AIBU to complain about smear test experience?

[Ktmc94]

On Monday I contacted my GP surgery to get a new prescription for my pill. I spoke to the nurse who sorted that out but then proceeded to ambush me into a smear test appointment. I have looked into the screening for myself and was not convinced that I wanted to participate (I'm 26). I got flustered and agreed to the appointment thinking that at the very least I could have a discussion with her about it.

Then yesterday I arrived for my appointment. Blood pressure taken for pill and then I was weighed (didn't see the weight on the scale but I'm about a size 14/16). What came next was effectively a lecture about my weight which sent me reeling because I was already feeling nervous and uncomfortable about what was to come.

I was then ordered to strip behind the curtain without further ado, I tried to intimate that I was feeling apprehensive and was basically told to get on with it "it's only 20 seconds it's fine". No reassurance, no chat about the procedure or pros and cons of screening.

She then presented which, to me, looked like a rather large speculum and I voiced my concerns about it and was told that due to my weight a larger size was needed (I have never given birth). I was shell-shocked by this pronouncement and the bloody thing hurt before it was even opened but was once again told to relax and get on with it.

I left the appointment absolutely devastated at being lectured about my weight while feeling too vulnerable to assert myself. Fine, I need to do something about it but to launch immediately into a diabetes and heart disease lecture and then telling me that because I'm a bit chunky it means I must have a fat vag and offering no further explanation on the matter was just too much in my view.

I couldn't sleep last night tossing between wondering if I'm overreacting and feeling very upset about what happened. I phoned the practice manager this morning to discuss what had happened and was not encouraged. She skipped over the part about me trying to make an informed choice before deciding to screen and said "but you're 26 you should have had one by now" and "the nurse has been doing these on a daily basis for 30 odd years" and then rounded off by saying "not in any way to diminish your feelings about what happened" while having no comment on the fact that a weight lecture took up more of the appointment than some much needed reassurance about an invasive test.

I can't find anyone of any size who has been refused even a try with a smaller speculum and if I'm being honest I'm not massively fat, just pandemic misery has got me seeking dopamine in the biscuit tin but she could not have cared less about the state of my mental health. I'm still spotting and cramping which I had to find out for myself were side effects.

YANBU to feel how you do of course, but I think you're feeling oversensitive about your weight gain.

You are incredibly lucky to get a smear test in a pandemic, I know 2 people diagnosed with cervical cancer after their smears were cancelled in the first lockdown.

They use the same size speculum for most women, unless very petite or big issues with the normal size. Yes it does look big though!

not sure where fat vag came from?? did the nurse say that?

Without having been in the room at the time it's really difficult to comment on where the nurse has done anything wrong

Encouraging you to have a smear and imparting health promotion advice is very much her role but it ought to be delivered in a sensitive and kind manner

It doesn't sound like her bedside manner was great but perhaps she just didn't pick up on your anxiety so I'd be inclined to give her the benefit of the doubt

Commenting on the size of speculum may be related to your height rather than your weight (assuming you are tall?) and not a suggestion that you have a 'fat vag' (should such a thing be possible )

*whether not where

It’s literally her job to discuss the chronic disease risk from obesity.
As a PP said, basically the same sized speculum for everyone unless exceptional circumstances.

What did you want to discuss about the smear program? It’s literally a decision between doing nothing and maybe getting some advance notice of potential cancer, hopefully within a treatable time frame.

OP I'm certainly heavier than you and the smaller speculum is used for me. That said, it is correct that overweight and obese women may need a larger speculum as there is essentially more (external) genitalia that needs to be supported.

I understand why you were upset and felt harangued into having a smear test but I can't see where you explicitly told her that you were not consenting to that treatment. You tried to "intimate" but that is very passive - if you do not want to go through with a medical procedure you must make that known rather than proceeding to get undressed.

It's worth you looking into why you felt that you didn't want to participate given the possibility for missing a deadly disease if you don't.

If I were you I'd just leave it at this stage.

