little_tippler

__________________
Whether we write or speak or do but look
We are ever unapparent. What we are
Cannot be transfused into word or book.
Our soul from us is infinitely far.
However much we give our thoughts the will
To be our soul and gesture it abroad,
Our hearts are incommunicable still.
In what we show ourselves we are ignored.
The abyss from soul to soul cannot be bridged
By any skill of thought or trick of seeming.
Unto our very selves we are abridged
When we would utter to our thought our being.
We are our dreams of ourselves, souls by gleams,
And each to each other dreams of others' dreams.

Fernando Pessoa, 1918

ngdawg

Is it possible for you to become an activist in the scope of women's health?
No one is condemning anything except the A*** that dare to call themselves doctors.
Cultural and religious roles in women's health are being addressed quite actively and in many arenas. What needs to also be addressed is the issue of separating those cultural and religious beliefs of sexuality from the mindset that somehow a pelvic exam is a sexual act. It's sad that that is what is happening. Regardless of whether it stems from mental health problems or how one was raised, simply validating another's feelings isn't enough. Women are dying and/or being exploited all over the world because no one "helped" or taught them this doesn't have to happen.

Did you know that women in parts of Africa that suffer aftereffects from childbirth that cause uterine wall rupture are being ostracized and disowned? The genital mutilation of young girls is widely reported on and activists are hard at work to stop this horrendous ritual, but very little is said about the women who, when giving birth, suffer a condition that tears the wall between the vagina, urethra and sometimes the rectum, causing bladder and/or rectal incontinence. The condition, called Obstetric Fistula, is almost unheard of in industrialized countries. These women are not treated for the condition, but rather tossed from their homes, disowned, their babies taken away. They can not have more children and no man, even their husbands, would want them.
It occurs because the women don't get basic ob/gyn care. Poverty as well as cultural leanings have everything to do with this.
Women like Dr. Catherine Hamlin aren't just writing books and offering support, they are doing an impossible task: treating these women. The surgery to correct Obstetric Fistula is simple most of the time.
But more has to done and that comes through education. Women need to be educated that a pelvic exam, obstetrics and gynecological medicine is NOT sexual, is NOT anti-religious or anti-cultural but life saving. And they have to know that they have the power over their well being, including getting quality medical care.

Julia51

I just wanted to mention that women in Australia and the UK DON'T have routine pelvic exams - they are considered unnecessary in asymptomatic women and in fact, my GP said they can be harmful...(false positive, unnecessary further testing, discomfort, anxiety - low clinical value)
I was surprised to read that US women are expected to have all these invasive annual exams...

In Australia - women are offered cervical screening every 2 years - starting 2 or 3 years after they start having sex...but the two yearly internal has been criticized as too often and many doctors ahve moved to 3 or 5 yearly intervals.
Too frequent screening exposes women to lots of false positives and unnecessary follow-up - colposcopy and biopsies, which can cause other problems. (psycho sexual problems, cervical stenosis, problems with fertility and during pregnancy etc)

Many are also critical of testing women under 25 or 30 as these women are more likely to return false positives or have treatment for changes that would resolve without any further treatment. UK now only screens from age 25, Finland and the Netherlands from 30...and these countries opt for 3 and 5 yearly intervals - so fewer women face the anxiety of a false positive. .
It sounds like US women are over-screened - I was shocked to read some US doctors even test virgins!
Cervical cancer is uncommon (about 1% of women) and the Test is unreliable...
Of the 1% that get cancer, one third of those women will have received one or more false NEGATIVES - they may be disadvantaged by screening because they're falsely reassured by the Test and delay seeing a Dr for symptoms - so that leaves about 0.66% of women who'll benefit from the test.
All women and especially, low risk women need to consider the risk v the benefits of testing.
Annual screening means 95% of women will have a colposcopy and biopsies, yet only a tiny number will have any sign of cancer - two yearly - it's almost 78%...(Koutsky)
Sadly, women are rarely given access to complete information - without risk information, you can't give informed consent.
The General Medical Council in the UK has warned doctors about the need for informed consent and now require doctors to reveal they have a conflict of interest (paid to recruit women and to take smears), disclose to women they have a low chance of benefiting from the test and explain they have a fairly high risk of an incorrect test result that may lead to further testing. (the risk varies with your sexual history, age and screening interval)
Cervical cancer is (in almost every case) caused by HPV...
My husband and I were virgins when we married - my GP, after discussing the very low risk of benefiting and the high risk of harm - left the decision to me - no smears at all or once every 5, 7 to 10 years.

