What I want

Found this kicking around on my hard drive from last year. I think this is a good thing for me to review before my appointment tomorrow.

What I don’t want: 

  1. Repeated tests if there are existing test results which can be used. 
  2. Referrals to specialists unless primary care physician is not able to conduct testing, procedure, diagnosis, or treatment for a specific condition or complaint.

 What I do want:

  1. Oversight and integration of diagnostics, diagnoses (or lack of), and treatment conducted by specialist. 
  2. A supportive attitude. 
  3. Understanding that I have a couple of long standing conditions and complaints some of which I am only seeking to have managed unless they change in frequency or severity. 
  4. Understanding that I am coming into this transition with a couple of existing complaints which I feel have not been adequately investigated up to this point.  Regarding these continuing issues, I welcome fresh ideas and even (warranted, reasonable) repeats of old ideas (see “What I don’t want, #1, above) if you think it will help identify or rule out something.  I am capable of accepting diagnoses like “Chronic Fatigue Syndrome”, IBS, or even “somatoform disorder” providing other likely causes have been ruled out (within reason) and you are not dismissive of the validity and impact of the subjective symptoms of these conditions. 
  5. Understanding that I am an empowered abuse survivor and as such, I have had years of psychotherapy regarding the effects the abuse has had on my emotional and social development, on my interpersonal interactions in my day to day life, on my self conception, on how I think others see me.  In general, I am a bit hypervigilant about perceived wrongs, injustices, and just plain unfairness.  My responses tend to take the form of “championing”.  I am very verbal about these feelings so you will likely get an earful if they start up.  I try to give the benefit of the doubt, at least initially.  I will forgive minor and really justifiable offenses along these lines, but I do not ever forget them and too many of them will add up to a very negative attitude on my part.  I need you to understand this and to try to accept it.  How hard should you try?  At least half as hard as I try to be reasonable and normal. 
  6. Understanding that I derive a strong sense of self from feeling independent and competent in my daily tasks and thus conditions, symptoms, or treatments which lessen my independence and competency present significant challenges for me emotionally, both interpersonally and internally. My most frequent response in those situations is extreme frustration, a fear of being perceived as a burden, and consequent apparent fixation on finding causes in order to develop strategies for practical immediate solutions if not outright remedies. 
  7. I expect that if, after ruling out medical explanations, my primary feels my physical complaints are of a psychological nature then s/he will be receptive to working with a psychologist of my choosing on the matter and will not engage in independent psychological assessment and diagnosis unless the primary has the background and training with abuse survivors to warrant such action.
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