An observation: I don't think doctors will believe it when

[skigirl1689]

…I say I have never been sexually active. I recently tried to have a cervical cancer screening but it was not possible because of my condition (I literally can’t relax my muscles due to spasticity, really common in my condition). The nurse practitioner I see is wonderful and believes me when I say there is no chance I have been exposed to any STD, ever.

But when she consulted with two other doctors about how to handle the issue of testing and my condition, they told her she was naive to believe me concerning my past, or I should say lack thereof. She had to tell them she did really believe me.

I mean, I get where they are coming from, people fib about medical history all the time, but it frustrated me to hear this.

Maybe it just saddens me that it reflects how society is and that it’s expected I’m not a virgin and unbelievable that I really am despite being in my mid 20s.

Oh, and the doctors don’t seem too willing to take the extra steps to test me though it is possible to get cervical cancer without being exposed to an STD…but that’s a different story altogether.

Thanks for letting me vent, though I really don’t know what point I am trying to make.

 

[EasterJoy]

Yes, it is because doctors have failed to treat their patients properly far more often because they failed to believe a risk could be present than for being willing to believe a risk could not be present. If virginity posed some threat to your health and you swore that you had been sexually active, they probably wouldn’t believe you about that, either. So sure, they are probably skeptical that you are really a virgin, but what they are really skeptical about is that a risk cannot exist. They do realize that there are still real virgins out there. They are just more aware of the dangers of believing someone who might be giving a bad history. People do lie to their doctors, and it is very hard to spot who is and isn’t telling the truth.

 

[1ke]

…I say I have never been sexually active.

If you encounter such a doctor, then you need to get a different doctor.

I recently tried to have a cervical cancer screening

Sexually active women need regular cervical cancer screenings as almost ALL cervical cancer is HPV related and non-HPV related cervical cancer is super rare. You are not sexually active. I am confused on why you went for such a screening at your age.

but it was not possible because of my condition (I literally can’t relax my muscles due to spasticity, really common in my condition).

Wouldn’t you already be under the care of a doctor for such a condition? Wouldn’t that doctor know your history? Confused.

But when she consulted with two other doctors about how to handle the issue of testing and my condition, they told her she was naive to believe me concerning my past, or I should say lack thereof. She had to tell them she did really believe me.

A) I am appalled at their lack of professionalism.
B) I am appalled that she would repeat what they said to you.

Oh, and the doctors don’t seem too willing to take the extra steps to test me though it is possible to get cervical cancer without being exposed to an STD…but that’s a different story altogether.

Then report them to the appropriate state medical board.

 

[St_Francis]

Skigirl,
It is a sad aspect of life that it anything is out of the ordinary in medicine, it makes the docs, et al, crazy, and they generally are then unhappy with the patient. To be fair to them, they are under a lot of pressure. We should pray for them and accept the difficulties as a cross, esp those difficulties which arise out of our faithfulness to God We can offer them up for our doctors!

 

[maryjk]

I don’t know that is has as much to do with everyone is “doing it.” It seems that it is more that doctors are used to be lied to.

People do it all of the time.

How often do you drink (alcohol)? Just socially. (Oh, and that glass of wine every night before bed.)

Do you exercise? Of course. (Every time I walk to the fridge for another slice of pie.)

I get it all the time.

I have Celiac Disease. That means that I should not eat wheat. ANY wheat.

Yet, when they ask if I have eaten any, and I say no, they don’t believe me. Why? Because everyone lies. (Or at least most people do.) (Oh and everyone that I met with Celiac? Eats wheat at least periodically.)

 

[skigirl1689]

Yes, it is because doctors have failed to treat their patients properly far more often because they failed to believe a risk could be present than for being willing to believe a risk could not be present. If virginity posed some threat to your health and you swore that you had been sexually active, they probably wouldn’t believe you about that, either. So sure, they are probably skeptical that you are really a virgin, but what they are really skeptical about is that a risk cannot exist. They do realize that there are still real virgins out there. They are just more aware of the dangers of believing someone who might be giving a bad history. People do lie to their doctors, and it is very hard to spot who is and isn’t telling the truth.

Yes, I do agree with this. I know someone who said she wasn’t sexually active when she was experiencing abdominal pain…and a few hours later she had a baby. So I do know why the attitude is there as the doctors have to cover all of their bases.

If you encounter such a doctor, then you need to get a different doctor.

Sexually active women need regular cervical cancer screenings as almost ALL cervical cancer is HPV related and non-HPV related cervical cancer is super rare. You are not sexually active. I am confused on why you went for such a screening at your age.

