The Doctor Will See You Now: Recognising My Hiatal Hernia

When I was 16, I started waking up during the night with crushing, debilitating pain in my chest. I would experience it maybe three or four nights a week. This pain left me gasping for breath, it kept me awake for hours — which as someone who’s had chronic insomnia since I was a small child, isn’t ideal — and sometimes was so intense it would make me sick.

This pain wasn’t normal, consistent with anything that I could identify and was completely dismissed by my doctor. A year or so previously, I had been diagnosed with an anxiety disorder. Ever since my anxiety diagnosis, I’ve discovered a whole host of things can be blamed on your mental health with no real follow up. I am intensely aware of the physical impact that my anxiety and sadness can have on my body, but I was certain this was not that, there was something wrong with me. However, I was told that this pain was probably some kind of panic attack.

It didn’t really seem to concern my doctor that these so-called ‘panic attacks’ meant that half the week I was going to school absolutely worn out because I’d barely slept or that I was up half the night in pain. I tried again a few years later when I joined a new GP surgery once I was at university to be told a similar thing: it was probably my anxiety.

This pain was finally diagnosed last year, when I was 28. Twelve years after the pain started. It turns out that I had a hiatal hernia, which is basically when your stomach bulges back against your oesophagus. Your oesophagus has a small opening that should close off to stop food and stomach acid etc to stop it leaking back into your oesophageal tract. Mine wasn’t doing that and my stomach acid was basically burning me.

Throughout my master’s degree I had this pain near enough every night. And I started to doubt myself. Maybe it was my anxiety, flared up by stress? After all, I was juggling full time work with a masters: I was working in hospitality and spending all my free time in the library, leading to never really eating proper meals and largely existing on A LOT of coffee.

Last winter, there was a weekend when I was staying at my partner Scott’s house, and I woke up about an hour after I’d fallen asleep and the pain was here, but it was worse than I’d ever had it. It felt like lightning had struck my chest and I was being ripped in half. I couldn’t stop being sick, I could barely stand, I was gasping for breath, my whole body was numb, and I had no idea what was happening to me, but I was 800% certain that it was not anxiety. I wasn’t sure what to do but I knew that I needed to be seen by a doctor but equally, I was terrified that I would be dismissed as ‘just having anxiety’. Unsure of what to do, Scott bundled me into an uber and we went off to St Georges, his local A&E in Clapham at 3am on a Friday night — if you’ve ever watched 24 hours in A&E, this is the hospital where it’s based.

We didn’t get off to a great start; the admittance nurse wrote down on my forms that we’d come in as I’d been sick… but after explaining to the next nurse what was actually wrong, I had all the tests done and then we waited. We waited for five hours. I was finally seen at just gone 8am, spending the night running back and forth from the waiting room bathroom to be sick with pain still vibrating through my chest.

Honestly, I’m not mad, in A&E, you want to be seen last.

Finally, I saw a Consultant and this man finally actually saw me. He saw the pain and he saw beyond the anxiety diagnosis. He diagnosed it as a hernia in my oesophagus or a hiatal hernia, gave me some medication, he wrote a letter to my GP recommending a course of treatment and some tips for managing it in the meantime. That doctor changed my life. The night is a haze memory of pain and terror, I couldn’t even pick him out of a line-up today, but he honestly changed my life.

I still very occasionally have a night of pain, although it’s never been as bad as ‘that night’. It’s hard to believe that I spent twelve years, experiencing almost nightly pain and the way this pain leaked into the rest of my life: actually making my anxiety and mood worse, because I was tired and irritable and it impacted my concentration as well as numerous other aspects of my life. Unfortunately, this isn’t the only example of my medical problem being diminished or dismissed as anxiety, but it’s definitely the worst case of it I’ve experienced.

Maybe the problem isn’t universal or personal. Maybe spending years fighting to get something I know isn’t caused by anxiety recognised and diagnosed makes me the exception, and usually these symptoms add up to anxiety. Or from talking to my friends and seeing both of my sisters struggle to have recent medical issues investigated, maybe it’s that I’m a woman. Unfortunately, my pain is often simply just taken less seriously than a man’s would be. A paper written for the World Health Organisation, Gender biases and discrimination: a review of health care interpersonal interactions , revealed that ‘gender, either alone or in combination with other determinants of inequity profoundly influence interactions between health care providers and patients.’ And that’s the case across the world. So female + anxiety = an often-unsatisfactory experience.

So, what do you do when you don’t believe that your doctor will take you seriously because of your gender or a pre-existing condition? When you’re worried will tell you that every ailment is caused by your anxiety? That you’re basically doing this to yourself by worrying all the damn time. Or that being a woman is uncomfortable, so you better get used to it. You just don’t go to the doctor.

I have become so convinced that I have had anxiety, something which impacts every part of my being, and I am also so tired of everything that’s wrong with me being blamed on my anxiety. It’s like a see-saw that just isn’t fun, never has been fun and honestly, is exhausting. And ultimately, it results in trips to the GP causing panic attacks because I’m so worried about not being taken seriously. Excuse me, I’d love to get off this ride now please!

At the end of this ramble, there isn’t really an ending. I’m better at advocating for myself than I was, I have a support network that will come with me, when needed, to my doctors appointments to insist that my medical problem is taken seriously. Thankfully, after a mere twelve years, my chest pain had a diagnosis. But I can’t tell you where we go from here; I can’t tell you how to get doctors and healthcare professionals to take your complaints seriously and not apply their preconceptions of anxiety or mental health or femininity. So instead, this story just stops, rather than ends.

It’s unsatisfactory and unfinished, but sometimes, unfortunately, that’s just how life is.

Originally published at https://theeverydaymagazine.co.uk on September 9, 2020.