My palms are sweaty. My knees are weak but I don’t eat spaghetti. No, I’m not just revisiting one of the biggest songs of my high school years, I’m thinking about the appointment I have tomorrow with a new gynecologist. It’ll be my first pap smear in at least five years. (I’ll talk about why the long gap in another post soon.)
Honestly, the pap smear part isn’t what is so scary. I’m expecting that to be somewhat painful, especially since I’ve had pelvic and bladder pain spring up today as I get close to my cycle. It might hurt to stand up straight, but getting prepped for this appointment feels an awful lot like squaring up for a rap battle.
I’ve got my lines that I’m working on, making sure I have a good hook in my intro. I want to sound prepared but not paranoid, well-read but not obsessive. I want to reflect a calm, cool, not-at-all-anxious demeanor while still communicating the reality of my symptoms. Me? Anxious? Psshhh, my heart rate is that high because I just ran a mile. Yup, right before the appointment. Just out running.
As I anticipate what the doctor might say, I don’t want to get stuck in Worst-Case-Disaster thinking. But also, I’ve been to doctors before. I have some experience to draw from as I get ready.
Doc: Tell me about your symptoms
Me: I have endometriosis. So, pelvic pain; back pain; urinary pain; bowel pain; GI pain; pain during ovulation; extreme menstrual pain.
Doc: Birth control!
Me: Sorry, I was on many kinds birth control for several years and it didn’t help my symptoms. I was also dangerously depressed and suicidal.
Doc: Lupron! Orilissa!
Me: Sorry, not an option for me.
Doc: Well, I’m not sure what you expect me to do then.
Me: Can you please just stick the q-tip up my vagina and do a pap smear?
I’m afraid of being brushed off, dismissed, and ignored. I’m afraid of being made to feel like I’m making poor choices for my disease management by someone who may be working from outdated or inadequate knowledge. I don’t want to have to be an advocate for myself, I just want to just be a patient.
My goal for this appointment is mostly to get a pap smear. I don’t think anything is wrong, but it’s been a while. I’m also hoping to find out what are the tests or imaging I should be doing to monitor the impacts of the endometriosis. I want to avoid another laparoscopy for as long as possible, but it seems like a good idea to keep track of things in my blood work, right?
We know that endo can cause imbalances in vitamin and mineral levels, especially B6, B12, and vitamin D. Maybe that’s something to keep an eye on? I also know that my liver showed signs of damage in my last ultrasound, so I’m hoping to find a way to ask whether that requires monitoring without sounding like someone who spends far too much time thinking about their own liver.
So, until tomorrow, deep breaths and lots of pelvic floor stretching.