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Why Don’t Dogs Have Gynecologists?

“What’s she talking about?”

 

I’m supposed to go for a mammogram this month. I went for my baseline last year, and the doctor wants me to go every year now, despite recommendations to the contrary out in the world. I almost fell down halfway through the test last year as they pressed each breast into the squeeze machine three times. How can this be the state of the art? Is someone under the impression that breasts can’t feel pain?

I’m afraid I’m not going to be able to push myself to go to the appointment, and my doctor will be mad at me for not doing it, and I will inevitably develop breast cancer and die and it will be my fault because I didn’t want to faint in the radiology office.

Like this.

Like this.

I’ve never heard of a gynecologist for dogs, though you never know what’s out there, somewhere. My dogs haven’t had to get mammograms. I can’t even imagine how that would work. Cricket thinks that having the goop removed from her eyes is the worst humiliation; can you imagine trying to squeeze some sensitive part of her anatomy until it is flat?

“What?”

I wish I could be more like Cricket, and feel like I have the right to refuse these humiliating tests, or at least to bite the person who tries to perform them on me. I feel like women need to rise up.

“Fight!!!!!!”

The thing is, veterinarians go into veterinary medicine almost always because they love animals and have compassion for them. Whereas doctors for humans often go into medicine because of the steady income, the prestige, or an interest in science. And gynecology? I don’t think too many kids grow up dreaming of becoming gynecologists.

I went to my first gynecologist when I was in my late twenties. I had been putting it off to avoid the inevitable panic attack and having to talk to a stranger about my sexual abuse history. I told the doctor my story as quickly as possible, and she seemed sympathetic for a minute, but then she told me to get on with my life. She said that my health would be better once I had babies, because that’s what the female body is meant to do. And then she complained that my body made the internal exam “difficult.”

“Grr.”

The next gynecologist seemed more down to earth. She listened to my spiel about sexual abuse, and promised to be careful with me, and asked questions. True to her word, she did her best to avoid hurting me during the internal exam itself, but as soon as I sat up, in my cloth gown, on the edge of the metal table, I started crying uncontrollably, and she said, “Are you sad that the exam is over?”

She meant to be funny, but her cluelessness for how that would sound to a sexual abuse survivor was bizarre. I don’t understand why female gynecologists are not more sensitive to this, given that the conservative estimate is that 1 out of 4 women were sexually abused before the age of 18. But, even if I had no abuse history, it would be normal for a woman on a table, being poked internally with a piece of metal, to be uncomfortable and self-conscious. And yet the doctors seem impatient with this.

My current gynecologist is pretty matter of fact. At the first exam, after a discussion, fully clothed, in her office, and changing into paper clothes and having to shimmy down the table, she tried the regular speculum and then said no, let me go get the one we use for the nuns.

She works in a large office, next door to a plastic surgeon, and around the corner from a cancer treatment center. It’s not comforting. It’s like a one stop shop for women: get birth control, have a baby, get cancer, get your breasts redone, get cancer again, go into remission, and then celebrate living a long life by getting a facelift.

I go to the gynecologist because I have to go, but I dread it all year. I’m not saying I’d rather be a female dog, but sometimes I wish I felt free to act like one.

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About rachelmankowitz

I am a fiction writer, a writing coach, and an obsessive chronicler of my dogs' lives.

101 responses »

  1. Rachel, you can do it! I have been going since my mom died of breast cancer when I was 26 because she was dead by 48 got it at 46. They did not know too much in 1986 sadly. I don’t like to go either but I do and have done so each year so this year will be my 30th mammogram. Please go, it’s not fun but it’s necessary 💕💕💕

    Reply
  2. Push yourself to go to the spot. I feel you pain because I have to go every ur too. If we had to put our furry friends through the process we would see a lot of bite marks on doctors. 😃

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  3. I empathize and sympathize with you. I think the MDs that you saw were crass and truly had no concern for your past or your feelings. I’m a retired RN and I saw that behavior from MDs and nurses as well, in a VA hospital.

