Dr James Gill I have started doing it with my patients and it helps me keep track most definitely! I’m more likely to remember my otoscopy findings if I say them out loud rather than try to remember them to put in the electronic chart afterward.
Despite the undeniable ridiculous comments you will get around this video, I have to say this is incredible. It's so important for women to feel at ease during these incredibly important examinations
Thank you for this Dr Gill. As a young female already worrying about my smear tests, this has put me at ease massively. I do hope I have such a professional and considerate Dr if and when I need an examination of this kind.
@@DrJamesGill hell would freeze over before I subjected myself in this humiliating position to a male medical provider. They need to give it a try before ever being permitted to do one. Only see female ob/gyns.
Thank you so, so much for doing this. Having had this exam performed by people who did not demonstrate this kind of care for my physical comfort and the potential psychological impact of the procedure, it gives me hope to know there are doctors out there who can and do make the process as easy as possible, and who are teaching the next generation of medical students to do the same.
Unfortunately its only getting worse. 92% of doctors say they were forced to do unnecessary internal pelvic exams on anesthetized women. 61% of those said they know that they did NOT have consent from the patient. Only 47% of them said they were uncomfortable with how their schools handled these exams. 30% of students haven't even read their hospital's consent form. 49% of these students report never meeting the patient prior to her pelvic EUA. (Exam Under Anesthesia) Its sick. Unethical. And rape.
Thank you for putting this kind of information out there. Every doctor should be taught to follow the same respectful approach you present here. I have never had the courage to go get a smear test, because my last visit to a gynecologist went so poorly I feel like crying just thinking about it. It was a humiliating experience, I left that office trembling and it took several hours for the nausea and tears to subside. Your channel provides the reassuring reminder that it does not have to happen that way. It's nice. :)
Jesus it sounds like you’re describing a sexual assault. What could possibly happen at a pap exam that would cause that kind of reaction? Rhetorical question.
@SnorgonOfBorkkad Though it's rhetorical, I just wanted to add a few precisions. :) It was a transvaginal ultrasound. I'd had an IUD put in (by a midwife and that had gone pretty well) and was getting a check-up. The Dr had a student with him, which I didn't mind, but... Neither said hello to me, when they finally spoke it was to sharply ask me to undress, not giving me any privacy, and the examination itself, well... They did not address me at all for over 7 minutes (I was staring at the screen on which the time was indicated) but would go back and forth taking the... "Wand" let's say from each other's hands without even checking in with me. My legs were shaking from being in an uncomfortable position and even though the guy was pretty gentle, it's not pleasant when someone repeatedly grabs an object from somebody else's hand without warning when said object is inside of you. The end of the appointment was a mirror of the beginning. No privacy to get dressed again, no goodbye, nothing. Just a "You're fine, get dressed." It took me a while to stop writing it off as "Drs do a difficult job, they can't always be polite".
@@lilib.g1816 wow... I get how you didn't just say stop this and walk off, cause you feel vulnerable at that moment but seriously, that is just terrible! I had a bit of a similar experience with an internist (not even a gynocologist). I was there because I had serious nerv pain in my stomach. When he asked me questions I felt like a robot was talking to me behind a computerscreen. And since he was not a gynocologist I was totaly nót prepared for the "take your underwear off and spread your legs" ramming his fingers in me with hardly any introduction or care. I already was in pain so relaxing was pretty much impossible. It seriously felt like he rammed a stick up my vagina! He thought it might be something with my ovary and pointed out where the ovary was, asking if it hurt there. I was like "well that's not the only place it's hurting right now!!". Then I got a minor "sorry" and I had to get dressed again. He basically told me that if it lasted he'd send me to a gynocologist so they could do that exam that you had. I thought hell no after that experience! I was in serious pain for the rest of the day! Anyway, turned out later that the nerv pain actually originated from my back but was emitting to the front so much that it felt like the source was at the front instead of my back.
@@YvieT81 I'm so sorry you lived through that experience... It's atrocious. I hope you're better now. Right now, in France (where I'm from) the main Authority for Medicine is "outraged" that people are circulating lists of "safe doctors", pretexting that all doctors are safe all the time. But then disregard all the negative experiences such as these.