I’m sorry you felt uncomfortable.

A 14/16 is on the large side though and it’s literally her job to discuss this with you.

I think you’re being over sensitive generally.

I'm not sensitive about my weight gain as far as I'm concerned it is what it is for now. I'm not ignorant of the facts of carrying extra weight but trying to explain that my mental health is not exactly at its peak at the minute and being rode roughshod over about diabetes and heart disease was not helpful.

I just wanted to be able to make an informed decision and have a conversation about the procedure to ease my nerves before having it done for the very first time but was just waved off despite there seeming to be plenty of time to spend on my weight.

As to the speculum, I was not under the impression that what she had there was the "normal" sized one as she specifically said that a "larger" one was required due to my weight. She didn't say the words fat vag but I don't really know how else that was supposed to be taken given that that's where the speculum is going. Friends and family of all shapes and sizes have said that, if anything, a smaller size was offered to make them more comfortable.

I mean, using a larger than necessary speculum wouldn't benefit her in any way so I doubt she used a bigger one just to emphasis your weight or whatever.
Many practitioners are very BAU when it comes to smears. Y'know, they see people's bits all day long several days a week and probably become a bit desensitised to how it feels for the patient the first time.
Did she know it was your first time?

Why didn't you want to get your smear out of interest?

What on earth do you mean 'I've looked into the screening myself and wasnt convinced I wanted to participate'. You dont want to be screened for a very common and preventative cancer? You sound quite childish or perhaps havent had a very open home life about these things. I'm 29 and have had both my screenings and never thought twice about booking it. It's not going to be an enjoyable experience to gush to your friends about. It's a necessary medical procedure! I know many friends who have had abnormal cells found early and had the op to remove them before they become cancerous. I'm not sure on the speculum thing as I have always laid back and not looked as it. Better not to see or know. Next time I recomend wearing a skirt or dress. Then you just take your pants/tights off and the skirt hides you seeing anything. Its always worse when you look at it

What did you do to find out about the procedure you were booked in for between making the appointment and turning up at the surgery? As a 26 year old woman you are definitely capable of doing a bit of reading, you must at least have looked at information on the cervical smear screening programme?

• Smear tests save lives
• Obesity is bad for your health
• Body size doesn’t really affect vagina size, she would have chosen the speculum size based on what you required.

But yes she should have discussed the procedure with you more to put you at ease, especially as it was your first time.

YABVVVU sorry OP. She didn’t “ambush” you, nobody had a gun to your head-her job to offer you cervical screening, you were free to say no. Also her job to discuss your weight with you, your choice to take her advice on board or accept that you are happy with your weight as it is despite the risks to your health. A larger speculum is indicated for obese patients, she was doing her job properly. Better that than need the screening test to be repeated as they didn’t obtain a sufficient sample in the first place. It’s uncomfortable and embarrassing for some patients but life saving and necessary.

You chose to book an appointment for a smear (you weren't 'ambushed')

The time for making your informed decision was before you possibly wasted a much needed appointment for someone else.

It's also her job to discuss your weight with you if she thinks it may cause you health problems, especially as you don't even know what it is and she does.

I didn't know there was more than one size of the sticky up thing either.
It's a shame you were made to feel like this, but please don't let this one person put you off next time. It sounds as though she was being very matter of fact, but forgetting you are an actual person.
Next time you have a smear, make a fist and use it at the base of your spine, to tilt your pelvis.

You are 26, you should've have a smear before now.
Just wanted to point out that if someone has never been sexually active they don't have to have a smear, no matter their age. They can choose to have one, but it's thought that as the risk of cervical cancer for them is so low it isn't essential.

It does sound like her manner was rather brusque. Yes her role is health promotion which involves advice about risks associated with obesity, and she should advise you of that but it should be done in a sensitive manner.

It’s also poor that she didn’t explain the procedure for cervical screening, and what’s involved. I always explain it to my patients whether it’s their first smear or their tenth. You can’t make informed consent if you haven’t been informed about what’s involved and why.

