Posted by My OB said WHAT?!?.
May
25
Posted by My OB said WHAT?!?.
“Hey, Are You Back For Your Yearly Lube Job?”
“Hey, are you back for your yearly lube job!?” -OB to 17 year old woman in for her second annual exam and PAP in her life.
There are 48 comments to this post.
IN. APPROPRIATE. HUMOR.
Man, I can remember being about this age and going to my GP for menstrual problems and refusing to even undress to have an exam. This would have not only nailed but welded the coffin shut on any confidence in my care provider NOW. I can’t imagine it at 17.
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Was it a male or female OB? If male then def not good. If female, I must admit I would have laughed. You get PAPs at 17 over there? I think you have to be about 25 in the UK before they start doing them.
When I had my first PAP (we call them smears over here, very tasteful!) I burst into tears. The nurse said “what you crying about” I explained that I had been sexually abuse as a child and she gave me a very harsh telling off for ‘not telling her beforehand’! Because, like, I was supposed to erm, walk into the docs and, erm DECLARE IT!!!
grrrr!
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Robyn Reply:
May 25th, 2010 at 10:50 am (Quote)
Yeah, we start getting them once we start menses.
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Sarah Dorrance-Minch Reply:
May 25th, 2010 at 12:53 pm (Quote)
REALLY? I didn’t. Mind you, my parents were religious nuts, and my mother in particular was such a wacktart that she threatened to take me to a doctor in Dayton for a clitorectomy when she thought I’d lost my virginity. (I still hadn’t seen a gynecologist yet for a regular exam, btw. That came with college. The occasion: a yeast infection that, for some bizarre reason, I was afraid to disclose…)
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Katelyn Reply:
May 25th, 2010 at 11:03 am (Quote)
Depends on when you decide to start seeing an OB/GYN. I didn’t get my first until I was 20 right before I got married and that was only because I started on birth control. I hadn’t had any concerns/problems prior to that to warrant a visit. I still saw a (absolutely wonderful) pediatrician until 18.
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Brige Reply:
May 25th, 2010 at 11:18 am (Quote)
I was forced to go at age 12… forced to strip naked, and be completely violated by an ob that didn’t speak any english… I will never ever ever forget the way that made me feel… I will never do that to my daughter, and due to this fear/anxiety I very rarely get annuals now… I think the new recommendation is once every three years…
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Sarah Dorrance-Minch Reply:
May 25th, 2010 at 12:59 pm (Quote)
It’s either every two or every three years, which, if one is not in a high risk group for cervical cancer due to genetics or to possible HPV infection, is perfectly reasonable.
I am so sorry your first pelvic had to be like that. I’m not sure what the point is in starting pelvic exams at the first onset of puberty. Unless there is reason to believe your daughter is sexually active, and thus in need of contraceptives and/or disease screening, there really doesn’t seem to be any benefit.
I too feel uneasy having males perform pelvic exams on me, and will only endure it under duress. I get most of my reproductive care from Planned Parenthood. It’s cheap, it’s gentle, they’re used to dealing with survivors of abuse, they even offer psychological counseling to help work through the aftermath of abuse and rape if you are interested in going (I’m not, I hate opening up my deepest feelings to strangers), and all the nurses and other health professionals are female.
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Robyn Reply:
May 25th, 2010 at 2:41 pm (Quote)
I actually prefer my male OBGYN to what I went through before. I was on TriCare because my dad’s military. The nurse practitioner they would send me to had some sort of problem with her leg and she was in constant pain. I’d go in for yeast infections and things like that and she’d shove the speculum up there, roughly, and it didn’t feel like she used any lube. I’d tense up from the pain and she’d tell me I need to relax. Grew up, got married, and got a civilian Dr with a gentle touch and an excellent bedside manner. Didn’t have any tensing problems with him.
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Nicole Reply:
May 25th, 2010 at 12:05 pm (Quote)
In Canada, we start getting them whenever we become sexually active, and need to have one before they will prescribe the pill. Making women wait until 25 is crazy, I know you have public healthcare, but we do in Canada too.
I am sorry the nurse was rude to you. She could have said it more sensitively that it would have been nice for her to know your history so she would be more gentle; there was no need for a lecture. And besides, what is so hard about treating every woman with a level of respect, sensitivity and gentleness during these exams that leave us all feeling vulnerable, not just the ones who have a history of sexual abuse.
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Kate Reply:
May 25th, 2010 at 12:16 pm (Quote)
I’m not sure ‘crazy’ is the correct way to perceive it. There is evidence to say that screening before the age of 25 is a bit pointless, that’s all. And no, the nurse didn’t have to comment at all, sensitively or otherwise. She could have just been sympathetic. I don’t think we should be obliged to inform anyone at all! Tbh my nurse had done an excellent exam, she just freaked a bit at the after effects and didn’t handle it well.
