NWR: Colposcopy and all the joy they bring

ellamber · February 2018

I'm looking for a large, broad audience to pose this situation to and I feel like WW can be good for that. I'm scheduled for a colposcopy in 6 weeks. I have had three previous, and none have been good experiences. All have been quite painful, and stressful, and due to this I'm experiencing a lot of stress and anxiety surrounding the appointment, so much so that I am thinking of cancelling and taking my chances.

I've spoken to my doctor, on NUMEROUS occasions, and explained my history and my fears and my apprehension. I have only been to this doctor twice, all of my previous history has been in previous offices (in different states). She has told me repeatedly to just "give it a try" and "itll be different here," and "well we have so and so here to hold your hand!"

Finally, she agreed to provide me a one time dose of xanax to take.

Here's my concern: It took a long time for my doctor to listen to me, and then she provided a one time dose of xanax, which I appreciate, but the anxiety is due to the pain experienced. I'm not drug seeking, if I were it wouldn't be from the gynos office. Do I take the xanax, hope my doctor is right, and cross my fingers? I'm afraid, sadly, if I don't have a bad, painful experience this time for whatever reason, I'm going to have to go through the same fight and possibly lose when this comes up again next year.

banana468 · February 2018

Are you able to take Advil?

ellamber · February 2018

banana468 said:

Are you able to take Advil?

I can, and have previously. Doesn't really do too much for me though to be honest.

OliveOilsMom · February 2018

I have had a similar, but different, procedure done when we started with the fertility doctor when we were TTC. Any type of procedure where you have to have a speculum inserted for a long time is not pleasant. What specifically is most painful for you? Before my procedure, I was told to take ibuprofen about an hour before to help with any discomfort. Has your doctor mentioned anything about that to help you?

You really need to have this procedure. This is probably to rule out a serious illness. There is a reason you need to get this done. Do you really want to cancel this appointment only to finally go through with the test next year and you find out you have a serious illness that could have been detected early?

STARMOON44 · February 2018

Trust the power of the Xanax. A colposcopy is a pretty short procedure. The Xanax will get you through the anxiety. You will be fine.

ellamber · February 2018

OliveOilsMom said:

I have had a similar, but different, procedure done when we started with the fertility doctor when we were TTC. Any type of procedure where you have to have a speculum inserted for a long time is not pleasant. What specifically is most painful for you? Before my procedure, I was told to take ibuprofen about an hour before to help with any discomfort. Has your doctor mentioned anything about that to help you?

You really need to have this procedure. This is probably to rule out a serious illness. There is a reason you need to get this done. Do you really want to cancel this appointment only to finally go through with the test next year and you find out you have a serious illness that could have been detected early?

The part that is most painful is the cervical punch. I think if anything is being removed from anywhere, I'd like to feel it less. And for me, this pain is jump off the table kind of pain. I'm typically a person that if able, I will watch medical procedures being done on me or let an intern do it because I have a pretty high pain tolerance and I usually make a pretty good pin cushion.

I have had many of these. It's to rule out possible pre cancerous cells. So I understand the need, but what I dont understand is, why my doctor is adamantly against prescribing me anything? Why should I have to have a bad experience so she can see my reaction for herself? I don't think that is very fair. I'm not requesting a 30 day supply of vicodin, I just want something to help keep me calm and quiet (which I have now) and pain free, for one day.

ellamber · February 2018

I guess my big issue is, if your patient is saying to you "I will not get this procedure unless I have some chemical help" as a doctor, why can't that be done? It makes me lose faith and trust in my doctor, which is still making me reconsidering the colpo despite her slight negotiation. I got more anesthetic for a tiny filling the other day than I will for a clamp being attached to my cervix and a "sample" being pulled off.

levioosa · February 2018

I think the Xanax will help considerably. Call the office and ask for the best time to take it before your procedure to maximize effectiveness. I would also ask if they would recommend taking Motrin the night before and the day of your procedure, how much to take, and when to take it. Don't cancel an appointment for something you really need. I get you've had bad experiences, but prescribing heavy narcotics is not something usually done for a colposcopy. See what the office recommends for OTC meds, try that, take the Xanax. Don't "take your chances." I get you're scared but "taking you chances" means potentially missing completely treatable cancer. Don't do that. It sounds like your provider did listen to you. She gave you a prescription for Xanax. That's her listening to you.

