# Does anyone NOT get pap smears?



## TopazBlueMama (Nov 23, 2002)

I'm sick of doctors. I'm dreading the thought that I might be "due" for another pap smear.
Should I feel guilty that I'm even considering not getting one, like I am "risking my life?"
I am NOT at risk for uterine cancer.

I've had 3-4 pap smears since I was 19. They all turned out fine. I was always the good patient and endured the procedure.

Now I have more feelings of sacredness about my body, fertility, birth, sexualtiy, all that; it just seems so degrading to sit there legs spread. No control. Humiliating.

Do I just be a good girl and buck it up?
Am I making too big a deal out of it?

What do ya'll do?


----------



## jandj+1 (Sep 14, 2004)

Maybe I'll get flamed for this, but I think you need to go. I say this because a pap smear found cervical cancer in my mother when she was 22. Even though she hadn't missed a year, the cancer had progressed to stage III (not good). That pap smear saved her life.

Not all of modern medicine is needless interference.


----------



## LoveChild421 (Sep 10, 2004)

I am debating having them or not too- mine is based on my basic distrust of doctors. I had an abnormal Pap in March when I went in for my 6 weeks post miscarriage check-up. They told me I needed to have cryosurgery- which they said was very minor and caused no pain I would be back to work right after it! Oh and then they wrote me an RX for another year of birth control pills. Well, stupid naive me (I was only 19) I went ahead with the cryo figuring it was better to be safe than sorry. Well, I can't express how sorry I am that I had that awful torture done to me. It was the most painful thing I have ever endured- I have had all sorts of injuries, etc. I passed out and my boyfriend had to catch me to keep me from hitting the floor when I got up. I felt like someone was torturing me while it was going on. I slept all day I think I was in shock from the pain. I couldn't have sex for 2 weeks.
All of this due to an abnormal pap smear that I later did some research on and found out that over 50% of them turn back to normal, stopping birth control pills and eating a better diet would have increased my chances of getting a normal pap, and that it is very common for women to have abnormal paps when they have recently had a miscarriage or given birth or are pregant.
I was supposed to go back for a "follow up" pap to make sure "nothing else had to be done" but I never went back and changed to another group who I lied to and told that I had just had a pap at a local clinic and it was fine. I just am so traumatized from that experience. I do feel like I am "risking my life" by not having them- but I would rather die than endure what I did. I think I will just have one 6 months or so after I give birth and if it's bad I will just do some self-medicating- with antioxidants, etc.
I just wish I had been more informed- after all you can say no to any procedure they recommend- I just wish I had known what I do now.


----------



## anothermama (Nov 11, 2003)

I had a good talk about it with my midwife one time and she said she felt that for women as young as me (late 20's) every couple years is ok. And I kind of feel the same way. But thats taking into account that I keep up with whats going on down there on my own so..........

I felt the same way as you and finally after 10 years, I found a nurse practitioner I LOVE who I will go to. My midwife also does them, however they aren't covered by insurance with her so I have to go the cheap route. If you can, invest some time in finding a GOOD practioner for you. A midwife, an OB, whatever. I spent the last year looking for a good care giver and I finally found one thats not making me dread getting my pap next month.


----------



## mezzaluna (Jun 8, 2004)

aren't there new recommendations that reduce the frequency of regular pap smears if you've had normal ones a number of years in a row?

i would suggest finding a doctor with whom you really click and who cares about what's going on above your neck... and then go to her/him for your regular pap smears... i don't see it as humiliating or being a "good girl" - in my mind it's framed more as being responsible, caring about my body, and proactive about my health to get these checkups. you are in control - you schedule the appointment, you ask the doctor to use their training and skills to serve you and your health, and in the end, you choose to open your legs and let them care for you. if your doctor is good (or trainable) maybe more communication from her would help you feel more comfortable and in control... i really appreciated yesterday when i was getting an internal exam that this OB said "now you're going to feel my fingers" - of course i knew she was about to do that, but i just felt more relaxed and respected that she announced what she was about to do instead of just going for it. just like every time i get my blood drawn the phlebotomist says "you're going to feel a little pinch" so i'm not startled.


----------



## LoveChild421 (Sep 10, 2004)

If they did find cancer in me I guess at least I could really start focusing on my diet and try some natural anti-cancer treatments like a macrobiotic diet- but I know this is probably strange- but I would never have a hysterectomy or any sort of surgery or chemo for any reason what so ever. I really would rather die. Besides chemo is just poison- it kills the cancer but them it just will reappear somewhere else because you've poisoned your whole body- or you will develop MS or some other problem from the poisoning


----------



## TopazBlueMama (Nov 23, 2002)

Lovechild, your story sounds awful.

Do you think it is still irresponsible of me if I end up not going-even if I have no risk factors?
-only had one sexual partner in my life
-never smoked
-never had any std's
-not taking birth control pills

Thanks for all the responses so far. I could always wait another year-it looks like they did increase the recommended time to every 3 years if you've had normal paps done.


