Sorry, this is going to be long. I had my first appointment with a surgeon this afternoon and it was horribly traumatic. I think most people would have found it stressful but to understand why this was a particularly bad experience for me, here’s some background information. I have some mental health issues, namely depression, anxiety, OCD and a borderline eating disorder. I believe most of these issues are the result of a trauma I experienced in my early teens when a doctor performed a DRE on me for suspected appendicitis without giving an explanation or gaining my consent.
I also have Asperger Syndrome and can find verbal communication extremely difficult. I tend to shut down in stressful situations and can then barely speak at all. I also find physical contact difficult.
So my appointment today… the doctor had absolutely NO bedside manner. He hardly even looked at me and just sat with his eyes glued to his computer screen while he barked questions at me. He didn’t really give me time to speak and I kept stumbling over my words because he was making me so nervous. At one point he said “it says here you don’t eat well—why not?” And his manner was so hostile! I could only answer with “I don’t know”.
I consented to an examination and he was just about to look when his phone rang and he went to answer it, with no apology to me, while I was just laying there! I felt so undignified! Then he examined me and was really rough and prodded the fissures quite hard, asking, “does it hurt there?” to which I thought, Well duh! Of course it’s gonna hurt if you’re pulling and poking so hard! :roll: 
And then, and this is the worst part for me, he finished his exam and just stood over me while I was still laying on the couch and carried on with the consultation, as if I wasn’t just laying there with my backside out! I mean, honestly, surely one of the first things they’re taught in medical school is to let the patient get dressed in private after an exam before you continue talking with them! Surely that’s just common sense—people don’t want to talk when they’re feeling that vulnerable and uncomfortable.
So he said they can do botox injections but I declined because I didn’t feel able to talk through my concerns about getting injections due to how distressed I had become. It was easier just to say “no”, even though I’m not sure what I want. Plus, I’m not letting this guy anywhere near me again!
Instead he has prescribed me Diltiazem ointment and I’m supposed to go back there in 8 weeks for a check-up. If it’s with him, I won’t be going. I can’t believe this has happened. I feel re-traumatised and I don’t know what to do!

I'm so sorry you have had such a bad experience today. Please don't let it put you off going back again in 8 weeks for a follow up.... Maybe you could ring the secretary and request to be seen by another member of the team and mention that this particular consultant has left you feeling upset by his brash consultation, and unprofessional performance of an examination.... Taking a phone call... I mean really.... That's awful...you poor thing. X
Is there anyone you can bring with you to your next appointment? It always helps to have someone there to speak up for you when things get too overwhelming. A friend or relative maybe?
I would also make the surgery aware of your aspergers, and let them know you need things explained clearly, and that it would help if they could provide you with written information where they can, to reinforce what has been said.
Try to take a step back, calm your nerves and try not to worry. Diltiazem is a very good start... A good proportion of sufferers heal very well with it.... I would think it was the right choice to start with the cream anyway.
 
OMB x

Hi Pamplemousse
It's unfortunate you had such a bad experience with your Dr. and we see that from time to time here.  Maybe you can ask for a different referral before the next appointment-(that you would like to see a specialist, if not already).
Just expressing your self here will help you as I can imagine how traumatic this was for you. You may also benefit by talking with an expert if you cant seem to shake this experience.
Looks like you have had more than your share of bad experiences with Dr's in the past and that a thorough screening process for your next Dr. should be in the cards.
Referrals from several trusted friends if not already tried may be the way to go at it, in choosing your next DR. Also was this a Colon Rectal Surgeon as they are more knowledgeable.  
So when did you first start experiencing anal fissure symptoms? We look forward to talking with you here and thanks for being brave and sharing your story.
GL

Hi Pamplemousse,
I'm so sorry to hear about your traumatic experience with that doctor. In my opinion, I would never go back to him and find someone else. You don't need someone like that. This problem is horrible enough as it is and having to deal with an uncaring, unprofessional doctor is not something you need. No doctor I've been to has consulted with me during an exam. They always leave to let you get dressed/cover up and then come back later. How awful of him to do that! Definitely see someone else.
I've had bad experiences with doctors before and I can definitely relate. I have an anxiety disorder (I get panic attacks very easily under very stressful situations) and depression, so I can't put up with doctors that are unsympathetic and have no bedside manner. Whenever I run into a doctor like that, I run the other way. They are supposed to help you, not cause you unnecessary pain and embarrassment.
If you can, get a referral from someone you trust (friends, family, other doctors, etc.). My GP knows about my anxiety disorder/depression and referred me to a CRS that is considerate, very professional and experienced, and doesn't want to cause me any extra pain. Doctors like that are out there; you just have to find them. Internet reviews are very helpful, too.
Also, definitely try the creams first before any kind of surgery. They are your first line of defense besides good diet and keeping stools soft. The creams have helped many people. I was prescribed Diltiazem and am healing/healed because of it. It took several months for me, but I am doing a lot better than when this started last December. The healing process is long and not a straight path, but you will get there. Definitely exhaust all other options before surgery, if you can.

