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What Aren't We Talking About?

A physician's perspective

Picture this. You are on your way to your doctor's appointment. It's taken the alignment of all the celestial bodies for you to even have time in your schedule to do this. The kids were dropped off. Your meetings, reassigned. Aunt Flo just cleared out the guest room and, wait for it...you even groomed!

Watch out world - you are filling your own cup!

The excitement from finally embarking on this self care journey is short lived, however, when you recall that you are currently headed to Stirrup City. Speculum exams are so awesome! (Said no woman, ever).

“It’s OK, you got this,” you tell yourself.
“It’s only once a year!” (Your last visit was 4 years ago).

You have been experiencing changes in your cycles, mood, and even your energy levels. Not to mention your friend recently had a cancer scare. This is your chance to have all of these concerns addressed. Here. We. Go!

Except, they don’t get addressed. They don’t even get brought up.

Your visit doesn't start until 30 minutes after its scheduled time. You are seeing someone you have never met before. The paper gown shreds as you try to breathe without expanding your chest. And apparently, pap smears can be done with the doctor having one foot out the door. Who knew!? Wait, were they a doctor? Did you even have a pap smear?

Welcome to healthcare today.

Being a physician, I feel compelled to attest that, despite popular thought, it’s not because your “healthcare provider” made the wrong career choice or that they don’t care (at least not most of the time). They are scrambling to provide the best care to the most people possible in a finite amount of time. Wrong or right, the “best care” component is what is taking the hit.

So what can a newly minted self-care warrior like yourself do to have a more empowered experience, regardless of who you are seeing?

Start by making a list!

Trying to recall what questions you need to ask on the spot can take up more time than the answer’s themselves. Having a list will keep you and your provider on track to efficiently address your concerns within the time allotted.

Have a better understanding of what you do and do not need so that you can nudge the time-crunched provider out of their autopilot mode. Pap smears are only every 3-5 years for women between the ages of 21-65*.

  • Mammograms can start as early as age 35 and are recommended every 1-2 years.

  • Colon cancer can now be effectively screened by pooping into a bucket* starting at age 40.

  • Bone screening can wait until age 60 as long as you are taking Vitamin D and calcium daily.

  • I also recommend that women over 40 have yearly screening for cholesterol and diabetes.

  • Ask to have your mammogram and blood work orders sent to you a few weeks before your appointment. This way, you can discuss your results at your visit (rather than “no news is good news”).

Advocate for your comfort!

Give your provider a heads up if you tend to have challenging exams historically. If you are having a procedure, ask for something to help with the discomfort or anxiety. Ask for a smaller speculum to be used. For particularly sensitive cases, it is perfectly OK to request the exam be performed while you are under anesthesia.

Make more than one appointment if you have multiple concerns.

As difficult as it may be to get the time to do this, trying to discuss too many things in a limited time slot is less than optimal for you and the provider. You will most likely leave feeling very confused about many topics instead of being clear on at least one. Have realistic expectations and set up ample time in the form of multiple visits so as to truly have an impactful discussion.

Ask “What are all of my options?”

And remember that the option of doing nothing is also one of them. You should be in collaboration with your provider to develop your plan of care. You have the right to play an active role in the decision making of your health and wellness. And you can only do that when you know all of your options. Not just the ones that are considered to be the best, most popular, or convenient.

Lastly, remember that your health and wellness is not just the sum of all of your separate body parts. This means having those uncommon conversations - about sex, your relationships, your nutrition, how you feel about your body, self worth, and purpose.

This is in addition to how your boobies and vagina are doing.

Whether it is because you haven’t been able to make the time, or because the healthcare system doesn’t allow for providers to give more time, is irrelevant. What is important is that women are left with a feeling of empowerment to take better care of themselves. And there is no one better to start these conversations about your Mind, Body, and Spirit, than you!