Wouldn’t you already be under the care of a doctor for such a condition? Wouldn’t that doctor know your history? Confused.

A) I am appalled at their lack of professionalism.
B) I am appalled that she would repeat what they said to you.

Then report them to the appropriate state medical board.

There are actually no specific doctors who just treat my condition, cerebral palsy. The only doctor I saw when I was a child for it specifically was my peds orthopedic surgeon. I guess a neurologist might treat me if I needed meds for spasticity but other than that, I’ve not heard of a doctor who solely treats CP and its related issues.

I went for the screening because the literature says to get screened within 3 years of being sexually active or when you turn 21, whichever comes first. There are mixed opinions concerning if women need it if they are not sexually active, because there is always a possibility the cells will become abnormal. I did a ton of research and did come across cases of such. I have a general history of cancer in my family and a few cases have had zero family history or major risk factors.

I’m actually glad she was so honest as it prepared me to expect this attitude.

Skigirl,
It is a sad aspect of life that it anything is out of the ordinary in medicine, it makes the docs, et al, crazy, and they generally are then unhappy with the patient. To be fair to them, they are under a lot of pressure. We should pray for them and accept the difficulties as a cross, esp those difficulties which arise out of our faithfulness to God We can offer them up for our doctors!

Yes, I cannot imagine being a doctor. I know my orthopedic surgeon was really glad when I told him I was glad I had the surgery he was a bit hesitant to do.

 

[EasterJoy]

If you encounter such a doctor, then you need to get a different doctor.

Sexually active women need regular cervical cancer screenings as almost ALL cervical cancer is HPV related and non-HPV related cervical cancer is super rare. You are not sexually active. I am confused on why you went for such a screening at your age.

Wouldn’t you already be under the care of a doctor for such a condition? Wouldn’t that doctor know your history? Confused.

A) I am appalled at their lack of professionalism.
B) I am appalled that she would repeat what they said to you.

Then report them to the appropriate state medical board.

Patients who do lie about their sexual history, particularly younger patients whose parents might find out about their accounts of what they’ve been up to, are so common that no one is going to be censured by a medical board for failing to believe that a particular patient *might be *lying. This is a failure in bedside manner, to be sure, but that is something to take to the patient advocate at the hospital or clinic, not something for the medical board.

A physician has to be extremely careful before deciding not to take precautions of a life-or-death nature on the basis of a patient’s insistence that he or she cannot possibly have been exposed to a virus that is typically transmitted by sexual contact and essentially sticks around forever once you have it. It is better for the physician-patient relationship if the physician is willing to admit that the virus (or whatever it is) could have been transmitted by means unknown–keeping any cynical and unflattering opinion about his patient that he may have to himself!–but you can’t let someone risk death over something they may have said in order to avoid embarrassment.

 

[EasterJoy]

…Yet, when they ask if I have eaten any, and I say no, they don’t believe me. Why? Because everyone lies. (Or at least most people do.) (Oh and everyone that I met with Celiac? Eats wheat at least periodically.)

The other issue is that sometimes people are incorrect without knowing it. For instance, when a physician asks, “Have you been sexually active?”, some patients will take that strictly to mean “Have you engaged in sexual intercourse?” and will say “no”, fully believing this answer to be truthful. Well, not to get detailed, but there are ways to spread STDs without going so far as intercourse. If you’ve been doing things that will give an STD a chance to be passed on to your genital region, then from a medical standpoint, you’ve been “sexually active.”

Likewise, it is so easy to get food with gluten in it without knowing it that even a patient who is “sure” of having had none at all may be mistaken. Not lying, but not telling the truth: it happens.

So why even ask? Because a positive answer is positive evidence. A negative answer might not mean much, but the positive answer does.

 

[maryjk]

The other issue is that sometimes people are incorrect without knowing it. For instance, when a physician asks, “Have you been sexually active?”, some patients will take that strictly to mean “Have you engaged in sexual intercourse?” and will say “no”, fully believing this answer to be truthful. Well, not to get detailed, but there are ways to spread STDs without going so far as intercourse. If you’ve been doing things that will give an STD a chance to be passed on to your genital region, then from a medical standpoint, you’ve been “sexually active.”

Some people lie. And some have no idea that they aren’t being truthful. And it is bound to get worse. Doctors are spending less time with patients. That means less time to explain their questions or your answers.

Likewise, it is so easy to get food with gluten in it without knowing it that even a patient who is “sure” of having had none at all may be mistaken. Not lying, but not telling the truth: it happens.

Most people have violent reactions to eating gluten, if they have Celiac. So they know. But there is a small percentage that don’t know.

