For the past two weeks I’ve caught up on some important and slightly overdue medical appointments. I’ve been to my gynecologist for my annual exam and pap smear. I also went to the dentist for some minor dental work. I was reading a blog recently which posed a question to women that really got me thinking. The question was: “Which would you rather go visit– the gynecologist or the dentist?” That was a tough one and one I discovered I couldn’t easily answer. And if going to the gynecologist AND the dentist wasn’t enough, I also went for my slightly overdue mammogram, and then to my PCP. All within a week and a half of each other. I’m sorta feeling like I deserve a medal or something.
Now don’t get me wrong. I love all my doctors. My gynecologist is a very nice man. He’s professional, a respected doctor, and a darn good gynecological surgeon I might add, but I would be perfectly fine if I didn’t ever have to see him again. I tease him every year that even though I love him, he’s just not one of my favorite people to go visit. And every year when I tell him that, he smiles and tells me I’m giving him a complex.
My gynecologist is a part of a very large group– a Women’s Health Care Center– that moved from a University Teaching Hospital to a shopping mall center (it’s still associated with the teaching hospital). When he was at the hospital, I hated everything about going there– from the horrible parking garages, to the rushed and not-real-friendly valet parkers, to feeling like I was just on one big assembly line. The teaching hospital had a very impersonal feel to it and as much as I hate to admit it, the people there were never caring or compassionate. I always felt I was just a number to them, not a patient or even a person. So when the group moved to the shopping center, I thought surely it would be an improvement. I was wrong. Check-in is done at a kiosk now. No human check-in but a machine. I’ve always had to stand in line for one of the two kiosks and there’s not much privacy with someone standing next in line looking over your shoulder. After the kiosk check-in, you go to the desk where you are handed a restaurant pager. No, I’m not kidding. A. Restaurant. Pager. Just like the one the restaurant hostess hands you that vibrates and lights up to let you know when your table is ready. When your pager goes off, there are signs telling you to stand by a big automated door until a staff member (usually a nurse) comes to get you.
I arrived about 30-35 minutes early for my appointment because there’s always a line at the kiosks and the desk, and there’s always a ton of paperwork to fill out. Just about every year, my pager buzzes before I can get the paperwork filled out. Not this year. I completed the kiosk check-in, was handed a pager, and took a seat to begin filling out the paperwork which was to update my medical/surgical history. I FINALLY got called back exactly one hour after my scheduled appointment. The nurse who called me back took my clipboard and paperwork, threw it aside, and then sat down at a computer in the exam room. Without ever looking at the forms I so meticulously filled out, she proceeded to ask me every question that I had just updated on the paperwork. Were there any new medicines I was taking since my visit last year? Yes, there was a new med which she would have known about had she looked at my paperwork. Had I had any surgeries since my visit last year? Yes, I had FINALLY gone through with the breast reduction that my gynecologist had told me for so many years that I needed. She would have known that too, had she bothered to look at the forms I had filled out. WHY do they waste our time having us complete all these forms when they obviously aren’t even going to look at them?
After her questioning, she handed me a gown, told me to take everything off, leave the gown open in the front and drape my lower half with the sheet. After giving me these instructions, she said, “The doctor will be in shortly.” Yeah right, I thought. Last year, after undressing and donning the lovely pink paper gown, I sat on the end of the examination table for one hour! Not comfortable at all when you’re butt-naked with only a paper gown covering you, you have no back support, it’s about 80 degrees in the room, and you’re sweating so much that your much too fragile pink paper gown is literally tearing and disintegrating, exposing even more of your body than you care to have exposed. I thought I would smother before the doctor finally came in.
I’m always extremely nervous at the gynecologist. I sweat a lot when I’m nervous and paper gowns do not like sweat. I know these are medical professionals and they think nothing of this exam (they’ll be the first to tell you they think nothing of it, that when you’ve seen one, you’ve seen ‘em all, blah, blah, blah). Well, they may be used to looking at ‘em day in and day out, but what they don’t understand is that I’m not used to showing my naked body day in and day out. Laying on an uncomfortable table with your feet in metal stirrups with one knee pointing east and the other west, while being probed with cold speculums and gloved fingers puts you in a very vulnerable and embarrassing position. I always feel violated after a gynecological exam. Silly I know, but I do. I don’t know of many women who care for this yearly exam, but it’s particularly hard on those of us who are extremely modest. (Although, I’ll admit I’ve become less modest after having given birth to 2 babies and after having the breast reduction surgery). My modesty has seemed to have flown right out the window.
Thankfully, this year, my wait was not long once I was undressed and on the table. And I actually was handed a cloth gown this year and not a paper gown. Thank you Jesus. It was three sizes too small and didn’t cover me worth a darn, but hey, it was cloth. I struggled to maintain some degree of modesty while trying to cover myself before the doctor came in for the actual exam, before finally realizing my efforts were futile.
My doctor walked in and made the usual small talk asking me how I was, etc. I decided instead of divulging the truth to him– that I was nervous, tense, uncomfortable and even a little fearful– that it was just easier to tell him I was doing great. I asked him how he was and was surprised when he very seriously said, “I’m a little shaken up right now.” I wasn’t expecting that answer and didn’t know how to respond to him. I automatically assumed he must have been upset over a patient. Not wanting to pry or ask questions, I responded that I was sorry. It was then that he told me he “had just heard about the Boston Marathon” and the news had upset him. Since I had sat in his waiting room for almost 2 hours, I was not aware of the breaking news out of Boston. I asked him what had happened and he told me there had been bombings at the marathon. There were people killed and injured. I gasped. I became very quiet and still. He put his hand on my shoulder and said, “Now I have upset YOU.” We talked about it a minute and talked about the crazy world we live in. He told me one of his sons was a big runner and had friends who were running in the marathon, and that he had just had to take some time from work to put a call in to his son to make sure all his friends were safe and make sure they had not been injured or killed. They were safe.