Recently had a testicular and rectal examination. Watched Dr Gills videos which put aside some anxieties. Videos both educational and ASMR filled. Thanks mate, brilliant content
That’s awesome. I know my fiancé has reservations about the male exams seeing that he’ll be 40 next year. I read that after 40 men should get prostate exams? 🤷🏼♀️
I had my first ever Uro check/DRE last week at 45, it was almost literally nothing. 30 seconds of Dr saying "ok, stand up and drop your pants" then some fidgeting up front. Followed by "ok, lean over the table and down on your elbows" then a quick and painless finger in the rear and some probing for about 10 seconds, no pain, no discomfort, just a little weird. My total experience was about 5% of what Women are asked to undergo every year 'just to make sure everything is ok' Quite honestly I'm surprised that Men aren't asked to do these checks every year just the same as the ladies, we all have parts that need to be healthy.
@@DougKremer What’s great is that you actually realize that a digital rectal exam is nothing compared to what a typical gynecological exam entails. Most men don’t understand or won’t admit that.
I know you likely won’t see this, but as a 19 year old female your videos have helped me so much. My only experiences with vaginal exams have been some of the most emotionally and physically painful moments of my life. It’s nice to know there are some doctors out there who actually care and have respect for their patients. I wish all doctors were like you :(
I have had a lot of women very scared about this procedure, and honestly I think that makes it worse IN THE ROOM I was terrified when I have my first general anaesthetic- it went really well however, and when I went in for my second op, that was all easy 😊 Hence why I hope these sorts of videos can help people with understanding what might happen - although to be fair that wasn’t the initial plan of the videos, but a benefit is a benefit 😊
Never been this early! This type of videos should be available to all, so people know what to expect. Going to the OBGYN can be scary, even by going multiple times. So checking this videos is great. Thanks so much for uploading and for sharing your knowledge! Peeps, always do your check-ups! 💕
Bringing this to my next obgyn appointment. Seriously though, pelvic exams have been traumatic for me so I think this video has given me more confidence to say, “what are you doing” or “ok what’s next” when there is terrible silence at their end of the table.
I think this is really great. To help students but also to help prepare women who are very anxious and don’t know what to expect. I think it makes it less personal, more scientific and you have a better understanding of what’s going to happen.
My doctor always talks to me and tells me what he's doing while he doing it and you're right , it fills the dead space. Awkward silence would be way worse. AS uncomfortable as it is my doctor does his best to make me feel comfortable but this video was great in showing me his perspective.. thanks Dr. Gill
Thank you so much for these videos. Im a GP in Finland and just happened to stumble on these videos few years ago. Of course using them as ASMR purposes first for I have some troubles sleeping. It is inspirational that you make these educational videos too and so that they benifit both professionals and patients too. Go GPs!!!
I’ve had exams that left me bleeding and terrified to return to the doctor. My current doctor is very sensitive and gentle thankfully (I’ve finally been able to begin attending appointments without anxiety after two years with her, also helps a lot that she has treated my chronic pelvic pain and made the exam itself and many other things far more pain free than it was beforehand.) but it is reassuring to see the other side too from your usual gentle and respectful point of view. As both a nursing student and a patient I’m always grateful for your videos, Doctor :)
👍 I’m sorry to hear about the chronic pelvis pain. It’s one of those conditions, as a chap, I can empathise with, but can’t appreciate what it must be like
Italian 28-year-old woman here. I’ve taken smear tests every year since I was 18 but I always feel very tense because the first one was really traumatic and I’m afraid it will happen again. I wish I had a doctor as relaxing and patient as you back then. Keep up with the good work!
Please learn about proper informed consent, ESPECIALLY when it comes to EUA's! Urology and OB/GYN are famous for breaking down med students beliefs and feelings about/towards informed consent. Please do your research on this. Before heading into rounds...it could save you from grave moral injury.
