Guest Lil Tiger

Some Tips before you att your Gyno/Ob appt

70 posts in this topic

Hey Fam (((HUGS)))

Here are some sugestions we came up with in chat today to make the apt with the gyno/ob re:pap smears a lil easier...
anymore ideas please mention :)

* Ask your GP for a referral to a good gyno
* Ask friends for a good one (word of mouth)
* Ring your local crisis center they may have some that they know are good or refer to.

* Plan your day, reward yourself after you have had your Pap, like going to your fav restraunt, seeing a movie, having a massage etc..

* go with a friend

* plan with your friends that soemtime during the week you all have pap smears done andthat w/e have a special girl night with them all :)

* do somehting relaxing before your appt ie walk in the park, going for a swim etc..

*avoid caffiene the day of your appt as it increases anxiety

* if needed ask your dr about anti anxiety agents such as diazapam (valium) that you can take prior to your appt (at least 1hr before but if you do, get s friend to drive you there)

*write down a list of all things that cold hapen during the exam and have a plan of action...ie: Trigerred I will do my deep breathing techs, visualisation / guided imagery etc..

* This helps you have mre control and know that if soemthing does happen like being triggered you know there are ways you van help relive the stress and anxiety

* Get the gyno to explain the procedure step by step whilst he/she is examining you.

* Ask to be shown what will happen before the procedure so you know exactly what will happen.

* Choose a female doctor, or have a female nurse present during the exam if possible.

* YOU have the choice on what position you have the exam..ie lying on your back or on your side. Gynos do have their own personal preferences but this is about YOU not them. Do what makes YOU feel most comfortable.

* If at any stage you don't feel comfortable during or before the exam. You can ask the exam to be stopped. YOU are in control and have the right to say NO at any point during the exam.

* Some breathing Techs... Deep breathing exercises...
- counting back from 20 or 50 etc..

20
deep breath
I am safe
19
deep breath
I am in control etc

or

20
deep breath
I can't wait to buy that new dress tonight
19
deep breath
I might have chicken tandoori tonight fro dinner..etc..

It depends what works best for you distractional or hitting your trigger head on. It's a personal choice.

Visualisation / Guided Imagery go to a safe place within yuor mind where you feel at peace, safe  and in a tranquil environment...

* Bring a walkman in case you need to escape into some happy music during the appt.

* The procedure is less than 5mins  though it can seem like a lifetime. Knowing exactly what they are doing and why they are doing it helps...Knowledge is power and helps you to be in more control. NEVER forget that YOU are in control. YOU have the right to say NO at any point. You are a paying customer, and the customer is always right ;)


Anymore IDEAS.....

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#Moderation Mode

This thread has been moved to the wonderful threads forum.

<a href="http://www.welcometobarbados.org/CGI-BIN/ikonboard/topic.cgi?forum=9&topic=42" target="_self">Moved here</a>

I moved it here cause it is awesome and a questions lots of people ask...

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Just one thing I remembered which I always forgot in the beginning:

When you do the counting back thing or any similar exercise remember that your subconscious mind doesn't recognize a "no" so something like "I am not afraid" is likely to reinforce the feeling of being afraid...go for things like "I am safe" instead...and yes, I actually made that mistake last week before my gyn appt. :P

Art

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I was thinking that I might be able to add something here, but it's more of a "look out" type thing.  
I got one of the worst triggers I've had in years (actually kind of stepped back from myself for a couple of minutes) when the midwife associated with the OB I was seeing asked (out of the blue) if I had ever been raped or abused.  Not long after that, I made a move to another state and another midwife.  Before she could ask me the same question, I told her (so as to be in control, I guess) and asked her why.  She said that it can cause added tension and trigger anger in childbirth, so they ask. It helps them to be on guard.
Anyhow, I just thought it could help someone to be aware that this question could happen at such an odd time.  It shocked me when the first midwife asked, and took me a while to get over.

(Edited by Fluxus at 9:12 am on July 18, 2002)

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Oh and when you go to a gyn you can leave on a skirt and a blouse or something without underwear...you may get a surprised look, but this thing was actually suggested in many youth magazines and I'm glad I remembered it because I felt a lot safer :)

And it's ok to be nervous...there's a multitude of reasons why you could be nervous, and you don't have to say that you're a survivor...for me saying that it was my first gyn visit did the trick just fine

Another thing is: if you decide to tell the doc you are a survivor, don't just say survivor, that is a loose term and not everyone will know that this means you have been ab*sed/r*ped.
If you can't bring yourself to *tell* but want them to know a good idea is giving them a card with that info.

