Afraid of sexual abuse when having the OP

I hope not all surgeons position their female patients like that :'(

Andrina -- I recommend not watching surgery videos. You are not a surgeon, you are the patient. You do not need to see the surgery to decide if it is the right option for you or to prepare for it. Doctors and nurses go through many years of training to be able to watch things like this and perform surgery without having a strong emotional reaction like you are. Don't go borrowing trouble.

I'm not sure but I believe that the lithotomy position (legs up in stirrups) was used in this procedure in order to allow access to the anus at the end of the procedure, because the stapled anastomosis was performed transanally. This can actually be better for the patient because it allows the surgeon to access the surgical site without making more incisions.

During rectum removal and j-pouch construction patients are frequently placed in the Trendelenburg position, which basically means the operating table is tilted so that the legs are higher than the head. Again, this is for the patient's benefit -- one of the challenges of this surgery is operating in the pelvis, which is very small, without impacting all of the other many organs in the pelvis. Surgeons use Trendelenburg because in that position gravity assists by pulling the intestines out of the pelvis, making the operating area less cluttered.

Ultimately there has to be a certain level of trust. Whether you're placed in lithotomy position or not, when you're under anesthesia anyone could theoretically do literally anything they wanted to you. Doctors and nurses go through a ton of training and licensing and are supervised closely to ensure that inappropriate things don't happen. You should choose a surgeon whom you are comfortable with and who you trust not only to perform your procedures but also to treat you ethically and with respect. Choosing a surgeon because they do or do not use the lithotomy position would be a really unwise decision. There are medically valid reasons to use it, and if you don't trust your surgeon enough to not abuse you just because you're exposed during surgery, then you shouldn't allow them to operate on you, period.

Keep in mind that although it is shocking for us to see a woman exposed in that position, surgeons are trained to see the body differently and there is nothing sexual or indecent about it to them. You'll notice in the rest of that video that the patient is draped as much as possible and her face and head are behind a curtain as well.

I'm glad you at least agree with me that it looks shocking. Thanks for understanding. And thank you for the time you spent in writing your post. I may have to come back to it and re-read it when I feel better.

Actually, that is how positioning is done for everyone who has a proctocolectomy. It is how they gain access to the anus for the anastomosis. There is no "funny business" going on. The room is full of people and it is all very clinical and professional.

Jan

quote:

Ultimately there has to be a certain level of trust.

This is basically what it comes down to. You either trust your doctor, or not. It is also not a female issue per se, as male patients can be sexually abused and assaulted too. If it is a huge issue for you and no trust is there, then you may want to go see a female doctor. But if you go with a female doctor, DO NOT rent the movie "Side Effects" under any circumstances, as that trust with a female doctor could be lost quickly by seeing this movie.

I had a girlfriend, years back, who discovered that she was not allowed to wear her panties when going into O.R. and freaked...someone told her that she would be naked on the table only covered by a sheet, if that, and she paniced and decided that she didn't want to go through with it...
I had been through over a dozen surgeries by then and just laughed (granted, I lacked sensitivity)...I tried to tell her that if she was worried about being naked on the operating table then what would she do later when she had to deal with child birth?
Not sure that she ever had kids after that...
It is all part of the process and trust is everything when it comes to surgery. If you can't trust them in O.R then you shouldn't be letting them near you with a scalple!
Sharon

I'm a nurse and can tell you that we're not even thinking about sex or whatnot when we're doing care. People can be totally undressed in front of me, in the ICU, and it doesn't even register anymore. Positioning is important in surgical procedures, and our surgery just happens "down there," but like Jan said... The surgical theatre is full of a surgical team, and there would be plenty of witnesses if someone tried anything inappropriate.

In addition (in case you were worrying about it) the patient in the video would have given permission to have the video taken and used for educational purposes.

Jan

It's all in a days work for these doctors....it's their job.

Do not dwell on these thoughts of what position you are in in the O.R. You are dealing with medical professionals (and many) who will be in that O.R. They are called professionals for a reason. Everyone who is in that type of high level surgery in a large, advanced hospital will be top notch. You have other issues to deal with at this time and this is one that you can safely take off that list.

Seriously? This is surgery to remove the colon and rectum or anus. Isn't roses and sunshine down there. It is surgery. I have had my boobs chopped off, stomach cut out, tummy tuck and vagina/thigh surgery as well as a procto... surgeons have seen and put me in every position. lol

I am a surg tech and have worked in the OR. Lithotomy position is normal for the anastomosis. Believe me, there is nothing "sexual" about it. Surgeons and assistants are seeking a precise surgical result. The nether regions are just a body part in the OR, not looked at any different than an arm or a leg---really!