My doctor was visibly shaken. I have to admit, I don’t even remember much about my exam after that. Years from now, people will be saying, where were you when you heard the news of the Boston Marathon bombings? And I will forever remember hearing about it from a shaken up gynecologist when my feet were up in stirrups.
Three days later, I had what can only be described as a painful mammogram. Painful due to having the bilateral breast surgery 11 months previously which still has me tender and sore. I was told after breast reduction surgery, that the radiologists essentially have to relearn the breasts and I was scheduled for a diagnostic mammogram instead of the usual screening mammogram. That means they compress you harder. There were some “changes” from the previous year, so they called me back into the mammogram room to do more views. The technician said the radiologist wanted her to do MORE compression and really magnify the questionable areas. This time when she compressed me, I couldn’t speak. She was asking me questions and I literally couldn’t answer her or do anything except stand there and wince. Tears stung my eyes. Finally, they told me I could get dressed and go. From there, I went straight across the waiting room to my PCP, who assured me the radiologist didn’t see anything that looked malignant, and that he thought all the breast changes he was seeing were postsurgical changes and were benign. Just to be sure, he told me they want to repeat the mammogram in 6 months as opposed to a year. I can hardly wait.
A few days after the mammogram, I went to the dentist. Yeah, I’m a glutton for punishment I guess. I like my dentist a lot. He’s fun to go to as he has a very good sense of humor. He’s a hoot. He keeps me laughing… mouth full of gauze, retractors, and all. As much as I like him, I don’t enjoy dental visits either. I rate them right up there with gynecology visits. The one difference is that his dental office staff are very friendly, personable, and caring, and that makes a BIG difference. But I always dread the actual dental work. I’ve had a couple of bad dental experiences, none of which this dentist was to blame for, but I’m terrified of going to the dentist now.
Several years ago, I had an episode of trigeminal neuralgia that hit me suddenly in the middle of the night. Trigeminal neuralgia is a pain that affects the trigeminal nerve, or the 5th cranial nerve, which is one of the largest nerves in the head. It causes episodes of severe pain which can only be described as excruciating. I was told trigeminal neuralgia is considered one of THE most painful conditions known to man and is also known as “suicide disease.” I can see why. My first bout hit me in the middle of the night and felt like a horrible, horrible toothache on the left side of my mouth, but I couldn’t localize it to even the upper or lower side, much less a particular tooth. My dentist took X-rays and referred me to an oral surgeon for another opinion after not being able to find anything wrong. I also went to my PCP, who referred me to a neurologist. They were all in agreement this was trigeminal neuralgia.
My pain was intermittent and the intensity of the pain was indescribable. Sometimes it would only last minutes, and sometimes hours. It was incapacitating when it hit, both physically and mentally. I was told the cause can be anything from compression of the trigeminal nerve by a blood vessel, damage to the myelin sheath by a brain tumor, or MS (multiple sclerosis). MS causes deterioration of the myelin covering the brain and the spinal cord. I had an MRI of my head which showed some tiny gray spots in my brain which the radiologists said could be demyelination areas compatible with MS. The neurologist disagreed and felt they were artifacts and nothing to worry about. I worried. I was terrified. The good news was that the MRI ruled out a brain tumor and they could not see any compression of the trigeminal nerve. The next step was a spinal tap. I remember being SO scared prior to that procedure. The neurologist was kind enough to allow my husband (who is a nurse) to stay at my side and hold my hands during the procedure. I also remember a nice-as-can-be nurse asking me if she could pray out loud for me. She did and she greatly comforted me. The results of the spinal tap were normal.
Most of the time, my pain felt like the worst toothache ever, magnified about 10 times. My dentist thought perhaps I was grinding my teeth in my sleep since my pain often hit in the middle of the night. I started wearing a mouth guard when I slept. The pain was so bad when it hit, I would have been willing to have every tooth in my head pulled at that point if it would have eased the pain. I swore it was an abscessed tooth. At one point, I begged my dentist to “knock me out” to relieve the pain. He told my husband at that point to get me to an ER for sedation. Eventually the pain spread to my cheeks, jaws, chin, lips, and around my eye. There was tingling and some numbness. Hydrocodone pain killers didn’t begin to touch the pain. Over the counter anti-inflammatories seemed to help some but not much. The only drug that did ease the pain was Neurontin. Thank God for Neurontin.
A cause was never found for my trigeminal neuralgia and it finally went away after 2-3 weeks. The neurologist ended up telling me he suspected it was a viral infection that for some reason decided to attack that particular nerve. A follow-up MRI 6 months later was perfectly normal. No more little gray spots. MS was ruled out.
So while I adore my dentist, I am terrified now to have any dental work done on that side of my mouth, because I’m afraid it will trigger another episode of trigeminal neuralgia. I hope to never again experience pain like that.
Believe it or not, I’m not done yet with the dreaded invasive medical tests. I’m a year late in getting that ever-so-fun colonoscopy done. And since both my parents had colon cancer, that’s a no-no for me. Next year, I really need to space out all these little routine medical visits.