Nurse refused to do a smear test

[weevilswobble]

Have been suffering alot of anxiety and part of that is a fear of cervical cancer. I got the HPV virus on my first ever sexual encounter aged 17, and was told i'd need an annual smear. I have had abnormal smears and treatment for abnormal cells in the past but i'm currently on a 3 yr recall. My doctor said to book in for a smear for reassurance, but today at the appointment the nurse refused to do it. Can i go somewhere else? I take full responsibility for my health and dont actually enjoy having smear tests, but its sensible i think. Feeling a bit confused.

Quick reply over breakfast, some links to the NHS CSP website pages:
HPV info
HPV testing factsheet - will be rolled out Spring 2012
Why wait for repeat tests/do changes go away?

These are things the GP should be able to discuss with you. To put HPV infection into context if you look at this link to the general page and read the ARTISTIC trial data it gives you more of an idea about how widespread HPV is, particularly in younger women i.e. 17 y/os and also that it will go away again. They're known as transient infections.

MrsJames - re "if someone is symptomatic then smears should be bypassed and go straight to colposcopy"

What exactly would you say are symptoms of precancerous cells on the cervix?

I'm curious, because i was not symptomatic of anything at all when I was diagnosed with CIN III.

weevil this really pisses me off. I had abnormal smears and after a few years had a hysterectomy.

The new guidelines look like they're playing russian roulette with peoples lives.

There was a news report the other week and IIRC the labs were binning smears for women under 25 .

I had a private colposcopy once, I think it was £400 or so.

I dont know how insurance works in Australia and France but, we all know about America. Of course they have annual testing, its all about the money. They pay for every single thing and are encouraged to get tested for every single thing. That doesnt make them a healthier nation either. GP rules over nurse, did someone say? I maybe biased but, I would go with an experienced nurse over a gp any day of the week.

Jade Goody btw made it very clear that she ignored letters and treatment.

OP if it will really put your mind at rest then, pay for a smear, I dont think that they are that much. If not please remake your appointment for counselling, it sounds like a good idea. I hope you get things sorted.

PS Op, when did you get a smear at the age of 17? how many years ago was it? Ive never heard of that before. I thought it was always 20.

I also had to have yearly smears for a while and when I went for one I was told I wasn't due but she did it even if she made me feel like I was a nuisance.

Can i also have a quick hijack to take advantage of the professionals on here?
I have to have a repeat smear for "borderline changes" in November. I hate smears,i find them extremely painfull as i have a tilted wombe and am very sensitiv on my cervix for some reason.
The last smear i had was done by the practice nurse and was the worst id ever had,i was literally crying out with pain but she carried on digging about regardless trying to angle the spec properly.
This has left me in fear of my next one.Is there any advice you can give me for making it less uncomfortable? I am going to get dh to take me and take a couple of syndol before but ive heard there are better ways to get asample which would make it less traumatic.Thoughts anyone??

sorry womb not wombe

Ledkr - I too have both of those issues. I've found by asking them to use the smallest instrument (what is it called again; I was going to say a spatula but that's not right!) they manage to do it. The last GP told me it was a child's size instrument she was using on me!

I think if I could have a Gin and Tonic before I went in I would be able to relax. Anyone done that?

Our receptionist won't even let you book an apt for a smear unless the computer screen says you are due or the doctor has made a note requesting it. Paranoia is not a good enough reason to waste NHS time what would happen if everyone that got a headache insisted on a brain scan in case they have brain cancer? Doctors use clinical judgement to assess risk and then make an educated decision. If you want an early smear go private.

sofa that sounds a bit harsh. Have you ever actually faced cancer because i have and i can tell you paranoia becomes a state of mind and i can also say my medics are extremely understanding about it too.
Its a bit different someone thinking a headache is a brain tumour and a person who has had cancer being extra senstive to their bodies.