I absolutely love this type of content from you. Thank you for thoroughly explaining everything using actual terminology but also delving into what everything means. You make this variety of learning tell relaxing, fun, and very easy to retain. 10/10 doctor. ❤
This was so informative. Having had exams like this for years, I never knew what exactly my OB/GYN was looking at. During my radiology tech schooling, I was allowed to participate in an HSG exam, and for the first time, I had a look down the barrel of a speculum. And something you mentioned in your video gave me a 💡 moment, so thank you very much for sharing your knowledge!
Thank you for all your educational videos. As an APRN student, no textbook would demonstrate this examination. Thank you for your professionalism presentation and suggestions.
WOW !!!!! Now I know what actually happens during my vaginal examination and exactly what happens when the speculum is open as well as what it looks like inside my body !!!!! I've always wondered what it was like in there and just how it looks . Thanks for such a WONDERFUL video , it was so informative .
Greg Stewart yes, but also considerate of the sensitivity of these types of exams and encouragement of physicians to talk and empathize with their patients.
donttalktomebye I don’t think it has much to do with the country, but mostly with the person and whether they’re considerate or not. A*hole doctors can be found anywhere, believe me!
True. But don’t forget we can all have a bad day. Ok, I’m intentionally underestimating, but 6000 pts a year is possible for some doctors. It is different to be 100% on form that that number of interactions. Don’t forget that might grow if you reduce the number for face to face consultations and increase the number of telephone conversations
Dr James Gill of course. But I’ve worked in costumer care in the past (thank god those days are over!) and then you deal with complaining people a LOT and you’re still supposed to stay customer friendly every day. If dealing with people is not your thing then don’t become a doctor and especially not a gynaecologist for that matter. Imo there is no excuse for acting like an insensitive robot, but unfortunately I’ve already met a few..
Jjajaja, it just also happened to me! His voice is so relaxing that even watching something like this cause some strange pleasure, even when I'm not interested in learning this, and I don't understand speaked english very well.
Wow ...... I was raped as a 16 year old virgin, got pregnant and lost my baby at 6 weeks. I’ve obviously never had any kind of examination but I swear to God this doctor would put me at ease
Thank you very much! you might just save my failing exams. coming from an online med student learner who is trying to digest through words and imagination
I'm in WHNP school and some of the PMHNP students are struggling with pelvic exams. I feel comfortable, being an L&D RN for many years. I found your video and shared it with my classmates to alleviate their fears. This is very informative; thank you, Dr. Gill! :)
Nicely done. Wish I’d known these videos were here. I definitely would have recommended my students watch you. Actually I still wish more of the seasoned professionals would watch you and brush up their skills and bedside manner.
This was a great insight, I've learnt so much. UA-cam is such a huge learning resource, not that I need to know specifically about any of this, but it feels good to learn. So thank you Doctor👍🏻
This has been very insightful. I have always been scared to go to the gynecologist and getting screened. This has definitely helped put my mind at ease! Thank you!
Generally speaking, most men would prefer to be examined by a male doctor and likewise a female by a female doctor. I suggest all of you in the medical profession keep that in mind, as it will eliminate a lot of humiliation and embarrassment for the patient.
I think most people would prefer care when then need it as a priority. Personal preference is ALWAYS supported and adhered to, however it comes secondary to expediency
Yes... I generally go to female gynecologists, but this week I'm going to a male gynecologist for the 1st time... Like Dr. Gill said, when it comes to a crucial situation you just prefer care I didn't found any female endometriosis specialists/surgeons in my area, ended up scheduling with a male gynecologist this time bc I need to get an excision surgery urgently... And I'll also get the pelvic exam since it's been 2 years But most of the appointment will be endo focused (I know things are really bad rn), so I feel things will go well... Will just talk about image exams and plans for that surgery Sometimes you just have no choice... And I'd rather have my endo under control than being extremely debilitated all the time (like I currently am rn)
I understand a lot of women are terrified of the Speculum because sometimes it can be painful. Getting screened regularly for Cervical Cancer, especially if you’re sexually active, is important. 20 minutes in the clinic once a year or once every 3-5 years will potentially save you from 5+ years of intensive chemotherapy and other treatments because you got Cancer. Yes, I get that it’s uncomfortable and awkward and embarrassing and sometimes downright painful. Most Doctors who perform these exams are professionals and are simply doing their job in looking after our health. The intention is to help us, to keep us healthy, not to cause harm and pain and distress. When the speculum hurts, say something!! It might be positioned incorrectly or it’s too big. I was terrified for years before I decided to book it. I booked it in October and got it done. It was my very first one, and I was 28! I’m 29 now.