Art *who has a gyn appt in 6 hours and tries to calm down*

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I can't tell you how glad I am to have just read this post and all its threads ... I have my first gyno appointment since my daughter was born 6 years ago and even though it is a little over 2 weeks away, I am already halh hysterical over it.  

My friends at work were appalled to learn how long it has been since I last went for an exam and were pestering me that this was something I had to do.  I "hemmed and hawwed" for as long as I could but short of just coming out with the truth of my fears, I finally caved and made the appointment.  

At least by reading this I don't feel stupid about being so afraid of going and can use these valuable tips to make sure I keep the appointment.  Many thanks.

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Thank you for boosting this wonderful thread Stacee!

I need to go to get a pap smear badly. It has been almost 6 yrs (since my last child) and I have even less excuse then most people since I am a cervical cancer survivor.

I WISH I had found these great tips before I got cancer, the treatments were beyond traumatizing.

One doctor casually asked me to get undressed and put myself in stirrups before he came in the room!

Him I told, no way, you'll have to deal with me face to face mister and reported his behavoiur with a complaint to the hospital. Horrifying.

Anyway, I am feeling inspired to make an appointment right now. Hopefully it will last long enough to gert me a nice clear pap smear.

Thank you friends.

Renata

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Another suggestion -

For those who, like me, find the whole speculum experience not just uncomfortable but downright painful - ask for a pediatric speculum. So long as they can see what they need to see and accomplish what they need to accomplish, there's no need to use an adult-sized version, and most gyns will be accomodating with this. The doctor I just saw actually took it upon herself to suggest and find one, after learning that I was a rape survivor.

Another suggestion, one that she actually made to me - have an initial visit to simply discuss any problems or concerns, to get to know the gyn/doctor, BEFORE the exam, then come back another day for the exam itself. It may help you become more comfortable with the doctor, if you're seeing someone new.

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Hello all,

So glad I found this board!  I am a rape survivor, and I'm a writer.  I am planning to write an article about how women who've been through sexual abuse have problems getting Pap smears.  Is there anyone on this board who wouldn't mind being quoted about it?  I know it's a sensitive topic, but it would really help if I could get a few quotes from people who've "been there."

If you're willing to be quoted, please write to me at [email=Jenglatzer@aol.com]Jenglatzer@aol.com[/email] and tell me...

1.  Are you afraid to get a Pap smear?  If so, why?

2.  When was the last time you had a Pap smear?

3.  If you are NOT afraid, please send me tips for how women who have been through sexual abuse can feel more comfortable getting an exam.  The kind of advice that's posted in this thread is perfect-- you can just send me your posts if you like, and let me know I have permission to quote from it.  (I won't quote from here without your permission!)

Also, let me know how you'd like to be quoted (for example, Jane Smith, childhood rape survivor, or Jane Smith, sexual abuse survivor).  Thanks so much for your help.

Take care,
Jenna

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I would just like to strongly agree with Anna.  I went for a smear at my Docs, where I met the Nurse for the first time.  Well, you can imagine the build up there, the changing of my appointments, etc.  Anyway, I nervously tried to explain why I was worried, but struggled to fight the tears.  She got annoyed that I was taking so long, and said, 'I haven't got time for this, if you have problems, can you make another appointment when I have more time.'  I was distraught and completely lost it, I was crying and shaking and a total wreck.  I ambled to the door as quickly as I could drag myself, even though I was sucking oxygen in like a mad woman, and then she must have panicked, and tried to stop me.  She was awful, her behaviour was terrible, but I was too shaken up to complain at the time.  I left it a year, but then I went to the local family planning clinic where they do free smears.  And I spoke for ages with the Nurse there, she was amazing.  I was able to set the appointment for a later date, and knowing it was going to be her and how comforting she was, it helped.  She asked me if I wanted another Nurse to hold my hand, and talked to me the whole time. I felt so much better when I left.  So, if you can arrange to meet first, I would strongly recommend it.