STARMOON44 · February 2018

ellamber said:

I guess my big issue is, if your patient is saying to you "I will not get this procedure unless I have some chemical help" as a doctor, why can't that be done? It makes me lose faith and trust in my doctor, which is still making me reconsidering the colpo despite her slight negotiation. I got more anesthetic for a tiny filling the other day than I will for a clamp being attached to my cervix and a "sample" being pulled off.

She did give you something. She gave you Xanax and that’s plenty. There is no reason at all to lose faith in your doctor.

banana468 · February 2018

ellamber said:

I guess my big issue is, if your patient is saying to you "I will not get this procedure unless I have some chemical help" as a doctor, why can't that be done? It makes me lose faith and trust in my doctor, which is still making me reconsidering the colpo despite her slight negotiation. I got more anesthetic for a tiny filling the other day than I will for a clamp being attached to my cervix and a "sample" being pulled off.

I've had two colposcopy procedures and tons of dental work. I don't think you're being fair to compare the two.

Also, how many Advil did you take? For after birth I took 3. Between your Xanax and Advil (seriously - ask now many they recommend taking OTC) I think you may be making yourself anxious.

We're in the middle of a huge opiate crisis in this country and doctors can't start prescribing stronger pain killers because patients request them.

MissKittyDanger · February 2018

What about a sedative? There some that can be done as needed. I had an endoscopic done a few years ago, and they gave me a sedative {anxiety and heart rate jumped up really quick}
It was low grade and not considered an opiate or narcotic, so there wasn't a concern there.

holyguacamole79 · February 2018

When I had a colonoscopy, I got put under. Is that not an option?

STARMOON44 · February 2018

holyguacamole79 said:

When I had a colonoscopy, I got put under. Is that not an option?

That would be extremely unusual for a colposcopy. It’s a very different much less intense procedure. I don’t think any doctor would readily offer sedation for a colposcopy for basically anxiety. It really is not much worse than a Pap smear in pain and duration. Xanax and Advil is appropriate

MissKittyDanger · February 2018

STARMOON44 said:

holyguacamole79 said:

When I had a colonoscopy, I got put under. Is that not an option?

That would be extremely unusual for a colposcopy. It’s a very different much less intense procedure. I don’t think any doctor would readily offer sedation for a colposcopy for basically anxiety. It really is not much worse than a Pap smear in pain and duration. Xanax and Advil is appropriate

I get a small dose of nitro when I get a filling for the needle only.

holyguacamole79 · February 2018

MissKittyDanger said:

STARMOON44 said:

holyguacamole79 said:

When I had a colonoscopy, I got put under. Is that not an option?

That would be extremely unusual for a colposcopy. It’s a very different much less intense procedure. I don’t think any doctor would readily offer sedation for a colposcopy for basically anxiety. It really is not much worse than a Pap smear in pain and duration. Xanax and Advil is appropriate

I get a small dose of nitro when I get a filling for the needle only.

I guess I was lucky ... I got propofol for mine.

STARMOON44 · February 2018

holyguacamole79 said:

MissKittyDanger said:

STARMOON44 said:

holyguacamole79 said:

When I had a colonoscopy, I got put under. Is that not an option?

That would be extremely unusual for a colposcopy. It’s a very different much less intense procedure. I don’t think any doctor would readily offer sedation for a colposcopy for basically anxiety. It really is not much worse than a Pap smear in pain and duration. Xanax and Advil is appropriate

I get a small dose of nitro when I get a filling for the needle only.

I guess I was lucky ... I got propofol for mine.

For a colonoscopy sure. But a colposcopy is completely different.

holyguacamole79 · February 2018

STARMOON44 said:

holyguacamole79 said:

MissKittyDanger said:

STARMOON44 said:

holyguacamole79 said:

When I had a colonoscopy, I got put under. Is that not an option?