I often use a broad speculum for a woman that is overweight as they usually have a lot of abdominal fat which can compress the vagina, so as I’m trying to open the speculum the vaginal walls collapse in and occlude my view. However I wouldn’t go straight to a broad one especially on a woman attending for her first smear, I’d go with a standard one but have a broad one to hand. They do look large, but it doesn’t all go inside you! There’s no excuse not to be kind and sensitive.

I’m sorry you had such a negative experience.

A lot of what happened to you could've been avoided if you spoke up so there's not much will come out of you complaining. It sounds as though you're over exaggerating a lot so don't know how much is actually true or just you overthinking it. If the speculum was too big, it wouldn't have gone in so you're likely just not aware of how big they need to be.

Though your clothing size isn't an indicator of whether you're overweight/obsese they're just doing their job to make sure you're healthy. They don't have time to be sensitive and hold your hand while they tell you to be aware of your own health.

Did you make it clear that it was your first smear? saying you're a little worried and then listening to them brush you off is your own fault. You need to be more clear if you're that worried, they hear it from everyone they'll only take it seriously if you make it clear.

You want to "make an informed decision" about whether you want a test that detects cancer...?

WTF?!?

Why wouldn't you want to know if you had cervical cancer?? I honestly can't think of any reason why anyone would turn down a free test that could save their life

OP, with all due respect, you need to get a grip.

Sorry but I think she was probably bewildered that you are 26 and hadn’t had a smear in the past. It doesn’t sound like she did anything wrong apart from be honest and rather blunt.

It’s her job to encourage health screening like smears and counsel you on the risks of being overweight.

Re the speculum I’m not sure, but I find even the small ones hurt. If you’re a large build or have large external genitalia it makes sense to use a larger speculum straight off rather than try them in size order and make you suffer more? Presumably she’d not have linked it to your weight had you not asked why it was a larger size?

I had CIN-3 when I was 26, and had bad cells from my cervix removed. I have 3 friends who have also had the lletz treatment. It's not uncommon.

I feel very lucky and grateful to have had this done.

Nobody likes smear tests. They're there to save your life.

I don't get what you mean about doing your own research and not knowing if you wanted to participate.

Her manner was well out of order, I must have had the same person when I went for breast screening. Complete moody awful cow she was.
Having said that, you have had it now, they are very important (my mum had a friend who didn't go to smears and she died of cervical cancer in her 40's)

I think some of these replies are a bit harsh, as someone who has pretty severe anxiety I would have felt put off for life after this personally (yes I know smears are important and I wouldn't ACTUALLY never go back etc etc but I would have felt the same as OP up to and including spending the night awake worrying about it). I could have sworn I've read threads about people scared of their first smear being told that of course the nurse will talk you through everything and put you at ease and it sounds like OP had the exact opposite happen. I'm sorry you had this experience and I hope that the next practitioner you get has a better bedside manner.

Sounds like the nurse was pressed for time- having the do the script, BP, height/weight etc, plus fit in the smear! I too am suprised they were doing them, because many others have missed out.

I used to do smears myself, and would always discuss the procedure, especially if it was someones 1st time. I also used to ensure the women knew what it being done for. It is true, that if people are carrying more weight, the vaginal walls collapse and compress down when doing a smear, making it almost impossible to see anything. I personally have a retroverted uterus, and know to ask for a long speculum. The long ones are often also ' large'. I've never had children and but not offended that I need that size. I'd prefer a quick procedure where the cervix can be seen straight away, rather than faffing about, taking it out for a larger/longer one etc and repositioning multiple times! A small size is absolutely useless for anyone other than a very young teen/child, and certainly wouldnt have allowed her to see the cervix!

Its hard to comment, because we dont have the nurses point of view. At least you had it done, and hopefully your results are clear.

YABVVU.

You booked an appointment with a nurse for a service.

She gave you information about your health and performed the procedure you wanted.

I think she probably wanted you in and out as quickly as possible seeing as she is risking her own health to help others at this time.