Also, I agree with owmybum that taking someone along with you to the appointment that you trust (friend, relative, etc.) is a great idea. I had my mom come with me to my first CRS appointment. It really calmed my nerves (although I was still terrified) and it's very helpful to have a second set of eyes and ears there to understand what the doctor is saying.

Hi Pamplemousse,

Just like everyone else here, I completely sympathise with the way you have been treated today. It's disgraceful. Please call them up and ask for an alternative CRS the next time you need to and don't be afraid to do this. I would be fuming!!!!!! I had a very rough experience with one of the CRS' I saw last year and I complained about her in the end and her harsh treatment. Needless to say I never ever encountered her again. No one should be treated like that. You will need to get a follow-up for the sake of your own health but it does not have to be with this guy - there are some wonderful CRS' out there who are very gentle and very understanding, so please don't let this experience put you off taking care of your own needs.
As OMB says, the Diltiazem is a great start! I also used this too and it made a HUGE difference to reduce my pain levels and helped my fissure heal well. I sincerely hope it does this for you too....
You don't even need to think too much about Botox right now because the cream may work wonders for you, so just try to relax in the meantime, keep your stools nice & soft and take good care of yourself.
We are all here to offer you as much support, help & advice as you need and trust me, there are some wonderful people on this website prepared to do that.
All the very best to you x x

Dear Pamplemouse, I got so fed up with my Gastro, Doctor that I brought along my sister, and I can be very verbal, My older sister being a retired teacher/principle, she is very assertive. She asked the Doc, questions that I didn't even think of. So try that, bringing some one you can trust , with you next visit. Eto is right, start out with less stress to your fissure by using the ointment or cream first.
:) 

Thanks so much everyone, for all your support. I really needed that!

owmybum wrote:Maybe you could ring the secretary and request to be seen by another member of the team and mention that this particular consultant has left you feeling upset by his brash consultation, and unprofessional performance of an examination.

Thanks for your helpful comments OMB. I noticed you’re in the UK too—do you think it would be ok for me to request another doctor?

owmybum wrote:Is there anyone you can bring with you to your next appointment? It always helps to have someone there to speak up for you when things get too overwhelming. A friend or relative maybe?
I would also make the surgery aware of your aspergers, and let them know you need things explained clearly, and that it would help if they could provide you with written information where they can, to reinforce what has been said.

Hopefully my boyfriend will be able to come with me next time. We’re in a long distance relationship but I’m hoping he can time his next visit with my next appointment. I think that’s good advice about letting them know I have Asperger’s.

buttastic wrote:Maybe you can ask for a different referral before the next appointment-(that you would like to see a specialist, if not already).

Thank you so much for your supportive comments, Buttastic. I think I saw a general surgeon rather than a colorectal surgeon. I’m not too sure how to go about seeing a specialist through the NHS but I will look into it. I wish I could afford to go private!

buttastic wrote:So when did you first start experiencing anal fissure symptoms?

My fissure started getting bad in December 2012 I think, though I’d had a few symptoms before then. I first saw my doctor about it in January but none of the treatments I’ve tried have worked and I now have two fissures! I can actually cope with the pain, as horrible as it is, but the constant discomfort is very hard to live with for me.

Luka wrote:I've had bad experiences with doctors before and I can definitely relate. I have an anxiety disorder (I get panic attacks very easily under very stressful situations) and depression, so I can't put up with doctors that are unsympathetic and have no bedside manner. Whenever I run into a doctor like that, I run the other way. They are supposed to help you, not cause you unnecessary pain and embarrassment.
If you can, get a referral from someone you trust (friends, family, other doctors, etc.). My GP knows about my anxiety disorder/depression and referred me to a CRS that is considerate, very professional and experienced, and doesn't want to cause me any extra pain. Doctors like that are out there; you just have to find them. Internet reviews are very helpful, too.

Thanks so much, Luka. I’m sorry you’ve had some bad experiences too but your GP sounds great. The thing with using the NHS is that I don’t really know how much control I can have over who I get to see etc. I will try to research this a bit.