That would be extremely unusual for a colposcopy. It’s a very different much less intense procedure. I don’t think any doctor would readily offer sedation for a colposcopy for basically anxiety. It really is not much worse than a Pap smear in pain and duration. Xanax and Advil is appropriate

I get a small dose of nitro when I get a filling for the needle only.

I guess I was lucky ... I got propofol for mine.

For a colonoscopy sure. But a colposcopy is completely different.

Reading would help, huh?

charlotte989875 · February 2018

STARMOON44 said:

holyguacamole79 said:

When I had a colonoscopy, I got put under. Is that not an option?

That would be extremely unusual for a colposcopy. It’s a very different much less intense procedure. I don’t think any doctor would readily offer sedation for a colposcopy for basically anxiety. It really is not much worse than a Pap smear in pain and duration. Xanax and Advil is appropriate

This isn't universally true; I had a colposcopy and it hurt when I had it done and for a while after. To the point where my doctor said he was surprised by how I reacted. I had many paps by that time that never bothered me, but this did. So saying it's not much worse than a pap might be true for you, but that's not everyone's experience.

I'm lucky I've only had one, but @ellamber I'd ask if they can give you the prescription strength Motrin/Ibuprofen ahead of time along with the Xanax.

charlotte989875 · February 2018

holyguacamole79 said:

STARMOON44 said:

holyguacamole79 said:

MissKittyDanger said:

STARMOON44 said:

holyguacamole79 said:

When I had a colonoscopy, I got put under. Is that not an option?

That would be extremely unusual for a colposcopy. It’s a very different much less intense procedure. I don’t think any doctor would readily offer sedation for a colposcopy for basically anxiety. It really is not much worse than a Pap smear in pain and duration. Xanax and Advil is appropriate

I get a small dose of nitro when I get a filling for the needle only.

I guess I was lucky ... I got propofol for mine.

For a colonoscopy sure. But a colposcopy is completely different.

Reading would help, huh?

Totally did the same thing.

levioosa · February 2018

I mean, do I think local anaesthetic and a little extra strength painkillers would be good? Do I think that if we did colposcopys on men it would come with a Xanax, local anaesthetic, sedation and a Vicodin after automatically? Yes to all of the above. But unfortunately that’s not how it works. I’d disagree that it’s just the same as a Pap smear. In a Pap smear you aren’t shaving and cutting off pieces of the cervix. Performing colposcopys will be in my scope of practice once I am done with school. It’s a shitty procedure for sure and I’m not looking forward to doing them.

STARMOON44 · February 2018

levioosa said:

I mean, do I think local anaesthetic and a little extra strength painkillers would be good? Do I think that if we did colposcopys on men it would come with a Xanax, local anaesthetic, sedation and a Vicodin after automatically? Yes to all of the above. But unfortunately that’s not how it works. I’d disagree that it’s just the same as a Pap smear. In a Pap smear you aren’t shaving and cutting off pieces of the cervix. Performing colposcopys will be in my scope of practice once I am done with school. It’s a shitty procedure for sure and I’m not looking forward to doing them.

I think that’s just complete overkill. And how does this help? She needs it, shitty or not, and her doctor won’t prescribe this. It’s a very short procedure that is usually not particularly painful. Anxiety is understandable. It is being treated appropriately with anti anxiety meds. She will be fine!

charlotte989875 · February 2018

STARMOON44 said:

levioosa said:

I mean, do I think local anaesthetic and a little extra strength painkillers would be good? Do I think that if we did colposcopys on men it would come with a Xanax, local anaesthetic, sedation and a Vicodin after automatically? Yes to all of the above. But unfortunately that’s not how it works. I’d disagree that it’s just the same as a Pap smear. In a Pap smear you aren’t shaving and cutting off pieces of the cervix. Performing colposcopys will be in my scope of practice once I am done with school. It’s a shitty procedure for sure and I’m not looking forward to doing them.

I think that’s just complete overkill. And how does this help? She needs it, shitty or not, and her doctor won’t prescribe this. It’s a very short procedure that is usually not particularly painful. Anxiety is understandable. It is being treated appropriately with anti anxiety meds. She will be fine!

