Ideas, please?

[urocyon]

It seemed worth a shot asking for advice, particularly from people more experienced in navigating the NHS than I am.

The immediate concern: a really suspicious-looking mole has cropped up on my arm, where I've had loads of sun exposure. I tried to convince myself that it was just a (uniquely) raised mole, since they will apparently sometimes do that with age. But, it shows more than one sign of possibly being carcinoma. I'd want it removed anyway, just because it's ugly and annoying, and I've been having to stick a plaster over it at night to keep from clawing at it. One night I managed to almost remove it that way--unintentionally--but it's back and bigger than ever.

This wouldn't be much of a problem on its own.

The complication: As I've mentioned before here, I have not so much a medical phobia, as medical PTSD based on bad experiences. (Long story.) It doesn't help that I've recently learned that most of the health problems I'm dealing with now can be traced directly back to inappropriate/sometimes flat-out abusive medical treatment--including the early-onset diabetes. This reluctance has only been enhanced by watching my mom die horribly last year, partly due to craptastic medical care and having symptoms dismissed. I haven't seen a lot of reason to trust the medical establishment in general.

As a result, I have not been to see my GP here in more than a year. I also know I'm not up to dealing with getting browbeaten (has happened before, after a shorter period). and/or brushed off. vatine is willing to help if I just shut down--both from autie overload and a learned response, hard to unlearn!--so I don't get completely blown off, but the GP is still likely to start ranting. I am not sure that even a straightforward "medical phobia" explanation would actually help, rather than producing more bootstrap BS. This GP has at least been polite about it, but he has dismissed things like "I don't want to take a statin" and "I am horribly depressed after the diagnosis" before. (Just as glad now about the latter, since SSRIs have done anything but help so far!)

Still, not too surprisingly, possible skin cancer is pressing enough to motivate me to get it looked at. That's scarier than the untreated chronic pain, or the diabetes which is under decent control. Now I'm wondering if there is any reasonably viable way of seeing someone other than the GP I'm registered with, as a first point of call. Besides just not being up to dealing with browbeating, I am also concerned that he'll get caught up enough in "Waaah, your diabetes! Waaah, the crazy noncompliance!" to pay attention to why I'm actually there. (Yeah, that's happened before, too.)

I even briefly considered putting it off until after we move, but not only is that a delay of unknown months while I'm worrying, we wouldn't have to pay exorbitant sums for the NHS to remove the thing!

Can anyone offer any suggestions for navigating this situation? I'm probably blowing things out of proportion, and missing available options. Thanks in advance!

Edit: There just might be one out when making an appointment, since my GP is the surgery's Diabetes Guy, definitely not Suspicious Moles Guy.

Comments

[green-knight.livejournal.com]

I understand how difficult this can be, but I think what you need to do is to make an appointment with your GP and take vatine with you. Make the appointment for the mole. If the doctor wants to talk about anything else, say 'I am here to talk about *this problem*'

I think there are times when we cannot afford to give in to out fears.

The worst that can happen is that the GP you see will confirm your fears - but the construction inside your own head is going to ALWAYS be unreasonable and agressive. Your GP _might_ be... and might be not. I think you're standing a better chance to actually face them. If the _particular_ GP you're registered with is one you've been running into before, go and sign up with another practice, because you don't need to tackle a _known_ quantity.

[urocyon-c.livejournal.com]

Sorry for the late reply--guess I really got caught up in avoidance. :)

Thanks. I'd suspected that was the most reasonable course of action. Focusing on This Particular Time is important; thanks for reminding me. ;) Glad you think it's reasonable to stick to the 'I am here to talk about *this problem*' approach. It's far too easy to work things up to the point that you're not sure what is reasonable.

Much appreciated!

[archanglrobriel.livejournal.com]

I don't really have much of an idea, I just wanted to drop you a note to let you know that you aren't the only one with this suite of issues who is currently in a doctor avoidant modality. I have medical PTSD too, based on flat out abusive early medical treatment facilitated by a Munchausen's by proxy/projective hypochondriac parent. And the medicalized abuse caused medical problems that include early onset diabetes, too.