So why even ask? Because a positive answer is positive evidence. A negative answer might not mean much, but the positive answer does.

They do that with blood donations.

Yes, they ask you about various diseases. But they also test for those same diseases. A positive answer and you don’t donate. A positive test and they toss the donation.

 

[EasterJoy]

…
They do that with blood donations.

Yes, they ask you about various diseases. But they also test for those same diseases. A positive answer and you don’t donate. A positive test and they toss the donation.

Exactly. Information from the patient’s history that tells them up front what they would otherwise have to uncover by testing can sometimes save them investigation, but if the patient says there is nothing there, then the physician has to investigate to see whether that is in fact the case.

 

[1ke]

Patients who do lie about their sexual history, particularly younger patients whose parents might find out about their accounts of what they’ve been up to, are so common that no one is going to be censured by a medical board for failing to believe that a particular patient *might be *lying.

I was referring to their refusal to treat her situation, taking the extra steps needed to do her Pap smear, not their terrible bedside manner.

 

[EasterJoy]

I was referring to their refusal to treat her situation, taking the extra steps needed to do her Pap smear, not their terrible bedside manner.

I stand corrected on your intent. Still, I have no idea what the standard of care is in her particular case. There are sometimes limits to what lengths are required for a screening test, particularly when the patient has essentially no risk factors and the test would put her under unusual duress. The OP says she has a “general history” of cancer in her family, but that is not the same as having a family history of cervical cancer. The genetic etiology of different cancers is distinct; I am not aware of any genetic abnormality that puts a family at risk for cancers generally, rather than a particular family of cancers. Therefore, the standard of care may be that the test is not done under her current circumstances. It is very likely that the standard is that they ought not subject her to a test unless she has at least some worrisome risk factor driving them.

 

[moon1234]

I would fire my doctor if I took one of my older children there with a pain or condition that COULD be an STD and did NOT tests for it.

People lie ALL the time. Doctors can NOT afford to miss a diagnosis because the take what someone says at face value. Even the president said he did “Not have relations with that woman.”

Doctors are there to heal and treat. By NOT testing for certain conditions they may miss something that a patient May or May Not have. STDs can be transferred by other than sexual intercourse. It is unlikely, but not unheard of. The tests are usually non-invasive, quick and painless. They are zero risk to you (other than maybe a bruised ego).

She should NEVER have told you what the other doctors said. That is a serious breech of ethics and confidentiality. A good doctor will get the tests needed with a minimum of upset to the emotional state of the patient.

 

[skigirl1689]

I stand corrected on your intent. Still, I have no idea what the standard of care is in her particular case. There are sometimes limits to what lengths are required for a screening test, particularly when the patient has essentially no risk factors and the test would put her under unusual duress. The OP says she has a “general history” of cancer in her family, but that is not the same as having a family history of cervical cancer. The genetic etiology of different cancers is distinct; I am not aware of any genetic abnormality that puts a family at risk for cancers generally, rather than a particular family of cancers. Therefore, the standard of care may be that the test is not done under her current circumstances. It is very likely that the standard is that they ought not subject her to a test unless she has at least some worrisome risk factor driving them.

The gist I got is that there is no reason for me to get the test despite the recommended age of 21. I don’t think they were refusing me but they just didn’t feel it was necessary…I do know the warning signs to look for so it is really up to me if I want to force the issue. I am really torn…but that’s something I need to decide for myself. The entire issue of getting screened is that sedation would have to be used.

I would fire my doctor if I took one of my older children there with a pain or condition that COULD be an STD and did NOT tests for it.

People lie ALL the time. Doctors can NOT afford to miss a diagnosis because the take what someone says at face value. Even the president said he did “Not have relations with that woman.”

Doctors are there to heal and treat. By NOT testing for certain conditions they may miss something that a patient May or May Not have. STDs can be transferred by other than sexual intercourse. It is unlikely, but not unheard of. The tests are usually non-invasive, quick and painless. They are zero risk to you (other than maybe a bruised ego).

She should NEVER have told you what the other doctors said. That is a serious breech of ethics and confidentiality. A good doctor will get the tests needed with a minimum of upset to the emotional state of the patient.

Actually it DID hurt me a lot, spasticity does not allow the muscles to relax and my doctor couldn’t get a sample. And I don’t understand why she would have breached ethics by telling me what the other doctors said because I asked her to consult with them and needed to know what they said.

 

[Iheartcoffee]

I think they are just so used to everyone lying to them that they have a hard time believing anyone is telling the truth. Also, if you walked out that door and had a baby 2 hours later there would be a risk that they could get sued even though you told them over and over you haven’t been sexually active.