----------



## LoveChild421 (Sep 10, 2004)

thank you tweety- I like to let people know what happened so that hopefully dr.s won't talk someone else into it


----------



## eminer (Jan 21, 2003)

It's not irresponsible to refuse testing, if you've considered your risk and the risks/costs of the test and decided it is not worth it. But having a pap smear does not have to be humiliating (or painful). I would suggest finding a good midwife and discussing your feelings with her. She will probably be able to do it gently, without the metal thing, and in a respectful, dialogical way. She might even be able to send in a swab you did yourself.


----------



## milk4two (Mar 20, 2003)

Christiane Northrup says if you've never had an abnormal result, it's ok to get one every 5 years rather than every year.


----------



## magentamomma (Mar 18, 2004)

I have a history of sexual abuse, and so I have decided not to get examined any more. Two of the three practicioners(all women) I saw were demeaning.I explained to them my history and still I was left naked and cold for over twenty minutes in one, and had my stomach flab lifted with a pen by another. Absolutely humiliating. I litterly cry through the entire procedure, and was made fun of by one of the ladies "You sure do overreact " she says. Well if you've experienced violation as a small child, it's a little hard not to react to a speculum a little strongly. Any way, I check myself out visually and manually so that I stay aware of any changes in my body. For me that will have to be enough until midwives in my area are allowed to perform paps.


----------



## georgia (Jan 12, 2003)

I have a huge distrust of many medical professionals from personal experiences AND a family full of doctors and nurses







. That said, I have a family history of gynecological cancers, and I feel I owe it to my children to catch anything early. I know my feelings about this have changed since having children. It's no longer just about me and my needs. I've recently lost a grandmother and my midwife to cancer, so I'm in a sad place about this.

I can see why one might say one would rather die than go through certain medical procedures (I know that feeling!); we each need to make our own decisions about what's best for ourselves and our families. We each have our own comfort level with testing/risk/etc.

If I had low/no risk, you bet I'd be doing only the minimum amount I felt comfortable with. I see a CNM who is wonderful, and that helps me a lot.


----------



## obnurse (May 18, 2004)

I believe that the new recommendations are for every OTHER year for people that have been negative for a while, not every 5 years. I agree with the above poster..you have to decide what comfort level you have for you and your family. But please keep in mind, good healthy people get cancer all the time. Heck, healthy babies get cancer, and what have they done wrong? It can strike innocent people at anytime..thats why screening programs such as paps were instituted. But if you were going to die rather than take treatment, then why test at all I say?

Also for the couple of people above, paps are for cervical cancer, not uterine cancer. A hysterectomy would be to remove your uterus, not your cervix. Cervical cancer is MUCH more common than uterine cancer. Pap smears done regularly will often diagnose cervical cancer in the very early stages, before full blown chemotherapy would be needed! Often some not horribly invasive surgery can be done without the need for the aweful side effects of chemo and radiation. This brings out one of the bad things about NOT having the yearly testing...is that you could miss the early stages of cervical cancer and go right to the really bad stuff. Then you would be forced to make a decision about heavy duty treatment, or no treatment at all.


----------



## mommy2madison03 (Jun 27, 2004)

I have had papsmears every year since I was 17/18 years of age. I always had normal paps. When I was 22 I had a pap done and they found severe displaysia, CIN 3 (I believe that's what it was called). This is the stage just before cancer. This all happened within one year after a normal pap. I would strongly suggest going yearly. I hate to think about what would have happened if I skipped that appt. I am completely healthy now and having normal paps again. I think you should find a doctor that you are truly comfortable with because even though you don't have any risk factors it doesn't mean you can't develope the cancer. I hope you can find a doctor that you can trust.


----------



## Peppamint (Oct 19, 2002)

I had three paps within a 16 month period, so I won't be going for awhile. The only reason I had so many was I had my normal yearly pap, 12 months later got my yearly pap again, got pregnant and had to see another OB who insisted on another pap. That pap was the worst experience I'd ever had "down there".









I'm uninsured right now, so I don't have much choice... I do know I can't pay my dh's hardearned cash to let some rough OB mangle my cervix.


----------



## anothermama (Nov 11, 2003)

I had to add a couple thoughts.........

In reading this, I'm hearing a lot of "I have issues with people being disprespectful to my vagina, so Im going to not let anyone go there".......and that seems very backwards to me. If we had a pregnant mama here who flatly REFUSED to address her mental issues and, instead wanted to immediately formula feed or have a c section, I know many women here would gently encourage her to maybe see a therapist and address those issues. I think this is the same........for me, I think of it in terms of the example I want to set for my daughter. Do I show her that its good to ignore or run away from things that make you uncomfortable? Or do I show her that sometimes we need to get our courage up for our greater good?

I think it's one thing to say "I don't think I need one so I'm skipping a year or two" but I don't feel like it's healthy to say "I am afraid of it, regardless of my health, so I'm going to run away from it".