Dr. Gill, at my last Cervical Smear Exam I was so traumatized and actually physically hurt by it that I now cannot bring myself to go to any of my following annual ones where I'm invited vis the NHS. Mental Health wise I suffer from Anxiety & Panic Disorder and unfortunately I have also been a Type 1 Diabetic for 25+ years now as well as battling a lifelong rare & chronic disease - CVS (Mitochondrial/brain/gut disorder) that causes me chronic pain to name but one of my daily symptoms. So at this smear exam, despite taking some Anti-anxiety medication before-hand at the advice of my GP, I was super anxious, very nauseated and felt very vulnerable. Despite these emotions I actually do have quite a high pain threshold/tolerance which I believe I've developed gradually over the last 8-10 years in having to deal with daily chronic pain and awful flare-ups from my disease. So my fears around this particular exam were wholly psychological to me in the sense that physical pain was the very last thing on my list of fears that day. Having had Cervical exams done previously I knew what to expect in a physical sense. Things seemed to begin ok. I had somewhat adjusted to the initial mild shock of the coldness of the lubrication combined with the very cold metal of the Speculum. However, once the nurse began to widen my cervix I felt a very sudden deep and sharp pain that escalated so quickly I actually cried out aloud for her to stop. However her response was something to the effect of that she was almost there, the hard part was over with and that it would now only take her seconds to complete the swabs. The pain did not stop or ease and I cried entirely throughout the rest of that procedure gripping the side rails of that bed so tightly that I cramped up my hands,fingers and my neck too. As soon as she removed the Speculum I began to bleed and the pain, whilst dulled slightly by the removal of it continued. I was still in agony. She appeared quote shocked at my affect and my sudden blood loss and only then asked me about how bad the pain was. I asked her to go help find me some things I could clean myself up with including sanitary towels which seemed so strange to me as having a Contraceptive Implant in my upper arm for so many years, the sight of blood pooling out of me below was shocking to see & experience. After sorting myself out as best I could whilst still weeping, upset & visibly shaking, I asked her what had gone wrong as I knew that this was just not right at all. She told me that I hadn't relaxed enough & had tensed up my muscle walls inside which was her explanation to my severe pain. She also said it was common for some women to bleed a little after this type of exam but again I knew that to be incorrect also as this wasn't spotting or a little blood. I had soaked through my gown, the sheets on the medical bed and had already bled through my firsy sanitary towel before I even got dressed properly. Feeling like she wasn't taking me seriously despite the obvious blood loss & pain I was in I asked her could it be down to the fact that I have a tilted womb (to the left) which I've had for 20 years & was not only known to my GP & in my notes but also something I had made her aware of just before this exam. She said no & that makes no difference, she then told me to go home, take 2 paracetamols and rest a while. I was in so much pain leaving the exam room I asked out at reception to call me a taxi home for what normally was around a 10 minute walk for me. I continued to lose blood for a few days after, likening it to a very heavy period I suppose but it had been years & years since I'd had an "authentic" one of those. The pain played out the same way, gradually decreasing in soreness over several days. I never ever want to experience that ever again & I'm still unsure as to what actually happened to me that day but I know I should be having regular tests. I would greatly appreciate any advice you could offer me. Sorry this was so long!!
I’m so sorry this happened to you and the person treating you that way was completely unprofessional and denying of your pain. I am not in the medical field whatsoever but do you think it may be because of the size of the speculum? If she chose one too large it might have caused you the pain?
I would love to see a response to this. Btw that woman was a complete a*hole the way she reacted to you! I'm just curious though, I'm assuming nothing abnormal came out of the pap smear that could have explained the bleeding?
