NOTE: I am a retired midwife. That alone makes many, many people nod and say, “I can see what’s coming now,” because care providers are the worst patients ever. I lived up to that expectation. In spades.
I had to have my Pap yesterday morning. It took until this morning for me to be able to relive the experience for a post.
It Unfolds This Way
I am ushered behind The Door by the Nurse-Practitioner’s assistant (LPN? I don’t know) and right there is the fucking scale. Knowing my weight, I told the girl and she said I had to get on the scale, she cannot take my word for it. I looked at her and said, “I am not getting on the scale.” She says, pretty snotty-like, “Patient refuses weight” and jots it on my chart.
I rolled my eyes.
She takes me into the exam room and there, laying out is the baby-sized paper top and a teeny sheet to cover yourself with. I wore a shift with no undies, no bra, expecting to just lift everything up. Easy peasy. I also spied the plastic speculum in the wrapping: medium.
The assistant took my blood pressure (incorrectly) on my forearm and I had to show her where to put the bladder tubing over my artery on my lower arm. She wasn’t happy I changed her rhythm. Tough shit.
Went over meds, any current problems, past STDs (HSV & HPV) how many sexual partners this year. I laughed. How many in a lifetime? I said hundreds. She turned and said, “Are you serious?” (which I thought was rude as fuck); I said I was. I imagine she then typed into the computer: DO HIV TEST.
When she was done with the computer question & answer part of the fun, she proceeded to tell me to take off my bra and underwear and put the teeny covering over my top, opening in the front for breast exam and to cover myself with the miniscule paper drape. Even the Chux on the table was infant-sized. Then she left.
The table was lower than the one above, so I sat on it… on the Chux and drape, with zero intention of taking my stretchy dress off.
Then my mind started going:
She (the wonderful Nurse-Practitioner) isn’t going to be able to see your cervix with that medium spec. You need a large at least, if not x-tra large. I already know my walls fall inward ( a common multip and/or fat issue, of which I have both). What if I need the specialized ones where the spec has the blades on the side, too? What if I need to go see a GYN? Are they going to fat-shame me because I need a special speculum? I hate Hate HATE putting my legs in the stirrups. (I can feel the tears welling in my eyes just writing this out.) What if she tries with the medium and cannot see my cervix? Then I will have to see someone else and do this all over again. Maybe I will just skip it altogether and just talk about my Dexa Scan and the Hematologist I need to see for my chronic anemia.
Where did all this anxiety come from?! Fuck, I have had at least 30 or 40 pelvic exams before, including student midwives so they could learn what a fat body feels like. This was so different, though.
Maybe I will just skip it altogether.
The Visit Begins
In came the NP and the assistant who was already gloved (a no-no). I didn’t say anything because I was too anxious about my body.
I love this NP. We share an obsession with Disney stuff and talk about it all the time when I see her. I told her how good it was to see her and I relaxed a little.
She had the HIV test in her hand (we used to do the oral ones when I was a midwife, too) and I said, “I guess you want to do the HIV test now?” and opened my mouth. She did the swabby thing over my cheeks and gums and then put it in the solution for the 20-min wait.
I shared my latest labs. My HgbA1c was down from 7.7 to 7.2 in 3 months. Yay! She was going to give me a referral to the Hematologist because my anemia had now turned chronic (Hgb of 9.9-10.1 over 9 months) and to the Endo again for the osteoporosis I now have (both the anemia and the osteoporosis from the Gastric Bypass in 2001) to get shots.
I then point to the speculum on the side table and tell her it ain’t gonna fit, do they have a large one? Ayup. They do. The assistant chick got it out from under the cupboard.
I say I do not want a bimanual exam because she won’t feel anything anyway and they always hurt because the provider tries so hard to find my tubes and ovaries and my liver already hurts. She said no problem. Just the Pap. (The fucking Pap.)
She asked if I had had my mammogram this year. Nope. Do you want a breast exam? Nope. Just the mammogram; I examine my own breasts, thanks. She said, “No problem.
The Fucking Pap
Then it was time when I had to lay back and put my feet in the stirrups. I whined about how fucking flimsy they were and she said she thought they were better than the leg supports and I said that, for fat people, the leg supports are far superior because it is difficult to keep our legs under control in the lithotomy position.
She put her gloves on then began touching my labia and I felt the fucking speculum. I know they aren’t supposed to hurt and for fuck’s sake I have done 100s of spec exams on women myself so know how it goes for many… it isn’t comfortable. Or pleasant. For me, they fucking hurt.
Ow ow ow ow ow ow ow until she was in and swerved the spec around upright, then the pain stopped. Opening it was fine. She said, “I see your cervix right there!” I was so happy I could have screamed. When she took the specimen, it didn’t hurt. Coming out was fine. That going in… sheesh. Sex sure doesn’t hurt like that. (Lube, lube and more lube, that is why. No lube is used on the specs lest they contaminate the specimen.)
And she was done. I wanted to cry with relief because she found my cervix so easily, didn’t have to take it out and retry again and again or send me to someone else. Goddess forbid something be wrong and I need to have dozens of them. Ugh.
(And in case you are wondering, yes I am a Survivor of Sexual Abuse & Rape and am sure that has an enormous hand in my discomfort issues.)
And my HIV test was negative. Yay! Good for 6 more months.
Fuck am I glad that fucking thing is over with for a year.