Breast exams - doctors have been reminded in the UK and Australia NOT to routinely examine breasts in women under 40 or 45...(false positives, false reassurance, low clinical value, unnecessary biopsies)
I started to have a CBE when I was 45 (every 18 mths or so)
Women are offered mammograms every two years from age 50 - I've decided not to have mammograms - there is lots of worrying research about this test - they can INCREASE the risk of breast cancer, (bruising of the tissue) have a high rate of false positives and unnecessary biopsies and they detect a slow moving cancer (Ductal Carcinoma In Situ) that roughly 40% of older women have to some degree - in most cases, DCIS will never harm you - however, once biopsied, it can become aggressive and once diagnosed, the breast usually comes off (the doctor fears liability)

I think it's really important for women to do their reading - it's the only way to safely negotiate the medical world - and US women are IMO being put through lots of unnecessary invasive tests and being overscreened...exposing yourselves to harm!

BTW the only exam required for the Pill is a blood pressure check - there are lots of articles on-line critical of the US practice of holding the Pill until women agree to unnecessary exams.
Good luck everyone....anyone interested should look at articles by Prof Michael Baum, Dr Angela Raffles (her research showed that 1000 women need to have regular testing for 35 years to save ONE woman from cervical cancer!) - also, L. Koutsky Cancer prevention, Fall 2004, Issue 4 & RM DeMay "Should we abandon pap smear testing" Jnl of Clinical Pathology 2000...

ametc

My friend has been going to annual cervical exams since she was 13. Mostly because she was sexually active at that age. (Yeah young.. but at least she was smart about it.) She ended up having cervical cancer at the age of 16. She's never had any type of STD before and it doesn't run in her family. They caught it in the nick of time and she's been good ever since.


I'm very sensitive down there.. but I actually don't mind going to see a gyno.. guy or girl. I know there are some sickos out there... so I judge the doctor by how long they take looking down there compared to what they see.

First two visits were veryyy quick. I lied down and spread my legs and scooted down a little and they lubed me up and stuck the metal thingamajig in and widened the thingers (I dunno what it looked like or what it was called.. I'm going by feel).. they took a light and checked it out then lubed it more and stuck in two or one fingers for like ten seconds. They looked up at the ceiling or towards the ground while feeling around. Then.. they took everything out.. let me sit up.. told me everything was A-OK. Oh.. they also explained everything they were doing as they were doing it.

Most recent visit took a bit longer because she saw and felt something.. and results came back as low grade cervical cancer.


Not saying that there aren't doctors out there that are sickos.. my sister has met one that was drunk at a party she went to. He said some really vile things about patients he's had before.


But, if you really feel uncomfortable doing it.. then ask your doctor to tell you what he's doing or talk about something else to take your mind off your vagina.


Also.. the guys that don't go to the doctor unless an ambulance has to take them are dumbasses and those kind of men end up dying all because they didn't want a scope going up their ass.

Anonymous Member

Nothing would ever turn me on during a pap test because I hate them.

I do agree totally about being uncomfortable with a nurse being there. When women go for these things they often have a lot of questions to ask their doctors and it's embarrassing to have an audience, so I don't ask them.

In fact, even though I do have cancer, I HAVEN'T HAD A PAP TEST IN YEARS simply because I don't like the invasion of privacy. I think it's terrible that women are treated like children who can't be trusted (or who don't trust their doctors). I think it's demeaning and I feel women should have a choice about whether or not they want an audience.