So in Canada, is the PAP done by an OB, like in the USA, or a nurse like in the UK?
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Heather Reply:
May 25th, 2010 at 1:03 pm (Quote)
Actually, nurses do PAPs here (US), too. Nurses, midwives and GYNs, which are sometimes also OBs, but not always.
We start getting them when we become sexually active, want birth control or if there’s an issue that requires one. That age differs for everyone. I had a fellow high school student diagnosed with cervical cancer and given 5 years to live, so for her, it was already too late when they found it (at 17). I had my first PAP at 18 after I lost my virginity, for an STD screen. Didn’t repeat it until 21 for birth control to finally deal with the endo that should have been caught years earlier (and still hadn’t been caught at this point–wouldn’t be until I was 27).
My best friend’s first PAP was at 26 or so. So it varies widely and there’s no “set” age at which people start going in.
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Nicole Reply:
May 25th, 2010 at 1:47 pm (Quote)
Ok, crazy isn’t the right word, but age shouldn’t be the only determining factor. If there are risk factors she should be allowed to have a test and not have to wait until 25.
I get mine done by my family doctor.
The recommendation here is after 2 negative results in a row, to get it done every 3 years, IIRC. I get them every year since I have a family history of cervical cancer.
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Adrienne Reply:
May 25th, 2010 at 12:08 pm (Quote)
I’m almost 30 and have never had one. US born and raised. I don’t see myself as extremely high risk, though. neither my husband nor I has ever had any previous sexual partners.
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Suzanne Reply:
May 25th, 2010 at 10:19 pm (Quote)
me too…well had two done, during routine pregnancy exams, but haven’t followed up with those. was thrilled when one of my midwives told me I didn’t really need to worry about it, since neither of us had previous partners (first medical professional to believe me that I wasn’t a sexually active teenager too…)
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Becky Reply:
May 25th, 2010 at 12:25 pm (Quote)
I got my first one right before I got married too, at 24. I wasn’t sexually active before then, so I saw no need for it previously.
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Becky Reply:
May 25th, 2010 at 12:26 pm (Quote)
ps–I live in the US.
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KushielsMoon Reply:
May 25th, 2010 at 2:35 pm (Quote)
“How often do I need to get a Pap test?
It depends on your age and health history. Talk with your doctor about what is best for you. Most women can follow these guidelines:
* Starting at age 21, have a Pap test every 2 years.
* If you are 30 years old and older and have had 3 normal Pap tests for 3 years in a row, talk to your doctor about spacing out Pap tests to every 3 years.
* If you are over 65 years old, ask your doctor if you can stop having Pap tests.”
http://www.womenshealth.gov/faq/pap-test.cfm#pap04
Planned Parenthood told me “21, or whenever you become sexually active (whichever is first).
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Emily Reply:
May 26th, 2010 at 8:12 am (Quote)
Thanks for posting the correct info! I was seeing a lot of misinformation here! The new current standard in the US is to start paps at age 21. It should be pointed out that in order to go to paps every 3 years, not only should be be at least 30 and have had 3 normals in a row, you should also not have any new sexual partners (new partner=increased risk for HPV=need for pap).
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Jade Reply:
November 20th, 2010 at 6:25 am (Quote)
Recommendations in Australia are to start having them when you are 18 or sexually active (whichever comes first). They are repeated every 2 years unless you have an abnormal one or a history of cerical cancer/pre cancer (eg my mother and grandmother both had pre cancerous cells burnt off their cervixes so I have to have pap smears every year)
And I think 65 or 70 is the upper age limit here (assuming no new sexual partners etc)
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Sarah Dorrance-Minch had this to say,
May 25, 2010 @ 5:07 am (Quote)
I call it my annual lube job and tune-up, when joking with my friends, but that does not give the health practitioner the right to do the same. Double standard? Absolutely. There are some words and descriptions that are okay when used within an in-group of one’s peers that are not okay when used by outsiders. Ask any member of a minority group. It can be an interesting and lengthy discussion.
Besides, unlike my nurse practitioner (I get my Paps at Planned Parenthood), I do not have to worry about staying within the boundaries of professional demeanor. You want to crack jokes about vaginas, medical exams, etc? Fine. Find another profession, or at least keep your thoughts to yourself when you are on the job.
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What a horrible choice of words! Hope you turned right around and walked out.
I also have my exams done at Planned Parenthood. I have to admit that the OB there (they only have one, its a very small office) is the BEST OB I have ever met. She herself has two small children and loves when I bring my son in and will always have toys ready for him etc. She’s very gentle and seems to make an effort to get to know what my comfort levels are. I have actually asked her if she works at a regular practice and she doesn’t 
. If I had to choose an OB to deliver my next child it would be her!