Also, to LoveChild.........I don't really understand what you are saying. It sounds like you had a bad experience. But getting Chemo doesn't mean you'll get MS.........that doesn't make sense. I'm grateful for Chemo, because it's saved the lives of people who are close to me, and now they are able to live full lives and be around for their kids.

I understand that getting bad paps or abuse in your past is hard to deal with and it can make this issue hard. I just don't feel like it's a good example to set to say that you're willing to risk your life because of a fear.


----------



## wednesday (Apr 26, 2004)

I recently learned that my paternal grandmother died of cervical cancer. She died before I was born and all my life I knew it was "cancer" she died of but I had never asked what kind. I knew she had been a smoker so I guess I assumed it was lung cancer. Last week I asked my mother to help me fill out a family medical history and was very surprised to learn it was actually cervical cancer my grandmother died of. She was young-ish, only 53. So I guess I won't be skipping any pap smears.


----------



## mommystinch (May 18, 2004)

I don't think you are making a big deal out of it. The only pap smears I have ever had were the first time I went to a GYN because of some aweful pains I was having, and at my first prenatal visit, and my six week postpartum visit. I endured those because I "had" to, but I will not be scheduling regular pap smears.

As a woman, it is your choice to decide what you have done to your body. As long as you are comfortable with your decision, that is all that matters.


----------



## calpurnia (Sep 26, 2004)

You might be interested to know that Britain has recently changed its system - you used to start at 21 and have smears every 3 years, but now they've changed it to starting age 25 and every 3 years.

Have you heard recently that they have developed a vaccine against the cause of cervical cancers?

http://www.guardian.co.uk/uk_news/st...349358,00.html
_
The results, published in the Lancet medical journal, relate to vaccine against two types of human papillomavirus (HPV), 16 and 18.

It was effective against all persistent infections linked to the virus among women who received three doses of the vaccine. Among those who received one dose, it was more than 90% effective against persistent infections and offered complete protection against pre-cancerous tissue changes. About 230,000 women worldwide die from cervical cancer each year, with most deaths in developing countries._

_Around 470,000 women a year are diagnosed with cervical cancer, but if detected early, survival rates are good. A preventative vaccination programme might first help in countries where screening for infection is limited or unavailable, although many believe a combination of vaccine and screening might reduce the costs of treatment._

Unfortunately, you'll need to get the vaccine before you become sexually active so we'll have to keep on with the smears. Maybe our daughters won't though.


----------



## lynchmon (Nov 12, 2004)

I think it's a personal decision. Does your family have a history of cervical cancer? Have you ever had an abnormal pap? I have had to have cancerous cells frozen off a few years ago when I was in my early 20's so I have to go at least once a year. Also, cervical cancer is the slowest growing form of cancer. Chances are you if wait a couple years in between paps you'd be okay.


----------



## magentamomma (Mar 18, 2004)

It is not just fear. I went three years in a row despite fear. What eventually stopped me was that besides the exams my midwives gave me while in labor, I never ever felt respected by the practicioners.I don't have money or insurance so I am not really in a position to shop around for a caring practicioner, and although I have dealt with most of the issues surrounding the sexual abuse, it is hard to process that I am paying someone else to violate me. If I were treatined as a human and not an oriface, I might feel better about the whole thing. As for the example I want to set my daughters= I hope things will be different in women's health care when they come of age, and if not I will support their choices.


----------



## josie&baby (Sep 3, 2004)

FYI- NAK!









I just have to add my thoughts here. I had normal paps from 16 until 21. When I was 7wks pregnant I had an abnormal pap that showed I have HPV. They say somewhere between 30-50% of the US population has HPV, so it is fairly common. But, it raises your risk of cervical cancer a great deal. Pregnancy hormones can awaken a dormant virus such as HPV and cause ALL kinds of troubles. Also, there are many different strains that may not cause the genital warts associated w/ HPV. Planters warts are actually a form of the disease.

I also must strain that anytime you are sexually active with someone you are essentially exposing yourself to everyone they have been w/. I learned this the hard way.

I suggest finding a practicioner you like & trust- interview as many as it takes- because your health is worth it. I also believe we owe it to our kids to be healthy & safe.

You may not be "at risk," per say, but wouldn't you rather be safe than sorry?

I am lucky that my midwife also does well-woman checks. I wouldn't trust my hoo-hah to just anybody!!


----------



## eminer (Jan 21, 2003)

Quote:


Originally Posted by *calpurnia*
Have you heard recently that they have developed a vaccine against the cause of cervical cancers?

Until you posted this, I had no idea that over 95% of cervical cancer is caused by HPV. A friend of mine has never had sex, and we've been talking about her dread of having her first GYN exam (which she feels she "should" have, because of the pap smear). So far I haven't been able to find any information on the web about that other 5% -- what is my friend's personal risk? I wonder if the information is available...


