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Ask a Nurse: If you’re concerned, get it checked out!

Ask a Nurse The ExCS site has teamed with a registered nurse and paramedic with a background in healthcare education and public health. Married to a former-CS, the Nurse would like to share their experience with the healthcare system, and answer any questions former-CS may have!  The Nurse will NOT get involved in diagnosing or giving medical advice, but if there are questions folks have related to going to a doctor, explaining medical terminology, how to advocate for yourself in healthcare, and so on, they might have a perspective that can help.  

Thank you everyone for your feedback on our first post! This post is in response to a comment from our first Ask A Nurse Post (slightly edited to protect everyone’s privacy).

From our Facebook group comes the following dilemma:

When I am able to access health care services one of my biggest fears is finding out that I had ailments that would have been preventable had I gone sooner (like in childhood) or that the current ailments that I have have progressed and only gotten worse by going untreated…. Am I being irrational? It makes me nervous, I definitely want to go, I have no hesitations about going, but I’m worried.

Ask A Nurse Responds:

Hi all, the feedback from my first post was really inspiring, building on that I’d like to respond to a comment regarding fear of going to see a doctor. From the sounds of it, it’s not that the person didn’t want to go to the doctor or feared how the doctor might react to hearing the person had never been to a doctor, but what the person might find out by going to see a doctor. *

I can empathize with that. I understand that the fear of discovering you’ve been carrying around a preventable or curable illness could be emotionally overwhelming. I’m not sure how to push someone to overcome those feelings, except to say, many things can be solved if addressed early. That and the idea, the more often you do something, the easier it becomes. Going to the doctor that first time can seem intimidating to the point of panic. It goes against everything you’ve been taught. My concern/fear is, I’ve heard enough horror stories of folks in CS who delayed care for so long, that they go past the point of being able to fix it. More than likely whatever you’re facing is something that can be addressed, but you’ve gotta take that first step and see someone. Again, I’m not here to judge CS, I was never in the religion, I grew up Catholic (Catholicism has its’ own set of issues), and as I like to say, I’m a “recovering Catholic.” But, if you’re concerned about a potential illness or nagging pain, get it checked out. The sooner you can figure out the problem, the sooner you can deal with it. 

Whenever you do decide to go to the doctor, how do you know who to see? This blog has a great description on how to find a primary care doctor, and I would encourage you to review that post. I will add though that if you need a specialist, in the US, most health insurances will require you to start with your primary care doctor and get referred to a specialist (as it sounds, a specialist is someone who focuses on a specific field of medicine). For instance, if you’re concerned about some weird heart palpitations, you’d go see your primary doctor first, and then that doctor would refer you to a cardiologist for further examination. This can be time consuming, but it saves money (at least for the insurance company). 

My biggest piece of advice, and this applies to anyone, anytime you do go to the doctor, bring a friend. Preferably someone you trust and who is familiar with the healthcare system. My mom was a registered nurse, when she was older, even though she was an experienced nurse, my sister and I would take turns going with her to appointments (sometimes we’d both go with her, and other times my sister would conference me in via FaceTime). The advantage to having someone with you is they can think of questions you might not or hear things you might not. Doctors can talk fast; another set of ears helps. Reportedly patients forget 40-80% of what is said during their appointment and 50% of the rest is heard incorrectly. I usually tag along to my spouse’s appointments to help interpret jargon and ask questions. Take notes during the appointment too. Most phones have a notes app or something similar. Old-fashioned pen and paper work well too and it’s less likely to be confused as texting 😉. 

It’s been pointed out that bringing a friend may be difficult given the pandemic.  At many hospitals and doctors’ offices, visitors are limited and, in some cases, not allowed at all.  My solution for this is simply to phone a friend.  Recently, a close friend of mine was diagnosed with a rare cancer.  The family asked if I could help.  As I couldn’t be with my friend directly, my friend simply called me, put me on speaker and gave verbal permission for the medical team to speak with me (some places might require you to sign a permission form).  The physician and nurse then spoke with my friend while I listened in, took notes, and asked questions.  As long as you, the patient, give permission, the healthcare team should never have an issue with you conferencing a friend in via phone (and if they do have an issue with it, well, that’s a red flag).  