I doubt men would tolerate a female doctor bringin in a male while he is having a prostate test and I don't understand why the medical profession is so much against WOMEN BEING GIVEN THE RIGHT TO CHOICE! This is an ultra ultra sore point with me and it makes me literally HATE the medical profession.

Shaindra

They bring in the nurse as much to protect you as to protect themselves from accusations. They should also have time to spend with you *clothed* to discuss any issues in private.

__________________
"Never regret something that once made you smile."

Julie25

They should but they almost never work that way.

The way it works in most office is that the woman books the appointment six months in advance. When she arrives, the nurse rips the paper off of the table and tells the patient to get undressed and get on it. Then the doctor comes in and does the test. Then he leaves while the patient gets dressed. I have never in my life seen a doctor return to talk to the patient after that. They are all very rushed and have many patients to see, so they don't come back for Part II of an appointment. Even if one ever did come back I would have wanted to discuss things with him BEFORE, not after!

I realize that there are probably more doctors who are fearful of neurotic women accusing them of wrongdoing than the other way around, but still, WHY CAN'T WOMEN BE GIVEN CHOICE? Would this cause major serious difficulties? Would it be an extremely serious crime to give women a choice? What's so terribly wrong with CHOICE?

Being liberated I believe ALL women should be entitled to choice and not just a few, especially with regard to their own bodies. After all, their bodies belong to them and not to anyone else.

I can understand also that many doctors would be disgusted and/or feel threatened by bold, overly-sexed patients. I would feel the same. I just wish there was a way to give everyone rights without limiting them to only the doctor and one particular type of patient. If only some imaginative person could think of an ideal solution!

Possibly the best, if male doctors are fearful of women, is to put thousands more WOMEN through medical school. While I prefer male doctors because I'm self-conscious in front of women (knowing they like to compare to themselves just as men do), given the choice I would still rather go to ONE female doctor who didn't require an audience than to one male doctor who did.

What's stopping me from doing that?, you might ask. "The shortage of female doctors!"

Julie25

..

Julie25

Thanks for your article Julie51! Wish I had read it before they discovered my extremely slow moving DCIS. I had a segmentectomy about two years ago. I refused radiation and chemo after that because I didn't like the thought of either. That entire process was tough.

First I got a biopsy two weeks before the operation. The needle in that first biopsy was like a knitting needle with a hole in the centre. If you want to see what it looked like, look up the VERICHIP on You Tube. It was exactly like the needles they use to implant microchips.

Because I read about it beforehand I realized they put such things in women’s breasts to mark the spot of the operation. (Guess they figure the breast is the size of a football field). Not wanting that, I asked them to please not put them in. They’re not called microchips anymore by the way. They’re called titanium breast markers. They promised they wouldn't put any chips inside. Hopefully they told the truth!

Although the biopsy itself wasn't too painful the inflammation that followed for the next couple of weeks was bad. I described it as a swollen red hot VERY ANGRY breast that had been suddenly awakened from a comfortable peaceful sleep! The wait for the operation seemed much too long at that point, yet that was probably good because it allowed the swelling time to go down.

After a couple of weeks I had to go to get wires put into my breast so the doctor would know where to operate. Then i headed to the hospital and waited for awhile. it was even more sore then.

I guess they were telling the truth about the chips not being put in as I requested; otherwise i probably wouldn't have also had the wires put in. But come to think of it, if I didn’t have chip put in, why did they need to use that huge knitting type needle with the hole in it? I still don't understand everything.

The next day they wanted to inject some radiation chemical (Techtenium I think it was called) into my breast before the operation. By then I was afraid of all that breast mauling, feeling that if I didn’t have cancer before, I was sure headed for it now, so I declined at the last minute.