    But there is the rare MD who is compassionate and knows what to say to a sensitive patient. You would need to hunt a long time to find a high caliber doctor. The MD that said “let me get the speculum used for nuns” was crass as well and I must admit that statement made me cringe.

    As an aside, dogs, both male and female get cancer involving reproductive organs. Chances of mammary cancer decreases if the females are spayed, I think, before the age of four. Males that are not neutered are more likely to get prostrate cancer and I believe that a male dog can, in rare instances, get mammary cancer- the same as in the human male.

    But these are things that you probably already know and your dogs have been “fixed.” We often use the slang where I live. 🙂

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  4. I agree…it’s a very painful process getting your mammogram..but it seems you have found the right gynecologist for you..I do wish they would make the ultrasound more readily available for all women as it shows a heck of a lot more and isn’t painful…

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  5. If the female docs aren’t doing it for you, have you tried a male doc?

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  6. I am SHOCKED at the callous attitude of the medical ‘professionals’ that you’ve had to see! I hope that despite these horrible experiences, that you continue to do what is best for your health,, and if that’s a yearly mammogram for a few years, then do it.

    Some tips that I’ve picked up when having to endure that procedure: Explain beforehand that your breasts are extra sensitive. This should make a competent person doing a mammogram on you take some extra care with the procedure. Second: If you get rough treatment, make a fuss about it. It might be embarrassing at the time, but it’s worth it. They don’t like it when some woman starts screaming in the middle of things. third: Can you take a valium or other milder sedative beforehand? that helps calm you so that you aren’t so tense, and being less tense makes things a whole lot less painful (not without pain..I’ve never had one in all these years that was pain free, it’s a part of the procedure I think because of how the damn machine is designed… and speaking of THAT, did you know there is a new procedure (well relatively new..I haven’t had one in about four years now) where they do a sort of image scan of your breasts, no squishing involved. Your GYN should be able to advise you.

    I was very lucky until I went on disability to be able to go to a woman GYN (I can’t handle men doing that stuff) who was down to earth, but who was also on my wave length. We were roughly of a similar age and she was also childless, which made her more sensitive to the issues that those of us who have never borne children face when dealing with GYN procedures. Yes it is more painful and a lot of times the cervix has retreated (it did in my case anyway) so far back that they have to pull out one of those huge speculums to do the exam. Feels a bit like they’re trying to build a bridge when they do a Pap smear. But with an understanding and competent physician it is easier. Please do try speaking up the next time you’re faced with some idiot without any idea of how to talk to a patient or who has limited skills vis a vis dealing with patients. I’ve found it does wonders. Best of luck whatever the decision is that you make!

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  7. My doctor said that I could do a thermal imaging scan some years rather than mammogram. Masses are hotter and can be spotted that way without the squeezer. Then do the full mammogram every few years to be sure. The insurance won’t cover it, but it could be done for about $250 (here). Just an option….

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  8. Not sure if there’s any significance to this coincidence, Rachel, but I read this post immediately before reading yours: http://luluopolis.com/2015/05/10/a-surprise/
    I am horrified at the insensitivity of your doctors! Don’t let those clueless people make you take less than excellent care of yourself. Your frankness and humor are tremendous!

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  9. I am sorry to read about such insensitive doctors- it took me a long time to find the right doctor, but I finally did. There is no need to continue with doctors that are so callous and unfeeling. The mammos are awful I agree, but a necessary evil- my sister’s breast cancer was found during her annual visit, tiny and stage 1 and would never have been detected by self exam. I hope you get a technician who is good and able to position you correctly to cause the list amount of discomfort.

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  10. I know exactly how you feel. My first gynecologist didn’t bother to make me feel at ease, and I had years of psychological turmoil from it. I found my current gynecologist through my therapist and she is completely wonderful. It’s a 2 hour train journey there, but it’s worth it.

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  11. Don’t feel bad! I *haven’t* faced sexual abuse, but I still find my regular well woman exams excruciating because my muscles in the area are so tight. It stresses me out every time I have to get a Pap smear because I know it’ll hurt, I’ll possible panic, and then the doctor will freak out on me.

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  12. The Echo Umbrella

    The very worst gyno I ever had was a woman.

