Wednesday, September 14, 2011

OTT - Let's get physical

I had no intention of writing about the following, but a good friend suggested it, and I've (sort of) warmed to the idea. If you're male, you may want to move along - nothing to see here.

Last week, I finally had a long overdue check-up. A simple enough procedure, but of the variety that I think most women put off doing.

First of all, a nurse ushered me into her little office to check my blood pressure, weight, height, and ask all the routine health-related questions.

Next, I was led to the consultation room to wait for the doctor. I was told to get undressed, put one of those backless gowns on, and that the doctor would be there shortly. Having never worn such a gown in either Australia or the UK, I'd always thought they existed solely for  American TV shows and movies. I first realised I was wrong about that when the Faery had to have a paediatric physical in order to attend preschool last year. She was four, and they produced a mini backless gown for her to change into. Really? That, right there, seemed like an OTT moment to me.

So, naked under my medical-centre-issued gown, I waited. The doctor arrived, and told me she just needed to wait for the nurse to come and assist. For a pap smear? Really? 

The nurse arrived, wheeling an entire tray full of shiny implements. Really?

The doctor instructed me to get on the bed, and place my feet in the stirrups. REALLY? 

It's not like I'm afraid of stirrups, but I've had this procedure done numerous times, had countless pregnancy check-ups, given birth twice... and never once saw a pair of medical stirrups. It felt so... unnecessary. OTT.

The Aussie equivalent of this procedure involves half-stripping, hopping onto the bed for the doctor, the doctor tells you to pop your heels on the bed's corners, shuffle your bum as close as possible to the edge of the bed, take a deep breath... and... then it's over and done with. Relax. No assistant on standby.

The British version (yep, I've been around the world where pap smears are concerned) is pretty much the same, except they call it a smear test, and registered nurses are also able to perform the procedure.

This American version? OTT, if you ask me. I guess the backless gowns could be interpreted as an attempt to provide some dignity by protecting one's modesty.... but then the stirrups go and do away with any sense of dignity.


An interesting aside - in Australia, pap smears are recommended every two years. In the UK, every three years. In the US, it's recommended every year. I wonder what the stats are for rates of cervical cancer in each country, and just how much difference yearly, versus every two years, versus every three years really makes.

At any rate, at least I can now cross this off my very long to-do list...


  1. Without looking at the statistics (and let's face it - I've got as much hope of interpreting them correctly as I have of calculating pi or baking a cake without it collapsing) but I think the yearly thing has more to do with the doctor getting paid for doing the exam.

    Secondly, the backless gown: I've done IVF and had two babies and the only time the backless gown came into play was during an actual surgical procedure or embryo transfer.

    Thirdly, the best pap smears I've ever had have involved me lying on my side with a sheet over me, one leg raised slightly higher than the other, in, out, done. No stirrups, no exposed pubic area, no worrying I'm going to fart in the doctor's face.

    It only seems commonsense to me: why not make it as easy and painless as possible for all concerned, then we can get back to our day?

    I've only ever had someone else in the room when it was a male doctor and that was his choice. I guess it is to guard against allegations of impropriety but it seems sad that the trust between patient and physician is eroding to that extent.

    Okay, worst pap smear ever? A young male GP when I was 26. It was so bad I was in tears and he kept apologising but he didn't pull out until he was done. I actually felt violated and I'm not easily shocked or upset when it comes to bodily matters so that's saying something. I think he was just clumsy but really he should have stopped at the first signs of distress. I just hope he's gotten better at it over the years.

    Best pap smear - my old family doctor and the lovely female GP we saw for years when we lived in Thornbury. She was wonderful. Actually thinking about making the trip to see her as I am due for one again.

    I'd cross town for good pap.

  2. Yes, very clinical compared to what we're used to. But in saying that, my pap tests have varied wildly in technique depending in the doctor. Perhaps knowing what you're going to get each time could be preferable?

    I had one doctor, a woman who must have been doing paps for over 20 years, who made the whole experience so awful because she was really scattered and clumsy. It was so odd.

    As for the backless gown, I have worn many! Wisdom teeth out - gown. Very early ultrasounds requiring dildo cam - gown. More gown occasions than I can think of right now!

    I had a lovely GP when I lived in Thornbury too, Mel! I often think of going back to see her - I have seen some dodgy bulk billing GPs lately that have me despairing....

  3. Mel, I have no doubt the yearly recommendation is more to do with health insurance companies ruling the roost here than a genuine need.

    Sounds like we should move to Thornbury then! I haven't had a GP that I've really liked or clicked with since my early pregnancy with F (she was also pregnant with her first child, so it was kind of cool) - then she up and moved to the UK because of her husband's work. How rude!

    Angie - you're right, I may have worn something for an X-ray once, but even then I think it was more of an apron than a gown. Apart from that, no gowns, ever. No even for dildo cam!

    I guess the world would be a boring place if things were done exactly the same way everywhere, huh?

  4. I almost forgot about dildo cam - or as I used to call him "the probe".