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The *most* important thing for me is for the medical professionals around me to *know* i was abused.  

this reminds them to be extra theraputic, and to understand your body language.  Also, they can use smaller equipment.

i've never had to much fear, because it was something i knew i had to do.  i don't like it, but i know everyone goes through this.

also... a have a gay male gyno.  makes me feel completely safe.

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one time my gyn began to talk to me about my overweight while i was on that chair and not able to run away. sometimes gyn doctors are like dentists. they talk to u when they know u cant run away.
now when i meet a new doctor i tell them, i only want to talk about safe topics while its done (like school, the weather, the new movies whatever)
and to tell me everything else when im dressed and looking face to face. a doctor not respecting this roule has seen me the last time in his life. (and wont earn money with me no more :o)) im in the position of a customer and concentrate on that part. cause its the customer who really has the power.
now im more relaxed and it doesnt hurt anymore

oh yes and i dont wanna be told that "it wont hurt if i relax" thats what a*users says as well. i want that they make me think of different topic, then i relax.

EW

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THANK YOU for these suggestions. I am supposed to go once a month, and ahve not been in a year and half. Can't seem to MAKE myself go, and I think it is because I feel the only way to have control over that is by not going. Working hard to convince myself that this is NOT a situation where I am powerless, but actually taking care of myself by paying attention to my health.

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i'm 24 and i've never been to a gynecologist.  the thought of it brings me to tears and panic.  i know i need to go.  i need to be tested for hpv because i got together with my best friend and she found out later she had hpv and had to have her cervix frozen because of precancerous cells.  

i'm terrified.  

hilary

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I read a site once that suggested you write a letter/call your doctor before hand and explain the situation so there are no surprises.  I usually email people when i feel i will have trouble verbalizing something.  Also- making a plan to be with a good friend or do something nice afterwards helps ground you.
pixie

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Thankyou for those suggestions.
I finally did it this morning after [b][u][i]10 years[/b][/u][/i] of trying to make the appt!!!
It was my first ever proper exam (they did everything all in one go!) the only ever exam i had was after a rape at a clinic just outside  Los Angeles airport (jet lagged, no american money - i had to interrupt a flight).  I was sooo dissociated the DR was soo horrible... but anywhoo!

I cannot tell you how kind they were.  I wrote a mammoth letter in bullett points explaining exactly my experiences, what i was scared of, what i wanted to know, what i didn't want to know < key point for me.
That letter will stay in my file.  I also spoke to a counsellor they had available before and after.  

She got the nurse to get a smaller 'one' for me.  I just cannot tell you how kind they all were.  It was a very positive experience.

For me I did get terrible pain.  But it wasnt unbearable, i was expecting it prepared etc

I had to have a longer examination because of some probs iv bn having but even then it was all over and done with very quickly

They were so considerate.  I would advise writing it out in a letter.  and asking to get everything all done with at one time.  

Also, i was referred there from the SARC  (assault centre), even if you havent say you've been referred from Rape Crisis coz as soon as they hear that then theyre ever so good. (well they were to me)

She said I'd done the right thing in being checked out.  THey all said they were so proud of me etc.  bless!!!

Ok so if i've done it after 10 years then u can!!!
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Well done for making your appointment Gateway!  Way to go girl!  i'm feeling pretty nervous because I have to go for a servical smear in a couple of weeks.  The only other time I've ever had one was when I was in the relationship where I was raped.  I went because I'd been experiencing bleeding and pain during sex (I'd blocked out my memories of being abused/raped and had convinced myself that it was the result of 'normal' sex).  I now realise that I was bleeding because he kept raping me or at least having very rough sex with me.  So I associate having a smear with that time in my life and feel very anxious about how I'll respond to the examination.  I found all of the posts on this topic really helpful and will certainly bear the advice in mind when I see my GP.  Its good to know you're not the only one who's worried about something.

amy xxx

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Hey everyone. This is probably a separate topic but I don't have the ability to create new topics on the board, so I hope it's okay to post this here.  

Does anyone else have problems with chronic vag. infections?  I feel like I'm constantly on Monistat for yeast, or Metrogel for Bacterial Vaginosis and I'm not sure if it's connected to the abuse/r*pes or not. I read on another site that sometimes women who've been abused this way can have frequent "female" problems but I'm not sure how that could be given that my last r*pe was ten years ago.  