    She was my first gyno that I went to in my very early twenties and she was so mean, so horribly rough and she harshly told me to get naked, get on the table and to spread my legs because she was in a hurry.

    Can you imagine the gall? Even though I had zero sexual experience (other than earlier child abuse but I don’t count that) I felt like a prostitute at my own doctor’s office but I was just a stupid kid then and so I did what I was told… but I still hate the very idea of her after all these years.

    I only see men doctors now because in my opinion they are much more tactful, gentle and professionally distant than women are even though it’s horribly uncomfortable and embarrassing.

    I still go though because my hubby and our two kids (Golden Retrievers) love me and I love them and catching a problem early helps ensure that I can stick around for them.

    Maybe you could drink some wine or something before a doctor visit and just have someone else drive your mellow self to the clinic. The whole bottle maybe? 😉

    Reply
    • I had a doctor once, not even a gynecologist, just a potential new internist, who expected me to just remove all my clothes, without even a how-do-you-do. I ran out of there, screaming, and never went back. I did stuff like that in my twenties. I try to be more accommodating now, but maybe that’s the wrong tack. The wine would probably help.

      Reply
  13. My goodness. That’s all I can think of at the moment. And the fact that, at my age (which I think you have some ways to go) I only have them once every 3 years. You are very brave to tell them your story. I have not.

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  14. Lots of good advice for you Rachel and I am sorry you have had such hopeless gyros and doctors. It is worth it though for your health and to ensure that you are there for those furry kids of yours.

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  15. I’m sorry that you have had a difficult time finding a compassionate gynocologist, it is awful that they are supposed to “do know harm” and yet they can do emotional harm with a lack of compassion. My experience with doctors tend to run along the same lines “there is nothing wrog according to the tests, it’s probably all in your head” or “you must have chronic fatigue good luck” I agree with you that seeing that 1 in 4 women are sexual abuse survivors you would think that there would be sensitivity to patients. I hope that you find the right fit in the future.

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  16. Bravely done. I wish you better days.

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  17. you know tests are so barbaric for the last 30 years…especially stomach tests…who thought these up?
    my obgyn was 600 miles away , so i go to one in maryland & he was like you are too young to go through the change,so i was like ,i like this man.lol
    then he took an hour , instead of going to lunch , explaining to me, that there was no such thing as fibromyalgia, toxic mold, asthma, bronchitis, cfids and whatever else.. then he said , you know what i could go to a dr. right now & he would tell me i have lyme disease & there’s no such thing….about 7 months later , i found out i was vibrating, from lyme disease , after millions of tests and mri’s..& i’ve had it since i was 7…
    what an idiot…it was like 1980…dr’s make themselves feel better & make you thin you’re crazy, when they are too dumb to know what to do…
    also he was like i will be glad to refill your med. even though i don’t think there’s a problem & ordered a test & it was exactly what i told him…i was dumb & shouldn’t have stopped taking it & he was dumber.

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    • What’s so upsetting, is that a lot of these doctors are very intelligent, just not when it comes to women’s health. And they have a tendency to assume that women are exaggerating or imagining things, before ever walking into the exam room to see us.

      Reply
      • yes, but this dr. was pretty stupid, to say there is no such thing as toxic mold ,when people were asking if i had sars & i had beencoughing for 11 years & to 15 specialists & 200,000.00 tests & drs. saying i was sick from toxic mold.. then he says there’s no such thing as mold or any other disease …

  18. Sending you lots of internet hugs and support.

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  19. Hopefully they have found a new way to do this ridiculous and painful test a better way soon… No man has to have his nuts squashed flat for a check, do they? So- which gender invented the mammogram, I wonder?!

    Reply
      • Although, to be fair, men don’t get off Scott free. Medicine is an inexact science – even for men. The treatment for (suspected) testicle cancer is sometimes to remove the affected testicle without first doing biopsies, etc. This happened to me where it was assumed that the lump in the second testicle was cancerous like the first (it wasn’t) and they snipped that one, too. As a result I’m now sporting an empty sack. One has to be philosophical about these things, I suppose.

