Anne Goes to the Doctor

“It’s been three years since your last pap smear?”
I grimaced.  I’d given the nurse a vague several years; she’d interpreted that as three.  “More than that, really.”

The doctor typed something into the little netbook she’d brought in with her.  This new doctor’s office was high-tech; my old doctor had always made do with papers in a manila folder.

In truth, it had been too many years.  Before Jack and I were married, and after I was no longer able to remain on my parents’ insurance, I’d stopped seeing my general practitioner for annual checkups.  The local family planning clinic was a Planned Parenthood Express; they didn’t do gynecological exams, but they handed me birth control pill and reminded me that routine exams were an important part of a healthy lifestyle.  With each visit, I smiled and nodded, assured them that I’d go get an exam as soon as I was back on insurance, and went on my merry way.

Sometime after we got married, I decided to go off of the pill.  Not because I was ready to have children, but because I was sick and tired of the various miseries the pill was inflicting upon me.  I’d gained weight when I went on them.  A lot of weight.  The doctors at Planned Parenthood all assured me that the hormone content of the pills I was taking was so mild that weight gain was a practically non-existent problem.  And yet, there I was, some fifty pounds heavier than when I’d started.  They also tanked my libido.  Again, the doctors assured me that I shouldn’t be experiencing any such problem, but there it was, despite their assurances.  And, worst of all, there were the migraines.  I’d never had a migraine until I went on the pill.  Over the years that I took it, my migraines gradually increased in frequency until, by the end, they were nearly every other day.  Early on, I’d tried going to a lower-hormone-content pill, but I’d gotten spotting mid-month.  When I wasn’t on the pill, I’d gotten terrible cramps during my menstrual period; the pill alleviated those, and there were the other obvious benefits, though the irony was that my libido was so low that I had very little interest in taking advantage of those benefits.  Eventually, the cramps became the lesser of the evils, so I’d stopped even my perfunctory visits to Planned Parenthood and we went back to buying condoms.

I started to actually be interested in sex again.  I started losing the weight I’d put on (still an ongoing project).  I still get migraines, but they’ve decreased dramatically in frequency, and are worst when I’m menstruating (thanks, hormones).  I get the cramps again, and sometimes (like this month) they’re agonizing.  It’s still better than crippling migraines every few days.

But then Jack and I decided to start this new adventure, and I needed to go in for that doctor visit I’d been putting off for so long.  And that’s how I found myself sitting in an unfamiliar doctor’s office, talking to an unfamiliar doctor, and, in short order, contemplating how wildly irresponsible I must look to her.

“You’re here today for a full physical?  Any particular issues?

“A couple things, actually.  I uh, need a full STI panel.  And I need to do something about birth control.”

She nodded, made another notation on the file.  “Have you thought about what kind of birth control you want?”

“I think I’d like to do an IUD,” I said.  “I used to be on the pill, and it screwed with me pretty badly.  I don’t think I want to go down that road again.”

She didn’t seem interested in pursuing the conversation.  “I don’t do IUDs, but I can refer you to someone who does,” she told me, standing and drawing her stethoscope up to her ears.

“Ok, great.”  I couldn’t help but compare her to my old general practitioner, who, I think, would have wanted to discuss my options with me.

“This STI panel,” she said, “is there some exposure you’re concerned about?”

“My husband and I are in a non-monogamous relationship,” I told her.  Not quite true–not yet at least–but close enough.  I stumbled a bit over the word non-monogamous, feeling like an idiot.

She didn’t respond to that immediately.  “Deep breaths,” she instructed, moving the stethoscope around on my back.  I breathed.  She finished listening to my lungs.  “Is this non-monogamous relationship a mutual decision?”

“Yes, it is.”

“Ok.”  She sat back down at the desk and typed some more.  “Do you give yourself breast exams?”

“I do.”  Probably not as often as is recommended, but I do.

“Any concerns?  Lumps?”

“Nope.”

“Good.”  She asked me to lie down, and pushed the paper shirt I was wearing up so that she could perform her own exam.

My previous general practitioner had always given me a cloth hospital gown to wear, and instructed me to put in on backwards, with the opening facing the front.  At this new doctor’s office, everything is paper.  I’d been given a paper vest that went on with the opening in the back to cover my upper body, and a wide paper blanket to lay across my lap.

The breast exam satisfactorily concluded, it was time for the pap smear.  The disposable equipment theme continued with a plastic speculum, which did not feel as cold as the metal ones usually do.  (Once upon a time, I had a doctor who used to warm the speculum by running it under warm water, and then warmed the lube by rubbing it between his hands, before putting the apparatus to work.  Always struck me as odd that while an older man was thoughtful enough to go to that trouble for his patients, the female doctors I’ve had since then have never bothered.)

The remainder of the visit was pretty routine.  After I put my clothes back on, the doctor gave me a business card for a gynecology office and told me to call them about an IUD.  Then I was escorted to the lab, where a nurse filled half a dozen vials with my blood.  That completed, she sent me to the desk to check out, which I did.  Then sat down in the waiting room to wait for Jack, who was getting his own physical.