They then asked if they could at least inject blue dye so they could find the lymph nodes. Since I escaped the conscious pain of the third one, and they would do this while I was “unconscious,” so there would be no pain, I reluctantly agreed.

Eight hours later I woke in comfort in a beautiful vibrating bed but with tubes in my nose and a huge patch over my breast for external stitches. After that I dosed off immediately and fell asleep for another 8 with the same breathing tubes as well as well as morphine draining into my arm. The operation was at 2 PM and I woke permanently at 8 AM the following day -- in other words, 16 hours after the operation. Then they said to go to the bathroom to get rid of the blue liquid. That wasn't easy because the anaesthetic made me forget how and without drinking water all night, there wasn't much to get rid of. I felt good after that and wanted to go home even though they said I could stay another day if I wanted. At 10 AM I was felling so well I left.

They had great news that day. The two Stage-1 cancer lumps they removed (each about an inch) had been very slow growing so they hadn't spread to the lymph nodes. Wow! Great! Later though, I started to think, "what if it hadn’t been cancer at all, and they just didn't have the heart to say so after all of that pain and trouble?"

Seriously though, it had to be. Fortunately I had received a digital mammogram before all of this took place. That meant it was possible to purchase the pictures (CD) for $30 and take a good long look at (which i did for nearly a year before the operation because i couldn't make hide nor hair of it and could find no good explanations on the internet) . Finally I took it to the cancer society and said, ‘if you think this is cancer, please show me in this picture why." The nurse was fantastic and explained the difference between cancer and a cyst. After that there was no doubt. Cancer is so ugly in a picture compared. Had I not had plenty of time to absorb that CD in detail, I likely would never have believed it was cancer and would most certainly have refused the operation.

Once I got home and the morphine wore off the pain was unbearable! They had given me about 10 extra strong pills and I started popping two at a time. My breast was swollen and flaming red so I drove to the clinic in fear to have it checked out, forgetting I was drugged to the eyeballs.

It was tough functioning on my own. By the third day I had accidentally torn out two stitches merely by attempting to put shoes on. Of course I couldn't see the stitches because they were internal but the tearing could be felt, and liquid ran down the inside.

By then my orange-sized breast was about five times bigger than normal! It was only then that I realized I had no drain tube! When I called, they said it wasn’t an oversight. It was just the way they did things sometimes. So women should always ask about that beforehand.

Now the breast was so filled with water that I couldn’t carry the weight. I should have gone to the store in advance to not only purchase the most solid bra they had, but also one with a cup size about four times bigger than normal! There was no way a normal bra would hold all of that squishy weight up! As I moved, it would go sqwish, sqwish. it was so painful I spent most of the next few days in bed.

When i was up i walked with my arm against my breast. This continued for nearly 2 weeks for about 8 hours a day during waking time. Today when I see a woman walking with her arm against her breast I know she has just had a breast cancer operation.

The 4-1/2 inch wound from that operation is still red and sore, although the three inch one under the armpit has long been healed. Before the mammogram i had no pain whatsoever. But I think it's starting to heal now and the pain will be gone in a few months.

It's been about 1-1/2 years since that operation and i still haven't gone for another mammogram, although I do worry constantly that all of those treatments should surely foster a much more aggressive cancer in the future.

I have also since developed centre chest pain which continues for several days a week. Hopefully it's not heart damage from the blue dye or anaesthetic (After all, I did sleep for 16 hours afterward and was so tired it was an effort to breathe at all, which is probably why the breathing tube was there. With a healhty night time rate of about 40 beats per minute, who knows what the pulse reading was at the time.

I don't know if I've done the right thing. If another woman asked for advice I wouldn't know what to say. But if i had to do it over again for my self, i might have chosen a double mastectomy instead. Segmentectomies or lumpectomies generally require more painful preparatory work and have a higher risk of coming back. They also generally require more radiation (for the innocent stage of cancer I had). Again though, i did refuse the radiation and chemo.