Also, feel free to interview the doctor a bit during that first encounter. I’ve shopped around for different doctors. I ask questions about how long they’ve been practicing, how long they’ve lived in the area, stuff like that. All I’m trying to do is build a rapport. If someone gives me a bad vibe, I find someone else. “Bedside manner” is important, especially if you’re looking for a long-term doctor/patient relationship. I also look for subtle things, how do they treat the nurses and other staff members? If they’re a jerk to their staff, they’re not someone I want to give my business to.   

Regardless, nobody is more invested in your health than you. Nobody knows what you are feeling better than you. Trust those instincts. You are your own best advocate. If something feels off, get it checked. Maybe it’s nothing, but the peace of mind afforded by knowing it’s nothing, or at least something that can be dealt with, is better than carrying around that stress in your head.  

*Quick side note, instead of a doctor, you might see a nurse practitioner (NP), or you might see a physician assistant (PA). I personally have been seen by all of the above and have no qualms being examined by either a doctor, NP, or PA, especially for routine stuff. For clarity in this post, I used the term “doctor,” but that could refer to any of the aforementioned disciplines.

Additional Former-CS-based Resources

Christian Science & Doctors
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Ask a Nurse: What to expect when calling 911

Ask a Nurse The ExCS site has teamed with a registered nurse and paramedic with a background in healthcare education and public health. Married to a former-CS, the Nurse would like to share their experience with the healthcare system, and answer any questions former-CS may have!  The Nurse will NOT get involved in diagnosing or giving medical advice, but if there are questions folks have related to going to a doctor, explaining medical terminology, how to advocate for yourself in healthcare, and so on, they might have a perspective that can help.  

Navigating the intricacies of the healthcare world can be difficult, and that’s for those of us who work in the healthcare system! For people who aren’t employed in healthcare but have a fundamental understanding of the system, especially in the US, it can still be daunting.  For those folks who may have never interacted with, (or worse, been made to fear), the healthcare world, it can be downright overwhelming.  I’m a registered nurse and paramedic, though I didn’t grow up in CS, I’m married to someone who did.  As we dated and eventually married, I discovered just how ill-informed and unfamiliar she was with the healthcare world.  Ironically, the healthcare world is very ill-informed and unfamiliar with CS.  In nursing and paramedic school I learned all about Jehovah’s Witnesses, but I had never even heard of Christian Scientists until I met my wife, at which point I had been working in healthcare for nearly a decade. When I would ask friends and colleagues if they had ever heard of Christian Science, many of them would say, “Of course! Isn’t Tom Cruise a Christian Scientist?”  

I’m hoping to use this forum to bridge this knowledge gap and provide a conduit for ex-CS’ers to have a safe space to ask healthcare related questions and get accurate and reliable answers.  I don’t claim to be an expert, but I’m experienced in the healthcare field, I understand the lingo, and I definitely have access to experts.  One thing I can’t do is diagnose or give much medical advice beyond telling you to go see a doctor.  That said, I can help with terminology, how to speak with medical providers, and help you find your way through this crazy system.  

As a new contributor, I want to make this as useful and relevant as I can.  In addition to being a nurse and paramedic, I also have a master’s degree in nursing with a focus on public health.  Having met several ex-CS folks and having read several books and articles on Christian Science, I realized the value of having someone who can help guide those less familiar through the healthcare system.  Questions posted through the site will be routed to me and I’ll answer them.  Of course, this is not a rapid system, if you have a healthcare concern you think requires immediate assistance, go to the hospital or call 911, speaking of, what happens when you call 911?

