Warrior Victorious in Pap Test

Thank the Goddess for Good Medical Care at Last! Photocredit: Great Beyond
Thank the Goddess for Good Medical Care at Last! Photocredit: Great Beyond

So the gyne visit went about as well as it could possibly go, and better than I could have envisioned.

The nurse-practitioner I saw was very experienced and nice and drew the correct line between warm sympathy and matter of factness. She said we could take as long as we needed, and she did the history taking and blood pressure stuff first. She explained everything really fully and was very relaxed, egalitarian and friendly.

She was matter of fact, thorough and respectful about asking my history – saying it woudl be helpful to know whatever I told her. I did a good job too, matter of fact and calm. She said she’d mail me copies of everything she put in my chart and all my test results too, so I’d have it as well.

I’d typed up all my questions, so I wouldn’t forget anything and just handed them to her, which worked well.

I did ask about the scar tissue.

She tilted up the exam table so I was sitting up and gave me a mirror to hold and I could see everything she did, which was great. She showed me the parts of my vulva that she thought showed old injuries. Turns out I have some vascular damage where the veins/arteries are really big and close to the surface and the whole area is hot, which she thought spoke to me having been injured and the veins being damaged when I was a kid. She also showed me some tags of flesh (like little lumps sticking out around the opening) around my vagina that to her looked like I’d torn and had healed without being sewn up. At this point I took a minute to hold my wife’s hand and breathe, since I got a bit emotional, but I didn’t really cry or anything till we left the office and were in the elevator. I haven’t really cried much yet, but I expect I will.

She knows some folks at a gyne clinic where care is given to children who have been raped, and she said she’d talk to them about what signs the vulva/vagina of an adult survivor might show as well.  She said she’d never had a survivor patient before (that she knew of, I add silently) and that the mirror and tilted table worked so well she’ll probably make that standard. She said when she was trained to do pap tests (I guess they practiced on each other) they did it with the ‘patient’ (another student) sitting up with a mirror, so that’s interesting, maybe a lot of female doctors or nurse practitioners were trained that way and might be familiar with it.

I’m pretty happy about finally having proof to back up what I remember, and also that she was able to give me some ideas to help reduce the irritation and sometimes pain all this causes me, that nobody’s been able to help me with so far. She’s suggested cold packs to reduce the swelling, which I think could actually work. We might also get an appointment with a gynecologist to see if they can remove the tags of scar tissue flesh, since they get sore.

I’m also really sad and angry for that little girl with the torn vagina and no-one giving medical attention I needed. I’m pissed at my mother, who obviously should have noticed a little girl with a ripped, bleeding vulva.

And finally, I gave her a copy of the ‘survivor safety form’ I made, and a copy of the article about survivors and pap test avoiding. I suggested that if the  health region wanted to put on a clinic for survivors, there were a lot out there that weren’t getting pap tests.  She seemed interested and said she was networking with a group of other women practitioners and they were looking for groups to offer care to (or something like that), I offered to be a ‘community informant’ if that would be helpful (in health region they like to have ‘advisory groups’). She asked me to email her a copy of the form, which I’ll do. So that’s hopeful as well.

All in all I feel blessed and hopeful. Yay!

If any health care providers (or survivors who want to talk to them) are reading this, here are some links I recommend:

*** My survivor safety sheet: http://sworddancewarrior.files.wordpress.com/2009/04/information-sheet-for-primary-health-care-providers.pdf

***[REALLY GOOD RESOURCE] Schachter, C.L., Stalker, C.A., Teram, E., Lasiuk, G.C., Danilkewich, A. (2008). Handbook on sensitive practice for health care practitioner: Lessons from adult survivors of childhood sexual abuse. Ottawa: Public Health Agency of Canada. http://www.phac-aspc.gc.ca/ncfv-cnivf/pdfs/nfntsx-handbook_e.pdf

Helping survivors of childhood abuse through labour: http://www.gentlebirth.org/archives/abuselbr.html

Prevalence of sexual assault history among women with common gynecologic symptoms. http://www.ncbi.nlm.nih.gov/pubmed/9790390?dopt=Abstract

Health risk behaviors and medical sequelae of childhood sexual abuse.  http://www.ncbi.nlm.nih.gov/pubmed/1434879?dopt=Abstract

Effect of Childhood Sexual Abuse on Gynecologic Care as an Adult http://psy.psychiatryonline.org/cgi/content/full/48/5/385

17 thoughts on “Warrior Victorious in Pap Test”

  1. In my medical school we were taught gyn exams by Nurse Midwives. We learned how to partner with our clients using the mirror to empower them and make them participants, not “subjects.” I will NOT for any reason allow a man practitioner of any type to go near my genitals or breasts. I was raped by a doctor when I was about 17. I can’t tell you how glad I am that I no longer need to have annual exams. When I was already in medical practice I empowered myself by having this huge tag, which was actually my hymen that the first rapist simply tore off rather than tearing through the hole, surgically removed. I later had the wall of muscle between the vagina and the rectum repaired where he had split the muscle, repaired. It still isn’t right, constant reminder. I admire your huge courage, and I’m so glad I found your blog! We fight gently on.

  2. I know this is an old post, but I am glad you shared on this. Not many do so. Appreciate you transparency! Safe hugs and thank you for having a voice!

  3. marjakathriver

    The skirt idea is fabulous! Thanks for sharing that. Thanks for sharing ALL of this for the blog carnival. This is so helpful and advocating and resourceful–with links even! Thank you so much.

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  8. One thing I forgot to mention that also worked well was that I wore a long loose skirt, so when it was time for the exam I didn’t have to wear one of those hospital gowns, which was more comfortable. I just removed underwear and hitched up the skirt.

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  10. Hi, SDW-

    I am moved to tears by this post. You have handled this, and shared with us, in a way that honors where you have been and where you are now. I am so proud of you that I don’t even have the words to express it. I am proud of the way you are caring for yourself, loving yourself.

    Well done!

    – Marie (Coming Out of the Trees)

  11. Hello Warrior,

    What a great job. You have a lot to be proud of.

    I have never asked about scar tissue. Though they know at my clinic that I am a survivor. That is one of the bravest things that I have ever heard a person do. I’m so in awe of you. I hope that I can ask about that the next time that I go.

    I’m glad that your wife was there with you.

    Good and healing thoughts to you.


    1. I’ve never asked about scar tissue before iether, and no-one has ever mentioned the tearing to me or the vascular damage. I guess without the information about what happened, they didn’t put it together, or figured I already knew and it would be insensitive to bring up. Me, I think I looked at my vulva in a mirror in college, but not knowing then what an undamaged vulva looked like, how would I know mine was different? I tell you I’d have liked to know this back when I was reporting shithead to the police. I wonder if this would be enough to reactivate the case?

    2. I’m really glad I asked about the scar tissue, so if you feel comfortable to do it, Kate, I recommend asking. It’s been quite a gift of validation. I’m also really glad I respected the fact that it would be a bit deal for me to know, and planned with lots of support. My wife took the day off work to be around for me at my request, and having her hear it too I think was a good thing. Sitting up and having the mirror was good too, so I could see what she was talking about. It’s really quite obvious once it’s pointed out, but since the nurse had seen hundreds of vulvas she was helpful to point out that the damage she was pointing out wasn’t typical of the vulvas she’d examined.

  12. Yay! Well done, SWD. You are so strong and brave and true – an inspiration to other survivors. I’m soooo pleased you had a caring and sensitive (but also sensible) practitioner to help you through. It makes all the difference. ((hugs))

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