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I literally gasped when I read that. As bad as the comment is, it’s even worse that it was said to a minor! Hello? A sexually derogatory comment to a teen in your medical care??? Creep.
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Reminds me of my first Pap. I was 16, scared to death, and very pregnant. I had no insurance so had to go through the local health department system- which was so screwed up I didn’t see a doctor until I was almost 7 months.I was laying on the exam table, and the doc walked in. He asked me if I wanted a boy or a girl as he sat down. I told him I didn’t care, as long as the baby was healthy, but I thought it was a boy. He snapped on the gloves and said “I like little boys-( wink) AND big girls.” I was too mortified to move.
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Sheva Reply:
May 25th, 2010 at 10:15 am (Quote)
I literally almost vomited just now, and had to breath and calm my stomach. That is the MOST disgusting thing, and I’m so sorry someone said that to you, EVER, let alone someone who you had just given access to your body.
Oh. My. Gosh.
Ok, I’m stopping now.
Wow. What a creep.
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Chani Reply:
May 25th, 2010 at 10:44 am (Quote)
Oh. Ugh. That’s beyond disgusting. In all seriousness, he should be arrested. And I’m so sorry for you that you had such a horrific experience. That’s a beautiful answer for you to have given, and then a nightmare-ish response on his part. Ugh. I’m really sorry for you.
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Cmat Reply:
May 25th, 2010 at 11:52 am (Quote)
Oh dear I just want to give you a hug right now hun. That’s horrible to deal with.
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Argh! Totally unprofessional and not funny. Speaking of which, there seem to be a lot of comments relating to doctors who THINK they are being funny, when really all they are being is RUDE. Why is that? Have they got a traumatized sense of humor? Are they awkward when dealing with people, which seems like a bad fit with this kind of career? What’s up with that, anyway?
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Jane Reply:
May 25th, 2010 at 12:03 pm (Quote)
Have you read “How Doctors Think” by Jerome Groopman? It’s enlightening.
Some doctors go into medicine in order to help people. We don’t need to worry about them; they’re generally compassionate and helpful and this website hears from them on Thursdays.
There are other doctors who go into medicine because they get to work with technology and equipment, because they have fantastic rote memory, because they like diagnosing problems and like finding solutions. These individuals probably don’t have the people skills to respond compassionately. A patient is a problem in search of a solution. A problem gives the doctor a good feeling and a chance to be a hero. And the doctor may also get to use technology and very sharp skills that most people don’t have, so now he feels emotionally on a pedestal compared to the patients.
So yeah, many doctors are awkward in dealing with people because the people-side of medicine wasn’t what drew them there in the first place.
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Sarah Dorrance-Minch Reply:
May 25th, 2010 at 1:18 pm (Quote)
I wouldn’t be surprised if a lot of doctors are every bit as autistic as I am. What social skills I have come from my being forty years old, and they were learned hard.
I interact with people far more on a social basis than the average doctor because I am a mother, not a professional who has spent ten years sequestered in academia and apprenticeships, then further separated from contact by a long day and heavy workload. I am not a social person. I’m about as social as your average bump on a log. It’s not that I dislike people, it’s that they stress me out. I find human interaction to be positively Byzantine in its complexity, I’m always opening my mouth just wide enough to stick my foot in, I never seem to understand what motivates people around me until long after the fact, and on top of that, I’m naturally introverted anyway and if I don’t have a decent amount of time every day to be alone to recharge, I turn into a grouch. This is probably my worst failing as a mother.
But I was an excellent student, and I always found science interesting, and the human body interesting, and I’ve had perseverations on health issues ever since I memorized my first aid handbook and my father’s army medical encyclopaedia when I was in fifth grade. I’m sure that if I’d done better at maths and chemistry, I would have been steered into med school. Who needs social skills when you are a bright, obsessive nerd?
Maybe it is a blessing that I was terrible at algebra and at balancing chemical equations. And thus never got put on the pre-med track. And that my experiences later in life as an expecting parent taught me that the American approach to obstetrics is not only broken, but barbaric. Call it a providential whack on the nose. Now I’m a birth activist.
Still terrible with people, though, although now that I am in middle age I am almost adroit enough to pass for, say, Al Gore, when twenty years earlier I could have passed for Mork from Ork (for those of you old enough to remember).
I think a lot of doctors have this encumbrance/disability. Most of them, if not all, are probably undiagnosed, because in our society, autism is framed as a tragic, debilitating, crippling “disease” and most people don’t think of Dr House, they think of the Rain Man.