By the way there was no detectable lump before all of this started. The entire discovery happened when my doctor insisted I go for a mammogram after not having had one for a few years. He did know I had calcifications several years earlier though.

I haven't had a mammogram since that operation about 1-1/2 years ago so I don't know if it has spread. Sticking an inflamed breast under a mammogram sounds quite silly to me at the moment -- insane to be honest. Nature never designed women's breasts to be treated so brutally, especially wounded ones.

Cancer itself doesn't hurt. It's the procedures and operations that hurt for months or years! Whether those things in themselves cause more aggressive cancers, I might not know for awhile, but the suspicion is definitely there. When you get cancer, your choices in treating it are much like playing Russian Roulette.

Twenty2

I realize that this is an old thread and this post will probably go unnoticed but whatever... I feel sooooo much better finding out that I am not the only woman that feels raped or violated or whatever after getting a pelvic. I've been on birth control for 4 years and this is the first time they insisted on a Pap test and a pelvic. I've only ever been with my husband and he has only ever been with me meaning neither of us have ever been exposed to HPV which would cause cervical cancer in someone in my age group (22 years old). My husband and I are not ready to start a family so we have been using birth control (we don't want to use condoms). The doctor refused give me a Rx without an exam claiming his malpractice insurance will not allow him. I am 100% willing to sign a legal waiver stating I am aware of the risks if I were to have cancers and the effect that taking supplemental hormones can have. I did research in college on breast cancer cells so I am NOT ignorant. Even with my husband there I cried and shook the whole time but at no point did the doctor ask if I wanted him to stop. I felt soooo powerless and humilitated. Afterwards he asked me if we were still friends... I am pretty sure that certain rapists use the same line once they too have "finished". At this point I don't even want my husband to touch me, so much for needing that birth control.

Eliz52

Twenty2,
If you and your husband were virgins when you got together, you need to be very careful with cervical screening. You accept high risks for no benefit - cervical cancer is linked to HPV, a sexually transmitted disease. (as you know)
Your age worries me as well...no country in the world has shown a benefit testing women under 30, but testing young women produces lots of false positives which means fear and worry while you wait to re-test or referral for colposcopy and usually some sort of biopsy - cervical damage can leave you with problems (especially after unnecessary LEEP and cone biopsies) cervical stenosis - infertility, infections, endometriosis and may require surgery if the cervix is scarred shut, cervical incompetence - miscarriages, high risk pregnancies, premature babies and more c-sections. 1 in 3 pap tests are "abnormal" (false positives) in young women caused by the pap test picking up normal changes in the maturing cervix. (or transient and harmless infections) CC is very rare in women under 30 and testing usually misses the very rare case anyway...these women get false negatives. (usually because the very rare case in a young woman is an adenocarcinoma and the pap is bad at picking up this even rarer form of cc)
Due to over-screening (annual testing) and including young women - the States has a very high lifetime risk of referral - 95% - almost all are false positives. (DeMay article)
The lifetime risk of cc is 0.65% but with no randomized controlled trials we'll never know "for sure" if anyone is actually helped by pap tests, if they are, the numbers are very small, less than 0.45% - after you take off the false negative women and factor in the other things that are naturally reducing the cases of cc - better condoms, more hysterectomies, less STD, better hygiene, fewer women smoking...
Anyway, many countries do not test sexually active women before 25 or 30 and then only 3 or 5 yearly to 50, 55 or 60, but in your case...you need to be VERY careful. (American doctors even test virgins from age 21 which makes no sense at all)
I'm a low risk woman and have always declined pap tests - the risks are too high for a near zero risk of cc. A high risk woman only has a remote chance of benefiting from pap tests.
I believe your doctor was dishonest with you...pap tests are an elective cancer screening test and have nothing to do with birth control. I'd report him and even seek legal advice.
Dr Robert Hatcher from the "Managing contraception" site has some harsh words for doctors who "hold" scripts. Also, see: "Women after birth control get unneeded pelvic exams" WSJ
Sadly, I can't link articles at the moment (this is my first post and you need 15 posts under your name before you have linking privileges)
The article by Dr Hatcher - search his name plus add the words, pelvic exams and birth control and it should appear....