What to expect when calling 911

Calling an ambulance can bring on a fair amount of anxiety.  With rare exceptions, most people don’t call an ambulance very often in their lives.  When they do, it’s because they need emergency care for themselves, or a loved one.  Now when you dial those three numbers, like you’ve probably seen on TV, someone answers the line asking “911 what’s your emergency?”  After ascertaining the nature of the emergency, other dispatchers will begin to direct the appropriate ambulance to your location.  Once the ambulance arrives, the responders will begin asking you questions.  Most will be pretty easy to answer.  Obviously, they are going to ask why you called 911, they’ll ask for your name, date of birth/age, and, (now we get into the tricky part), if you have any medical history (which you may or may not know).  They’re also going to ask if you have allergies to any foods or medicines (which again, you may or may not know).  They’re going to ask if you take any medicines routinely. As you’re already in a vulnerable state, a ton of emotions are probably flowing through you.  Fear, pain, embarrassment, & shame are all possible emotions and feelings you may have.  You also may not want to get into the intricacies of CS and Mary Baker Eddy.  So, if you don’t know your medical history, the easiest thing to do is tell the EMS providers that you grew up in a family that didn’t use medicine, and you either don’t know or are unsure of your medical history or allergies.  They might raise an eyebrow for a second, but believe me, we’ve encountered stranger things (I won’t mention the guy I picked up once, with the thing, in the place, it shouldn’t be), so not knowing your medical history won’t shock us.  

There are some patients that believe calling an ambulance will speed up the process to see a doctor.  I can tell you for a fact, this isn’t true.  I have definitely brought patients into an ER, via my ambulance, and been told to bring those patients to a chair in the waiting room.   Others may believe if they call 911 for a loved one, the ambulance has to take them to the hospital, also not true.  If you call an ambulance for a loved one, and the person is over 18 years of age and of sound mind, if they tell the EMS providers they don’t want to go to the hospital, they can’t take them.  They may be bleeding out all over the street, but if they say they don’t want to go, and EMS takes them against their will, that’s kidnapping.  Legally, the EMS providers can be arrested and charged.  Now, this isn’t to discourage you from calling 911 if you need it.  You should absolutely call 911 if you think you need help. 

Point is, most of us who got into healthcare did so because we genuinely want to help people.  So, when you tell us you’re not sure of your medical history, most healthcare providers are simply going to note that fact, and continue treating you.  One thing to never do, is be afraid to ask questions.  If a provider is saying something that doesn’t make sense or is unclear, ask them to clarify.  Tell them to explain it to you like you’re a 5th grader.  We throw around jargon almost as badly as the military (the first time I worked in an ER someone had written next to the patient’s name “SOB,” which I thought was a bad attempt to warn staff of a difficult patient, actually it means “short of breath”).  

As intimidating as it might be, do your best to get clarification if you don’t understand something.  Providers may get frustrated, especially if they believe they already clarified something, but as I tell my wife, push the person to give you an answer that you understand.  Some ex-CS’ers I know never attended biology class or sex education in high school or college.  There may be things we in healthcare assume everyone knows, but if you haven’t even taken a high school biology class, you may have a severe blind spot.  

Truth is, even though you’ve called 911 for an emergency, rarely is something such an emergency that providers don’t have time to answer questions.  I once treated a patient who was CS, and was as close to dead as you can get while still alive.  The patient’s spouse allowed me to treat their loved one, and despite how sick this person was, I was still able to provide the necessary care while explaining everything to the spouse and ensuring they were comfortable with the treatment I was providing. 

In any case, calling EMS can provoke some anxiety, but it’s better to call them and find out later you didn’t need to, than to not call them, but realize later you should have.  To quickly summarize:

  1. Understand the EMS provider may be a little thrown when you mention your background.
  2. Despite that, they should still treat you respectfully and with compassion.  
  3. Get clarification and ask questions.  