@@YvieT81 Hey, thank you for commenting ❤ Yes, my test results for that came back completely normal, no abnormalities/anomalies etc. Whilst of course that was good news it more firmly validated to me that it was the actual physical exam and how she performed that procedure which caused my physical pain, my heavy & prolonged blood loss and my sheer distress of it all at the time. Suffering already with mental health issues as I explained I am confronted with an almost PTSD type response each time I get a letter telling me I'm due for another one. It has also placed extra fear upon me because I know they are very important tests to have done and I should be going and having them but I absolutely cannot because of what happened to me. So now I'm left afraid that something could be wrong but I don't know about it. Thank you for your supportive words. I appreciate them ❤
I'm so sorry to hear you went through that. Well, in my particular case I forced myself to watch this video and though I'm a fan of Dr. Gill and how nice he explains things, it just reinforced my denial of going. In my case I'm 32 years old, never had sex before and never been to a gynecologist, let alone have one of these exams. I can't stand the idea of a stranger looking at me down there, touching and the fact that they have to have something inserted in me. I never even looked how a speculum would look like cause I was afraid that I would find it horrible and convince me to never go. Now I saw this and said "ok... you gotta go one day, for your own good and your health, take a look and understand it, maybe it's not so bad, all women do it".... i can safely say the sight of the speculum shocked me and, no matter how big or small, metal or plastic, did nothing but terrify me. My mind has completely shut down and is like "nope. That's it. I'm never going. Ever". And I know it's wrong, I know I have to do it at one point but right now my mind is winning the battle and refuses to even consider going some day. I kidd you not, I still have chills. Even though Dr. Gill explained it so nicely i just find it too invasive and it terrifies me that it might be painful. And I know you may be wondering... but no, I never had a traumatic experience that could be the reason for this fear. And no, the fact that i never had sex isn't because of religion or trauma... I wasn't lucky to find someone who makes me feel comfortable. I need therapy, I know hahaha
My last smear was quite an uncomfortable experience, the nurse struggled for about 15mins to find my cervix causing me quite a bit of pain as she dug around with the speculum and eventually gave up with some frustration directed at me. I had to return to see a specialist doctor who did it very quickly. She told me that the main reason that some cervical exams can be such a horrid experience, is that often when performing them the nurse/doctor simply neglects to check on the position of the cervix with their finger (as you showed) before inserting the speculum. It’s always painful, but the experience needn’t be harrowing.
I would love to be like this - specifically in my upcoming OSCEs. I think an upbeat and interesting personality is what patients need to make embarrassing procedures less so.
There were several things you mentioned here that weren’t done during my first smear and it was so painful 😣 it’s put me off slightly having my next one, I’ll still go but I’m dreading it!
Ask to speak to the person who will be doing your smear beforehand to discuss all the things that were missed last time. Also if you have any pain or feel uncomfortable at any time you should speak up and they should stop immediately!
It's really important to find a doctor you're comfortable with, and it's OK to "shop around," as it were. I've gone to the same doctor for the past few years because I feel heard and I'm at ease. It's all very natural, and you should never have to feel embarrassed or uncomfortable in any way.
When I found out that I had very large fibroids I was so scared.. I chose to have the hysterectomy done and although recovering was terribly painful, it was worth the pain. My quality of life has greatly improved.
I’m further adding that I still have my ovaries so as not to put me in immediate menopause. Plus the stress on my adrenals would be too much having to rely on them for sex hormones. Lol- I still get physiological symptoms but without the obvious issues I still know when it’s “my time of the month” 😆 anyway I’m done now. 🤓
Never been to this channel before, but i was curious. I've been putting off doing this exam because I'm scared. This was actually quite calming. Maybe I'll be able to say yes next time my dr suggests it.
How would you know? Have you had your legs spread for a pelvic?’ Do you actually think a silly video “takes the fear factor away” in real life. Lol. Typical man’s clueless commentary.
I have extreme issues with this for several reasons, to the point I have to be slightly sedated. But knowing what's supposed to happen and seeing it from a perspective other than being the patient actually makes it a little less horrifying to think about.
