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#258933 - 10/29/08 10:44 PM Re: Male examinations since I am over 50 [Re: Trucker51]
ttoon Offline
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MaleSurvivor

Registered: 06/19/07
Posts: 977
.



Edited by ttoon (11/16/08 10:40 AM)
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#258935 - 10/29/08 10:55 PM Re: Male examinations since I am over 50 [Re: Tinman]
Chester Offline
Member
MaleSurvivor

Registered: 10/28/07
Posts: 48
Loc: Long Island, NY
Oh, thank God you posted this. I thought I was the only one. I have my own medical stuff going on, and I had a colonoscopy the week before I went on the WoR. I was anxious all week. I mean, even if he wasn't doing anything wrong, at best my dr would still be penetrating. And I have only just started going to the doctor's again, as I haven't trusted a Dr in a long while. I asked if my wife could be in the room with me, and he said, no. However, he assured me I wouldn't be alone in the room with him. I let it go, but I didn't relax until I was actually brought in the room and saw the anesthesiologist and a 3rd MD. I knew my wife was in the waiting room, and then they played some music to relax me. They didn't know it, but it was our wedding/love song. Then I woke up in recovery.

So, it has to be normal to be fearful of a colonoscopy. Even moreso as a survivor. I'm pretty sure they can sedate you either way. However, as anxious as I was the week before, I dreaded the idea of having to watch the procedure more.

So, there is no way around the recommendation. We need to get annual prostate exams after 40, and a colonoscopy at 50. That being said, you have every right to make sure it is done the right way for you. Having such a procedure forced upon you isn't right. So if you want to be awake, and they can do it for you, insist upon it if that is the only way you will be ok with the procedure. If you are going completely under, insist on all the details. Insist on knowing who will be in the room with you, by name. You have every right.

Good luck, Paul. And if it's any consolation, the recovery room will be a funny experience. They filled up my colon with air to get a good look inside. Me and about six other guys were farting away in the recovery room much to the nurse's dismay. My wife was in tears laughing.

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#258972 - 10/30/08 05:34 AM Re: Male examinations since I am over 50 [Re: Chester]
blueshift Offline
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Registered: 01/21/08
Posts: 1242
Loc: infinity
Anual at 40! Ugh! Getting old is such a pain in the ..


When I was in the hospital recovering from an abdominal wound eight years ago I got a prostate exam for some reason and I seriously thought the guy had to be getting off on hurting me!

I'm bi (also not bi, same as not straight and not gay) and I have taken some big penises, but that finger f*%$# hurt! It's not like they just stick it in and pull it out! What that guy did was brutal and he kept doing it for a long gd time! I'm just not crazy at all about the idea of doing that every year. sheesh! I used to get cake on my B day.. now I get anally tortured. Yay smile frown frown

At least with the colonoscopy they will knock u out if u want them to.






Edited by blueshift (10/30/08 05:38 AM)
Edit Reason: to add comment
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#258979 - 10/30/08 07:29 AM Re: Male examinations since I am over 50 [Re: blueshift]
joelRT Offline
Member
MaleSurvivor


Registered: 09/11/08
Posts: 1357
Loc: Québec, Canada
Female doctors don't play around "up there". My postate exam takes on average 30 seconds. If there is nothing wrong with the prostate, no anomalies, the whole shebang should never take more 30 to 45 seconds and at no time should it be painfull.

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#258982 - 10/30/08 08:34 AM Re: Male examinations since I am over 50 [Re: Davesc]
mike5 Offline
Member
MaleSurvivor

Registered: 08/01/07
Posts: 170
Loc: Cleveland, OH
Dave - I like your idea of having a trusted friend observe. Give that friend the authority to stop it if it is not safe. It is always a good idea to go into scary/risky situations with some one we trust to watch our back!