----------



## Marlet (Sep 9, 2004)

I hate them as much as the next lady but I do think they are necessary. I have had annual paps since I was 16 (I was on birth control and had to have one in order to get it). I am not at risk for cervical cancer but I have had an abnormal pap. I had abnormal semi-cancerous cells on ONE pap not to long ago. Instead of waiting the 6 months they usually wait (to see if they grow or anything) they wanted me in in three months. I wasn't even 18 yet. All of my paps have come back normal before then and since then (the one I had to check up on everything three months later turned out perfectly fine). I was glad I went....I would have rather found out in such an early state then to go through it growing and possibly becoming something worse and not knowing it til it was too late.


----------



## TurboClaudia (Nov 18, 2003)

Finding the right provider that you feel comfortable with is of the utmost importance.

ACOG guidelines summarized here: http://www.acog.org/from_home/public...05-04-04-1.cfm

from the page linked above:

First Screen
About three years after first sexual intercourse or by age 21, whichever comes first.

Women Up
to Age 30
Annual cervical cytology testing.

Women Age 30 and Older
Three screening options:
1. Women who have had three negative results on annual Pap tests can be rescreened with cytology alone every two to three years.
2. Annual cervical cytology testing.
3. Cytology with the addition of an HPV-DNA test. If both the cervical cytology and the DNA test are negative, rescreening should occur no sooner than three years.

*Women of any age who are immunocompromised, are infected with HIV, or were exposed in utero to DES should be screened annually.

warmly,
claudia


----------



## LoveChild421 (Sep 10, 2004)

To anothermama- what I was saying is that chemotherapy is just another quick fix medical technology so common in our society. The medical culture in the U.S. focuses more on addressing symptoms than curing illness and creating well, thriving people. Chemotherapy if you are unfamiliar with what it is- is simply a cocktail of poisonous chemicals infused or taken orally by the cancer patient to kill cells- cancer cells- but it also kills immune cells, nervous system cells, and reproductive cells to mention a few.

I believe in a more holistic model of health that treats cancer as a symptom of being unhealthy in some way- the treatment is thus- high antioxidant whole foods diet, vitamin and herb supplements, spiritual realization, etc. to address the root of the problem- not just kill cells.

In _Women's Bodies Women's Wisdom_ Dr. Christiane Northrup discusses cancer in these terms- and she states that the main reason cervical cancer develops is that first anywhere from 50-80% of women have some form of HPV which is linked to cervial cancer but MOST IMPORTANTLY- the reason some women carry HPV forever and never develop cancer and some women do develop it is simply that the women who don't get it have a strong and healthy immune system capable of keeping the virus dormant and those who do get it do not have as strong immune systems

So what can one do to keep a strong immune system and thus prevent cancer? Dr. Northrup suggests- 1)get OFF birth control pills and stop smoking cigarettes 2) learn to reduce and deal with stress 3) watch your diet! whole foods high in nutrients! 4) deal with any emotional or spiritual issues you have

It makes sense to me that the one time I had an abnormal Pap- I was on birth control pills, smoked, had just gone through the stress and trauma of a miscarriage and the stress that placed on my relationship with my boyfriend amd didn't eat a decent diet since money was not there

Chemo may save lives, but it also strips the quality of life away from those who don't have long and doesn't cure everyone like the magic dr.s make it out to be. I have never known someone survive cancer from chemo and radiation or "conventional" medicine alone- at least they haven't survived long- maybe go in remission for a couple years (they spend feeling bad) and them dying of cancer in another part of them.

The only peopleI know who have survived cancer have either done a mixture of alternative/ holistic therapies and conventional treatment or have just done alternative/holistic treatments.

But that is my experience. In a nut shell, chemo is not the knight in shining armor dr.s make it out to be. We would all do better if we look at medical issues in a more holistic fashion


----------



## Ms. Frizzle (Jan 9, 2004)

I have gotten one every year since I was 18, I also get a mammograme yearly as well. When I was in high school a friend lost her breast to cancer, so I take no chances. you have to catch it early of you want to beat it.


----------



## Arduinna (May 30, 2002)

Well, let me share my story for those that don't know anyone that has survived long term after chemo. A cousin had chemo for his cancer and so far has lived a normal happy life for over 10 years and has since become a father. He was a child when he got cancer. I've been in remission for almost 7 years with no recurrences and have a normal happy life after having 6 months of chemo for the cancer I had. A very good friend of dh is alive over 6 years after having a bone marrow transplant. I also know another man that has been cancer free for over 20 years after chemo, he had the same kind of cancer I had. I have more stories, but I will limit them. None of us has a poor quality of life.

None of us did any alternative treatments during our cancer treatment. I only know one person (my cousins MIL) that refused conventional medicine and chose to go 100% alternative to treat her uterine cancer. She died in less than 6 months.