Thanks la bag I actually considered having a large wine too,id be interested to hear if anyone has ever done it too.

ledkr - just don't go to a practice nurse for a smear... Apparently they aren't trained to do an internal manual examination when they are taught how to do smears, which means that if your cervix is difficult to find and they are causing you pain, their only option is to cack handedly and blindly keep shoving the speculum about, banging it very hard up against the cervix they apparently can't find, asking you to change position and asking you to cough, getting a longer speculum, getting a shorter one, pulling the same one in and out and getting visibly irritated. After several traumatic sessions with various practice nurses in more than one practice, generally taking 30 minutes to do something that should be done within 5 minutes, I refused ever to go back to have a smear done by anyone who had so little understanding of my internal anatomy that they should hurt me in that way for so long and yet still be allowed to continue taking smears. I find it incredible that the person responsible for taking smears in a practice should not have sufficient training to do this on women whose vaginas don't travel in a perfectly straight line up to their cervix. I now always have my smears done by the GP, who finds where my cervix is before inserting the speculum and therefore gets the right spot straight away. An alternative would be to go somewhere, eg a sexual health clinic, where they spend all day, every day inserting specula into women... surely they would also be pretty good at hitting the spot pretty quickly.

thankyou rabbitstew interestingly i once had one done by a gynea. and didnt feel a thing,and one lady Dr who isnt there anymore used to take her time and it was fairly comfortable too.I had already though id aske a Dr to do it and my friend suggested the sexual health or fp clinic.I wonder if i can just self refer when i get my recall letter.I just hope its ok cos i cant even imagine how id be if i had to have treatment

And actually thats exactly what she did,dug it around as if there was nobody attached to that vagina!!

"Of course they have annual testing, its all about the money. They pay for every single thing and are encouraged to get tested for every single thing."

Sorry, but bullshit. Of course the US DO NOT test for everything unnecessarily. IMO smears should be an annual test and so should mammograms when you reach a certain age (not sure about whether or not these are yearly in the UK?).

If you look at the WHO website, www.who.int/hpvcentre/statistics/en/, and click on the incidence map, you can see that the USA and Australia has much lower rates of cervical cancer than the UK. Early screening and detection? Would make a lot of sense!

www.who.int/hpvcentre/statistics/en/

OP, do you know what type of HPV you have? There are many different types, and some do go away on their own. Another HPV test would be able to specify the type of HPV you have.

If the NHS is going to cut corners on this to save money, then the least they could do is offer annual smears only to those of us who have the type of HPV that causes cervical cancer.

Sofabitch - are you sure that YOU are not a medical receptionist? Just saying..

Go to your nearest family planning clinic next time. The opening hours are usually better as well. I don't know that the quality of nurses would be better though as my friend works at a gp clinic and she does smears for six hours at a time and works nowhere else. I would think experience goes along way. A newly qualified doctor would not be anywhere as good as a specialist nurse. They just haven't had the experience.

OP, might it be a good idea to have a chat with the Practice Manager?

Don't complain but explain that Dr told you X then Nurse told you Y. You are npw confused/anxious and not sure how to proceed.

He/she might be able to bypass the wait to see the "nice lady GP", get you some good advice and get you in to see whoever you need for the appropriate treatment, whatever that might be. Oh, and make sure that everyone in the practice understands for next time what they can/can't do with regards to out of cycle smears.

People in the medical sphere feel free to comment but I thought it might be a way to get a resassuring ear without too much of a wait.

What ever the usual rules re recall and smears only being done at recall time - the GP said to have one. Surely that should be enough?
I agree with BarbaraWoodlouse - speak to the practice manager if you can't speak to the doctor.
Good luck op and try not to stress.

No defiantly not a medical receptionist I have faced cancer thanks. It's not harsh it's a fact of the NHS. That budgets are tight.

Well you are very lucky then to have escaped so unaffected then sofa i lost my breasts at 26 and 17 years later still live in fear as do a lot of women,to get an abnormal smear has been terrifying for me and is so for others.Just because you have not had any further fears then dont jusge others.The nhs is there to serve a purpose and money is watsed far more on other casuses than an extra smear test fgs.

sorry for the shocking amount of typos.

Sofabitch - referring someone for an early repeat smear test in order to help them deal with their anxiety over a specific issue is probably cheaper for the NHS than cognitive behavioural therapy and antidepressants. It may not be the best or most sincere way to deal with it in terms of long term help, but it's pretty damn cheap if you can get away with it (as you might well do if the anxiety is currently only focused on one issue). A shame the NHS is so poor at dealing with severe anxiety, really, but you can't refuse both tests that could allay anxiety and treatment for anxiety without failing to do your job as a GP, surely? And a good GP might well opt for both, given that waiting lists for CBT are unbelievably long. Or don't you think the NHS should have any role to play in patients' mental health? Or maybe you don't believe that anxiety can be chronic and severe and have a serious impact on someone's general well being?