Mike


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#259015 - 10/30/08 01:13 PM Re: Male examinations since I am over 50 [Re: mike5]
TJ jeff Offline

Moderator
MaleSurvivor

Registered: 08/07/04
Posts: 3365
Loc: Northern Wisconsin
Paul,

I just recently had a colonoscopy done myself due to some internal bleeding that was not going away

I was in a total panic the week before it - my mind was telling me that it was going to be so very bad

but... - you know what?

it really was'nt half as bad as my mind was telling me that it was going to be

you'll get through this ok - just do your very best to not let your mind race on with all the bad thoughts (talk the bad thoughts out with us - so as we can help to put your mind at ease) - the people who do these exams are very proffessional - at no time are you ever alone durring the exam - there is always at least 3 or more people in the room (so there is no chance of something innapropriate being done while you are under anesthesia)

if you need to talk - I'm always just a PM away

TJ jeff

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#259047 - 10/30/08 03:00 PM Re: Male examinations since I am over 50 [Re: Trucker51]
Paul1959 Offline
Member
MaleSurvivor

Registered: 05/17/06
Posts: 525
Loc: NYC
11 months ago I was diagnosed with prostate cancer. I was 46 and had had it for two years it seems. I had surgery this year and it saved my life. PLEASE allow the DRE.

Two things - for the DRE, it is less vulnerable if you lie on your side and pull your knees up to your chest. This is far safer feeling than bending over a table with the doc behind you. Also, get the PSA blood test before you do the DRE.
Second, some valium will be helpful. There are no medals or discounts for suffering or enduring fear. Tell your doc your history, and ask him for drugs. he will comply - I'm sure without question. if he doesn't, as Dave said, get a new doc.
Paul



Edited by Paul1959 (10/30/08 03:01 PM)

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#259059 - 10/30/08 03:56 PM Re: Male examinations since I am over 50 [Re: joelRT]
blueshift Offline
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Registered: 01/21/08
Posts: 1242
Loc: infinity
Originally Posted By: joelRT
Female doctors don't play around "up there". My postate exam takes on average 30 seconds. If there is nothing wrong with the prostate, no anomalies, the whole shebang should never take more 30 to 45 seconds and at no time should it be painfull.


Hmm. Well, then I guess my last prostate exam is more material 4 the survivor stories. frown Doesn't surprise me. Sadism is everywhere it seems.


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#259113 - 10/30/08 08:36 PM Re: Male examinations since I am over 50 [Re: blueshift]
Ken Singer, LCSW Offline
Moderator Emeritus
MaleSurvivor

Registered: 08/24/00
Posts: 5778
Loc: Lambertville, NJ USA
From my forthcoming book:

Chapter 20
Fear of Dentists and Doctors


Men are generally not good patients of doctors and dentists. It has been said by many wives and parents that it is next to impossible to get some men (and teenage boys) to these medical professionals.

Why? It may be because few men, besides exhibitionists and body builders, want other people to see them naked. Sometimes it is okay for his lover to see him naked, but for many survivors, no one can look at his body without him feeling some shame. The discomfort that a lot of men feel having a physical that includes removing one’s clothes and being poked and prodded, is often a disincentive for many, despite the understanding that prevention or early intervention is preferable to treating some illness or problem at an advanced stage.

Although their dentists or doctors have abused some survivors, most who are reluctant to get medical attention are likely to have been abused by someone else and the abuse may have involved oral or anal penetration. A physician who is examining the genitals or rectum of the patient may unwittingly be re-enacting some of the touch that the survivor experienced years ago. For many survivors, the thought of going through that experience again may mean putting off any examination or procedure that feels similar to the abuse.

The medical professional is, in some ways, taking on the role of the abuser. The professional is in a position of authority. It is his office, you are the patient, and you are expected to follow orders or directions. The doctor or dentist is pretty much in control of the appointment. If he is running late and you have to wait, there is little you can do except leave. You generally are expected to comply with the directions of the professional to take off your clothes or open your mouth, and you could be touched in ways that might cause you to recall previous situations of abuse that were beyond your control.

This recollection might be on the surface of your consciousness and remembered, possibly with the emotions that accompanied the abuse. Or it might be more unconscious, so that you have no connection between the abuse and the medical procedure you are going through. You might not know why you are feeling so scared or uncomfortable, but the feelings are real for you, even though you are likely in no danger today from the medical or dental procedure.