Again, not particularly painful for you. Not for everyone. Why is this hard?

STARMOON44 · February 2018

charlotte989875 said:

STARMOON44 said:

levioosa said:

I mean, do I think local anaesthetic and a little extra strength painkillers would be good? Do I think that if we did colposcopys on men it would come with a Xanax, local anaesthetic, sedation and a Vicodin after automatically? Yes to all of the above. But unfortunately that’s not how it works. I’d disagree that it’s just the same as a Pap smear. In a Pap smear you aren’t shaving and cutting off pieces of the cervix. Performing colposcopys will be in my scope of practice once I am done with school. It’s a shitty procedure for sure and I’m not looking forward to doing them.

I think that’s just complete overkill. And how does this help? She needs it, shitty or not, and her doctor won’t prescribe this. It’s a very short procedure that is usually not particularly painful. Anxiety is understandable. It is being treated appropriately with anti anxiety meds. She will be fine!

Again, not particularly painful for you. Not for everyone. Why is this hard?

In general, not just for me, this is not a particularly painful procedure. Which is why standard care is not sedation. Since it has been painful for ellamber, her doctor has prescribed Xanax which should help. It isn’t just not particularly painful for me. It’s not particularly painful for most people which is why she is getting pushback on wanting more medication.

ellamber · February 2018

@STARMOON44 Yes, I keep hearing how "routine" and "minor" and "quick" and "minimal pain" this procedure is. I'm aware of how painful it is for me, I have had three of them. There is a reason why I am requesting something for anxiety (because who knowingly is okay with making an appointment to be in pain?) and PAIN RELIEF. Do I need a weeks worth of vicodin? No. The pain that comes after the procedure is nothing compared to the pain I experience during, and with family history of drug abuse, I do not want more than enough medication (so one dose) to get me through the procedure pain free. I just don't want to be in pain, and I don't think thats too much to ask. I understand the hesitance of a provider to prescribe narcotics, but again if I was drug seeking I wouldn't be asking a gynecologist for one dose.

I recently read a study that while it did show that the pain level on a scale of 1-10 was an average of a 3, most participants in the study requested sedation or local anesthetic. Those who got sedation or local anesthetic then rated the pain as a 1 and stated it was a much better experience and much less stressful.

ellamber · February 2018

I also, for the record, experience anxiety and pain during pap smears as well. I haven't always been that way, but unfortunately I am now and I think a lot of that has to do with past experiences (and probably scarring, which I have a lot of).

charlotte989875 · February 2018

ellamber said:

@STARMOON44 Yes, I keep hearing how "routine" and "minor" and "quick" and "minimal pain" this procedure is. I'm aware of how painful it is for me, I have had three of them. There is a reason why I am requesting something for anxiety (because who knowingly is okay with making an appointment to be in pain?) and PAIN RELIEF. Do I need a weeks worth of vicodin? No. The pain that comes after the procedure is nothing compared to the pain I experience during, and with family history of drug abuse, I do not want more than enough medication (so one dose) to get me through the procedure pain free. I just don't want to be in pain, and I don't think thats too much to ask. I understand the hesitance of a provider to prescribe narcotics, but again if I was drug seeking I wouldn't be asking a gynecologist for one dose.

I recently read a study that while it did show that the pain level on a scale of 1-10 was an average of a 3, most participants in the study requested sedation or local anesthetic. Those who got sedation or local anesthetic then rated the pain as a 1 and stated it was a much better experience and much less stressful.

Maybe I missed this above; but are you seeing the same physician this time as you did the last time? Did you share with them last time how bad the pain was after?

STARMOON44 · February 2018

ellamber said:

@STARMOON44 Yes, I keep hearing how "routine" and "minor" and "quick" and "minimal pain" this procedure is. I'm aware of how painful it is for me, I have had three of them. There is a reason why I am requesting something for anxiety (because who knowingly is okay with making an appointment to be in pain?) and PAIN RELIEF. Do I need a weeks worth of vicodin? No. The pain that comes after the procedure is nothing compared to the pain I experience during, and with family history of drug abuse, I do not want more than enough medication (so one dose) to get me through the procedure pain free. I just don't want to be in pain, and I don't think thats too much to ask. I understand the hesitance of a provider to prescribe narcotics, but again if I was drug seeking I wouldn't be asking a gynecologist for one dose.

