How can I explain this to my doctor...Hygiene Issues

I am 5'2" almost 300 pounds and I have short arms short legs, my stomach hangs past my private area, and my back side is very very big. My problem is that I have such a hard time washing and wiping that I am pulling all of the muscles in my back. Both my low back, mid back and my shoulders feel like I'm pulling them out of socket from the struggle. I haven't mentioned how bad it is to my doctor because I just don't know how to say it in a way that I can still preserve my dignity. I have an appointment with him on Thursday and have decided that I am in too much pain not to mention it to him. He has already given me a letter of medical necessity refering to my back pain, but I feel it's an emergency now. What can I do? And does anyone know how I can ease the discomfort in the meantime? Thanks.

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