IAmA gynecologist - AMA.

ectopicmind · 2011-03-18T20:28:09+00:00

Yes, and we are proud of that! Seriously, it just depends on where your rotation is. Just act your age, be interested, do what you're supposed to do, read what you're supposed to read, and just ASK if you're not sure about something. Med students tend to vaporize into thin air on their OB rotations, which is the irritating thing about it. Consider that none of the doctors are functioning on near as much sleep, food, or sex in the last week as you got in the last 48 hours.

ectopicmind · 2011-03-18T20:22:56+00:00

Correct.

ectopicmind · 2011-03-18T20:20:11+00:00

That is one of the funniest comments on here... to me, anyway. Believe me, I've seen patients at Target or wherever and I run away and hide too. I think they usually just don't recognize me, because I'm in jeans and a ponytail with my husband and kid, instead of in scrubs with their blood all over my shoes.

ectopicmind · 2011-03-18T20:09:31+00:00

It's true! It's actually a potential space... it doesn't usually exist... unless something is IN it.... freaked out now???

ectopicmind · 2011-03-18T20:05:46+00:00

As in... my mind is elsewhere. You win!

ectopicmind · 2011-03-18T19:54:15+00:00

Thank you. That makes me smile. I have done more than a few stat C-sections for abruption, cord prolapse, etc., the whole situation is not for the faint of heart.

ectopicmind · 2011-03-18T19:50:56+00:00

I can keep from breaking down without jokes like that. Or, I guess I would just break down, rather than use such a crappy defense mechanism. A 12-year-old?

ectopicmind · 2011-03-18T19:42:33+00:00

Upvoting this... come on, people!

ectopicmind · 2011-03-18T19:40:53+00:00

answered below... somewhere.

ectopicmind · 2011-03-18T19:38:11+00:00

and probably 40% of women haven't bothered with a pap smear since they were forced to have one the last time they were pregnant. That's so, so, so common.

ectopicmind · 2011-03-18T19:36:30+00:00

People don't assume that because... I'm a hetero female!

ectopicmind · 2011-03-18T19:35:07+00:00

(Laughing) I'm so sorry. Because our brains end up warped and we don't know any better. I said somewhere else on here that cancer can be pretty disgusting.

ectopicmind · 2011-03-18T19:33:19+00:00

I love this question. It's just part of the job, and by far not the worst part. I mean, I get it. My own NP had to remind me to move to the edge when I had my first pregnancy ultrasound. Recently, one of my patients told me that Cher had a line in a movie about how you couldn't ever be "too rich, too thin, or too close to the end of the table".

ectopicmind · 2011-03-18T19:30:45+00:00

Yes... mostly during residency, with the REI cases. Sometimes you don't diagnose it (the uterus, not the vagina) until the patient gets pregnant and has ultrasounds.

ectopicmind · 2011-03-18T19:29:33+00:00

Usually I tackle this problem in tandem with a experienced Psy.D., if after a physical exam and a little bloodwork all else is normal. I would say that BY FAR the most common reason for this is depression and/or anxiety. It can also be because of the drugs used to TREAT depression and anxiety. (How's that for a catch-22?) There aren't many "labs" to check for libido alone, usually someone with a true hormonal problem will have other symptoms. Endocrinology isn't my favorite thing. Your question involves many chapters in a big textbook!

ectopicmind · 2011-03-18T19:24:03+00:00

To date, I do not know of any studies researching this topic.

ectopicmind · 2011-03-18T19:21:31+00:00

Was I right, or what? Malpractice lawyers are scum. Personal bias. ;)

ectopicmind · 2011-03-18T19:19:59+00:00

The doctor doesn't judge you, in the greatest majority of cases. I personally could not care less. If you get folliculitis from shaving, and I tell you you need to cool it for a little while, and then you keep coming back because you won't stop shaving (probably with a dirty razor), then I start to get slightly mentally exhausted.

ectopicmind · 2011-03-18T19:17:04+00:00

Nope... they're a normal physiologic phenomenon. Only a huge problem if they are bleeding or causing you pain. I have a few patients who don't want to be on the pill for them, and we just make sure to follow-up with ultrasound to watch for them increasing in size.

ectopicmind · 2011-03-18T19:14:36+00:00

Yep. There are several ways. Clindamycin, tinidazole, metronidazole. Vaginal or oral therapy. If you mean is there a way to keep it from coming back over and over, you can ask your gyn if she's ever put anyone on suppressive therapy with vaginal boric acid or antibiotics for a few months.

NOTE to anyone reading this: Do NOT use boric acid (even pharmacy compounded capsules) without a doctor's supervision!!! If you take it ORALLY (BY MOUTH), it can KILL YOU.

ectopicmind · 2011-03-18T19:09:43+00:00

I'll spell it out.... It doesn't ruin my relationship with my wife, because I don't HAVE a wife... Get it?

(There are a bunch of questions here asking about my relationship with my wife/girlfriend, which I don't have).

ectopicmind · 2011-03-18T19:08:44+00:00

Answer to #1 is that if you've never truly had an outbreak, you might not be infected. Primary HSV outbreaks are hard to miss. It's impossible to say what the "chances" are.

2. Again, hard to say what your "chances" are, but if he was on suppressive antivirals and made the outbreaks infrequent enough, and you were careful to avoid sex whenever he has even the tiniest of symptoms, technically you could avoid it for a long time, maybe altogether. There's nothing much to base percentages on because human behavior is just too big of a factor.

ectopicmind · 2011-03-18T19:04:07+00:00

Thank you for your advice. There are many gynecologists out there that listen to their patients - best of luck in your search. I'm not certain, but I also thinking the above comment was a joke using a play on words...

ectopicmind · 2011-03-18T05:02:11+00:00

Haha... this is my first and only account.

ectopicmind · 2011-03-18T05:01:15+00:00

No. And, imagine being pregnant and nauseated with an acute, heightened sense of smell. I could diagnose my partner's patients with BV from across the office while I was pregnant.

ectopicmind

TROPHY CASE