Iatrogenie

djinnIatrogenic. Yes, it is a thing.

Be careful what you wish for. Getting help for medical conditions can quite often cause or exacerbate others, since there’s always some kind of equilibrium, and medication is more or less explicitly designed to disturb that.

<spoiler for clinical ick>
I have a condition known as a urethral stricture. Scar tissue builds up inside the urethra, making it harder and harder to pee. This causes pain, infections, muscle strain, potential harm to kidneys, Uncle Tom Cobbley and all.

I’ve had this since I was a kid. It was caused by sexual abuse. So it goes. I was sincerely hoping it wasn’t going to flare up again before I have my Gender Confirmation Surgery later this year – because it was very likely that that surgery would remove the problem permanently. But it’s back, and it’s bad, as they say in sequels.

There is some talk of me needing “reconstructive surgery”, which may interfere with my GCS later on. So lots of discussion going on in the Corridors Of Ower, to none of which I am invited.
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Anyway, the fun part at the moment is about pain control. I can’t sit down comfortably for more than about half an hour without painkillers. So far, the only painkillers that cut the mustard are opiates such as Tramadol – but opiates such as Tramadol seem to interact with my PTSD, and make me go somewhat crazy. Paranoia, anxiety, awful nightmares, and so on. Currently I’m on the hunt for a non-opiate painkiller that won’t interfere with my sanity. Other recommended treatments for neuropathy (the kind of pain I have ) are anti-epilepsy drugs such as Gabapentin – which also make me crazy.

So this is proving to be an interesting time. I’m constantly feeling the pull between being in pain and being insane (which is another kind of pain). How to stay bigger than this? It’s not easy. My whole last year was about learning to keep company with painful states of mind, and yet here I am with body pain and just want to push it away at all costs. And also I don’t want to do that, since the cost is my state of mind. I’ve never felt as close before to what it must feel like to go surfing. Both kinds of pain bring a frightened and angry little kid to my surface, and I want to curl into a ball. But I also don’t want to be isolated, so I’m making myself open out at the same time as curling up. I’ve just begun doing some very gentle Scaravelli yoga, to help me stay in my body (sorry, I can’t think of a way to say that that sounds less Californian), help me to get confidence in opening out.

And speaking of staying with things…

<spoiler for more clinical ick>
Yesterday I had a urethrogram – where they squirt radio-opaque dye upstream through your waterworks and take x-ray pictures to see where the Tube Strike is. Once again, I had this peculiar experience I only seem to get with male medical professionals, where I say “I have this experience”, and they say “No, you don’t.” In this case, I told him “Listen, this is going to hurt me a lot, and I’m anxious. Please proceed gently” because I’ve had this done several times, and having a stricture means it bloody hurts having stuff forced the wrong way through a tight spot. He basically told me that it wouldn’t hurt, because of his magical anaesthetic gel (and that’s what they always say, and it’s never true), so he got on with it, and it hurt like bloody hell, and I started having abuse flashbacks in the middle of all this. Luckily, I’d told them already that I have PTSD in relation to the cause of my stricture (because I now know that it’s better if I don’t keep silence). The nurse could see I was in distress, and was great with me, and the doctor bloke eventually apologised when he realised how much it was hurting me. At least they got their pictures. Urethropaparazzi.
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So today I’m still recovering from this, and was forced to take a Tramadol in order to get through the day. That’s 2 in a row, and seriously pushing my luck. I’m going to see a doctor I don’t much like this afternoon (she’s kind of transphobic, but she was the only one available)*, to see if she can prescribe me something that won’t make me insane. But my biggest challenge today is not getting caught up in my anger about the whole situation. Angry about the stricture, and what caused it, and how I was treated yesterday (and by extension, rippling back to all the previous times I’ve been treated badly). So many reasons to plummet into IT’S NOT BLOODY FAIR!!! – and so many opportunities to make people around me feel worse as a result. Shan’t. Won’t.

An iatrogenic condition is one caused by the treatment of another. In this case, I don’t just mean “taking painkillers makes me crazy”, or “having exploratory investigations makes me much more sore”, I also mean that if I treat my anger in the wrong way, it causes bad conditions for myself and for others around me. So I’m invoking my Inner Fennec (a new addition to my totem family) to do protection and affection, because she is nobody’s victim. I wish to do least harm, at the very least.

Sorry, now it’s the Tramadol babbling :). But seriously, you don’t fight anger with anger, because you don’t fight anger, you don’t fight your way out of anger. You love into it. Not easy, but doable, and worth it. When I let the iatrogenie out of her bottle, my first wish is to be loving.

fennec-stretch

[*edited for accuracy: the aforementioned doctor is not, in fact, transphobic, she just lacked training in how to interact with trans people (I think I just wrote the “transphobic” thing out of grumpiness because I was anxious about seeing her again since I sent her a copy of the NHS guidelines on interacting with trans* patients). Today she was very friendly and helpful.]

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2 comments on “Iatrogenie

  1. Hey, I’m also a PTSD person. I can’t do medical (Pain and “doing things” to my body are big triggers) and I am allergic to narcotic pain pills. So, I get what you are saying and it’s horrible. They give me either Ativan or Klonapin to do the tests and higher doses for pain. I guess the logic is if I’m stoned enough, the body will relax and the pain not as bad. It has helped even in major surgery. Notice I said helped and not stopped. Good luck to you on so many levels.

    • womandrogyne says:

      Thank you, and the same to you. EMDR therapy has definitely helped me over the last few months – but I was shaken up by how much I can be shaken up in a situation like this. Little things make a big difference, like the doctor not smiling much. PTSD can be such a burden.

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