Why You Don’t Speak Up…The Tale of Two Pre-Op Nurses
acute pain | anxiety | chronic pain | cortisol | disease | fight-or-flight | safety | stress | stress response | trauma

August 29, 2022

Female Patient AloneA colleague and I were talking about the medical system and how we have found ourselves in the very situations we coach clients to advocate for themselves, and yet walked out of those situations simply going along with the situation rather than challenge the provider. So, what is going on here?

Let me take a step back and tell you the story I like to title, The Tale of Two Pre-Op Nurses. I am guessing this story will resonate with many women and their own experiences. The medical system seems to know nothing about female anatomy or hormones, a topic I would love to get into in a later post.

The Tale of Two Pre-Op Nurses

In late 2020, I had two procedures, three months apart. The same surgeon, the same hospital. The procedures required me to be under twilight, or conscious, sedation. Most people experience this type of sedation when they get wisdom teeth removed or have a colonoscopy. Since the procedure involved anesthesia, I was asked upon each check-in if it was possible I could be pregnant. Both times I explained I had an IUD.

IUD Effectiveness and Ectopic Pregnancies

According to article after article about IUDs, they are 99+% effective in preventing pregnancy. The only more effective birth control for sexually active individuals is a vasectomy. If someone would become pregnancy with an IUD, they are at 3-5 times more likely to have an ectopic pregnancy. An ectopic pregnancy is when the fertilized egg implants in the fallopian tube rather than the uterus. Early signs of an ectopic pregnancy are vaginal bleeding, dizziness, and pain. Pain in the lower back, pelvic pain, pain in the shoulder.

I explain all of this because I have been trying to prevent pregnancy for 20 years with a 100% success rate. And if on the tiny chance I could be pregnant, there is a high risk of ectopic pregnancy, which would not only cause me pain, but would not be a viable pregnancy. Meaning anesthesia would not be a risk to the fetus.

Procedure 1

The pre-op nurse I had for the first procedure was a woman, seeming in her 50s. She revisited the question about whether I could be pregnant. When I explained I had an IUD for two years, which is easily verifiable in my medical records because I use the same hospital system for my primary care services too. That nurse explained that they usually require a pregnancy test in pre-op for any woman who could possibly be pregnant but since I had an IUD, she didn’t think it was necessary. And I went on my merry way into the surgical suite and under twilight anesthesia, a place, apparently, I tell very inappropriate jokes.

Procedure 2

Three months later, I was scheduled for the 2nd procedure because the first one was not successful. Since the healthcare system was overloaded in late 2020 and messages and follow-ups were dropped, my procedure was scheduled December 30th, the last day the hospital was scheduling surgeries for the year. This pre-op nurse was male and probably in his late 20s. He explained I needed to take a pregnancy test. I explained back that I had an IUD and I kid you not, he just stared at me and told me it was required. I told him that I wasn’t pregnant. He repeated that it was required. Since I needed this procedure done prior to the start of the new year and before my health insurance deductible restarted, I wasn’t in a position to risk the procedure not happening. I told myself I wasn’t paying for the test, and all I had to do was pee in a cup. My attitude and mood must have been very evident because a different pre-op nurse showed up for the rest of my stay. Except, just before going back to the surgical suite, the original nurse returned to tell me my pregnancy test was negative. I looked at him and replied, in a deadpanned tone, “Shocking.”

I know there are probably some readers who are nodding their heads and thinking of their own stories. And there are probably other readers who don’t understand why this was such a big deal when it didn’t really cost me anything. Regardless, it highlights is how much medical providers don’t understand female anatomy or their own science! The first nurse was able to use her critical thinking skills and determine a pregnancy test wasn’t necessary. The second nurse, I would venture to guess, had no idea how IUDs worked! How many other things are women subjected to because we don’t understand, much less teach, medical providers basic female anatomy.

Fawn Response

But the point of this story was to explore what is happening with my nervous system and my fight-or-flight response when I knew I wasn’t pregnant but let someone who I perceived had power over me, push me into taking a pregnancy test. It was the fawn response. And next week, we will look at how the fawn response shows up when we feel threatened.

Do you have an experience in which you felt pressured by a medial provider to go along with something you know was a waste of time or unnecessary? Post it in the comments below.

Any information provided about medical matters is purely educational and the author is not a medical professional and is not recommending any specific intervention for any specific person or giving medical advice. Please consult your own medical provider for information about your own situation

This blog post is for informational purposes only and does not create any type of therapeutic relationship. For specific assistance, please consult your own medical and/or mental health provider.



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