I hope this quick snapshot was helpful.  If it was, leave a comment and feel free to ask me questions.  Like I said in the beginning, I want to make this as relevant and helpful as I can for you; so, if there are questions or specific topics you’d like to be covered, let me know.  

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How to get Vaccinated

This post has been submitted by an ExCS group contributor. If you have questions about vaccinations, please ask your Doctor or other healthcare professional. For more posts about Healthcare see Healthcare Resources

As someone raised in Christian Science, you may not have received recommended vaccinations as a child. This can leave you vulnerable to preventable diseases, and can also make you a carrier who could transmit these diseases to people who are unable to get vaccinated. Many ex-Christian Scientists view getting vaccinated as an important step in their recovery.

In this blog, I use the terms immunization, vaccine, and shot interchangeably. I also provide resources for the United States because that’s what I’m familiar with, but similar resources for vaccinations standard in other countries are easily found online.

Immunizations are covered at 100% by health insurance because they are classified as preventative care. So, they will not cost you anything out of pocket if you have health insurance. There are several different types of vaccines that you will need to catch up on and get in the future. There is a standard set that all children in the US should receive, there are vaccinations that adults need, and there are also vaccinations that you should get every year, like the influenza (flu) vaccine. There are also specific vaccines either recommended or required if you are traveling to certain countries. When preparing to travel out of the country, you should check the CDC website to find out which vaccinations are recommended. In some cases such as for the yellow fever vaccine, you will not be able to re-enter the US without proof that you received a particular vaccine. Don’t worry, your doctor will tell you which ones you need.

I want to tell you about my experience with vaccinations to illustrate why it is important to get them now. I got the measles at CedarS Camps, a major summer camp for Christian Scientists, when I was a small child. There have been many measles outbreaks at Christian Science camps and Principia College. Every time, the CDC comes in and shuts it down, and the children’s parents make the choice of either having their child receive the measles vaccine or going home. Unfortunately, many faithful, well-meaning, but woefully and willfully ignorant Christian Science parents expose their children to complications including pneumonia, encephalitis of the brain, and death by skipping this one vaccination.

My family moved several times when I was growing up. Every time we moved and I had to enroll in a different school, my mother had to scramble to produce notarized documentation that exempted me from vaccinations for religious reasons, which was legal in the state I grew up in. Every time, either she had to find these documents after having just moved or get new ones notarized and this always caused a scramble and an awkward delay. This happened again when I was registering for college classes and the delay caused me to miss getting in to some of the classes I needed because of the time it took to get forms notarized and physically sent to the college. I also had to deal with this awkwardness when traveling internationally for a job. So, by getting vaccinated, you can avoid situations like these for times you need to produce an up-to-date shot record.

I got caught up on childhood vaccinations in my 20’s so that I could travel internationally, even though I was still sort of a Christian Scientist then. However, I stubbornly did not get the flu vaccine every year even after getting the recommended childhood vaccinations. One year, I traveled to my home state to visit extended family and got sick while visiting. It was miserable, and I remember being sick like that several times before. When I got home, I went to the doctor and they tested me and told me that I had the flu. During my trip, I had interacted with an infant and an elderly person while visiting my extended family, and felt horrible for exposing those vulnerable populations to an easily preventable, but potentially fatal, disease. I’d also exposed two planes full of people while traveling home. I felt incredibly stupid. Now, I am proud of myself every time I get my flu shot every year.

When you go to your primary care doctor, tell them that you were not immunized as a child and that you would like to get caught up on your shots. If you are comfortable doing so, you can let them know that your parents raised you without medical care. After some initial surprise, they are usually pretty understanding and relieved that you would like to get immunized now.