@@doyouhearthepeoplesing2At the time I was told I had to have it done for certain reasons and I was like 16 so I just believed it. And I VERY nearly lost an aunt to cervical cancer so I try to be good and get that kind of checkup when suggested so hopefully that doesn't happen to me.
Thank you for this video! As a middle-aged woman, I have had a few of these examinations but I was never explained why they needed to out fingers in me and press my stomach. A question: when you open a speculum, are you able to lock it in a non-fully-open position, or are there just two positions for it: fully open and fully closed? I have also 'ranked' my doctors by their bedside manner, professionalism and their skills (sorry). I recently had a small procedure done in which a speculum and a catheter were used. The speculum and the catheter didn't hurt AT ALL and I barely felt them!!! In my eyes he is now a superstar physician, Ironman, Spiderman and so on!!! A little later I had another thing done with similar tools and gosh she was rough-handed!! I grunted of pain and discomfort when she used the the speculum and the catheter. Both doctors were kind but only one of them is a superstar in my eyes... Doctor, if you are able to make examinations as comfortable and painless as possible while being kind, appropriate and professional, I promise you, you too will be a superstar in the eyes of your patients (maybe you already are)!! I actually asked to see the male obgyn for the second time because my first experience with him was so good.
Out of interest, if you’d gone to the doctor with a problem, let’s say intermittent vaginal bleeding, and they said a pelvic exam was needed (which is quite likely) why wouldn’t you be happy to proceed? Genuinely curious, as I might be able to learn how to help and reassure a similar patient
@@DrJamesGill For me personally I was sexually assaulted as a child and I know that is more cause to get examined but due to the trauma I freak out really REALLY bad! So if I can avoid it I do. Also I don't know much about Europe but so far with my experience in the U.S. the gynecologists I've met have never asked if I've been through any sexual trauma in the past before trying to examine me and the catch 22 is I'd be hesitant to tell them even out of my own volition because I worry that I'll be pressured into doing something I'm mentally incapable of handling. (Yes I am going to therapy.)
In the U.S., metal speculums are often used, particularly in gynecology clinics, because they come in a greater variety of sizes and shapes and can provide better visualization in certain cases. The metal speculums usually sit on a special warming pad to ensure they are at a comfortable temperature for the patient.
That’s great to hear. Medicine can be really worrying for patients, hopefully with some of these videos it will reassure patients as to what is going on 😊
I am 65 and have given birth twice, so I have had many of these. When I was 25 I went for my normal pap and the doc called and said it showed a bit abnormal. Said we would wait, but I said "no" and asked him to refer me to a specialist ASAP. I went to the specialist and he said I had cervical cancer and wanted me to have surgery in less than a month! I did and they removed my cervix, uterus, and one ovary through my vagina. Then my daughter, at age 28 died of ovarian cancer in 2006. Ovarian cancer is cruel and her time spent in the end stages of her life was painful, slow, and disabling. Anyway, had I not pushed my GP back then, I would have died with a 2-year-old and a 9-month-old left behind! Go with YOUR gut feeling...or change doctors! Right, Dr. Gill?
I'm sorry for your loss. I'm glad you demanded to be seen by a specialist. I'm so tired of doctors just saying we'll wait. I push too. Did you have any symptoms before you found out by the specialist?
@@Gaibreel My MAIN symptom was frequent, almost constant, scant bleeding That is why he wasn't worried about it, You know, I didn't fit into the textbooks that he had in med school! Crazy, but I never do seem to be the norm! LOL!!.
I'll be honest, I came to educate myself and feel more confident for my upcoming smear, but the comments have definitely deterred me from making the appointment!
You should book it. If you can book a doctor who specialises in women’s health/gynaecology always opt for them, especially if it’s your first time. They have a few different sized speculums, don’t be afraid to ask for a smaller one if you’re uncomfortable. A lot of women have no issues, I personally always experience pain (nothing unbearable). Tell them if it hurts. It will likely be over in a few minutes, if not sooner if you’re lucky. Some women can’t relax their muscles from anxiety/discomfort etc. You can request a light relaxant/sedative but you’d need to talk to your doctor about it.
