Nightmare consultant appt - smear test. Long post. Sorry!

[Katts]

Sorry in advance for what I know is gonna be a long post. Just had an appointment with the consultant yesterday that has left me upset, frustrated and confused. It really was the most horrible experience and I?m now terrified that this is the kind of care I can expect for the rest of my pregnancy.

The only positive thing about it was that I got to hear the babies heart beat for the first time. For 2 whole seconds - before she yanked the scanner away. Talk about killing the magic right off the bat!

I was referred to her by the midwife at the hospital (UCH) 1. because of my asthma and 2. because my last smear test showed abnormal cells. So on count 1. she asked me if I'd ever been hospitalised with asthma and that was it. Didn't ask me how often I'm taking my medicine. Didn't even listen to my lungs - which aren't sounding too good at the moment - another bloody cold! Just said my asthma could get worse or it could get better. This is exactly what the midwife said, so if no one cares to do an assessment of my asthma then why was that a reason for my being referred to a consultant?

And on count 2. she decided to do another smear test - after first saying she couldn't do anything because she didn't have any of my medical records and implying this was somehow my fault because I'd had my original smear & subsequent colposcopy done privately. (I was referred to her 5 weeks ago! Why didn't she have time to get my records from my GP?!)

So she does this test on an exam table squeezed into the corner with another smaller table at the foot of the exam table where she can't even get round to the foot of the table. Has me undress with nothing to cover myself. Then she proceeds to gauge out my pubic bone with the speculum. And when I told her it really hurt she said. "That's because you're tense. You have to relax." Yep. That REALLY calmed me down. Don't know how you're supposed to relax with some strange person bending over your legs because there's no room at the foot of the bed where she belongs? She did the test and I look down at what she's been scraping around inside me and it's some kind of flat wood thing? Errr...don't they usually use a long cotton bud thing? Christ. Then she didn't even leave the room for me to get dressed.

She kept telling me it was uncomfortable because I was tense and this was pushing my cervix downward. I happen to have a tilted uterus and my cervix tilts down naturally. I can only think that if the exam had been done on a table with a bit more room then she wouldn?t have had that problem? I?ve never understood why in America they put you in stirrups for a smear test so they can have a good look and in the UK they seem to just hope for the best. Incidentally, I?ve never had a doctor have a problem getting my cervix into the right position in any internal exam in America. (Not wanting to start a debate on who has better care though as there are plusses and minuses of both systems)

So now I?m waiting to get the results of the smear test and she says if it comes back abnormal again then she?ll refer me for another colposcopy. I don?t even know what the point in that is since they won?t do anything about mildly abnormal cells while I?m pregnant anyway?

I?ve left out a lot of details ? all the verbal exchanges which were terse and rather confrontational. From the beginning she had a ?What do you expect me to do about it attitude.? And the whole thing was rushed ? she was actually trying to question me about my asthma in between doing the smear test and me trying to get dressed (no privacy) whilst tripping over my knickers ? which is why I didn?t exactly have the courage to be more assertive about the problems I?ve had.

Afterwards I met my partner for lunch and ended up crying all through the first course. I didn?t even realise how upsetting the whole thing was until after it was over. Can?t believe I actually thanked the b*tch before I left.

So just a few things I?m wondering:

1. She didn?t weigh me or measure the height of my uterus. Aren?t they supposed to do that at every appointment?
   
2. Is 2 seconds enough to determine the baby?s heart is beating normally?
   
3. Why the hell was the smear test so painful?!
   
4. What can I do about it? Should I make a complaint or is this pretty much acceptable NHS behaviour?
   
5. What can I do to ensure I don?t ever have to see that woman or repeat that kind of experience again?
   
   Again sorry this post is really long. But any comments welcome.
   
   Thanks for listening!

[dyzzidi]

Oh my god poor you!

I would ask to see my midwife again to ask quetions about care.

Some doctors are a nightmare!