I've been to the gyn and the reg. doc and have been tested over and over for everything from HIV to STDS and luckily nothing like that has come up.  What's frustrating is that when I "know" I have something like a yeast infection and go to the doctor to make sure it isn't something else, I'm always told that they can't "find anything" and that I'm "fine".  Grrr....I am very glad that soon my husband and I will be switching insurance so I can go to a different doctor.....

Meantime, I'd love to know if anyone else is dealing with this and what if anything your docs have said the cause is.  

Thanks so much,
Wounded Angel

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I also think I have chronic vaginal infections.  unfortunately although I tried to get help from my pmd about this last year, lived through three attempts at a gyn exam only to be told it was candida... which then I had a hard time treating and even after I did the treatments twice it didn't seem to go away. I thought it might be bv but that didn't show up on the tests they did.  I've sort of gotten used to living with chronic itchiness. I have such difficulties with the whole pelvic exam thing I can't even imagine going back to see her and tell her I'm still suffering.  I guess I just am not persistent enough to find a doctor solution.

When I was younger I switched away from antibacterial soaps and that helped some.  

I guess i'm just a me too and no help at all. I wish I had a solution every so often I just get sick of being uncomfortable and dealing with it.

ayelet

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You are TOO a big help. Just having someone else understand and know what I'm going through is a HUGE relief!  I was beginning to feel like something was wrong with me. lol

I hope that both of us get healthy soon and find doctors who are able to help us out.

Thanks so much for sharing and good luck!
Hugs,
Wounded Angel

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[url="http://pages.ivillage.com/rape_pathfinder_help/rapecrisispathfinderonlineresources/id12.html"]Health info for survivors[/url]

From a website selling the book:
The Truth About Rape
[url="http://www.raperecovery.com/truth_about_rape.htm"]http://www.raperecovery.com/truth_about_rape.htm[/url]
intellectual property of Teresa Lauer, M.A.
I pasted it here bc the link keeps breaking.  The url changes slightly every 3 months and I think it could help people to know about it.
pixie
"
"I'm nervous about my next OB/GYN appointment.  What can I do?"
"Should I be tested for AIDS?"
"I'm terrified that I'm going to become pregnant from the rape. What can I do?"
"I think I may be developing an eating disorder; how can I stop this?"
"Why do I want to hurt myself?"
"I feel disconnected from my body; why don't I "work" sexually anymore?"
"What can I do to feel safe again?"


"I'm nervous about my next OB/GYN appointment.  What can I do?"



A Personal View



My first gynecological exam following the rape was filled with apprehension. A gynecological exam even without the experience of rape is difficult because you're in a position wherein you have little control.  You're on your back, with your feet up, a (virtual) stranger is inserting things inside you.  And generally it's a male. I did come up with some ideas though that served to make my experience a little more palpable.  First, I made the appointment with my gynecologist – a male doctor that I'd been seeing for about seven years – for first thing in the morning. That way I knew I wouldn't be waiting if he got backed up throughout the day.  Waiting means anxiety – something you don't need.  And I requested that I be able to see him for 15 minutes longer than the regular appointment so that we might have a consultation prior to the exam.  I wanted to see him in his office, with my clothes on and my feet on the floor. 

This would be the first time since the rape that someone touched me and I wanted it to be on my terms.  Second, immediately after making the appointment I dropped off a copy of the report that the examining doctor at the hospital had prepared after the rape. I asked his nurse to add it to my files and requested that my doctor read it prior to our appointment. Third, I made a list of my injuries at the time and how I was feeling now.  I was very succinct.  I knew I'd be nervous and didn't want to miss anything.  Fourth, I took the remainder of the day off from work and did exactly what I wanted – I had an early lunch with a friend, went shopping for a couple of hours and then went to a movie and dinner with my boyfriend. This was a pretty big deal for me and I was proud of the way I went about it.  You must take care of yourself and taking care of, and following up on your physical injuries is of utmost importance. – Janice, 33 



A Clinical View



What Happens During a Gynecological Exam


What happens during a gynecological exam is a mystery to most of us. Whether or not you received injuries during your sexual assault, it's important that your OB/GYN know that you were raped.  You may have been treated by a physician in a hospital or may not have been treated at all, however, your own physician is in the best position for determining your follow-up care.  In addition, knowing what to expect allows you to be prepared for the physical sensations you will feel in various phases of the pelvic exam.  Informative guides on gynecological exams can be found on the internet sites in the following resource section.  In addition to a breast exam, a very brief overview of the pelvic exam includes:


The External Genital Exam



A visual examination of the vulva and opening of the vagina; abnormalities, rashes, cysts, genital warts, etc. are noted.