Please do book it. Remember the nature of the internet, people tend to comment more on negative experiences THOUSANDS of smears are done a day. I’m not saying they are pleasant, but the vast majority are just a simple procedure with no issues. These are important tests, please do book it
Still way too freaked out to get one done, but it was really nice to see what actually goes on. Gives a lot more perspective besides hearing other people talk about how much it hurt or how uncomfortable it was
Most of Russian gynecologists never mind patients comfort.... for me to visit a doctor is like to have an appointment to the hell. And I think, that’s great to have such explanation and taking care of patients comfort and feelings.
PSA is still used and determines probability for prostate issues for early intervention if need be. The normal is under 4 ng/ml. But yes you are correct, the only way to monitor is through a biopsy. For the female inspection, I think you missed speaking about Chlamidia which from I understand has an array of symptoms and often show no symptoms. So upon inspection and releasing your patient and basically providing them a great prognosis, you may indeed have let them go for the same reason they walked in. I think the chlamydia lab test doesn't provide the same results for all people and many laboratory results will be false negative. You may need to get with a laboratory to see if that's still the case today.
With chlamydia the patient will have come in for a reason, it isn’t routinely just checked on GP land, however it IS in the GUM clinic. Part of the best care is ensuring the patient is in the best place, and that is from ensuring a good history. Maybe we need to do a video on HOW to take the histories ?
Under the guise and explanation of examinations ‘for only cervical cancer screenings, and in males early prostate detection isn’t reliable’. The textbook exam and as-performed checked a whole lot more here on this female model than just collect the cervical pap: Bi-manual exam checking for masses in pelvis, uterus, ovaries, sensitivity, visual cervical exam, external genitalia exam, and as specified here in the US is a recto-vaginal exam and sometimes separate full rectal exam. And in my experience males get NONE of this unless we exhibit issues and bring it up ourselves, repeatedly, to our physicians. I’m 45 and only just now have I had my first ever male urological exam and only because I sought out a urologist for issues, after my general practitioner (whom I see on a regular schedule every 6 months) didn’t seem interested in examining or referring me after I reported issues multiple times. The Urologist listened to me, examined me, and confirmed there are some definite and ‘very concerning’ issues. Any sort of routine exam of the degree of the ‘cervical cancer screening’ would have found these problems potentially years ago. It’s looking to be gradual onset cauda equine syndrome symptoms from a back injury many years ago, which I hope aren’t permanent. Guys need wellness visits too, but we don’t get them.
Helpful video thanks, had my first smear this week and it’s nothing to worry about at all, slight discomfort for about 5 seconds and then done. Definitely an important examination and could save your life. Also I have ectropion myself so interesting to see what this looks like in examination 👍
@@DrJamesGill Not EUA's. They are just predatory...in the name of teaching med students how to do a manual internal exam. Your average patient isn't going to be sedated, so therefore its an inaccurate representation of the procedure in real like.
You had done a great job explaining what will happen and a good job demonstrating, although even as a man and watching I still felt nervous. The part about commentary/consent is absolutely phenomenal and regardless of what exam or which gender it is for I feel that is something all doctors should do and be made mandatory. Please don't treat patients as test dummies and even if it is our twelfth time for the exam it should still be communicated. I do have both one concern and question, how come the speculum is inserted vertically but then turned horizontally? What major factor would there be in form of viewing the cervix? As the process of turning it horizontally and opening it seems to cause to much pressure and possibly pain as when it is open it is almost cone shaped and viewing the female anatomy the fully open speculum seems as if it crushes the urethra, bladder, and prostate of the patient. Do you feel the design or the speculum should be redesigned with more comfort or while placed vertically in couldn't the doctor simply expand it while it is vertical and still see and examine the cervix? The pressure on the labia walls seem better for expansions
All male doctors should have the humiliating female experience of: stirrups, spread legs, penile swab and anal speculum exam plus DRE prostrate exam and testicle palpation. They have no idea how exposed and stupid women feel in that ridiculous position. Any male Drs willing to do that once a year?