It is hard to think that way if you are a patient, but a body part is a body part, and the surgeon's only focus is to fix it and to fix it safely.

I rarely comment but wanted to chime in here. Andrina, you have every right to feel uncomfortable with this image. I second Pluot's comment, who gave a much more eloquent explanation than I could.

The experience of having IBD is such a physical, emotional, and psychological roller-coaster. There are so many moments when you feel like you're no longer in control of your own body. You're allowed to feel scared or uncomfortable with any and all moments, whether others experience the same fears or not. Understanding that medical professionals deal with this sort of thing every day and don't view your body in a sexual way may not be much of a comfort, but it's true.

If this is a big fear of yours about surgery, I encourage you to talk about it with your medical team. Nurses in particular are very compassionate when dealing with people from all walks of life and with all different backgrounds and comfort levels. Whether or not you have a past that includes sexual abuse or trauma, you're entitled to be fearful of sexual abuse during surgery. I would recommend not looking up any more pictures or videos, but instead working through your fear with a medical professional.

Before I had my first surgery at 17, a nurse asked what my biggest fear was, and I said that it was being naked in a room full of people with zero control over what happened to my body. I absolutely loved my surgeon, and the fear had nothing to do with him personally. The nurse was completely empathetic and comforting and even brought in a scrub nurse to tell me that she personally would be there to make sure I was treated with respect every step of the way. No one took my fear personally or as a preemptive accusation, and no one told me to get over it. I felt reassured by how respectfully I was treated pre-op.

I know how scary this whole experience is but I also know that there are so many compassionate people, both online and in your real life, who are here to help you through whatever fear you have. Never be afraid to reach out for reassurance.

I prefer not to think about what happened to me during surgery. My surgery was open, so it's bad enough considering that I was laying on a table with my insides splayed out and people tinkering around with my innards. Believe me, NOTHING about surgery is pretty. I felt comfortable knowing there were a lot of people in the room and I was confident with the caring hospital staff. My surgeon was great. What it comes down to is trust, as others have mentioned. It was also a life or death situation for me, so there wasn't enough time to get hung up on the mechanics of it all.

You can certainly discuss your fears and reservations with the surgeon and/or nurses. I'm certain they get these questions all the time and will be happy to provide any information or explanation to make you feel more comfortable with an already difficult event.

Adriana,

When I was boy, I used to hate getting a shot from a Nurse if I was sick because they always stuck the needle in my butt. I had a problem with that because not only did that hurt, but I was a male and she saw my bottom.

Anyway, I can't remember when this happened, but the nurse sensed my embarassment and said, "With Doctors and Nurses, if we have seen one behind, we've seen them all. To us, its just another face in the crowd."

I thought that was pretty funny until she stuck me.

Anyway, I share that story because for me, I try and use humor when I am sick lots of times, esp when I had Cancer in 2009. Fear and worry is useless an unproductive and not helping you at all. For your sake, please do not watch videos such as what you posted.

Rocket

Hi I haven't been here in a while.

This has nothing to do with J-Pouch or IBD but I was in the ER last week.

I needed an EKG and a guy nurse performed it. I insisted to keep my bra on. It didn't have any wires (sports bra). I've had a couple of EGKs before. Every time went well. But this time the guy pulled down my bra so he and his other guy assistant could see my bare chest. I complained and he said: I do this every day. I asked for a lady nurse. She came in, put on the stickers around my bra WITHOUT having to expose me. There was really no need to pull down my bra so far. Every other time they were able to put the stickers on without having to expose my bare chest. I feel so embarrassed.

Can I complain against him? I still remember his name. I hope you see now why I'm sooo paranoid about sexual abuse.

Andrina, I've gone to the ER before for stomach pain and had them tell me to take off my bra. I've had a stress test done (twice) and had to do it bra-less with just a gown on top. Skin exams are just awful as the doc should look everywhere.

The electrode placements go around the left breast. He should have taken your request into account, and placed the electrodes from the bottom of your bra, but I'm doubting he did it to leer at you.

As for why the female nurse didn't move your bra...I'm guessing the male nurse went out and told her what happened so she didn't touch your bra. The electrode placement was then less than optimal but worked.

I don't mean to sound negative, but do you have some sort of trauma in your past?