What I learned is that when you are faced with your own mortality and leaving your children motherless, you make whatever decisons are correct given your individual diagnoses and personal beliefs. There isn't a right or wrong answer to this, except not to get sucked into the propaganda from BOTH sides. I've actually seen much more promise of cures from alternative practitioners than oncologists. In fact I was seeing a natural health practitioner at the time I was diagosed and she recommended I go to Mexico (interestingly that is where my cousins MIL went that died). Some people are incurable. They should be given the best care possible and pain relief.

My Dr gave me a 30% chance, I beat those odds but I know I would have died without treatment as I felt myself dying before I was diagnosed. You don't ever want to know what that feels like. I never thought I'd agree to chemo either. It was very very difficult for me to get over my distrust and alternative views. There is no 100% cancer cure all. The best we can do is research with an open mind and make personal care decisions based on our medical condition. After all cancer is not one disease, but many many different diseases with different causes, treatment methods and potential outcomes.


----------



## paloma (Feb 24, 2004)

There is a definitive need for competent, respectful care. If any of you need a pap smear and are in my area, I can do it with you, showing you how to use the speculum for yourself if you wish, and making you as much a part of the process as you would like to be. PM me. I, too, hate it, and that is how I got into teaching OBGyn residents how to perform the exam in a competent manner. There is a lot of misunderstanding as to how to correctly do a pap smear, not just in the clinical sense, but also integrating the procedure with the fact that the patient is not likely to complain. Thus, the intolerable becomes tolerated.


----------



## Lousli (Nov 4, 2003)

Quote:


Originally Posted by *LoveChild421*

In _Women's Bodies Women's Wisdom_ Dr. Christiane Northrup discusses cancer in these terms- and she states that the main reason cervical cancer develops is that first anywhere from 50-80% of women have some form of HPV which is linked to cervial cancer but MOST IMPORTANTLY- the reason some women carry HPV forever and never develop cancer and some women do develop it is simply that the women who don't get it have a strong and healthy immune system capable of keeping the virus dormant and those who do get it do not have as strong immune systems

So what can one do to keep a strong immune system and thus prevent cancer? Dr. Northrup suggests- 1)get OFF birth control pills and stop smoking cigarettes 2) learn to reduce and deal with stress 3) watch your diet! whole foods high in nutrients! 4) deal with any emotional or spiritual issues you have


You know, this kind of bothers me. There is already so much social stigma against diseases that are sexually transmitted, despite the evidence that up to 80% of the population might be affected by them. Now we're adding in the idea that somehow whether or not I contract cancer or "only" get HPV is ALSO my fault? Great. Let's blame the victim, shall we? I had a tremendous amount of guilt and shame when I got HPV as a 17 year-old, and certainly learned the hard way that any I was getting all the past history of my partner. So if I ended up getting cancer from my HPV, that would have been my fault too, since I was on the pill. Oh yes, I also hadn't dealt with my "emotional or spiritual issues." So my unresolved spiritual issues gave me cancer? I'm sorry, but that is just so F'ed up.

As far as paps go, I had a few abnormal ones, at age 17 and 18, but they have been normal ever since. My sister and a close friend were not as fortunate. Both of them have had surgeries to remove pre-cancerous cells. Both of them had these surgeries before the age of 30, and I believe my friend's surgery was before the age of 25. I don't like getting them, not at all, but as far as I am concerned they are preventative medicine, and important in keeping me healthy. My grandmother and great grandmother both died of cancer (uterine and ovarian).


----------



## doctorjen (May 29, 2003)

I realize as an allopathic practioner myself, my opinion may not count for much, but I can't resist chiming in.
The new guidelines for pap smears take into account that for most young women, HPV-caused dysplasia is transient. This means many pap abnormalities will resolve without treatment and for pre-cancerous findings there are many different reasonable methods of treating or simply following the abnormality. Therefore, the recommendation for healthy young women is to start screening at age 21 or within 3 years of starting sexual activity. Pap smears are a screening test. They do not diagnose accurately. When one has an abnormal pap, usually a test called colposcopy with or without biopsy is recommended to diagnose what exactly the problem is.
About 10,500 women a year in the US get cervical cancer. About 3,900 die from it. It used to be one of the most common causes of cancer death in women, but in the last 30 years is very treatable, due in part to early detection because of cancer screening.
Pap smears, and chemotherapy, and other allopathic medical treatments and tests are of course not 100% effective. No honest medical doctor would tell you they were. Any reasonable adult can look at there own risk factors and make their own decisions about any test or treatment there is out there.
To say that no one survives long after chemotherapy is just not accurate. My best friend is getting married Saturday. His bride had a bone marrow transplant after high dose chemotherapy for Hodgkin's lymphoma over 10 years ago. Thankfully, her treatment was successful and she is living a very full life, and starting a new life together with my friend! Although that's a personal anecdote, the hard data on success is available from the American Cancer Society, and many other places.
I agree that competent, compassionate care is sorely lacking in many places. A pap smear should never be a humiliating or painful experience. No medical care should be. Ask around to find who's good in your area. Complain if you are treated badly. And of course, find out the facts and decide for yourself what is best for yourself.