Ever the Optimist wrote:Just like everyone else here, I completely sympathise with the way you have been treated today. It's disgraceful. Please call them up and ask for an alternative CRS the next time you need to and don't be afraid to do this.

Thanks, Ever the Optimist. Do you know if it’s ok to do this with the NHS? I’m sorry to hear you had a bad experience too. I sometimes wonder why people become doctors if they have no people skills!

please go-away wrote:Dear Pamplemouse, I got so fed up with my Gastro, Doctor that I brought along my sister, and I can be very verbal, My older sister being a retired teacher/principle, she is very assertive. She asked the Doc, questions that I didn't even think of. So try that, bringing some one you can trust , with you next visit. Eto is right, start out with less stress to your fissure by using the ointment or cream first.

Thank you. I wish I was more assertive! Hopefully I can take my boyfriend with me next time.

Hi Pample,
It's terrible to hear of your experience. It's such a personal thing that you'd hope it would be treated in the most sensitive way possible. I had a wonderful GP to begin who was so sympathetic and gentle. A female one too which was relieving. After 3 years of suffering and then finally seeing my GP (with my mum) with another year of back-n-forthing with various creams, she referred me to a specialist (in Wales on NHS).
She was amazing and it took me a few visits to other GPs to realise that all doctors are different in their bedside manner. The most recent GP (old grumpy guy) paid no attention to me and was more interested in his screen and telling me how expensive my cream was. I won't be returning to him.
My CRS Dr Torkington was amazing. I was on the waitin list for 3 months before my condition got so bad I was crying after every BM. My mum went to his secretary and pleaded to get me in to see him. His secretary then rang me to say I could come in before his first appointment. I did this and he'd sent a trainee in to interview me first.
When he finally came in, he was really engaging and could see the pain on my face. He made some light hearted jokes about Botox and having the most youthful bum ever. While examining me, I let his trainee in too because more people need to know about these types of conditions, he was very gentle and only did an external examination and once I flinched he stopped.
I bought him and his secretary a bottle of wine to thank them for their helpfulness.
I then had a pre-op appointment with a nurse who was so fantastic and went out of her way to make me feel at ease as I've never been to hospital before. I made sure I dropped in a thank you card so that she knew she was doing her job above and beyond.
That doctor that you saw needs to be told about his lack of bedside manner and professionalism. I'd write a letter if it were me, outlining how it made you feel. If these people aren't told, they might never change.
At the very least he should've made you feel at ease and sympathise with your other conditions.
I've had a double fissurectomy and Botox. I'm also using Diltiazem and movicol (get yourself some stool softeners as I'd highly recommend movicol as I'm someone who can't control the consistency with my diet alone.
I couldn't heal naturally with creams as my fissures had been there for so long they were chronic. If I don't heal now (after 5 weeks ago today) I will be asking for Botox again. It's a godsend. There's a few of us on here who have had it and its a positive way forward.
Keep with the Diltiazem religiously as I found it to be the best of all the creams I've tried. I also use Andrex washlets - which. Are flushable wet wipes and these too are soooo comforting when you're in pain after a BM.
I hope your 8 weeks go well and keep us informed. We're always here to give you support and not just for your fissures, I've found that you can bring your stresses to talk about too.
Take care, drink plenty and poop gently!
Welsh x

Hi Pamplemousse,
Yes, it's perfectly OK to do this!
I'm also from the UK and based in the Midlands and all appointments were done on the NHS. My team was made up of 4 CRS' plus support and I saw 3 out of the 4 of them in my time there. Two really were great, very knowledgable and considerate. The other - well you know my feelings on that one!
I checked prior to the appointment on who I would be seeing and complained about the treatment I had received to my "designated" CRS. After that, I only ever saw the latter on following visits.
So this is definitely an option if there is a team working together. I guess if you are in a more remote area or within a smaller trust, then you would perhaps have to look at travelling to another hospital but it is possible to do.
It definitely is worth airing your complaint because we pay for this service and deserve to be treated humanely and as Welsh says, if no-one ever complains then there will be someone else at some point on this site I'm sure, feeling as belittled and as miserable as you were made to feel.
You just need to ask your GP for a referral to a CRS and yes, there will be a waiting list but I just kept calling up asking for stand-by appointments to speed things up! The last time, they got me in within 2 weeks of me calling, which was really good going!!........I booked my very first appointment privately because I was fortunate we have a Cash plan, which I can reclaim money back from. I saw a CRS pretty much the next day I think!! but he also works for the NHS, so I was able to continue my treatment on the NHS with him after at no cost, of course. I think I paid Ј180 for the original private appointment.
Truly all the very best in getting this sorted out and I hope things get moving very soon for you.......