I think from now on, you should always request a female immediately. If you are going to be examined by a male doctor, ask to have a female team member present so you feel more comfortable

I've always had my EKGs without a bra. I also had an echocardiogram (an ultrasound of the heart) with a male technician which required me to remove everything from the waist up. He asked if I wanted a female chaperone but I felt very comfortable with him so I declined. The point is, unfortunately, that many of these tests must be done with personal areas revealed. Electrodes must touch the skin and there will be tests where you will not be able to keep your undergarments on. There's no getting around it. I'm not sure what the guidelines are in the US, but in Ontario, it is your RIGHT as a male OR female patient to ask for a nurse/chaperone for procedures involving breast, pelvic, rectal examinations etc, even if the person performing the examination is the same sex as you. Alternatively, you may have a family member sit in if you and the physician are comfortable with that. I'm sorry this was such a traumatic experience. Next time, you should immediately ask for a female assessor or, if one is not available, a female chaperone who can sit in on the procedure with you. If at all possible, you can also research in advance the nature of the test that you will be undergoing, so you know what would be considered standard procedure. Obviously in the ER you may not have the opportunity to research every procedure you might be required to undergo, but in general, if you know what is standard and what is always done for a particular test or exam, as well as how one should generally prepare for the same, perhaps you will feel more comfortable.

I just had an EKG done and they had to lift my boob up and I had no bra on. I think you are being a bit paranoid, maybe this is something to talk to a professional about so you can better understand the medical industry. I am sure this man was doing his job and would take offense to accusations.

I have many male nurse friends, they work very long hours and deal with many people, some who are horrible and mean to them. The last thing they think about is boobs and vaginas to check out.

Andrina - I agree with Vanessa. This fear needs to be discussed with a professional.

I think what we need to consider here is that some of us are just more sensitive and embarrassed to have what we consider our private parts revealed.There is nothing wrong with that. It is a good idea to let the person working on you know this. They will do all they can to make you more comfortable. I have always asked for a female to be in the room. Whatever can be done to make you feel better should be done. It doesn't matter that it is just a job to them. Our modesty and need for privacy prevail. To think a person needs counseling because they are modest is foolish. Also it will help to have they explain what they are doing and why.

Judy,

You raise a good point. There are vastly varying levels of privacy/modesty and obviously on a forum like this, issues such as culture or religion aren't generally known and don't usually come up. In short, we don't know the circumstances.

That being said, I stand by the advice I offered previously - many tests and surgeries simply MUST be done with certain areas exposed. That is why it is important to understand what might be involved in a test, so you can be prepared, not feel as if you are being treated differently than any other patient, and certainly not feel as if your privacy has been violated. Again, in many jurisdictions, it is the patient's right to have a chaperone. In the future, Andrina should always ask for one BEFOREHAND so to avoid any confusion or misunderstanding. Not to mention, ask questions about the procedure and tests being administered. You'll find that many practitioners are happy to explain things. (I always ask what is being done, administered, and why, etc, but then again, I'm a bit of an information junkie so that's just me. ).


I would add, too, that sometimes procedures become so routine to healthcare practitioners that they forget some patients may feel uncomfortable in these circumstances. I highly doubt there was any malintent.

I don't think this particular situation in any way warrants a complaint, but then again, I was not there. However, I still feel that having the correct information in advance would have prevented misunderstanding and allayed many of the concerns.

As a health care professional I probably am biased, but maybe my input could be helpful.

Being more modest than others is not unusual, but fearing sexual abuse during medical procedures most definitely is. Whether counseling is recommended or helpful in this particular situation is purely up to what the original poster needs or wants. I don't think it is foolish to suggest that this is a more serious problem than simple modesty or embarrassment.

When you come to the ER, you have to expect to give up some of your control, otherwise they cannot do their job. This does not mean you should be put on display or have your privacy invaded without good reason.

But, here is the thing. You, as the patient, are the only one who has advance knowledge of what your fears are. You cannot assume that people going about their business should anticipate that you have more fear of exposure and possible molestation than the average person. Most people trust their providers in the clinical setting to do what is necessary.

To properly place electrodes for an EKG, they are supposed to count rib spaces and place the electrodes accordingly. This is to have consistency with all EKGs, so the cardiologist can determine if slight changes are signifigant. Ordinarily, this means exposing the chest all along the breast bone and under the left breast.

If the nurses seem impersonal, just keep in mind that they are focused on their work. Some nurses are better at being a calming influence than others.

So, it just makes sense to request in advance to have only female care givers. This may delay treatment, but that seems to happen anyway. As to whether you can report or file a complaint regarding this nurse, of course you can. It is doubtful that the hospital will find wrong doing, but it can be a good learning moment for the staff regarding how to best handle these situations with more sensitivity. It could have been handled better, to avoid you feeling abused and the nurse feeling accused of something criminal.

Jan

I had a problem with a doctor when I was 18. I did nothing and told no one about it and I still believe there are medical professionals that cross the line and get away with things like it. When you hear about cases it usually involves many women complaining. That is why you see nurses in examination rooms these days, not the case back when I was a young lady.