----------



## josie&baby (Sep 3, 2004)

*Lousli--*

I just wanted to send you some







! I think people say things w/o thinking about they can come across on a computer screen as opposed to saying them face to face.

I totally identify with the shame that comes along with an STD. I am glad to hear you've had good paps since those first two abnormal ones! That makes me hopeful for a clear one next time around!

*LoveChild421*

Some people are inclined towards modern medicine and others are not. It is a very PERSONAL choice one has to make for one's self. There are a lot of factors that come into making decisions like paps, chemo, etc. But, after seeing my older sister go through chemo and live to be a grown woman I think my parents made the right choice for her (she was a child at the time). I am EXTREMELY thankful that we have modern medicine to fall back on when needed and to help prevent the preventable. I mean- think of how many women's lives have been saved by a simple pap!!

As for the thing about strong immune systems and whatnot-- Lousli is right. Women with HPV feel bad enough without the idea being put into our heads that it's OUR FAULT that we're in the situation we're in. I did everything the right way when it came to sex and STILL got HPV from someone. Now please don't tell me that ending up with pre-cancerous cells is my fault too.


----------



## Verity (Aug 29, 2003)

I was exposed to HPV 18 years ago, and I've had only one abnormal pap in all that time. Will the HPV-DNA test tell me what type of HPV is in my system, and whether it puts me at higher risk for cervical cancer? Aren't some types of HPV more "benign" than others?

I would love to avoid having to go every year (I have grown to loathe any doctor who requires me to undress ;-) ), but I don't want to skip pap tests if I'm still in a high-risk group.

I am not even sure what kind of practitioner to see, now that I am past having babies. Going to an OB/GYN seems weird now, but I can't imagine going to a family practitioner.


----------



## doctorjen (May 29, 2003)

HPV high-risk DNA can be tested for using liquid-based cytology for a pap smear. Without high-risk type HPV, the risk for cervical cancer is quite small.
Edited to add - we family docs aren't so bad! And many of us are more likely to view someone as a whole person and not just a body part. Probably 2/3 of my practice is women's health, including performing pap smears.


----------



## anothermama (Nov 11, 2003)

Quote:


Originally Posted by *LoveChild421*
To anothermama- what I was saying is that chemotherapy is just another quick fix medical technology so common ....

But that is my experience. In a nut shell, chemo is not the knight in shining armor dr.s make it out to be. We would all do better if we look at medical issues in a more holistic fashion

edited to say:
I would suggest spending more time researching all aspects of this issue.


----------



## Verity (Aug 29, 2003)

_Probably 2/3 of my practice is women's health, including performing pap smears_

Part of my reluctance to see a family practitioner is the thought that she wouldn't do pelvic exams/paps very often. I guess I am wrong about that!

I wouldn't go to a male family practitioner, but I wouldn't go to a male gynecologist anymore, either.


----------



## love2all (Dec 13, 2003)

Whoa-
i am starting to worry.
I am 35yo and I have NEVER had a pap-smaer. I have a radical approach to medicine ( in our culture anyway) and have always intuitively known i was doing okay.
BUT reading these posts sends a shiver up my spine- I guess it is abnormal for a women my age not to be getting them. Maybe I can find a lost cost clinic- but the health centers always seems like behemoth impersonal places... a mw maybe?


----------



## doctorjen (May 29, 2003)

Many planned parenthood offices have nurse practioners who do paps and pelvic exams at low cost. Many county health departments do the same. In my county, the county provides vouchers for paps and breast exams and mammograms to low income women that can be used at any participating provider's office (In our community, all of us who provide well-woman care accept the vouchers.)
Although I understand many women don't want to see a male practioner (which actually is great for my practice since I'm one of the few female docs where I practice) I have found personally that when it comes to an MD, personal philosophy is more important than gender. The best well-woman and pregnancy care I have ever received was from my male family doc with my 3rd pregnancy, and the years right before and after that. He was compassionate and careful, and believed in a very non-interventional style of attending births. He attended me in the family birth center of a large teaching hospital, and was amazingly quiet and unobtrusive, climbing into the queen size bed with me and dh, older ds, and a friend of mine to catch the baby. It was definitely my nicest attended birth. (My accidental UC at home with #2 was pretty nice, too, though!) I was very sad when he moved away.
I've found some female MDs seem to almost have less compassion for their patients - I think feeling that since they have assimilated the medical model to get their training, their patients should just buck up and do the same.
Some family docs do a lot of well-woman care, some don't do any, so you'd want to ask around.


----------



## TopazBlueMama (Nov 23, 2002)

Quote:


Originally Posted by *love2all*
Whoa-
i am starting to worry.
I am 35yo and I have NEVER had a pap-smaer. I have a radical approach to medicine ( in our culture anyway) and have always intuitively known i was doing okay.

LOL! I kind of expected more posts like this, here at mothering!







guess not though. It's understandable.

love2all, I think that you should continue to trust your intuition, and not react out of fear, but that's just me.









