April 14, 2017 Liza Swedarsky, MD FacebookTwitterPinterestHonoring Health Vow #6 I Vow to Advocate for Myself and Pledge to Prioritize my Healthcare Needs Seeing a gynecologist for many women is very challenging. Anticipating and visualizing conversations about your body, breasts, period, vagina, and relationships can come all packaged up with a diverse mix of life experiences, perceptions, emotions, and beliefs. The experience can be positive or negative. Being comfortable with a physician is your right and there is an ideal match for everyone. You just have to be committed to finding the right doctor. If picking up the phone to schedule your gynecology appointment has you uneasy it’s important for you to have an internal dialogue. Ask yourself “Why?” Be mindful about identifying what bothers you with regards to your appointments with your doctors. I’ve realized many women fear not only the actual exam but also they are going to be judged. Keeping this is mind helps me to provide better care, but I still have my challenges. My only expectation is that my patients come to the table informed about why they scheduled their appointment in the first place. Besides that, judgment has no place in my office. Keep in mind, a doctor should be there to serve, educate, and treat... not judge. And many personalities that ultimately pursue careers in Obstetrics and Gynecology are more likely on the liberal side of the spectrum when it comes to being open to the many life choices and experiences one may present with. Of course this all depends on the individual clinician and their background. One thing you can likely be sure of is your gynecologist is not concerned with the things you may find embarrassing or uncomfortable. I’ve made a list of common things women have told me make their visits to the gynecologist uncomfortable. You should know we don’t spend time thinking about these topics in the ways you likely imagine. Your Gynecologist Doesn’t Judge…. Your Weight We recognize women have all different backgrounds, genetics, body types and eating habits. Weight on either extreme, overweight and underweight can introduce challenges in providing care or performing surgery. However these are challenges we’ve learned to take note of, be aware of, and plan for. But judging is not part of the equation. If You Shave Your Vagina Pubic hair is natural and expected. Many women due to cultural norms, preferences, sexual practices, and societal pressures choose to shave off some, most, or all of their pubic hair. That choice is yours. If You’ve Shaved Your Legs Women have actually mentioned this to me before and exam… “I haven’t shaved my legs.” Half the times I want to put them at ease and inform them I haven’t shaved mine either. But I can’t. That would be unprofessional. But it would be true. Bare legs or hairy, you are all welcome. 4. Your Pedicure Some women are worried about their pedicure. We honestly don’t care if your pedicure is well over due or brand new. However fresh feet and socks is always nice. Foot odor is most distracting than any other. So I’d focus on clean socks instead of your Pedi. If You are on Your Period and Need to be Examined A menstrual period is no problem for a gynecologist. Again, it is natural. We are trained very early on dealing in most scenarios involving blood, bodily fluids , and the most unpredictable amniotic fluid. We become comfortable from the start delivering babies, performing surgery, and in managing miscarriages and pregnancy complications. There are certain procedures that are best scheduled when you are not on your period. But if you need to see your doctor and happen to be on your period this is no reason to be embarrassed. If you’d rather postpone your exam speak up. Remember, you are in the driver’s seat. Sexual History Your gynecologist will need to know your sexual preferences and history and whether or not you are single, dating, have one partner or many. We ask these questions to determine how often you need Pap testing and whether or not you are at risk for sexually transmitted infections. We recognize everyone has a different sexual palate, beliefs, and desires. Your Pregnancy History Discussing pregnancy history can bring many emotions into the room. This is especially true for women who have had difficulty getting pregnant, had multiple miscarriages, women who’ve given their child an option to be adopted, and especially for women who have terminated one or more pregnancies. Knowing whether or not you’ve been pregnant before and the outcomes of those pregnancies is often very helpful. This is your personal story. Own it with all its grief, glory, life lessons and personal growth. You should not feel ashamed. Your Drug Abuse History Anyone can become addicted to substances; all they have to do is try them one time. Drug and alcohol addictions are treatable if you are ready. Your doctor can be a change agent and provide useful tools, resources, information and direct you to programs. We ask about your drug abuse history to identify areas we can help. Ultimately the choice is yours. But know we ask to serve and not to criticize. Marital Problems Marital problems often cause stress, fatigue and may contribute to one’s overall sense of well-being. Likewise a happy, healthy marriage is extremely beneficial and I enjoy involving partners in the conversation especially if surgery or a procedure is being planned. Every marriage is unique. Besides medical problems, relationship discussions are often at the forefront of the topics many women want to discuss. You are not alone. Your Questions No question is a bad question. It is important that you feel comfortable asking your questions. You should gain clarification and request an explanation in a way you can understand when discussing topics pertinent to your health. Advocate for yourself and don’t be afraid to ask questions. The entire doctor-patient relationship is in place for your benefit. Don’t forget that.