How to handle a GYN exam in this situation?

[Anonymous]

Do not lie to your doctor. That is crazy. You don't want to have errors in your medical record. Make an appt with a female ob gyn and just go. Explain your apprehension before the exam starts. Seriously, they people see so much. Don't worry about it.

[Anonymous]

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Anonymous wrote:Time to take care of yourself! Go to a doctor (gyno) not a mid-wife.

You do realize that we're all talking nurse-midwives, right?

The op's original post asked about a doctor - not midwife. Everyone is trying to convince her to go there, so yes I realize midwives have been mention. However, they do not have the same training as a DOCTOR. It's her first time. She should see the highest educated person as possible.

Yes, and a Certified Nurse Midwife is specialized in women's health issues. OP is looking for someone with the experience and bedside manner to make the exam the least awkward possible. A midwife would be an excellent fit for her.

I'm sure I'm going to get flamed for this but go to a doctor for your first time. They have more training and education. I'm sorry, but a nurse that a 2 years extra training IS NOT THE SAME as a medical degree despite what's posted here.

OP here -- I agree. Given that I see doctors so little, I tend to prefer MDs rather than NPs, PAs etc. Same thing applies here -- esp for the first time. Sounds like a midwife is great from a bedside manner point of view, but when I look online at a few bios and see the random credentials, I'm not so sure; I'm more comfortable with someone with a MD, residency, fellowship etc from a traditional med school -- even if that means I give up something in the way of bedside manner.

Just FYI, CNM credentials are not random. It is a BS/RN+Master's degree, which entails getting the RN degree (Bachelor in Science), passing liscensure, getting a master's degree, at least one year practicum, passing another exam to be board certified. Of course, who you see in the end is totally your call, but the quality of care is every bit as high as seeing an OB for this type of routine care.

This. One delivered my daughter. The OP is stressed and a CNM would be the best for that.

Also, random credentials? LOL. Get back to me when you have the education a CNM does.

[Anonymous]

Not the OP but when I was deciding midwife vs. OBGYN last yr, I also felt like the midwife credentials were "random." I know for a fact that they go through a defined program BS and masters with boards and clinicals along the way, so I don't mean that the credentials are made up. However, in this area I found a lot of midwives from schools like U. of Southern Kentucky or Minnetonka College that I had frankly never heard of and could not assess what kind of training they get over there. And then I found a lot of OBs in this area from the powerhouse med schools and residencies -- JHU; UCSF; Penn; Duke: Harvard etc. and frankly I understand what it takes to match into those residencies.

I realize and agree that education isn't everything and experience matters more but if it comes down to a UPenn trained MD with 20 yrs experience and great recommendations for bedside manner vs. a U. Southern Kentucky midwife with 20 yrs experience and great recommendations for bedside manner -- I'm sorry but I'm going with the MD. And frankly I think the OP should as well, at least for the first time. It's the same reason I think people should go to MDs for general physicals when they haven't had one in 20 yrs -- no matter how great that MD's NP or PA might be; at the end of the day if anything is wrong or concerning, the midwife, NP or PA will have to refer you to an MD anyway -- why not save yourself the stress esp. for your first GYN exam and cut out the middle man?

[Anonymous]

With a practitioner 20 years out if school, I'd be a lot more concerned with their practice history, major complaints against them, and continuing education than what school they graduated from.

[Anonymous]

I'm an OB-GYN nurse (more GYN, much less OB now), you are going to do totally fine. You sound like you have a good idea of what to expect. If you really want the pelvic over with first, just ask. All drs. examine in each patient in a certain order every time (so as not to skip anything), but for a first timer who is nervous, I can't imagine anyone saying no I don't do it that way. In fact, if you meet with them in their office first (many make you do that for a first ever visit), I'd say to them there "since this is my first pelvic, is there any way we can get it over with first," and if you get any kind of attitude or pushback, it may be a sign that you're dealing with someone who isn't going to be particularly sensitive during the exam.

Honestly any kind of reaction that you have is fine -- we see everything from women who are in obvious pain but when we say "are you ok, does it hurt," they just say no and power through to women who will involuntarily scream or cry upon being touched on the thigh -- before anything is even inserted to women who may just say that they feel pressure or ask if the dr. is almost done but 99% of the time do let the dr. finish. All of it is normal. None of it is "interesting" enough to talk about, as you're seeing 3-4 patients/hr for 8 straight hours. The things that get talked about are like the patient who once kicked the dr. in the balls (true story -- apparently bimanual hurt when he hit the ovaries; on the first side, she said it hurt and told him to stop. 2 seconds later he moved to the other side. Somehow she thought he wasn't going to do that since she said it hurt, and he was standing at the wrong angle. Poor guy actually had to leave the room. Then the poor guy actually had to come back and say "I'm sorry -- I wasn't able to feel the left side at all and I do need to do that again." Somehow she let him but he stood really really far away).

I agree with the PP that says this will be mostly a non-event for you, esp if you pick someone who is known to be kind and supportive. Maybe you'll have a few min of pain and say something or maybe you won't. Honestly when we see the more "violent" reactions like screaming, shaking, pushing the dr's hands away etc -- it is from virgins who are in their teens or maybe early 20s who are reacting to the idea that no one has ever seen them down there and someone is about to touch them. You may be a virgin, but with age comes a certain "maturity," and given that you feel like you need to do this for your health (you do!) and are not being forced by your mom or something, I don't think you'll react to it as some kind of "violation" that'll leave you shaking on the table.

If you go through with it (you really need to), come back and post how it went -- I bet someone else in your situation will run across this thread and it would be great for them to hear that this isn't THAT big of a deal.