I thought one response was interesting, that said to see if you could do the swab yourself--I would be interested in that, but I'm sure it would be very hard to find a doctor that would allow that. That's kind of what it is about for me, I'm an independent soul and don't really like being told that I have to do something.







I like to learn how to be self reliant, and these pap smears are the only thing that are making me think that I have to go to the doctor. I'm fine with doctors if I'm already sick and need help, but I like to avoid the whole medical scene when I can.

I also have read things that doctors have written about women and vaginas that were just very rude and disrespectful, imo. So, I do think it is key to find a good practitioner, but how the heck are you suppost to do that? Go from doctor to doctor until you find one that is respectful? I don't have the time or money for that. It's all a little frustrating. The whole medical scene has gotten so out of hand. I wish we could just get back to basics. I'll keep my eye on the look out for someone I trust.

Thanks everyone!


----------



## Peppamint (Oct 19, 2002)

Quote:


Originally Posted by *tweetybirds2*
So, I do think it is key to find a good practitioner, but how the heck are you suppost to do that? Go from doctor to doctor until you find one that is respectful? I don't have the time or money for that. It's all a little frustrating. The whole medical scene has gotten so out of hand. I wish we could just get back to basics. I'll keep my eye on the look out for someone I trust.

This is my trouble... I'm currently uninsured so there's no way I can go to a doctor unless I'm very sick. The local WIC office offers care on a sliding scale, but the doctors available there are doctors that I and my family have dealt with and there's no way any of them are touching me anywhere, let alone my yoni. My midwife's backup OB (a male, but he's okay I guess) would be my first choice I think, but since I'm not insured I'm just not doing anything right now. I may sign up for medicaid when I get preggers next, get a pap and then drop the insurance since they won't pay anyone but a doc (not CNM or CPM) and I will only homebirth from here on out.

The best pap smear I ever had (as far as paps go LOL) was from the female OBGYN that caught dd (and also did a lot of unnecessary interventions including cutting my perineum). For some reason though, she's gone kind of "classy"- won't accept patients on medicaid even if they plan to pay cash etc etc.

Don't get me started on insurance... dh's employer offers it for me if we pay $75 a week just for me. That's our grocery budget.







On the other hand, dh has several family members who are fully insured and go to the doctor if they fart too hard or get a tickle in their throats.


----------



## josie&baby (Sep 3, 2004)

I thought of another pap related thing...

If you have to go in for a pap ask for the plastic speculum! My last pap was w/ one and it was WAY better than the cold metal ones!!


----------



## paloma (Feb 24, 2004)

Oh, nuts! They should warm the metal spec. under water! Some of the cheaper metal specs have sharp edges. I think the kind with the clip-on light has the sharper edges. If you are going to be getting a pap at a new place, find out from the old place what size spec you used the time before, if it was comfortable (comfort is, of course relative).

Believe it or not, sometimes a larger spec. is more comfy. It affectively holds back the vaginal walls so it does not need to be wrenched open to visualize the cervix.

Oh, it is kind of hard to swab yourself. Your hand gets in the way of the mirror.


----------



## AnnMarie (May 21, 2002)

I don't go either unless I need birth control. Mine have always come out fine and there is no family history, so I'm not worried about.


----------



## LoveChild421 (Sep 10, 2004)

damn I didn't mean to ruffle feathers- just thought a more holistic opinion would be accepted here- guess not. I agree that decisions about using conventional medicine or alternative medicine is very personal. I am not saying that no one ever survives if they use chemo- I only know what has happened to the 6 people I know who have had cancer. The only one who is aliveand well today is my great-uncle who had an experimental herb-based treatment in Europe for advanced prostate cancer. The others I know are dead with the exception of a 24 year old cousin who is now infertile due to radiation and chemo.

Hey I have HPV too- at least my dr. said that it is likely since I had an abnormal PAP. I'm not saying we should "blame" ourselves if we get abnormal paps- I am simply saying hey there is something we can DO to PREVENT them ourselves. I am simply saying that precancerous cells are not some "random" thing that we have no control over at all. That's silly- ok I can smoke a pack a day and take birth control pills which rob my body of B vitamins (look it up I have had several registered pharmacists tell me the same thing), and I can eat a fast food diet- gee I have no idea why I got an abnormal pap and my friend who exercises, eats well, and takes care of her body as if it is truly a temple never gets abnormal paps anymore even though we both have HPV.
We have to stop acting as if cancer is just random and has nothing to do with how well we take care of ourselves. And if you think there is no connection between cancer and spiritual/ emotional issues- consider reading Dr. Northrup's book Women's Bodies, Women's Wisdom- she is an OB/GYN who has 20 yrs of experience and has seem many patients whose cancer stems from these sort of issues- once they resolve them they "mysteriously" clear up.
Oh and I know that sometimes perfectly healthy people get cancer- I am merely suggesting that we as women do play a role in our own health- how we treat our bodies and ourselves directly impacts our health- why not take as good as care of ourselves as possible?


