Monday, October 17, 2011

The Lady Bits Inspection

Today I had my second round of long-neglected medical tests. The first round consisted of a standard battery of tests on blood, urine, and stool samples as well as an EKG, blood pressure, and a cursory exam by a doctor ("open up and say, "ah"). The results of those tests were all in the normal range. The one disease that most obese people fear, type 2 diabetes, was not an issue. My blood sugar was normal and my HbA1C test was 4.4 (and 4-6 is "normal"). 

The tests I took today were for "lady's problems", as my mother would so quaintly put it. I had a pelvic ultrasound, a pap smear was taken, a mammogram, and a breast exam. The pelvic ultrasound revealed nothing but a benign cyst on one of my ovaries which I suspect has been there all of my life based on a certain pain I feel during ovulation. The doctor said it's no problem and is the sort of thing which changes in size based on menstrual cycles. The breast exam also revealed no abnormalities. The mammogram and pap smear have to be developed and examined by physicians and the results will come in two to three weeks, but my husband was in the room during the mammography and saw the images. While he's no doctor, he saw nothing strange on the images (no dark spots or shadows).

My sense is that all of the tests will come back fine. My last pap smear was about a decade or so ago, and I know how foolish it was to put off the test for so long. However, I'm a virgin who married a virgin and there's zero risk of HPV so I'm on the lower risk side for cervical cancer. Also, I've never taken birth control pills so there's little risk of hormonal contamination affecting my reproductive health.

The reason I resisted the test for so long was my weight, though not because of the weight itself. One of the last two pap tests I took resulted in a doctor trying to use an mechanical table to elevate me and I was too heavy for the motor to work. The doctor angrily asked me what I weighed and then scolded me because I might damage their table before scoffing in disgust and moving me to an old-fashioned table. She then hastily did the test and scurried away after an experience which she obviously viewed with distaste. I could not bear the humiliation again, so I put off the test until my weight was in a range that I felt would not yield a similar experience. 

I had another bad pap test experience at a clinic in which I struggled to get there with terrible back pain only to have the doctor refuse to give the test because the speculum wasn't big enough and caused me pain. I told her to just go ahead and do the damn test and get it over with and I'd put up with the pain for the brief time she did it. She said she had to order a bigger one rather than pinch and hurt me with one that was too small. I was extremely angry that she wouldn't do the test, and even madder that the clinic attempted to charge me for the office visit when the doctor was the one who refused to follow through and do it. I refused to pay and I never went back. 

This time, the experience was fine. The doctor was kind and the chair, which was different this time and incredibly comfortable, had no problems moving my 182 lb. body into position. A standard speculum was used with no pain or problem and, while not the most comfortable experience, it was not painful or negative. After reading so many horror stories on the internet from people who were harassed about their weight by gynecologists, I had myself practically whipped into a nervous wreck thinking that I might get derided for my BMI. No one said anything, though my husband did mention to the gynecologist that I had lost a lot of weight so that she would not be alarmed by the extra skin hanging off of my body. 

Having this generally positive experience is the first step in healing the damage done to me from my bad experiences in the past. When all of the tests are done and (what I am sure will be) normal results are in, I feel like I can start over with my relationship with the health care system. Part of what happens when you avoid getting routine care is that the longer you avoid it, the harder it becomes to face it. You develop a mindset through time that makes you think that going to the doctor will confirm your worst fears so you live in denial of the truth about your health. You believe that finding a problem on a medical test makes it real, rather than deal with the fact it was real all along. You imagine all sorts of things, and just keep avoiding "confirmation." If you did routine checking, you'd catch them at an earlier time, but the fear of humiliation and degradation keeps you away from that and the fear compounds as the years go by. 

I'm absolutely certain that if I regained weight and exceeded 250 lbs. again (or got near 400 as I was before), that I would find the experience of these health check-ups far more difficult and very likely traumatizing. People who have lost weight like to say that people treat you better because you change your outlook, but I will never believe that. I am the same except for my body. I was regarded as an object of disgust before, and now I'm treated like a human being. 

These tests, which I have avoided nearly all of my life, are the next leg along the path to "normality" that I'm attempting to tread down. It's extremely hard emotionally for me to do what I'm doing even though it's the sort of thing people without my fears take for granted as necessary and an undesirable but routine task. I asked a work acquaintance how she felt approaching her annual physical (which all people in the country I currently reside in can take part in for free) and she said she felt nothing at all about them. That is, she experienced no stress, anxiety or fear because she didn't form a set of neurotic responses from being treated poorly at such times. It was just what she did as part of her normal life to catch health problems and deal with them. This is "normal", and I have to desensitize myself to the experiences of having medical tests if I want to keep moving in this direction. I'm two steps in, and have one more to go when I finally take the thyroid test that was recommended during my initial check-up.


Val said...

Ugh. Unfortunately this reminds me that I'm way overdue for my own checkup...
At least my gyno no longer gives me the "ELMM" lecture since she herself has gained a little weight in late middle age ;-) !

screaming fatgirl said...

Hi, Val, and thanks for reading and commenting.

One interesting point was that, when I was filling out the questionnaire for the exam, the nurse avoided asking me my weight. I told her she could write it down and I told her what my weight was. I don't care about telling it like it is, I just don't want any condescending advice or bullying. Fortunately, I didn't get any.