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Suzanne Reply:
May 25th, 2010 at 10:28 pm (Quote)
Sarah, I really appreciate you perspective and honesty about being autistic. I have limited experience with people known to be autistic, and all three situations are fairly to extremely debilitating…so it’s wonderful to hear from you, and work on broadening my mind and perceptions in that area. 
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Sarah Dorrance-Minch Reply:
May 26th, 2010 at 8:27 am (Quote)
Since high-functioning autists tend to not apply for disability benefits, get steered into therapy, etc, we often go undiagnosed.
Autism is a spectrum. The people who are more severely disabled get more attention. Maybe that’s a good thing, because they need the therapies more anyway, but I’m convinced that the more severe autism is, the less common it is.
Remember homeroom when you were in school? In grade school, there was always at least one utter misfit who didn’t seem to get along well with anyone due to being shy, having few social skills, and basically being just a little bit “odd.” In high school, the oddballs settled into nerd/geek cliques or just became loners.
There’s a lot of us out there. We often don’t get diagnosed until our kids get diagnosed. Oh, yeah. I think autism is partly on the rise because it is a recessive gene (a few weeks ago the genes involved finally got discovered, can’t remember which paper I read that in, but it vindicated my theory nicely) and we nerds tend to inbreed with other nerds rather than with “normal” people.
Silicon Valley has a particularly high rate of autism. Funny thing that.
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Dee Reply:
May 26th, 2010 at 8:34 am (Quote)
Thanks, Sarah (love the icon also) for sharing your perspective. My son has Asperger’s. I wouldn’t have known, but his doctor was pretty astute and had both us and our son’s teachers do observations over a few weeks with a scale from the Australian AS research folks (they are doing a lot of the work on AS right now). And I do remember Mork, lol.
dee
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Dee Reply:
May 26th, 2010 at 8:31 am (Quote)
Thanks, Jane, I need to get the book and read it! I like how you analyzed the reasons for going into medicine and how they affect patients. Makes a lot of sense!
Dee
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Jane Reply:
May 26th, 2010 at 8:40 am (Quote)
I should have said: A doctor who went into medicine because of the technology and the problem-solving challenges CAN be a people-person or can develop those skills. But it’s not first nature to some doctors and they honestly may not realize why it’s necessary.
But one of my doctors turned around on a dime once and became very compassionate and personable to me after years of being a cold fish. It does happen.
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forex robot had this to say,
Jun 6, 2010 @ 12:04 am (Quote)
Wow this is a great resource.. I’m enjoying it.. good article
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My first pelvic exam was when I was 21 and a virgin. The woman tried to shove a regular size speculum in me…I gasped in pain and screamed at her to stop. She laughed at me. She asked me if I was sexually active, and snorted derisively when I said I wasn’t, then snorted again in disbelief when she asked me my age. Then she shoved the speculum into me again…it wouldn’t go in. I told her to stop, tears running down my face. She belittled me by saying that “15 year olds come in here all the time, and THEY don’t complain….” No idea what that had to do with anything. Finally made her stop. Left the room bawling. Evil witch just looked at me with contempt and let me go. Sobbed in another room for several minutes before I could get myself under control.
I’d never been able to use tampons. They just didn’t fit! I was too tiny. When I was 22 and engaged, I saw my wonderful (regular) NP in order to get a script for birth control pills. She ever so gently talked me through it, then stopped immediately when it was apparent that even the smallest speculum she had was going to be painful for me. She told me not to worry about it, and then talked to me very sweetly and encouragingly about what sex would be like and what we could do to help it work for me, specifically some things my husband could do when we were ready, and asked me to come back to her for a follow up appointment after we’d been married for a few months. She actually offered to bring him in to talk to him if I wanted her to. What a sweetheart, huh?
It helped SO much. I was so tight and small(and my husband is a well-endowed man well over six feet tall) that sex didn’t actually WORK for us till try number three! (No honeymoon night for us!) But knowing ahead of time that it might be difficult but that we could do things to help was absolutely invaluable and turned what could have been a nightmare experience into something safe and loving.
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Suzanne Reply:
June 6th, 2010 at 11:48 pm (Quote)
I’m so sorry that happened to you Mel – I can identify some in medical professionals treating me like a liar about not being a sexually active teen, or having any partners before getting married – but that is horrible that she treated you like that.
What a wonderful NP to come after that, though, and offer so much compassion and encouragement…wish all doctors and nurses were like that!
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Dear Doctor:
Quit being disgusting. And as a matter of fact, I’m not. I’m leaving.
No love…
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Mistie Reply:
May 25th, 2010 at 10:37 am Mistie(Quote)
Jane I love your letters! They are always so perfect!
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