----------



## lorijds (Jun 6, 2002)

Here are some thoughts:

* Everyone should read the book "The Abnormal Pap Smear, what every woman should know." It is a couple of years old, published in 2000 or 2001, right before the change in recommendations; but filled with good, solid, very easy to understand information.

* Busybusymama--if a person has a medical card, it is illegal for them to go to a medical practitioner and pay cash. For us, anyhow, if we accept cash payment from a medical card client, we could be in deep trouble with the state and the board of healing arts.

* Emotions play a huge role in our health, and I don't think that Lovechild421 was way off base. I think that what she was saying is that being healthy includes spiritual and emotional well-being. Certainly emotional stress depresses the immune system, and a depressed immune system can be associated with HPV problems.

* HPV is a sexually transmitted disease. If you have ever had intercourse with a person who has ever had intercourse with another person, you are at risk. The only people who are at no or virtually no risk for HPV are lesbians who have never had intercourse with a male, and a woman and man who have never had intercourse with anyone else. The vast majority of women who die of cervical cancer have not had a pap in the last 5 years. Cervical cancer is slow to develop, and very treatable. Most HPV virus subtypes are not associated with cervical cancer. Unless you have a test done to determine the viral subtype, you have no idea which you have.

But a pap/well woman exam is more that a pap. The internal exam feels for size and texture of your internal organs. An enlarged or tender ovary, or an abnormal feeling uterus should have an ultrasound. Ovarian cancer is very deadly, much more so than cervical cancer. Even exclusive lesbians can and do get ovarian cancer.

In our office, the speculums and gel are heated; mirrors are offered to every woman, to be able to visualize her cervix and vagina, as well as her vulva. You can have anyone present whom you wish. As far as scheduling, you still need an appointment every year, but you don't have to have a pap if you meet certain guidelines. Really, you don't have to have a pap at all; but we would certainly reserve the right not to prescribe certain medications. If you've had many normal paps, are in a relationship with a long term partner, don't have any other high risk issues, then you can skip a year. (These are the recommendations of *our* practice, just fyi).

I really recommend that you find a practitioner you like, and get a pap done regularly, on a schedule that you both agree upon. Asking friends and like-minded people who their well-woman practitioner is can help you find a good practitioner. Or, call a rape hotline and ask if they have a list of recommended practitioners, ones who have been recommended by women who have a history of abuse. Typically these practitioners will be more sensitive in general. We have even been known to prescribe ativan or valium for a couple of our clients who are high risk, but who have huge issues with having paps.

Ultimately the decision to get one or not is yours; and as long as you are comfortable with that and it is an informed decision, fine.

Lori


----------



## Peppamint (Oct 19, 2002)

Quote:


Originally Posted by *lorijds*
Here are some thoughts:

* Busybusymama--if a person has a medical card, it is illegal for them to go to a medical practitioner and pay cash. For us, anyhow, if we accept cash payment from a medical card client, we could be in deep trouble with the state and the board of healing arts.

Wow, I didn't know that. That sucks.







They were pretty snotty with me though... but there were other issues going on I think. I have considered trying to pay cash for an exam now that I'm totally uninsured. But when my mom had to pay for her visit even though she was insured (office copay was 100%







) it was over $100 just for the visit and that didn't include sending the pap to a lab for testing... I can imagine it would end up being the equivalent of a car payment for me!

I think I will apply for Medicaid when I get pregnant, then I can get a pap smear from my midwife's backup OB and then cut off the insurance since they will only pay for a hospital/OB birth.

LoveChild- I meant to say earlier, I too wouldn't do chemo. I would try natural/alternative treatments. I watched my baby brother die from complications of chemo and I could never put that stuff into my body. It would be a much harder decision to make if it was my child, but for me I just cannot do it. I've been following Samuel's Story and the chemo almost killed him this summer. His mom lives on pins and needles, praying that the chemo will kill the leukemia and not her son or anymore vital body parts. But that's JMO.


----------



## Goku Son (Feb 24, 2017)

TopazBlueMama said:


> I'm sick of doctors. I'm dreading the thought that I might be "due" for another pap smear.
> Should I feel guilty that I'm even considering not getting one, like I am "risking my life?"
> I am NOT at risk for uterine cancer.
> 
> ...


I think its your choice really my daughter was asked to have a pap smear she is 21 never had sex never had a sexual partner she loves life loves to hang out with me her bf dumped her cause she refused to give him sex and the doctor said he wants to give her a pap. I am really angry about it and seething he said she's at the age now I told him its not your job to sexually humiliate my daughter. I want her to loose her virginity to a man not to a long piece of metal.


----------



## poshbymeggymegs (Feb 26, 2017)

Not bad at all! They're awful! I've only ever had TWO and that was because I was pregnant and basically had no choice, if I'm not pregnant I don't get them done, I too was fine both times.


----------