First, you need to find out which shots you need. You can choose to either go ahead and get all of them, or you can request an Immunity/Vaccine/Antibody Detection test. Because you were not immunized as a child, you may have gotten some diseases and already have immunity to them and therefore do not need a vaccination for those diseases. If so, you can avoid the soreness that occurs from getting an unneccesary shot and any potential side effects. You will also learn more about your childhood by finding out which diseases you had. For example, I got chicken pox and measles as an unvaccinated child raised in Christian Science. That meant that I did not need the chicken pox vaccine. I did still need the MMR (measles, mumps & rubella) vaccine in order to get immunity to mumps & rubella. I remember having the measles, but I don’t remember having the chicken pox. It’s also good to know for your health history, and having this data on record will contribute to statistics which inform public policy.

The doctor’s office will need to draw your blood for the Antibody Detection test or refer you to a lab for bloodwork. So, you will need to wait for the results before you can find out which vaccinations you need. At your follow up appointment, you will find this out and can now decide how to proceed. (You don’t have to get this test if the additional step will be inconvenient or if it’s not covered by your health insurance.)

Here is a common list of vaccinations:

Your doctor will tell you which ones you should get based on your age, health history, risk factors, etc. Some shots need to be gotten in a series of two or three within a certain period of time, like 30 days or < 6 months. If you need a series, it’s important that you come back to get the subsequent shots within the specified time period so that the immunization will be effective. There may be some vaccinations that came about more recently that your doctor might recommend for you, like the HPV vaccine, that may not be covered by your health insurance because they have not yet been added to the CDC’s list for your age group. So there is a chance that the cost for these additional vaccines might not be fully covered by your insurance, but you can call them to check beforehand. Even if there is an out-of-pocket cost, it is a good idea to get them if you can afford to do so.

Now that you know which shots you need, you can decide on the timeline for how to get your immunizations. You can get several at once or spread them out. I personally recommend that you plan to get one vaccination per month, but it may be more convenient for you to get most of them all at once and then only return for the series shots, or spread them out to get a few at a time with your series shots. For example, military members are often given 8+ vaccinations at once. Either way you choose, it should not make a difference on the cost (free).

The nurse administering the shot will ask you where you would like it. The most common place to get a shot is in the upper part of your non-dominant arm. They may also be able to give it to you on your hip. You might want to consider which side you sleep on and get the shot on the opposite side.

You may have a choice in vaccine delivery mechanisms. Anything that can be breathed in will be more pleasant than receiving it as a shot. There are also “live” vaccines, which may not be recommended if you have small children in your household, are pregnant, or live with someone who is pregnant. You might be advised to wear long sleeves to sleep in for some period of time while the vaccine is absorbed. Your doctor or nurse will go over all of this with you and send you home with a pamphlet containing all of the information you need.

The annual flu shot is available at pharmacies for convenience and you can use your health insurance and skip the doctor’s appointment if that works better for you. A nurse at the pharmacy will administer the shots.

Be aware that there are potential side effects from vaccinations. The FDA has concluded that the benefits outweigh the downsides. Read the information you receive thoroughly. I personally experienced a swollen lymph node from the MMR vaccine. This happens in 15% of children who receive it. If you are self-aware and informed about what could happen to you as a result of getting particular vaccines, you can recognize when you are experiencing a side effect and find ways to reduce the impact of these side effects. You can also call your doctor’s office for advice on how to handle side effects if you experience them. For my swollen lymph node, I read that it helps to sleep on the opposite side so that the lymph node gets less blood flow. After I did this, the swelling went down. Even though I had this unpleasant side effect for about two weeks, I am still glad that I got that shot. Most of the time, the area where you received the shot is simply sore for a few days to a week and there are no side effects. I’ve gotten probably fifteen shots total and only had this very minor side effect with one.

Now that you have been vaccinated, you can feel good about participating in a free public health benefit and display your new shot record proudly. You will get sick less often, and can no longer be a potential carrier endangering infants, elderly, or people otherwise unable to get vaccinated with easily preventable diseases. Now you can rest assured that you won’t get a debilitating disease that is easily preventable. You will also no longer need to feel awkward about a misinformed religious exemption imposed on you by well-meaning parents. Your shot record will come in handy when you apply to live in a college dorm or for certain jobs.