        I should also mention that I was in the hands of mostly women throughout. The surgeon was a woman and, of course, so were all the nurses. I have to say that that wasn’t a problem once I’d gotten over the initial embarrassment. True professionals. The one negative was a nurse explaining to a nurse intern what a bilateral orchiectomy was: “oh, they cut his balls off” or something to that effect.

        I wasn’t supposed to hear that.

  20. Appalling. I think the problem essentially is that medics on the whole aren’t tuned in to human emotions. They just see the machine, and are accustomed to being seen in control. Nevertheless, I am fairly amazed at the treatment you have had from women, lacking even the imagination to understand why such invasive treatment might be acutely distressing

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    • I keep thinking that I should write up some new curriculum ideas for medical schools and send them out en masse. My brother’s descriptions of his four years of medical school made my skin crawl.

      Reply
      • The essence of the problem is that attitudes must change. This won’t happen with book learning. Continuing experiential groups with students, would be best, but colleges would take some convincing. Perhaps you could make some useful suggestions

  21. You are one strong person, Rachel. I admire the way you can lend positivity to what must have been some dreadful traumas to live with. As for the mammogram, I have never succumbed. In Denmark, my home country, there is a body of opinion that the violent procedure can actually do more harm than good, and my mother (long dead, but not of cancer!), sister and I agreed decades ago that we were taking our chances without the “pizza-machine”. Happily, we have been lucky so far, and we are not spring chickens.

    Just imagine if the test for testicular cancer was similar – it would take researchers less than the blink of an eye to find a better way. Women are somehow expected to have an impossibly high pain threshold, or perhaps they are just expected to shut up and conform…

    Reply
  22. momwithoutpaws hates those squeezy things she says if men had to have this they would have found a better way. My advice to you do not faint do what pawbabies do you have a choice
    1. bite the tech
    2. pee on them
    3. refuse
    4. leave a poop dollop

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  23. I sympathise and understand fully. The internal exams always hurt but here in the UK we are called every five years until we are 65, so I only have two more to go!
    Mammagrams are every year, though this year I may have two as I’ve just had the anniversary check since my last one, but with a new surgery I may get called again on their rota which is in November. It hurts too, I never realised there was so much of my breasts as they are squished and squashed into submission on the glass, but cancer has been apparent in my family so I don’t object to it.
    From a dog’s point of view though, taking their temperature isn’t fun for them and yeah, I’d bite, pee or poop if a GP tried it!

    Reply
  24. Bravo! I have often wondered why the machine that does my breast exam has not changed in the past 30 years during which time we are able to access facebook with our phones. Barbaric – and invented, no doubt, by men who are somehow able to profit from our pain and discomfort.
    I get one every year. My dogs deserve for me to live as long as possible. 😦

    Reply
  25. There are many insensitive, ignorant doctors out there. I have heard from many that mammograms cause more cancer than they prevent. I believe it, and without the medical history in the family, I plan to take my chances. I’m sorry for what you went through as a young person, and what you’re continually subjected to in what passes for a “health care” system here. Hugs to you.

    Reply
    • Really CAUSE cancer? That’s terrifying!

      Reply
      • That’s what I’ve heard from someone I trust who does acupuncture on herself and is well-versed in homeopathy and self-healing. I’ve never looked into it further because I’m a bit phobic about “medicine” here due to multiple bad experiences anyway, so I was inclined to go the “skipping it” route already. Her advice just solidified it. She’s told me many shocking things over the years about “health care” in this country, but over time, I’ve seen her information to be proven out time and again. As I said, I’ve never looked into this particular nugget, but I trust her completely.

    • There is no evidence that mammograms cause cancer. They can show suspicious things that turn out not to be a problem, which causes distress and expense. They can miss things that actually are suspicious. That’s the reason it is being recommended that women have mammograms every one or two years beginning at 40 years of age. Mammograms are no fun, but cancer is hell.

      Reply
  26. Check out a thermagram. It’s less invasive than a mammogram, pain-free and more accurate too. And if a doctor doesn’t have bedside manner, find a new one. I’ve went through gynocylogists like I change underwear (no pun intended) until I found one that I liked.