[docket]

sorry to hear about your horrible experience.

i don't know about the other questions but if i were you i would complain, nhs staff are supposed to treat people with respect. you might feel better / more empowered for doing so?

[foxinsocks]

you can make a complaint. Every NHS hospital will have a person who deals with complaints. You should be able to look them up on the internet or ask over the phone for their details.

Here's the blurb... patient advice and liaison service (pals)

[Katts]

Thanks for the link foxinsocks. I don't even know what outcome I should or could expect from complaining but maybe it would just make me feel a bit better - more empowered like Dockett says.

[Gwenick]

God that sounds awful - I thought they didn't do smear test when you're pg?? Or maybe that was just my Dr.s

Anyhow, I can 'sort' of sympathise, I've got vaginismus and made this VERY clear to my MW when I was in labour with DS2. She was fantastic, but the flipping consultant that came in was a completely GIT, payed no notice of my notes (which had plastered at the top VAGINISMUS) and told me to stop screaming everytime he did an excrtuatingly painful internal.

[highlander]

OMG, you've had an awful experience

I'm British but moved to Vancouver last year when PG so here's my opinion:

Firstly, maternal weight is no longer regarded as relevant (although I know they are obsessed with it in North America), so don't worry about that. Fundal height is only a rough gauge as to how the sprog is developing and there is plenty room for 'operator error'! Foetal heart sounds can be useful, but only if listened to by a skilled OB. My OB said she does it more for maternal reassurance. The most impt part of your check-up is getting your urine dipped and your BP checked.

When I went for my smear test at 12 weeks post-partum, the speculum insertion was very painful, and the OB said it was because my vaginal tissue was still heavily 'soaked' with oestrogen which can make it more sensitive. She loaded up with tons of that gel stuff and really took her time.

In terms of making a complaint, which I would urge you to do, find out what grade your docotor was. Junior doctors (SHOs) help the consultants and registrars run the clinics and can be very inexperienced. Often they don't ask for help when unsure what they're doing. In terms of their training it is crucial that any inadequacies are 'flagged up' to their consultants. My DH (consultant in a different speciality) had to deal with an SHO like this and they take it very seriously indeed.

Your referral appointment (the first time you go) is alloted a time of approx 30 mins to allow a complete medical history and examination to be taken - they completely failed you in this. Repeat appts are generally 15 mins, but tend to overun! These times are taken from DHs clinics.

Good Luck, hope you get the care you deserve.

[Tissy]

as highlander says,1) your weight and uterus height don't correlate well with how the baby is doing, so no reason why she should have done it.2)if she used a doppler to listen to babies heart, it measures the gap between heartbeats to calculate the rate, so plenty of time 3) smear test probably was painful due to you being tense, but she didn't do much to relax you. The flat spatula to take the cells is pretty normal, and preferred by some labs, as the cells come off in a "sheet".

As for the lack of privacy. I doubt if this was altogether her fault, similarly the size of the room and the layout of the furniture. She may not have been in post for long (or as highlander says, may not actually have been the consultant), so might not have felt able to comment about it, even if she did feel it was a problem.

AS for the asthma thing, an obstetrician won't necessarily be skilled in asthma management, and she may have been wondering what the midwife was doing referring you to her! No reason to take this out on you, though.

Her attitude and rushing may have been because she was pushed for time, or exhausted from a night on call. In the NHS, it is fairly par for the course that clinics are overbooked- if they weren't waiting times would be even longer, and in obstetrics, you only have so long you can make a patient wait. Highlanders times for new and review appointments are an ideal, and certainly not what pertains in most departments.

Whilst i don't condone what you went through, I think you are being perhaps a little harsh in calling her a bitch. Sure if you write a letter calling her that, you won't get to see her again- but you may get someone equally tired, overworked and pushed for space in the consulting room.

