one when I'm there- I know what's going on, but I can only process things in simple terms, and I can barely talk, and I need to be reminded that I'll be fine afterwards. They've been really great about it and totally understand, but I'm concerned that I'm going to get myself into trouble later on, perhaps someone higher up thinking I'm just acting weird to get attention and having to go elsewhere for the treatment. That happened years ago when I was first getting used to being in a wheelchair- for me adjusting wasn't the dramatic display that everyone expects, but rather was one long meltdown and constant stress and depression because I was having to adapt and put on an act and pretend to be stoic and adapting far better than I was really was, because persons with disabilities apparently aren't allowed to be too emotional, never mind being very emotional and not having an outlet for it. When I was younger, before I was disabled, I was running into similar problems, trying to deal with health issues on my terms only to get into trouble for supposed attention seeking.

So basically, I want to be sure that I'm not giving the impression that I'm secretly enjoying the attention, because that's not it. It's embarrassing that my brain goes into child-mode when I'm really stressed or upset, and frustrating that I've never gotten used to certain aspects of my disability, such as the monthly clinic visit. At the same time though, I feel a little better knowing that just being honest about what I need to handle those visits better has helped, and knowing the clinic staff understands and is ok with talking to me like I'm a child has made the recent clinic appointments go much better than they did before. It's one less thing to worry about. I've even given them permission to decide for me about what needs to be done because when I'm stressed like that, I know I might try to avoid something that's necessary.

I'm hoping I'm just worrying a bit too much and that I won't run into problems later on.


I don't have meltdowns at the doctor's office, but I do sometimes get a little flustered, just because there's a lot going on around me that I'm not familiar with and I can't process it fast enough to anticipate what's going to happen next. I find this particularly true when I see a specialist these days, as they tend to be at a teaching institution and so there are sometimes as many as three other people in the room asking me questions and moving around me, all fairly rapidly.

However.

Last time I went to see one of my specialists, things were different. First, I was the only one in the waiting room. Second, they had the lights turned down everywhere. Third, when they took me back, instead of the normal hustle and bustle of doctors and interns in the hallways, there wasn't anyone back there. It seemed as if they were seeing me during off hours, though that wasn't actually the case. In any event, it was a far more pleasant experience than usual.

Some of the hospitals here have started to turn down their lights, which tend to make people more quiet and slow the pace of things down, so you might suggest that to the office manager at the clinic you go to.



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25 Mar 2017, 2:07 pm

Congratulations on a successful negotiation and solution. I think you are right to worry that other places will not be so accommodating. I once had a therapist ignore my intake notes, which made the whole weekend workshop a negative experience. I'd suggest going in, possibly outside of regular visiting time, to thank the staff for the extra service. Maybe take flowers or snacks. Then, you might ask them for a reference letter to show to others you encounter. Get everybody to sign it if you can.

When I go to the dentist, it is almost an out-of-body experience. I got sold some remarkably bad deals before I learned to be careful, but I still can't think of the right questions on the spot.



EzraS
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25 Mar 2017, 11:14 pm

I'm given Xanax for doctor visits.



Simon01
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27 Mar 2017, 2:51 pm

Thanks for the responses, glad to know my solution isn't as odd as I thought :-)

BeggingTurtle- I think part of the exhaustion for me is having to suppress the urge to stim, since what I do to calm myself isn't really allowed unless I'm alone.

Chronos- I'll ask next time about whether or not the lights in the exam room can be dimmed. I've also noticed that I'm a bit more calm when I go during "down" times to an appointment when there are fewer people in the waiting room.

Dear_one- I'll see about sending them something as a thank-you. I can relate a little to staff ignoring prior info- early on with my disability I'd have to re-explain everything and still have to deal with clinic staff trying to ignore whatever was already written about my condition. I once even had a vocational counselor take a quick look at my medical info and then ask me what was going to happen when the doctors she picked for me to see found nothing wrong with me.

Visits to dentists have been sort of hit and miss, although more recently the dental clinic I go to has an environment that makes it not as stressful as it was for me in the past.

EzraS- I might look into the possibility of taking something beforehand. I might end up on anti-anxiety meds overall so that might also make clinic visits easier to deal with.

I'm just glad that so far being honest about what I need has been a positive experience. I think part of my reluctance to say anything to clinic staff has been both from past experience and simply not being sure how to explain it, but they totally understand that I can be independent and functioning ok but still needing extra help in certain situations.

What I'm trying to figure out now is how to communicate when I can't talk or trying to talk but not making sense. It would be much less draining than trying to force myself to talk.



Simon01
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29 Mar 2017, 3:13 pm

I'm still trying to find a more long term solution to being able to communicate when having a meltdown, but in the short term for the clinic visits would simply agreeing on something with the staff to at least express very simple things, such as gestures for simple words or perhaps even as simple as blinking to indicate yes or no? At the very least, I just need to feel like I'm interacting, even a little, so I'm not feeling totally passive and can still let the nurse know I'm ok or not with what's going on.

Alternatively, would it be better to just go with talking in very simple terms if I can get a few words out but speech is sort of "glitching"? Already the nurse has been talking to me in simple terms to make processing easier, so I think she might be ok with hearing me saying only simple words.



friedmacguffins
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29 Mar 2017, 4:38 pm

I showed decorum, outwardly, but they wondered what was wrong with my vitals.



Simon01
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30 Mar 2017, 12:00 pm

friedmacguffins wrote:
I showed decorum, outwardly, but they wondered what was wrong with my vitals.


For me showing decorum or acting "normal" is what is so draining in some situations, and people still catch on that I'm hiding being distressed.



friedmacguffins
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30 Mar 2017, 1:51 pm

One way of rationalizing this, is to say that the situation is dysfunctional, and some of the people in the room are never going to know what is normal. Sometimes, your stress is appropriate to the situation, and not an example of failure, on your part.

Being sensory-attuned, I found negative air pressure to be claustrophobic. There is some disinfectant, in the air supply, like hand sanitizer, Lysol, or pore-cleaning astringent and (saying this as a large and active person, myself) some people mortified me, by their body odor.

I watched mechanically-inept people, operating an infusion pump, and, besides that, should not burden you with my politics.

There is some ordinary, logistical hustle, which can be unsettling, but that has to be separated from personality conflicts.