The Speculum Exam



A speculum is inserted to facilitate examination of the cervix; abnormalities are noted; testing for STDs is performed as is a Pap Test.



The Bimanual Exam



One or two gloved, lubricated fingers are inserted into the vagina while your physician presses down on the lower abdomen to feel the internal organs. Size, shape, tenderness, pain, swelling and enlargement of organs is noted.



 Rectovaginal Exam



A gloved finger is inserted into the rectum to local possible tumors and check the conditions of the muscles.




General Resources



American Medical Association (AMA)
Phone:  (312) 464-5000

American Medical Women's Association
Phone:  (703) 838-0500

National Woman's Health Information Center, The
Phone:  (800) 994-WOMAN (800) 994-9662



Internet Resources



American College of Obstetricians and Gynecologists
(Excellent source for violence towards women)
www.acog.org/from_home/departments/
category.cfm?recno=17&bulletin=199#sexassault

American Medical Association
www.ama-assn.org

American Medical Women's Association
www.jamwa.org

National Institutes of Health
www.nih.gov/health/InformationIndex/HealthIndex/pubina-e.htm

National Women's Health Information Center
www.4woman.gov

OB/GYN.net's Women's Pavilion
www.obgyn.net/sexissues/sexissues.asp#Rape



Book & Pamphlet Resources



Color Atlas of Sexual Assault
     By Girandin

Everything You Always Wanted to Ask Your Gynecologist
     By Dr. R. Scott Thornton & Dr. Kathleen Schramm

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness
     By Jon Kabat-Zinn

Sexual Assault: A Manual for Emergency Care
     By Patricia A. Hargest and Robi Findley, R.N.

Violence and Abuse: Implications for Women's Health
     By S.B. Plichta"

[url="http://www.plannedparenthood.org/Zip.htm"]http://www.plannedparenthood.org/Zip.htm[/url]

Planned Parenthood operates approximately 875 health centers in 49 states and DC, serving nearly five million men, women  and teenagers every year.  Enter your zip code for the nearest location.  Planned Parenthood Federation of America,  Inc., is the world's largest and most trusted voluntary reproductive health care organization.  You can get a medical  examination at one of these locations if you don’t have a regular gynecologist.

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[url="http://www.cwhn.ca/resources/csa/faq1.html"]Getting through medical examinations[/url]

[url="http://www.cwhn.ca/resources/csa/links.html"]More Links[/url]

I thought these were helpful.

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Thank you for this post I have my appt for a pap smear in a few weeks. Im going to use some of the suggestions im scared to go. I was sobbing the last time I went cause of what happened to me it brought back flashbacks. I hope some of the suggestions will help me.

Lyn

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I thought I would never go have another smear as the first one was so painful emotionally/physiacally...now I know some good techniques I think I can muster up some courage to go make that appointment-thank you!

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Great thread!

I was like so many people have described... Just couldn't even think of it... But, at 29, I had my first smear test (we don't have routine pelvic exams in the UK, just the pap smear) this year!

Luckily I have a great GP who has been treating me for depression too, and I was able to tell her that I had problems in that area. Together we came up with a plan to split the test into sections... I cannot tell you how much this helped...

We ended up having three sessions, with each going a little further than the one before - and all the time at my own pace. She explained everything thoroughly, and reassured me constantly.

Now this is going to sound daft, but actually, by the last session, I really felt like I was receiving some kind of gift... It was actually incredibly moving & ended in me disclosing parts of my history. And now, I'm trying to get pregnant, so I must have moved!

All I will say is - although of course you must do only what you are ready for - please please please think about your health. I have a friend on another survivor board who went for her first pap smear this year too - unfortunately the results weren't good, and she was told that had she gone earlier they might have caught things sooner. That breaks my heart... Though of course I understand it so so much...

Sending lots of support.

:hug: Ruthie Edited by tealight rookie

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