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Expectant and Postpartum Moms
Does anyone else get bad reactions from telling nurses "no"?
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Anonymous
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Seriously, what are the chances that I would suddenly develop cancer between my annual (6 mos ago) and the prenatal appointments? I am not saying that all breast exams should be refused. The exam is unpleasant enough, I don't see doing it when it would be painful as well. You know what? The doctor agreed....without hesitation.
I don't have any issue with preventative care or I would avoid the annuals and prenatal care altogether. I am not rejecting all traditional medicine and I can't believe that is how you are reading my posts. I prefer to weigh the risks and benefits, given MY particular situation. I am not at risk for HIV and have tested negative before, why test again?? Is there any legitimate reason for it? I have a right to make my own decisions and I am not asking for your opinion on my medical choices. Honestly, I really don't give a shit what an anonymous poster on a board thinks about what tests I should agree to. That is between my doc and myself. If you want to be treated like a mindless head of cattle, more power to you. If you go back and read the question that I posted at least twice, you will see that I was asking about how to handle the nurses. |
Anonymous
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If the OP actually wants to know how to handle bossy nurses, here's how: "no thank you." "no thank you." "NO thank you." Not so complicated.
They only managed to bully me into one unneeded test when I was pregnant, and I still don't know why I didn't stand my ground on that one like I did all the others. And after a round or two of no thank yous, they stop bugging you. They tell you one time what test they want to do, you say no thank you, and that's that. My OB was actually quite respectful of my decisions, and told me that she liked that I did my research. |
Anonymous
| OP you should be getting annual Paps. Whoever told you that you didn't need another for 2-3 yrs was wrong. |
Anonymous
Yes, until recently Paps were to be done every year, however this isn't true anymore. Paps are now recommended every 2-3 years. Maybe a new test has come out? Whatever the reason, when I saw the OB just a few weeks ago, I was informed that they are now done ever 2-3 years. |
Anonymous
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During one visit to the doctor, I had to refuse an amnio to 2 nurses and 1 doctor -- even after I signed a piece of paper saying I was decling the amnio. I just tried to stay as happy as possible and said "No, thanks. I understand the risks/rewards and I've decided not to have the amnio." Just keep saying No thank you and don't let on that you are annoyed. If you keep parroting the same thing, then you are essentially shutting down any discussion of the matter.
There's a book called _Difficult Conversations: How to Discuss What Matters Most_ that has some good strategies for dealing with difficult people. It's a short read & it's come in handy in my life in many ways. |
Anonymous
| almost everyone who responds on this website responds with animosity to posts. i think it has to do with people spending too much time with just non-adult human beings. they lose touch with social norms and respect for other people. |
Anonymous
I've heard that if you're HPV negative, and you've had three normal paps in a row, then you can move to every 2-3 years... |
Anonymous
http://www.mayoclinic.com/health/pap-smear/HQ01177 |
Anonymous
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Here's a physician's perspective on those who refuse tests and recommended treatments: go ahead and make your own decisions. It's your body and I'm here to figure out your options and educate you about them. They remain your options and I don't want to coerce you into anything.
HOWEVER, DON'T: - say you will follow the course of treatment I recommend then come back complaining you still have your symptoms, not having tried what I recommended. - pick and choose half of an "integrated" treatment decision ("I'll have the surgery, but not the radiation"). - expect me to come up with some alternative solution for you when I have presented you with the only medically appropriate or effective option. - expect me to tell you it's okay to ignore my advice not to drive, go scuba diving, sky diving, etc . . You can make your own decisions, but I can't tell you it's safe if it isn't. |
Anonymous
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I'm really dismayed at some of the bitterness and venom displayed towards the OP here. Not that it should matter at ALL, but her choices (including what type of practice she's going to, what medical tests she's undergoing, and what treatment she's refusing) make perfect sense to me.
