Despite my anxiety, I can usually be cheery and talkative with nurses and doctors. Too talkative, often. They aren't generally interested in hearing my comments and weird style of joking. The real problems happen when they send me back to the waiting area during the visit. In July I was at an eye doctor and they dilated me. The doctor then brought me to the waiting room and said that they'd call for me in 30-45 minutes.
At this point, I had already been in the office for a long time. Not having my contacts in prevented reading. I didn't have headphones with me. Sitting amongst the other patients, with the TV blaring, wasn't a good option, so I paced around the elevator area, listening to an audio book on a lowered volume. The light was also too bright, and this was before I began to be more comfortable with putting on sunglasses indoors. As the time passed, I grew more frustrated and upset. It was with some strength that I eventually went to the front desk to remind them that I was there.
They brought me back in after 85 minutes. Well before this time, talking had become extremely difficult. (I've never had a full shutdown, where it wasn't possible to speak.) The same doctor, who had seen me chattering earlier, knew that something was wrong. She chalked it up to me being tired, which wasn't a good-enough explanation for an adult acting as I was then. I managed to whisper the words necessary to get us through the rest of the visit, but I didn't speak to anyone for the rest of that night.
If the same thing took place now, I would have tried communicating by writing. That I could do. I've become more bold at letting others know when I'm in distress and more open to being seen as disabled. I haven't yet checked out the AAC stuff that members here keep talking about, but I will soon.