Tejumola M. Adegoke
@TejuAdegokeMD
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OBGYN Fluent in English and Medicalese Views=mine.
Joined November 2019
Out today. @BostonGlobe.
Ideas: “Now I recognize as I didn’t then, that the night we met must have divided Catherine’s life into a before and after — with the after involving all the pain, stigma, and expense that comes with infertility,” writes gynecologist Tejumola Adegoke.
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Reflecting on Alexander Morris getting a psych evaluation for introducing himself and clinicians seeing things are not there.
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A gentle reminder that a pelvic exam is part of the evaluation for lower abdominal pain in a person with gynecologic organs. Patient's right to decline, but w/o is incomplete without it.
Let's talk about yesterday's ER visit, and how I got care. Initially, I went in thinking I had a bowel obstruction. I could not pass gas or stool after taking laxatives, and had all of the other symptoms. They performed a simple exam and then took an xray.
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I don't know the details of Jessica's case and I won't speculate on that here. Please get your annual exam, which is different from a pap. And you always have the right to a second opinion. If your provider ignores your symptoms, go elsewhere.
@DRollins_ Always curious when I see this if we mean an annual pap smear (a specific test for cervical cancer) or an annual pelvic/speculum exam. The earliest guidelines for paps I can find are from 2012 and the rec was still for every 3-5 yrs. #WomensHealth #GynHealth 1/
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The main trend in this thread is Black folk pain at having their concerns dismissed and the lengths they must go to just to feel safe and cared for. For that reason alone, we need to do better. It also leaves room for misinformation.
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Anyway the point is: Gyn/speculum exam ≠ pap smear. Please get your annual gyn exam. If you feel more comfortable also getting a pap smear/ screen for cervical cancer every time, please discuss with your provider. Ask all the questions so you know exactly what's happening. 10
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The specific situations where a pap is recommended more frequently that every 3-5 years and why you can go longer if you get a negative HPV test would be it's own very long thread, but happy to do that if there's interest. 9/.
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If symptoms (bleeding, pain, discharge (often watery with foul odor), ABSOLUTELY get a pelvic exam + discuss risk for cervical cancer/need for pap. A 28 yo with all normal paps incl last year has lower risk than a 45 yo who hasn't had a pap in 10 yrs or who has had abnormals. 8/.
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With annual paps, there is a chance you will find an abnormality, get a rec for a biopsy and or to remove part of the cervix (LEEP) for something that would likely have cleared up on its own (assuming you have no symptoms). These invasive procedures have their own risks. 7/.
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The point is to prevent or quickly detect cervical cancer. Most cervix cancers will start with a change on the pap, but most abnormal paps will not end up as cancer. Folks with healthy immune systems can have temporary changes that clear on their own in a year or two. 6/.
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I've had visits where I advised a patient their pap was due and they were certain they just had it, but when we looked at the records they actually had a routine speculum exam +/- STI tests. I wonder if providers don't always explain clearly what they're doing during the exam. 4/
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What's a full exam? 1)Looking at the vulva 2)Checking internal organs with a gloved hand (aka a bimanual) and 3)Looking in the vagina/at the cervix with a speculum (This is the part where a pap smear can happen). @ACOG recommends a chat with your provider about when to do this.3/
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There is a clear recommendation for an annual gyn exam. Some debate as to if a full exam is necessary every time, but it's an opportunity to check in about any concerns (pain, bleeding etc) + routine screening (pap, mammo etc if they're due) + family planning/contraception. 2/.
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RT @RJEpiOBWarrior: 🗣 Attn: Black mothers and birthing people seeking pregnancy related care at BMC pls check out the FIRST and ONLY patien….
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RT @nejmcatalyst: How @The_BMC’s Health Equity Accelerator aims to eliminate barriers to #HealthEquity: via @ElenaM….
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RT @RJEpiOBWarrior: My @CulturalRigor team & I are so excited to partner w/ @The_BMC @ResilientSP to advance institutional awareness, actio….
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