That being said, it might be good to look around a bit more. If you have a doctor that is very religious they may be more inclined to believe you have truly been abstinent.

 

[PartoftheBody]

I had a similar experience when I had some minor surgery at 25. I told them I was not sexually active, and I was even on my period at the time, but they still delayed my surgery for about 20 minutes while we waited for the results of the pregnancy test. I was annoyed, but I appreciate that in the doctors’ and hospital’s thinking, it is better to be safe than sorry.

In terms of your problem, have you tried pelvic physical therapy? I have a good friend who had a lot of pain with pelvic exams, and it really helped her.

 

[skigirl1689]

Yes, I know what you mean. They asked me to sign a form for x-rays saying I’m not pregnant recently…but I found it interesting they did not ask this of me when I was a teenager and had tons of x-rays taken for surgery and post-op checks. But it was also a different hospital system too.

Thanks for the suggestion but my spasticity is caused by neurological damage so it is highly unlikely it would help me. I actually tense up more when people tell me to relax so it is pretty “major” in terms of inability to relax.

 

[EasterJoy]

The gist I got is that there is no reason for me to get the test despite the recommended age of 21. I don’t think they were refusing me but they just didn’t feel it was necessary…I do know the warning signs to look for so it is really up to me if I want to force the issue. I am really torn…but that’s something I need to decide for myself. The entire issue of getting screened is that sedation would have to be used.

Actually it DID hurt me a lot, spasticity does not allow the muscles to relax and my doctor couldn’t get a sample. And I don’t understand why she would have breached ethics by telling me what the other doctors said because I asked her to consult with them and needed to know what they said.

Keep in mind that testing guidelines are made to balance benefit and cost, and part of the “cost” is not just financial but in suffering caused to the patient. Sedation puts a test in a different “cost” realm entirely, both in cost to do the procedure and in how hard it is on you. (Sedation is not a risk-free procedure.) Insurance probably would not pay for the more complicated and costly test, since it is so unlikely that a woman of your age and history will have this disease (which as I understand it does not “turn on” at age 21, but is nearly unknown before 20).

The thinking may be that the condition that makes the test impractical now may be treated pr may subside by the time you are 25, and that the risk of “wait and see” for a few years are easily low enough to warrant waiting.

 

[moon1234]

The gist I got is that there is no reason for me to get the test despite the recommended age of 21. I don’t think they were refusing me but they just didn’t feel it was necessary…I do know the warning signs to look for so it is really up to me if I want to force the issue. I am really torn…but that’s something I need to decide for myself. The entire issue of getting screened is that sedation would have to be used.

Actually it DID hurt me a lot, spasticity does not allow the muscles to relax and my doctor couldn’t get a sample. And I don’t understand why she would have breached ethics by telling me what the other doctors said because I asked her to consult with them and needed to know what they said.

The VAST majority of STDs can be detected with a blood sample. HPV is one of those diseases that is only transmitted via sexual intercourse. There is no IMMEDIATE need to test for HPV. Cervical cancer is bad, but HPV infection does not necessarily mean you WILL get cervical cancer, just that it increases the risk. HPV is NOT routinely tested for anyway as it does not cause serious acute complications.

A doctor would not routinely test for any STD unless you came in on an emergent basis or were pregnant.

 

[Gordon_Sims]

…I say I have never been sexually active. I recently tried to have a cervical cancer screening but it was not possible because of my condition (I literally can’t relax my muscles due to spasticity, really common in my condition). The nurse practitioner I see is wonderful and believes me when I say there is no chance I have been exposed to any STD, ever.

But when she consulted with two other doctors about how to handle the issue of testing and my condition, they told her she was naive to believe me concerning my past, or I should say lack thereof. She had to tell them she did really believe me.

I mean, I get where they are coming from, people fib about medical history all the time, but it frustrated me to hear this.

Maybe it just saddens me that it reflects how society is and that it’s expected I’m not a virgin and unbelievable that I really am despite being in my mid 20s.

Oh, and the doctors don’t seem too willing to take the extra steps to test me though it is possible to get cervical cancer without being exposed to an STD…but that’s a different story altogether.

Thanks for letting me vent, though I really don’t know what point I am trying to make.

When my wife and I got married and we were applying for our marriage license they asked if we had HIV. We both said no. When they asked how we knew and I said I was a virgin, they didn’t believe me and practically insisted that I go in for a blood test. I’ve had several doctors question how I could possibly know I was HIV-free without a test, then scoff at me when I told them I’d only been with my wife. I didn’t appreciate the attitude but I wasn’t going to lose any sleep over it.