[starshaker]

i had a smear scheduled for november but as i was pregnant they have postponed it till june (baby due on friday) as they told me they wouldnt do anything until bumps was born anyway and didnt want to agravate anything. i would make a complaint she sounded like a nasty person. i think i would have prob been the same as while naked u feel vunerable and the last thing u want to do is have a confrontation with ur knickers at the other side of the room. i would speak to ur midwife and explain that u dont want to see this woman again and im sure there are others that will treat u with a bit more respect

[piffle]

Heck!!
I had an abnormal smear 3 mths before getting pg with dd, when I was referred on for further testing they gave me a brief consult, and decided that they woudl wait until I delivered and follow it up at 6 wk post natal check, as it was not in anyones best interests to procede with further investigations while I was pg as it can be painful and difficult to get clear specimens due to uterine changes when pg (hormones etc).
But I had a clear smear 6 mths earlier ( I am on twice annual smears due to previous "issues")
I am really sorry you had such a vile experience
xxx

[expatinscotland]

Vaginal child birth does slough off abnormal cervical cells.

When I worked in a women's clinic in the US, they wouldn't do a colpo unless the smear had shown CINII or the woman had been treated for CINIII or CINII that had been present in the endocervical canal first. Or if she were HIV+.

[Fran1]

Im afraid i've put up with this sort of behaviour, your post will make me think again next time. Guess i'm just following the British rule of keeping quiet, but may change my mind.

I have had a colposcopy several years ago, and every smear since has reduced me to tears, done by various nurses/doctors. The last nurse to do it told me the reason why i suffered so much pain is becuase the wound from the colposcopy still hasn't healed, and she told me that was normal.

[Katts]

Thanks for all your comments and my sympathy to everyone with similar experiences.

First of all she was the obstetrical consultant - or at least that's what she told me - I make it a point to find out what everyone's "job title" is since it's frustrating sometimes not to know if the person you're talking to is a nurse, midwife, doctor, consultant or what.

I understand fully the points about her being rushed. I was told when I arrived that they were arriving an hour and 1/2 behind schedule. And I really didn't mind waiting because it's kind of par for the course. I was the last patient to be seen. So she may have very well been pressured to get out of the clinic and get to her lunch date but it wasn't as if there was a full waiting room to deal with.

Also the smear test wasn't painful vaginally it was because she was digging the the speculum into my pubic bone. I was actually worried she was going to scratch me or cut me with the thing.

Whatever...I think I will write a letter of complaint. Not that it will do much good. But it might make me feel a bit more empowered. (Oh, and of course I wouldn't call her a b*tch in an official complaint!)

[expatinscotland]

Fran
I had a LEEP on my cervix about 4 years ago (after colposcopy), and although it is healed I can STILL feel the bloody thing around the time of my period! I think some peoples' nerve cells are different from others, b/c I still still feel some other injuries that are long healed.

[CharBell]

Katts - for what it's worth, I really think you should complain. Noone likes smear tests and noone would want to have an experience like yours.

She needs to be told and she needs to think about whether she is usually that crap and needs retraining on her bedside manner or she needs a wake up call that when she has a bad day it really has an impact on her patient. Either way, she needs a bit of a slap.

[goldenoldie]

Katts - definately put in a complaint and put it in writing to the head of the department - should be able to find this info on their web-site. I've had crap treatment at UCH before and complaining verbally gets ignored, but put it in a letter and they seem to listen.

I would also copy in the Maternity Services Liaison Committee MSLC for the hospital (each hospital has one) and the MSLC for your Primary Care Trust - as they are the ones paying the bill for your treatment there.

Don't let them get away with it...............

Sadly, there is no way to ensure this does not happen again - avoid this member of staff, but there are likely to be others, just as bad.

[champs]

hi there
sorry you had such a horrid exp.
i think each hosp is different within one country so comparing in two different is hard. I have had horrible experiences in some hosp and better ones in others also i have had good experience with some docs/mw/cons in same hosp as have had bad ones. I thought all hosp/gp put legs in stirrups for a smear, one of many reasons i hate them
I do think you are within your rights to complain.
as for weight issue some hosps dont weigh patients, wish mine was one of them as I hate getting on scales!!