Men who experienced forced oral sex, for example, may have strong reactions to anything placed in their mouth. The dentist, in his position of authority, is probing around your mouth with a mirror and pick. He may pack your gums with cotton wads or insert a latex dental dam. Your saliva can build up and cause a choking sensation. You are fixed in the chair and can’t protest except for grunts and hand motions. The procedure may be painful, and there can be blood as well. Not a pleasant situation to be in.

The physical situation may be reminiscent of the abuse experience. You are lying on your back with someone hovering above you and you are pretty helpless. One survivor wrote:

One of my most horrific memories involved being held by my head, so any dental work is a huge trigger for me. I've been avoiding the dentist for years, even though I know it's a bad move on my part. I hate being controlled by those old fears, but I find it difficult to break free from them. Even the thought of going to the dentist is enough to send me into a near panic.

Another survivor described the dental experience as the same as flying: “I hate the dentist the same way I hate flying. I don't like feeling trapped.” Just as the airline passenger is somewhat trapped in his seat, the patient in the dentist’s chair is pretty much helpless to move about. This can be a strong trigger for some survivors. And, even for those without a history of being abused, the trip to the dentist’s office is not a pleasant experience.

Unless your dentist has abused you, the sensations – both physical and emotional – are likely reminiscent of the abuse you might have endured, although the medical or dental procedure is for your benefit, not the benefit of the abuser.

There are similarities as well with medical doctors. The difference between dental and medical procedures may be life and death. The dentist’s work is necessary for your teeth and gum’s health. Generally, a person who avoids going to the dentist has only his teeth to lose. The person who avoids the physician may actually lose his life if he does not follow recommended medical suggestions or agree to examinations and testing.

For many survivors, the prospect of a physical exam is very upsetting. The medical professional may want you to undress and may touch your genitals, buttocks or anus. If you have been abused, physical contact with these areas or even your body in general may feel very threatening. Although your brain tells you that this is a normal non-abusive procedure, your emotions may be screaming inside as if you are being abused all over again.

I think that most medical and dental professionals are not aware that the person in the chair or on the table in front of them may have childhood sexual abuse issues. I’m sure that many physicians and dentists have the same experiences as you do, but many – if not most – seem to be insensitive to this problem. Awareness of sexual abuse histories is generally not taught in medical or dental schools, to my knowledge. Although there are undoubtedly some doctors and dentists who were victimized as children, they probably push this experience to the back of their minds when in a professional situation.

I am not a survivor, but I’ve had a couple of situations in the past few years that made me feel uncomfortable in physicians’ offices. When I had a colonoscopy a few years ago, I realized that the doctor was going about his business like I either should know what was coming or there was no reason for me to know what to expect. It was my first colonoscopy and I did not know what exactly was going to happen since the doctor was pretty basic in his greeting and preparation for the procedure.

He started the process and I told him that I work with male survivors of sexual abuse and found his lack of preliminary information felt as sudden moves, which were intrusive and somewhat startling. Had I been a victim of anal penetration, I might have had a strong reaction, either physically or emotionally, to what he was doing. He basically thanked me for the input, which I suspected was due more to my status as an assertive patient in his estimation, rather than as an overly sensitive patient or survivor of sexual abuse.

One survivor, in an attempt to educate his doctor wrote:

My urologist asked me about stress in my life. I told him I was working on it. Told him I was seeing a therapist regarding some childhood sexual abuse. I figured this was fairly important to tell him because of issues with scar tissue and pain during a biopsy. He was quite uncomfortable with that info. I asked him if I was the first to ever tell him that. I was. It was a teaching moment. Told him one in every six boys is molested by 16. Told him about MaleSurvivor. Told him he probably needed to be on the look out for symptoms in his line of work. He seemed to not especially grasp it or didn't care. Either one, it was just another small attempt to educate the public about CSA.

If you are fearful of the rectal exam, particularly if you are of the age or have a medical family history where you should be examined, you may die for your avoidance of a colonoscopy or other unpleasant procedure. While this valuable medical course of action is recommended for all men over 50 and also for those younger who have a family history of colon or rectal cancer, many men avoid it because of the intrusive process around their anus. (Although many say that the worst part is the preparation with lots of laxatives and enemas the night before.)