As to your initial question OP, I think if you're basically happy with your OBs, that is a relatively hard thing to find. I'd stick with the practice. I would not talk to the office manager/head nurse, mostly because I don't think it will do any good (especially if its a large office). If you had one particular nurse who was pressuring you, it might be worth complaining about her individually... but I wouldn't take a general complaint to the office manager. Perhaps AFTER the baby comes. I think your best course of action is to continue to be firm and polite, and put up with the minor aggrevation its causing. But that's just me. |
efeldman
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As a breast surgeon, I will tell you that women who are 30 can still get breast cancer, the sensitivity of your fingertips is about a 2cm cancer whereas for a trained health care professional it is about 1cm, and there is a disturbing incidence of breast cancer in pregnant women. Just something to think about. |
Anonymous
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"HOWEVER, DON'T: - say you will follow the course of treatment I recommend then come back complaining you still have your symptoms, not having tried what I recommended. - pick and choose half of an "integrated" treatment decision ("I'll have the surgery, but not the radiation"). - expect me to come up with some alternative solution for you when I have presented you with the only medically appropriate or effective option. - expect me to tell you it's okay to ignore my advice not to drive, go scuba diving, sky diving, etc . . You can make your own decisions, but I can't tell you it's safe if it isn't. " Here's some friendly advice for treating today's patient who does not worship at the alter of the white coat 
"- expect me to tell you it's okay to ignore my advice not to drive, go scuba diving, sky diving, etc . . You can make your own decisions, but I can't tell you it's safe if it isn't." Try providing your reasoning and evidence for why you recommend or do not recommend something. The "because i said so" loses value with anyone over the age of 5. Drs should be able to say whether a test, restriction, or advised approach is supported by recent or dated studies, evidence based, or simply what they have always been doing. There is a wide range of decisions within "the standard of care" and doctor vary consideribly on whether they update based on current evidence based approaches. "I don't know" is a reasonable answer. For example, if you have no idea whether scuba diving is dangerous or not, simply say so. I would respect that more than conveying something as a fact when you have no clue. Often patients are not pressing for "permission" but realize that the 2 seconds answer may not be based on great logic. This does require speaking to your patient for more than 20 seconds. "- expect me to come up with some alternative solution for you when I have presented you with the only medically appropriate or effective option. " Doctors should be aware of the alternate approachs and inform their patients of the existence even if you do not recommend them. Failure to inform and acknowledge the presence of tests, alternate, and approaches is withholding information and dishonest. You do not need to recommend or even bother yourself to pull out a referral but you should be aware of not only mainstraim but emergent approaches even if they differ from your approach. Your porr patient has no idea she has landed in the office of someone who stopped changing in 1975. I have a great example. I went to a generalist ob/gyn for 1 st preg (later switched she was awful on several fronts) who never informed us of the existence of the NT test, just informed as of the AFP. When it came back for a higher risk for Down's she conveyed that we came back with a positive for Downs but it was probably false as they often are and she would be sending us for an amnio.try not to worry. When I asked her about the AFP test values she was short and said it didn't matter. Of course, when we met with the genetics couselor it certainly did matter and we realized that our risk had only increased slightly putting us over the balance between risk of m/c from amnio and having Downs. I also found out about the NT at that point (too late obviously), when I asked her why she had not informed us about this test she blew it off saying it wasn't proven (this was 2 years ago) and there is a high very risk of m/c form CVS. Again we left the practice, the NT is very standard and ironically the m/c rate for the group we went to for CVS with #2 had a lower m/c rate than the m/c for amnio rate from the group she sent us to with #1. I always do my research now, ask questions, and havemuch less trust in doctors. |
Anonymous
| I think the Internet while wonderful has made a lot of people think they have the knowledge of someone who has gone to medical school. Keep in mind folks that as we move to socialize medicine doctors will be more pressed with patients and will have less time to go through lengthy discussions on why you need that breast exam. If I were a doctor and a patient weren't listening to my advice --I would just tell them to see other medical attention. The majority of doctors don't mind if you have a question since that is understandable--they just hate when someone with no medical background emphatically decides how their case should be handled full stop. Breast exam and pap smear are not like asking for a CT scan or a spinal tap. Get over it already. |
Anonymous
People just aren't listening to the OP! She is having a hard time with the *nurses* not the doctors. She said a doctor had no problem with her decision in at least one instance. This comports with my experience - we aren't MDs but you do have a responsibility to try to be educated about your care and discuss things with your doctors. Doctors (again, not nurses) have happily allowed me a lot of the flexibility OP is looking for. |
Anonymous
Geeez, you need to calm down. PP made some great points. Just because you read about medical conditions and tests on the Internet, it doesn't mean you have any medical expertise. Just read what the breast surgeon said above about skipping breast exams. |