Routine bimanual pelvic, rectal, recto-vaginal and breast exams are not recommended by our doctors - they are of poor clinical value and risk your health - they partly explain your high rates for hysterectomies, cervical and breast biopsies, other procedures and even surgery. (removal of healthy ovaries etc) See: "Questioning the value of the routine pelvic exam" and comments by Dr Carolyn Westhoff.

I think doctors who mislead and coerce women into pelvic exams or pap tests need to be challenged and reported - I know the practice is widespread in the States, but there are many American doctors working toward change.
You'll find some great references and discussion at Dr Joel Sherman's medical privacy forum under women's privacy issues - see research by Dr Angela Raffle, Prof Baum and Dr DeMay. You might also like to share your story at Blogcritics and "Unnecessary pap smears" - which has more than 4500 posts from concerned women.
Hope this information helps...

---------- Post added at 07:10 AM ---------- Previous post was at 07:04 AM ----------

The other important reference for: Sexually active women under 30 don't benefit from pap tests (only American doctors test women not sexually active - it makes no sense at all and risks their health) - See: "Cervical cancer screening" in "Australian Doctor" 2006 by Assoc Prof Margaret Davy and Dr Shorne - it's a download.
Angela Raffle's research rocked the UK in 2003/4, "1000 women need regular smears for 35 years to save one woman from cervical cancer"...she also talks about the high numbers of false positives produced by young women - 1 in 3 smears.
You'll find the reference in the British Medical Journal at Dr Sherman's site.
See commentary at, "Why I'll never have another smear test" by Anna Saybourn.

Eliz52

Julie25, What an ordeal...
You might be interested in listening to a 35 minute lecture at the Medphyzz site - given by Prof Michael Baum recently at UCL and called, "Breast cancer screening: the inconvenient truths"...any woman considering mammograms should listen to this lecture. Prof Baum is a senior UK breast cancer surgeon who helped set up the first breast screening clinic in the UK...he knows about screening and now has some SERIOUS concerns. Also, the Nordic Cochrane Institute were so concerned at the misinformation being given to women that they produced, "The risks and benefits of mammograms" - it's at their website.
Make up your own mind - I've passed on breast screening and CBE's are not recommended here, they don't help....I practice "breast awareness" devised by the late Dr Joan Austoker - simply taking note of the look and shape of your breasts in the mirror every morning after showering. Breast self-exam has been out for years - it leads to excess biopsies.

chinese crested

I dont understand why they put you through this. I am in England, where we get smear tests at a certain age - but not the horrible stuff described by some of you ladies. I did keep going back to my doctor because I had pain after having a coil. It was not taken seriously. Some years later I bought myself a gynaecologist for xmas. A very nice man, he said a pelvic exam wouldnt show what he had decided was most likely wrong with me. That from an excellent surgeon. Yep I was right, I did know my own body. Because of stuff from the coil being fitted, I ended up having a laproscopy first, and then five hours of corrective surgery. One thinks, a good specialist should know by description if these things, these invasions are necessary. I feel sorry for those of you who feel raped by the medical profession - and I dont think you are being unreasonable at all for feeling that way. I think you need to try and find a good GP - ask your friends for recommendations - its what us old bitches do.
Oh, and if you come across doctors who are particularly horrible - kindly suggest to your sisters, that they might prefer to go elsewhere. Sometimes you have to circle the waggons and protect each other.

Mssmartypants

Hmm, I never thought about it that way. I had a pap smear once at 21 because I was told it was necessary at 21 by the gynocologist even though I wasn't sexually active. I haven't had one since then(three years ago) because it was an uncomfortable experience. However, what you mentioned about other kinds of cancers would be a something to take into consideration. I wasn't going to get my second pap smear until I became sexually active.