    And, some of these female gynos are SO CREEPY the way they stare at you …. ew, just ew!!

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  27. By the number of comments I see you really hit a nerve here Rachel, and I am not surprised. I have seen time and again better care provided by vets than human MDs but I know that human medical training is deliberately designed to desensitize the practitioners.

    I have a theory that directly answers your title question. Veterinarians treat animals holistically, in the standard definition of “characterized by comprehension of the parts of something as intimately interconnected and explicable only by reference to the whole”. Dogs don;t need gynecologists because the care of their reproductive system is a part of their total care. Humans doctors approach patients like they are a bunch of dissociated parts. When I worked in hospital I heard patients called all sorts of dehumanizing slang or referred to as “the gall bladder problem in Room 213”. Hardly fits the holistic definition, quite the opposite.

    To answer your question about why insurance doesn’t cover thermography, it is because they produce a different kind of information. It shows changes in heat and blood flow which MAY indicate a problem area. The changes shown have a statistical correlation but not a direct correlation to cancer development. Mammograms show masses, tumors, cysts, and calciifications, what insurance companies consider “hard evidence”, pardon the expression.

    Reply
    • I love your description of vet care as holistic, because every doctor Cricket and Butterfly have been to has treated them like whole people. They get ear scratches and gentle handling, and their anxiety is treated with respect. It’s amazing! It makes me want to go to a vet for myself.

      Reply
  28. I can’t trust doctors anymore. They’ve killed off too many of my family. If I ever need an operation, I’ll give the job to Dr. Perez, my cats’ vet–her I trust.

    Reply
  29. Sometimes it’s hard for a doctor to remember that the patient doesn’t work for them, they work for the patient. If the doctor isn’t doing a good job, my suggestion is keep trying to find one that works well with and for you. You deserve the best care for you and if you’re not getting it, then I encourage you to find someone else who can give it too you.

    Reply
  30. There’s a point at which a person doesn’t benefit from getting pap tests any more, depending on age and way of life. Mammograms; there is benefit, and the cost can be pretty high. Decide how often, and when you go remember to say ‘no’ when it hurts. Uncomfortable is OK, pain is not, and you get to decide what is too much.

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  31. I have had mammograms annually for decades because my mother had breast cancer and a radical mastectomy. She died years later from what I am convinced was a result of the subsequent radiation treatments. It helps that our local hospital has sensitive female radiologists that do the exam. It also helps me to take some tylenol before I go. A necessary evil.

    Reply
  32. Medicare will pay for mammograms only every third year, which suggests to me it may not be medically necessary more often than that unless there’s a history of breast cancer in the patient’s family. Moreover, as various other readers and followers have pointed out, mammograms are not always accurate, in that they sometimes produce false positives. It seems to me they are most helpful in third world countries and medically underserved parts of the United States, where women have not been taught how to examine their own breasts for suspicious new lumps. Perhaps you should reconsider this annual trek for pain and embarrassment during your gynecological checkup? Just because a doctor advises it doesn’t mean you have to do it.

    Reply
    • i agree with you. In addition to false positives, I’ve also read that the radiation from mammograms can actually cause breast cancer. Keep in mind I’m no doctor – do your research. I just did breast Thermography today. It doesn’t hurt. No touching. Cost $150 in Ann Arbor, MI.

      Reply
  33. Such an honest and feeling piece, Rachel. Women put up with so much! Pip

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  34. Unfortunately you are generally correct that human doctors don’t go into the field for wholly altruistic reasons and whatever empathy they had entering medical school is whipped out of them. I have found gynecologists kind of concrete although since I am male my experience have been limited. Keep looking for someone who you feel comfortable with. They are out there although they tend to have very busy practices as what you are looking for is what a lot of other women are looking for out of their gynecologist. Also don’t feel afraid about advocating for yourself. If you don’t no one will. If you are comfortable with the every 2 years mammogram then go for it. There is a lot of literature to support that this is a reasonable approach for many women.

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  35. I think we all want to go a little Cricket on gynecologists. Don’t give up on finding one who has the compassion and empathy you need. Perhaps soon the field will realize their patients don’t appreciate being treated as simply a procedure and not a living being.

