Nurse 'can't find cervix' for smear?!!

[Diege]

This all happened a month or so ago, and going back this afternoon (different practice) and hoping for some reassurance that what happened last time is (within the realms of) normal
Basically usual nurse not there. Stand-in draws breath and blanches when I say I'm there for a smear. Says she'll 'have a go' . And have a go she certainly did. After 20 mins she admitted she couldn't find my cervix (tried 2 speculums) and said I'd have to come back again. I've never had a problem in the past in terms of them actually getting a sample (though I have a history of CIN/treatment, hence the yearly smears).
Just wondering if anyone else has had this problem? I had ds 1 in June (also have 3 dds). She alluded that it might be due to my age (I'm 39 ) and that she has seen it in the past in 'obese ladies' (I'm not). I was also the first smear she'd done for 15 years...
So, due to many factors (that being the icing on the cake) changed surgeries and have a appointment at 2pm today. To say I am nervous is a massive understatement!

[Rollergirl1]

I have had this, although not when having a smear but when having DD1! I was being induced with a prostaglandin pessary because of my waters breaking early. The midwife routed around for ages before exclaiming that she couldn't find my cervix and had to call for another midwife. The second midwife found and explained that it was nothing to worry about, just that my cervix was very far back. I was 32 at the time and not overweight, just heavily pregnant.

I am sure there is nothing worrying here. Sounds to me like the nurse was very out of practise. What a pain for you though!

I am sure all will be fine this afternoon. Good luck!

[welshandproud]

Good Luck. I'm sure a more experienced nurse will find it straight away. I am in a similar situation to you recently had DC4 at 42. Have also had colposcopy treatment in the past and should have been on yearly smears but have been pregnant for the last 3 years! Had a smear 2 weeks ago and dreading the result!
My fingers are crossed for you even though i'm squirming as i think about it.
Relax those knees!

[CarmelitaMiggs]

I've been on that couch for 30 mins with 2 nurses and a GP taking it in turns to poke about hopelessly for mine, so I feel your pain. You might have a retroverted cervix (lots of old threads on how to get them to show themselves at crunch time).

Either way, your nurse sounds incompetent and a bit of a loon.

Flag up that your last inspector couldn't find it, so they get out the longest specululm. And there's some position they can get you into wedging a pillow under your hips which makes a difference. And breathe out.

[sfxmum]

I always have similar problems and often have to repeat smears as when they find it they don't collect enough cells or something
seems to be regarding the position on the uterus
btw not obese
it is intensely annoying

[Diege]

Oh thank the lord that it's not just me . Will explain to the nurse about last time and see what sort of speculum she produces...
Sounds like we have similar backgrounds WELSHANDPROUD (and I am also Welsh and proud of it
CARMELITA, I did consider it might be my uterus, but have never had a problem before. Can a uterus turn retroverted or is it something you're born with?
I suppose part of my worry is that there may be abnormal cells and that them not finding the cervix might in itself suggest there's an abnormality. I am being stupid aren't I??!'

[hellymelly]

two midwives and a consultant tried and failed to find mine when I was in labour with DD2,hence second c-section.there was another modwife in the room with fingers like an aye-aye but she was too shy to suggest that she tried when the consultant failed.I am also Welsh...do we have some bizarre secretive cervix tendencies?

[havoc]

Did she think you left your cervix at home?

I have been accused of having an unusually small one! I sometimes have to put my fits under my buttocks to get the angle right, maybe this would help you.

Don't worry, its not you, just an inexperienced nurse. Good luck next time!

[Diege]

Lol at welsh cervixes . Will let you know if she says 'Well if you'd said you were Welsh we would have got the right equiptment out ready...'
Off now for appointment - will let you know how I get on

[hellymelly]

That should be a MIDWIFE not a MODWIFE (thinks dreamily of Paul Weller and ponders on freudian reasons for typo....)

[rabbitstew]

Shame I missed you... I've always had this problem, too. It has NOTHING to do with being overweight (I've always been normal to slightly underweight). It does have everything to do with the position of your uterus and therefore cervix, though - at some times of the month it may be better than others...

Do NOT allow anyone to do a smear on you if they are not trained to do an internal examination with their fingers, first. Many practice nurses are not trained to do this and get you to cough and other ridiculous things in the vain hope they will suddenly be able to visualise your cervix (which may work for most people, but honestly...). If you get someone trained to examine you internally, they can feel where your cervix is before they shove an enormous speculum up inside you and bang it up against the cervix they can't even find. I now have the requirement for an internal, manual examination prior to smear test written in my medical notes, enabling me to bypass the practice nurse altogether. Frankly I think it is scandalous they let people do smears without training them how to find a difficult cervix first. I got TOTALLY fed up with people making me increasingly uncomfortable for 20 minutes, pushing a speculum in and out and then giving up, leaving behind someone very unkeen to have to repeat the process.