I hate going to doctors. I tell them this, but they seem to think that it's just a small sort of hate rather than a capital letter kind of HATE that leads me to avoiding them whenever possible. I hate when GP's do that whole browbeaty, disapproval, paternalistic, dismissive thing. I hate it when they get so preoccupied with making sure I know they don't approve of my avoiding them (and going off, as you say, on the whole Waah your diabetes! Waah your noncompliance! thing) that they won't listen to the reason I -am- there. It sets up a nasty cycle of avoidance being fed by disapproval/lecturing. You'd think doctors would understand that, especially after I've TOLD them this.
I think being honest about hating doctors is a healthy first step in my figuring out how to deal with them. ;)
I definitely wish you luck in your mole removal/investigation quest. I have a big red mole on my forehead that I'd like to get removed. I had it looked at a couple of years ago to find out of it was worrisome and it's not, but it's ugly. I'd love to see a dermatologist about it, but my insurance makes me go through a referral from my GP and...well...I was supposed to have bloodwork done about six months ago that I kinda...haven't done...so...
Yeah. Maybe this month I'll get that done. Or maybe after Christmas...

[urocyon-c.livejournal.com]

Sorry for the late reply, but you can probably understand trying not to think about it. ;) Both glad and sorry to find out that I'm not the only one running up against this sort of thing! Things were hard with a nervous, projecting parent who preferred to think there was something wrong with me rather than admit that we were both living in an abusive situation, but your earlier situation--ouch. It sounds like you're handling things pretty well, all things considered.

It sets up a nasty cycle of avoidance being fed by disapproval/lecturing.

Exactly. I was glad to see precisely this addressed at Dental Fear Central (http://www.dentalfearcentral.org/) (yep, HATE dentists too). A lot of the stuff there applies pretty well to other medical settings, too. Shame there aren't a lot of doctors specializing in "anxious patients" too.

Thanks--will probably need all the luck I can get. *g* I hope you can see about your mole soon, too. It doesn't help my state of mind with this one that I did go in a few years ago over an ugly red one on the end of my nose, and just got brushed off because it wasn't dangerous and, hey, it's the NHS. Turns out that the spider angiomas/nevi like that will usually scar pretty badly if they're removed anyway, with all that blood supply. Hope yours is easier to remove!

Haha, procrastinated bloodwork was the first excuse that got me into this year-plus delay.

Thanks for the moral support. :)

[arkady.livejournal.com]

Not sure what to suggest about the PTSD, but what you need out of your GP is a referral to a dermatologist, as s/he is the specialist who would deal with the removal of your mole (regardless of whether or not it's cancerous).

You are quite within your rights to make an appointment at your GP surgery and insist on seeing any other doctor but him - I did that once at a GP's surgery. The GP in question was the senior GP, but I insisted that I would refuse to allow him anywhere near me in future and I would see any other GP at that surgery.

[urocyon-c.livejournal.com]

Thanks. Yeah, I wish they'd let you go straight to a specialist, but that's just not going to happen. :-| One of the few benefits I miss of being uninsured in the US: no gatekeeper. *wry smile*

This GP is not actively bad--it did get to that point with the last one. This time, it's simple avoidance, and with any luck getting Ingvar to run interference will be enough. That, and not giving myself much more time to work things up. ;)

[nitoda]

If your surgery or health centre has a number of doctors you can ask to see any one of them and don't have to see one you have already seen and have issues with. If you don't even want to do that, you could try going to an NHS Walk-In Centre if there's one in your neighbourhood. You'd probably have to be prepared to wait and they may have to refer you back to a GP, I'm not too sure about that aspect of them, not having had to use one personally.

[urocyon-c.livejournal.com]

Thanks for the info. :) Knowing this would have been handy with my last GP. This one's not too bad; it's mostly avoidance. I did consider a Walk-In Centre, but figured they'd just send me back to the GP.