I recently read a study that while it did show that the pain level on a scale of 1-10 was an average of a 3, most participants in the study requested sedation or local anesthetic. Those who got sedation or local anesthetic then rated the pain as a 1 and stated it was a much better experience and much less stressful.

And you are getting it! You are getting Xanax. You are going to be okay. And if you have terrible pain during or after the procedure you can revisit this with you doctor.

Im sorry. I think it seems like I am minimizing your pain and that isn’t my intent at all. But you do really really need to do this and your doctor is helping you get through it. Not trying to minimize at all here but I think you should give it a try with the Xanax.

VarunaTT · February 2018

Okay, so: https://www.webmd.com/cancer/cervical-cancer/do-i-need-colposcopy-and-cervical-biopsy#1

I skimmed through here and didn't see any, but everyone IRL person with uterus I know who has had one, including myself, didn't feel adequately prepared by their doctors for this procedure. While I don't rate it very high on my pain scale like a broken bone or something, it was painful, shockingly so, and I cramped like a mofo afterwards.

It sounds like you're really anxious about it b/c of your past experiences. While I wish your doctor was being more understanding, they have relented and given you the Xanax. Xanax is really commonly prescribed for this very reason, and is known to work. Let it work it's magic, and it will, and you will be okay.

The doctor is not going to give you pain medications for this, period. I'd ask if you can take the prescription strength levels of Advil or Aleve (I found Aleve to be more effective for cramping generally).

6fsn · February 2018

I can’t help but wonder if part of the reason you have so much pain is because of the anxiety, not the procedure. I’m not trying to minimize this, but a shot hurts worse when you’re tensed up. Maybe the Xanax will minimize the pain simply by relaxing you.

I have had had this procedure. My doctor explained everything to me before and during. She made me laugh by saying it might smell like she was dying Easter eggs, but she wasn’t. I felt the pain and I did cramp some after, but it was minimal.

6fsn · February 2018

Also, you know you can’t put this off forever, but if you really feel this doctor is mishandling your case and you maybe put it off long enough to look around some more.

levioosa · February 2018

STARMOON44 said:

levioosa said:

I mean, do I think local anaesthetic and a little extra strength painkillers would be good? Do I think that if we did colposcopys on men it would come with a Xanax, local anaesthetic, sedation and a Vicodin after automatically? Yes to all of the above. But unfortunately that’s not how it works. I’d disagree that it’s just the same as a Pap smear. In a Pap smear you aren’t shaving and cutting off pieces of the cervix. Performing colposcopys will be in my scope of practice once I am done with school. It’s a shitty procedure for sure and I’m not looking forward to doing them.

I think that’s just complete overkill. And how does this help? She needs it, shitty or not, and her doctor won’t prescribe this. It’s a very short procedure that is usually not particularly painful. Anxiety is understandable. It is being treated appropriately with anti anxiety meds. She will be fine!

Where did I say she doesn’t need it? Above I said expressly that she needs to go. And I said that a Xanax and otc would probably be fine. Healthcare tends to minimize the pain and experiences of women. Women’s healthcare was built on the coercion of women without consent, anaesthetics, or bodily autonomy. So yeah, I do think colposcopys should have more attention paid to the pain than is currently acknowledged. Just because women are told to “suck it up” doesn’t mean it’s right. Studies have shown that local anesthetic during the procedure greatly reduces pain. It’s a procedure that carries a lot of anxiety, so sure, go ahead and give a Xanax before hand. I’d probably say 600 mg of ibuprofen is enough after the procedure to manage pain, but if a patient had repeated procedures without relief than I would prescribe a one time stronger painkiller.

I think OP should proceed with the Xanax and OTC since the Xanax will be new to the mix. It might work wonders for her. I think her doctor has responded appropriately. But feel free to ignore the fact that I’ve already said that three times.

NWR: Colposcopy and all the joy they bring

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