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  36. Bless your heart – I can only imagine the trauma you face with each visit.
    Not to make light of it, I truly would love to see you bite the tech who does the mammograms! 😉
    My prayers are with you for strength to endure another physical. Keep in mind, it was a mammogram that helped in my diagnoses of breast cancer at age 38. I felt a lump but it was the mammogram that showed the cancer went deeper which opened a path of other tests and procedures to determine I had breast cancer in three areas one close to my chest wall. So please get it done – you are loved by many people and especially by Cricket. Do you have a woman’s clinic to go to?
    Let us know how you make out – just envision all of us with you encouraging you through the next physical.

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  37. I have my annual squish coming up in a few weeks. ugh.

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  38. Wow. I’m so sorry that your doctors have all been clueless a$$es. They really should take a course in how to deal with victims of abuse. I’ve been fairly lucky, though I did get the “have a baby” comment, which I thought was rude since my body won’t allow it. Now, I have a great doctor who warms the metal instruments on a heating pad before using them, and then talks about anything but what’s happening. Which is fine with me!

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  39. John Coleman

    Yeah, the old mammo! I’ve often thought that if men had to have their testicles checked by smashing them, the medical community would quickly figure out another approach. Thanks for sharing, Rachel. Peace, John

    Reply
    • I was told today that I shouldn’t complain about mammograms, because most men have to have a testicular biopsy at least once in their lives, and it’s worth a hundred mammograms. Told this by a woman. Harrumph.

      Reply
  40. I had to pop in here. Medicare now pays for a mammogram every year. They also pay for your well woman check up. Both came about due to preventive medicine requirements. If your tech is less than sensitive to your needs, ask for a different tech. Also ask for the protective pads. We don’t allow our pets to be mistreated by vets, don’t take it from your medical professionals.

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  41. i used to cry and panic during my pap test, my husband would have to come and hold my hand…. now i just don’t have them anymore… and i REFUSE to have a mammogram, like EVER… my doctor tried to make me, but yeah, he TRIED…. i had a vajayjay cancer scare when a beauty mark i had since birth (down there) fell off and left a wound, and then ANOTHER grew in another spot… i asked my doctor, a handsome young man, to refer me to a female gyny, and he said he would have to see (it) first…. i said ‘well i guess i die of cancer then’ and walked out…. i once read that gyny practices were originally invented to abuse women, back in the day, and i have never formulated a reason to doubt that.

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  42. Like many on here, I too used to cry before going in and my hubby came with me. I made it clear that I would not have a mammogram and both my OBGYN and Primary haven’t pushed me. When I was having my first baby the nurse practitioner (active duty military) was mean and ant-sympathetic. I was in labor for 36 hours. My husband got in her face and told her to stay away from me and get the doctor – NOW! I also agree that you need to be your own healthcare advocate. Look into Thermography. That’s what I do every 6 months and my doctors are ok with it. $150. Blessings!

    Reply
  43. Powerful piece. . . .I so get it. Thank you for writing it and sharing it too!

    Reply
  44. Hereabouts these things are every 3 years, not every year. So I am told anyway. My human says it’s not very nice, so I am pretty glad I don’t have to have them…

    Reply
  45. Oh my gosh, THESE DOCTORS! Honestly, I think you should have to pass a special personality test to become a gyno — stupidity and insensitivity should automatically kick you to another field. Infertility docs can also be fabulously impatient/insensitive. (Sorry – sarcasm is my second language.) Wonderful piece, which sounds weird considering the topic, but still…

    Reply
  46. Congratulations in your Sisterhood of the World award by Journey of Compassion.

    Reply
  47. Not all GYNs are unfeeling. Keep shopping around until you find one you are comfortable with. Yearly exams are essential. I do understand what you are going through. It took me a long time to come to terms with my own abuse.(Now happily married with 2, almost adult kids) Everyone heals differently and at different rates. Don’t let anyone rush you.

    Reply
  48. You definitely should have had the right to bite some of those gynocologists.

    Reply

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