[YanknCock]

Mine apparently 'bends round the side' according to the consultant performing my hysterosalpingogram a few years ago. Wonder if that's why I had a few abnormal smears and had to keep going back for repeats until they got one that was ok.

[VinoEsmeralda]

I had the same, she had to admit defeat after 30 minutes of prodding. Saw a more experienced nurse who got it the first time, done under 2 minutes!

[Sidge]

Hope it went well for you today Diege.

Firstly, that nurse shouldn't have been trying to take your smear if she hadn't done one for 15 years and you should report her to the practice manager. Nurses are required to update their skills regularly, cervical cytology updates should be done every 3 years. Also the process of obtaining and storing the smear has changed relatively recently to liquid based cytology, so that nurse wouldn't know the correct procedure.

Having said that I have had ladies who have a cervix I struggle to find - they can be retroverted or tucked up really high and hard to access. Usually a longer/wider speculum, or changing the woman's position does the job! A VE is rarely needed and as I have very small hands wouldn't be particularly productive anyway (I have been trained to do VEs but can't always feel the cervix).

[Diege]

Success! New nurse was lovely, and while she did admit my cervix was a 'little tricky' (retroverted and tucked away to one side)she asked me to sit on my hands and that did the trick . She also said as you did SIDGE that the other nurse shouldn't have been doing smears in the first place what with her not having done one for 15 years.
So just the waiting now!
Thanks again everyone - you made it bearable!

[rabbitstew]

A longer speculum and sitting on my hands never worked for me. I guess I'll have to make sure I also avoid people with small hands! I have had 8 experiences of people not finding my cervix without internal examination (yes, I did perservere and was unlucky enough to have had abnormalities previously, so have always been on 6-monthly or annual recall) - and one experience of being 8 centimetres dilated before anyone actually found my cervix (the midwife must have had small hands...). However, I have also been told that my cervix is not in THAT unusual a position.

[Sidge]

LOL rabbitstew you'd better not come to me for your smear! My titchy fingers would be no good!

Have you ever had your smear on your left side? That can sometimes coax an elusive cervix out

[thedollshouse]

I never had a problem until after having ds and now they have difficulties finding it and the smear hurts too. One nurse even asked me if I knew where it was. I was tempted to say that I had left it in the waiting room.

[rabbitstew]

No-one has ever suggested I lie on my left side. I might try that for my forthcoming smear test! And I will inspect the nurse's/doctor's hands for size, first, too!!!

[Littlefish]

Yank - I'm the same as you - off to one side. Like thedollshouse, I was fine until I had dd.

[NorbertDentressangle]

Mine is tilted apparently and can be difficult to find -one nurse got me to tuck my fists under my buttocks to lift my bottom half IYSWIM.

I've discovered, after many years at the same GP practice, that one nurse is much more efficient at doing smears than the others -shes in and out in seconds so to speak

[Kewcumber]

"hysterosalpingogram" - thats known as the "torturegram" in my house partly due to the consultant not being able to keepo the ctaheter in my uterus to inject the dye (I think it kept spitting it back out after he's inserted it ), subsequently he decided to leave the speculum in with the catheter but couldn't get a grip on my (retroverted and distant) cervix... so he hammered the speculum on [ouch emoticon] and left it in for the entire procedure and had to use a second load of die which sent my blood pressure sky high and I was kept in the unit for hours to recover before they would let me home.

Hi Littlefish - bet that was more info than you really wanted

OP are you sure the orogonal nurse was looking in the right place?

[Littlefish]

• Norbert and Kew on the same thread. How lovely, even if the subject matter is a bit icky!

Kew - yes, possibly just a little bit TMI! But I agree, an HSG is really nasty, even when you're not having s speculum shoved up your chuff.

[NorbertDentressangle]

lol at "up your chuff"

Personally I prefer "up your flue"

[Littlefish]

"up your chuff" is a favourite phrase in this house. (When dd's not around, obviously!)

I'm too busy with woodburning stoves at the moment to think of a "flue" as anything more than something to do with chimneys!

[Kewcumber]

Still, an improvement on the consultant whoinspected my cervix and said "how pretty"