I gave birth at 22 to our first child, back we still did so in a delivery room. Right after I was wheeled in 4-5 extra people came in with my doctor. He said, "I hope you don't mind I have a few medical students with me today". I wanted to said that I did mind and that he had more than a "few" medical students with him but I said nothing. He didn't realize I was embarrassed, he and they were use to it but I wasn't. I think it motivated me as I pushed her out in one contraction!

Fast forward, I needed an ultra sound after a mammogram. FYI, I've never seen a male mammogram technologist. A man came in and I apologized to him, told him it wasn't personal and requested a female technologist. I have never had a male masseuse either because I would feel uncomfortable.

Call me a prude, call me rude and call me a grandma. I don't see anything wrong with requesting a female over a male in these cases. The male nurse didn't explain the medical reason the EKG required the Andrina's bra removal and in any case she told him she felt uncomfortable and he should have gotten a female nurse in the first place. That is why they have us change into medical gowns in private rooms, pull curtains around us and put us in private rooms during examinations, for privacy and to make us feel comfortable.

I had no problems with any of my other male medical male medical professionals, particularly after my j-pouch surgeries - especially the medevac guys that started my IV line, when I was dehydrated, in the middle of the night after every RN on the floor that night couldn't!

I'm older now and you've got to admit it we've have had a disease in the worst area of the body. I still am not comfortable discussing it all with just anyone, female or male. Put us all in a room and I'll show you my scars

Each to their own and medical professionals should have a little sensitivity training too.

Thank you all for your input. Lots to think about.

I don't mind if my GI sees my bottom. He has scoped me many times. I have a female gynecologist and I have no problem with her. I would never see a guy gyn though.

Today I'll have an echo done to my heart (I'm having chest pain still) and I called beforehand and asked for female technicians and if I can leave the bra on. They agreed to all of it. So this time there won't be hassle. So thanks for that advise.

It might be paranoid but even if I had better self-esteem I would totally stand by this. I was bullied in the past because I'm underweight, bony and have a small chest. They said they'd vomit if they ever saw me naked. So maybe that's the trauma, I don't know.

Thanks to everybody for letting me talk about this. It really helps.

Life is full of trade-offs. It's important to be aware that the information from the study (echocardiogram, EKG, etc.) may be less useful if the equipment can't be placed where it ought to go. Just because you have the right to demand certain conditions doesn't mean they have no consequences.

One more suggestion. If you are adverse to having medical students, and a parade of other levels of professionals in training from witnessing or paticipating in your care, you should avoid teaching hospitals (although they are often described as having some of the best and most up to date care standards). When you consent to treatment there, there is generally a clause indicating that students may be involved in your care. Even private hospitals have students, just not in such large numbers.

I am not saying it is a good or bad thing, but just a reality. Another reason to read those papers you are signing and discuss your preferences up front.

Jan

I'm glad to hear that you are being proactive and requesting the female nurse/etc. It's very important to get those chest pains checked out.

I don't like being treated by medical students. I actually left one primary care physicians office and went to a new primary because there were always a slew of medical students at the old one. I would typically get questioned by the med student first then the doc would visit. I was just done with it. I'm no longer a "simple" 30 year old. I have too many problems.

I also had a pelvic exam one time done by a midwife. It hurt sooo much. Now I had had pelvics for five years at this point so it wasn't my first time or anything. I almost passed out. Now the only person allowed to touch me is an experienced Gyn.

I just wanted to add that, even though I haven't seen a picture, I'm sure your body is fine. Teenagers and kids can be cruel. Even some adults are idiots. When I was younger, people used to tell me I was so ugly. Now I'm told that I'm "beautiful" but the comments made when I was younger still rather bother me. I'm also rather small chested so you definitely aren't the only girl out there!

I hadn't been a patient in a hospital for years and I don't recall ever being given a bed bath while a patient......until my proctocolectomy. I was barely coherent (from pain meds) when a male attendant seemed insistent on offering me his services to bathe me. Bells and whistles went off inside me and I said, "No, thank you." When a female nurse came in I explained that I only wanted a female to bathe me. Wish granted. I didn't feel this way about any other nurse or attendant at this hospital. Something just rubbed me the wrong way when this particular male attendant was so persistent. Most of my physicians and surgeons are male. They don't bother me at all.

I had a female nurse that made me feel that way and she made me cry on top of it. The only one. She came back into my room later on and asked if I wanted her to not be my nurse the rest of my stay, they honor requests like that at the hospital. I said it wasn't necessary. She saw through me, I'm a bad liar, as she never was my nurse again. Not for my first, take down or 6 months later incisional surgeries. I remember her name and said hi to her when I saw her while walking the halls. I don't remember all of the good nurses names!

It's best to go on your instincts. Don't get on the elevator alone with someone if your intuition tells you not to.