Sometimes, the avoidance or fear of physicians is tied into the belief that they might know about the abuse from doing the examination. We are sometimes brought up with the belief that physicians or others in a position of authority will know what has happened to us. One survivor recounts his childhood experience.

I don't trust doctors. I have a memory of when I was around 6 or 7 and my family doctor examined my genitals. I recall being extremely scared that he'd know what they had been used for by that time... Not only that but being exposed was so uncomfortable. I always feel so intimidated by doctors.

Although most sexual abuse does not leave injuries or scarring, sometimes it does. Some survivors carry the physical damage for many years and are unwilling to go for treatment because of the shame connected with the abuse. This is another example of the legacy of the abuse – it continues to trap and control the survivor long after the abuse ended.

A survivor in his 50s writes: “I have colon surgery coming up to deal with old scarring from when I was a kid, and of course I'm not looking forward to that. But I will do it because I know it's in my best interest.” Apparently, it took many years for him to motivate himself to take care of an old problem. Sometimes, the victim may feel like he was physically damaged, but by refusing to get an examination, he may spend years living in fear that there is still an injury, even when an examination may reveal that there was no damage or that a simple procedure can resolve it.

The doctor-patient relationship is never one of equality. The doctor is generally more educated than you, probably making more money than you, presumably has his life more together than you, and is not your buddy or equal in this relationship. You enter that association feeling a notch or two below where he is. In reality, he may be having a more difficult time than you regarding his life but that is not the condition you generally will be seeing when you come for an appointment on his turf.

For survivors, the abuse took place in an unequal environment. The abuser was stronger, older, and had more resources than you had at the time. That may be the situation that you are feeling with the physician. Even though you might be older than the doctor, he still is in a position of authority and power over you. You might be a powerful person in your job function but when you go to the doctor or dentist’s office, you will hopefully be treated with respect and consideration whether you are a CEO or a sales clerk at the convenience store.

I make the assumption that status as a survivor is not something most medical professionals or their staff knows anything about. A few years ago, I went to my cardiologist’s office for a routine exam. As per the procedures, I was weighed and given a blood pressure exam before seeing the cardiologist. The nurse who took my vitals also got my blood pressure. She was a short, heavy woman who grasped my left arm to take my pressure. She pulled my arm into her crotch to get a good grasp on my arm and I felt a bit uncomfortable thinking that if a female abused me, I might find this seemingly innocent movement to be intrusive.

I mentioned this to my cardiologist (one of eight in the practice which shared clerical and nursing staff) and she said she would pass this on to the other doctors and advise the nurses. The next time I went in for an appointment, the nurse took care to minimize contact. I’ve been there four more times since and have not had the intrusive experience again so I assume the nursing staff got the message, although I don’t think I was singled out as the complainer in this busy practice.

A big problem with survivors is that the discomfort they feel in dealing with medical professionals has kept many from getting the necessary treatment they need to prevent loss of teeth or maintaining medical health. Although the process of preparing for a colonoscopy has turned many men off and discouraged them from having this necessary medical procedure done, the additional issue of fear in the physical exam has put so many more in danger of untreated disease or conditions.

It is important to educate medical professionals about the needs and emotional issues many survivors have. Unfortunately, the profession is not always open to hear about sexual abuse. In my experience, a group of us, led by the then-president of MaleSurvivor, who is a psychiatrist, found that the American Medical Association’s annual conference did not have enough interest in the topic of sexual abuse of males to sustain a workshop for more than 25 medical attendees one year. We received good evaluations from those who attended the workshop, but when we offered it the next year but the Association was not interested, although tens of thousands of physicians attend this important conference.

So, what do you do? If you are an activist, tell your dentist and physicians that they should be sensitive to male survivors. You don’t have to educate them about the statistics or what research says. Simply telling them that you had this problem in childhood is another purposeful disclosure for you. Although some physicians or dentist may not want to hear your message, there are some who will. If you sense that your medical professional is not interested, consider that a grounds for leaving and finding a new one. That may be hard to do, particularly if you live in a place where there are not a lot of doctors or a place where physicians don’t take new patients.

