OK, I know sometimes it’s a big deal and sometimes it isn’t, but how often is it a big deal? What is the range of possibilities and the approximate probability of each?
(And yes, I will talk to my gynecologist ASAP, but she won’t even be in her office until tomorrow afternoon, and I’ll go nuts if I don’t know something by then! Plus, I need to know what questions I should be asking her.)
Side rant: why the (@%(^%!! would she do something as stupid as leave a message at 10 am on a weekday on my home answering machine, when she knows damn well that I’m at work then? Does she not realize that if she says something as vague as “your Pap smear was abnormal, but I won’t be in until tomorrow afternoon to talk to you about what you need to do next,” that I will be endlessly obsessing until then?
Side rant #2: I need a new gynecologist. I should have done it the first time she screwed up, which was by prescribing a sulfa drug for me, for a condition for which there are apparently numerous alternative rtreatments, after I told her she was asthmatic (asthmatics have a much higher than usual rate of sulfa allergy, and I was a prime example…I found out by breaking out in hives, and then passing out on the floor of the pharmacy when I went to pick up a replacement, non-sulfa prescription. Always more fun when one has no insurance.)
Leaving a message…Abnormal pap smear without explanation is not a good way to deal with patients.
Most pap smears which are not completely normal generally indicate atypical cells which are often the result of cellular changes from viruses, or other organisms
More significant abnormal pap smears suggest varying degrees of abnormal cells indicating more severe stages of cellular abnormality from viral or other infections.
A minimal number of abnormal pap smears may suggest pre-cancerous changes or even changes which meet the criteria of cancer either localized to the the surface epithelium covering the cervix or in the cervical canal itself and a few may suggest cellular changes far more advanced.
Most of the pap smears which are read as atypical or abnormal require either repeating the pap smear at intervals suggested by the gynecologist or observation via a magnifying instrument and/or biopsy.
The important thing is that it is frightening to most women to get a message abnormal pap smear without a phone call from the Drs’ office explaining the significance to be placed on the atypical or abnormal pap.
Issue # 1. Depends on the abnormality. Class I: treat for yeast or vaginitis if present, redo pap in 6 months. Class V: Go to Oncologist today. Bad form for your doc to just leave that kind of message on the phone, tho.
Issue # 2. If a patient has no history of sulfa sensitivity, but a history of asthma, I’ll still prescribe it. So many, many things can trigger an attack theoretically but usually don’t that if I precluded all of them, I’d have nothing left to use to treat anything.
Thanks, guys; I have a call in to my gyno, and am much calmer now with the help of the work of my good friend, the late, great Andres Segovia.
Out of curiosity, though, about the sulfa thing: if there’s another perfectly good treament that you KNOW your patient isn’t allergic to, because she’s taken it before with no problem, why would you risk prescribing sulfa? (BTW, it was a simple UTI that time; also, my sister, also a patient of hers and also mildly asthmatic, is also allergic to sulfa.)
I’m going to strangle her now!!! Nobody has called me back today, so I just called her office again; apparently they close Fridays at 3 pm. There’s no message on my home machine either. So it seems I have to stress all weekend. Why the @(%%&%@$ did she leave me the damn message in the first place if she didn’t have 5 minutes to talk to me about it?
because for an uncomplicated UTI, sulfa is such a nice treatment. It’s concentrated in the bladder, you only have to take it twice a day, generally 6 tablets or less are all that’s needed, it doesn’t interact with many other medications, and tends to be associated with fewer vaginal yeast infections than penicillins or floxins. And it still kills most common causes of UTI’s.
Besides maybe last time with the different medication the patient was just getting the sensitization part of the drug allergy, and the next course would have caused severe problems.
Damned if you do, damned if you don’t.
But that was real rude of the doc’s office. I bet you’ve got a class I (not really a problem pap), that is by far the most common type. Complain to your doc about how this was handled!
Well, I don’t know what number my Pap is, but it’s apparently enough of a concern that my doc wants to haul me in for a colposcopy, and depending on the results of that, a biopsy. Yippee.
Why she couldn’t manage to find 5 minutes last week to explain that rather than letting me obsess all weekend, God only knows. I will have sharper words with her in person, once I digest the meaning of the results of my Pap and decide exactly how stressed out I should be about the upcoming test(s), which apparently take about 10 minutes, but need to be done at the hospital for some reason.
In the meantime, I think I’m going to lay back with a glass of Godiva chocolate liqueur and my copy of Our Bodies, Ourselves and try to make sense of it all. Those of you who weren’t born with female plumbing are damn lucky, and my plumbing usually doesn’t give me any headaches.