"PAP" Series part 3: What the PAP?

***In order to keep this series light-hearted and easy to read I am not going to quote or site any sources except the knowledge of what I have learned through conferences, school, from pathologists and others who have gone on before me. THIS IS NOT TO REPLACE ANYTHING YOUR DOCTOR/NURSE PRACTITIONER/MIDWIFE/PA etc IS TELLING YOU. This is just some easy to read information***

ps- there is a diagram of a cervix on this page- just a warning. I found the image HERE

So what exactly is a pap smear? and why is it called that?? I really have no idea why it is called that- and I don't want to look on Wikipedia for the answer- so let's just say some it is named after some man named Dr Pap Smear (ugh- I couldn't help myself- I looked on wikipedia and the guy's name is Georgios Papanikolaou.)

A pap is a collection of a small sample of cells about 5 million cells- eh- no biggie) on your cervix (the entrance to your uterus). It is called a "smear" because we used to take those cells, smear them onto a slide, and look at them under a microscope (like 15 years ago). Now we just take the sample of cells- deposit them into a container of liquid and send it off to the lab for them to evaluate. So that is the reason why it kind of pinches when it happens... We are scraping off cells from a very sensitive area of your body. This is also why you might have a little spotting or cramping after your exam.

Bleeding after your pap smear doesn't mean your cells are abnormal or not... it doesn't mean you have an infection... it just means your cervix sometimes bleeds with a pap smear. About 50% of the pap smears I do a day have a little bleeding.

Anyway, a pap smear is a screening test for cervical cancer. SCREENING. It does not show if you have cancer of your cervix.

Then why get a pap smear? Well, a pap smear gives us an indication on which women need to have further evaluations or a DIAGNOSTIC procedure. To diagnose if there is cervical cancer or even any precancer cells.

other couple other examples of this:

-glucose test in pregnancy- if this screening test is elevated you do a 3 hour test as a diagnostic procedure to see if you actually have diabetes in pregnancy.

-Mammogram- if you have abnormal breast tissue you do a diagnostic breast biopsy in order to see if you actually have breast cancer

-AFP testing in pregnancy- a screening test to find out if there is a risk of your baby having downs, spina bifida, etc. The diagnostic test is an amniocentesis.

Like any of these tests there are false negatives and false positives. The pap smear could indicate you have abnormal cells, and then we do a diagnostic test and you don't have any. It could also show that there are no abnormal cells, when in all reality you may have them. However, this is the best we have currently. Since there are really no signs on cervical cancer- no pain, weird bleeding (unless far progressed) it is important to have your pap smears done.

Stay tuned for the current guidelines of when and how often to get your pap smear done.

"PAP" series part 1: The Pap Prep

***In order to keep this series light-hearted and easy to read I am not going to quote or site any sources except the knowledge of what I have learned through conferences, school, from pathologists and others who have gone on before me. THIS IS NOT TO REPLACE ANYTHING YOUR DOCTOR/NURSE PRACTITIONER/MIDWIFE/etc IS TELLING YOU. This is just some easy to read information.***

Image via HERE

So this mini series I am going to write is all about Pap Smears. The majority of the patients that come to my office have no idea why we do a pap smear, all they know is that they have to get it done in order to get birth control. They know it is supposed to happen once a year but really, what the heck is a freakin pap smear??

We will get there... but today I am going to give you a few tips about how to prepare for this visit.

1. If you normally wax or shave or laser or go hairless for some reason or another- no problem, keep it that way. However, if you do not normally do this... Please DON'T do it for me. I often see patients with irritated skin, cuts, chafing, and I feel so bad that they went to all that trouble when it doesn't matter either way if it is done or not.

Sometimes cuts or bumps from shaving can be confused with herpes outbreaks, bad yeast infections, warts, or cysts. We don't want to alarm you and you sure don't want to alarm us.

I promise. If you are unshaven it doesn't make our job easier or harder. We don't notice one hairless or not patient from the next. Do whatever you are comfortable with. Please don't be embarrassed. If someone ever makes you or has made you feel uncomfortable in the past do not return to that provider. Shaven or not is none of our/their business and it is not appropriate to comment on that or make you feel self conscious.

2. If you are on day one or two of your period, call ahead and let us know. Sometimes we are perfectly find doing a pap smear when you are bleeding, we wipe away the blood- get the pap smear and then you go on your merry way. If you are bleeding HEAVY please call to reschedule, don't just not show up. Common courtesy. If you call and cancel early in the morning or the day before we will fill your slot with someone who needs to be seen that day, if you don't call, we will sit around and wait, which wastes everyone's time.

3. Don't have intercourse right before your pap smear. If your husband/boyfriend/partner has some sort of fantasy about you being at the gyno- tell them you will replay it after your appointment. The semen on the pap can interfere with the results and we don't want you to have a false abnormal result.

4. Know your insurance. Some insurance companies pay for a pap smear once every year- like 2011, 2012, 2013- any time during the year. Other companies pay for one no sooner than every 365 days. We will try to verify insurance before your pap smear, but double check- just in case.

5. If you have a whole list of problems- your practitioner may not be able to cover them all in the allotted time slot. Please tell the scheduler if you have more concerns so that they can schedule the right amount of time for you. If you want blood work, come fasting; if you want an STD check, let them know; if you need birth control, ask for it. We aren't mind readers even if we have your chart in front of us.

6. Let us know if you have had an abnormal pap smear in the past, it can change if we add extra testing to your pap smear. If you are unclear what this means, let us know so we can discuss it with you (or stay tuned for the rest of the mini series by me..haha).

7. Last but not least- know that we are trying to be sensitive. We don't do this to intentionally inflict pain. We don't want it to be uncomfortable for you, but sometimes it will be. Let us know if you have had a hard time with pap smears in the past, or if you have a history of sexual abuse because both of these things can make pap smears more difficult for you and we want to understand how we can help you better.

Stay tuned...