I think it is important to let a dentist or physician know that you have a history of sexual abuse. It is not necessary and I believe that most doctors or dentists won’t have the time or interest in knowing the “complete information” of your abuse. If one should ask you that information, all you need to say is “I’m not ready to talk about that at this time”. That should give them the basic information to be more sensitive and you can tell (or not) the details at a later time, if you wish. My sense is that they probably won’t ask again, but at least you got the message across and they will hopefully act with more sensitivity and understanding.

One survivor recently wrote in a discussion about dentists:

So this morning, had my dentist appointment. I was sooooo nervous I thought I was gonna be sick, So as the dentist comes over I tell him right away that I am extremely nervous and that I am one of those people that fear going to the dentist. I said something that happened in my childhood made me nervous so if he could please tell me what he is going to do before he does it I would be most appreciative. So he says that it’s no problem and if at any time I feel really uncomfortable just wave at him and he will stop.

Then he goes on to question if what happened to me was related to a bad experience at the dentist, and now I have no idea what to say or how to respond. I tried to say that "I am a survivor of ...” I couldn't get myself to “childhood sexual abuse”. So after a short silence, 10 seconds maybe, I say “I was molested when I was a kid”. He just nods his head and says it will be OK. I feel shocked because of what I just said! It was weird, I did not feel ashamed. I felt very relieved for getting that part over with, and somewhat proud of myself for saying it.

Being assertive and speaking up for yourself is very important. As long as you keep the abuse a secret, you are doing what the abuser wanted you to do – keep quiet. There is great power in disclosure, when you are ready. Telling a medical or dental professional may be an easier step than telling others who have a more personal relationship with you. One survivor put it this way:

My own experience with doctors is that now I always say I am a survivor of CSA. In most cases it has gone well and I feel I am treated in a more caring and attentive way. On one occasion, when I told a nurse who was poking at me, she said, “Oh, well okay. I guess we have to think about that”, which struck me as a way of saying, “What are you talking about?” I had caught her by surprise and she wasn’t prepared to hear what I was telling her. But even in that case, never mind: I said it!

When I told my family doctor she was grateful and said that doctors should always be ready for comments like this because it helps them to relate to their patients better. When I return for checkups or anything else now, she always asks me how I am doing in therapy. It’s great to have support like that.

But most importantly, I think, is the fact that when I tell a medical person about my past I am empowering myself and asking for my needs to be met, something I could never do as an abused boy. Being able to do that now, after so many years of feeling doomed, ashamed and condemned to silence, still sometimes overwhelms me.

A survivor I work with recently told me that he first told his wife, then his mother-in-law, then me, then his brother, and later a few friends and colleagues. Then he talked to a reporter for the local paper where the abuse had taken place. This last conversation was six months after he first told his wife. He said the emotional upset he felt from the first disclosure was like night and day when compared to the one with the reporter. The first disclosures were emotional and upsetting. By the time he spoke with the reporter, he was totally comfortable talking about the details that were so difficult in the earlier disclosures. This survivor happens to be a physician who is an anesthesiologist.


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#259120 - 10/30/08 09:05 PM Re: Male examinations since I am over 50 [Re: Ken Singer, LCSW]
beakin Offline
Member
MaleSurvivor

Registered: 08/13/08
Posts: 44
Loc: Texas
Paul:

I had a colonoscopy about a year and a half ago. What helped was that I wasn't alone with the doctor. There was at least one nurse throughout, I think two. Not sure if it was Versed that was used, but I was aware throughout the procedure. Your help is needed during the procedure. The great thing about what they used is that I have no memory of it after the fact.

My colonoscopy was simply because I'm over fifty and it was time. They found a benign polyp, which just means they'll want me to do it again probably after three years instead of five or ten.

It helped me knowing that I really wasn't helpless during the procedure. The drug simply interferes with short-term memory and that allows me to be blissfully ignorant after the fact.

Hope that helps. I prefer to know if there's a problem sooner rather than later. Since colon cancer is such a major problem for men, I felt the need to get informed about the procedure to feel protected, then get over my fear (or try to) and just do it.



ben

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