@@DrJamesGill All male doctors should have the same awkward experience that women endure: Naked, paper sheet, feet in foot rests/stirrups, legs spread, a penile swab, a rectal exam with an anal speculum, and prostate exam via digital rectal exam. Also, palpitation of the testicles. With a chaperone. Then they might have just a hint of understanding how exposed and vulnerable women feel in that humiliating position.
I agree that it is a difficult procedure for many people to perform, and having the anatomy and experience would undoubtedly improve things, but I’m not sure I agree with the sentiment. I’ll never given birth to a baby, but I firmly believe that all appropriate painkillers should be offered and encouraged I’ll never have a period, but I’ll never dismiss dysmenorrhea. Moving away from the female complains specifically, I’ve never broke a hip, but when I’ve dealt with those patients, painkillers has been a number one priority, and when I’m doing a nerve block directly into the groin, being conscious of how that patient is feeling exposed and frightened is hugely important as I’m putting the needles in. Having empathy doesn’t mean KNOWING the experience, but being able understand and share those feelings.
Fantastic, respectful video as always! I can see from the comments that I'm not the only one with these sorts of questions, so I really hope they can be addressed in the future: what sort of steps can doctors take to minimize potential re-traumatisation to women who have either been abused, or have had bad experiences with these types of exams in the past? I know more than one person who either hasn't ever had a test done or hasn't had it done in years for these reasons. What can a patient who is worried about these things to do advocate for themselves during the exam?
I’ve dealt with a few patients like that. It takes time. Sometimes just coming in for a chat about what we MIGHT do. Took several consultations but we got it done. Care, let the patient set the pace, and lots of communication
One good tip is to touch the woman’s inner thigh with your hand prior to interesting the speculum or fingers, it reduces the startle or the tools. Also, wiggling their toes helps to relax the pelvic floor muscles and reduces discomfort.
I’ve truly tried and tried to research and understand but I am absolutely terrified to get a pelvic exam even the thought of it almost brings tears to my eyes .. I know that as a women I have to have it done but I can’t bring myself to do it
Lots of things are often worse in our minds than reality. I am terrified if the dentist - had issues in the past - but have now found a dentist I trust. Don’t get me wrong, I still grip the chair, and tense up in the most ridiculous fashion, but it is never as bad as I fear now Talk to the person doing your smear, your worries are valid, they will be able to help
i honestly appreciate dr.gill explaining these exams because in most cases we just go in and are scared because we don’t know what to expect
Pleased it has given an insight
Agreed. It was terrifying as a teen going for an exam.
I was so scared for mine. I cried before I went in.
Now THIS IS a doctor. Obviously qualified and compassionate. Thank you for this thorough explanation.
I hope it’s been useful 😊
He's in it for one reason !
I love the running commentary! It’s so much better than silence.
It really helps me think
Dr James Gill I have started doing it with my patients and it helps me keep track most definitely! I’m more likely to remember my otoscopy findings if I say them out loud rather than try to remember them to put in the electronic chart afterward.
Despite the undeniable ridiculous comments you will get around this video, I have to say this is incredible. It's so important for women to feel at ease during these incredibly important examinations
Hopefully they will
Alone reasonable
@Baby Yoda Up In This Mofo aww you again :'(
There..there.. Little one
Your comment was the most ridiculous. Everyone else was completely supportive of the educational material. 🙄
Yeah He doesn’t Fanny about 😂
My misses got a Nasty Gash what can i do about it…😂
I love how u address her as ‘The Lady’ such a polite gentleman!
Thank you for this Dr Gill. As a young female already worrying about my smear tests, this has put me at ease massively. I do hope I have such a professional and considerate Dr if and when I need an examination of this kind.
Or an equally professional nurse 😊
@@DrJamesGill hell would freeze over before I subjected myself in this humiliating position to a male medical provider. They need to give it a try before ever being permitted to do one. Only see female ob/gyns.
The ladies modesty. ❤️ He is such a gentleman
@Baby Yoda Up In This Mofo hey, you got a bad day huh? I'm very sorry hope you have better day in the future
Thank you so, so much for doing this. Having had this exam performed by people who did not demonstrate this kind of care for my physical comfort and the potential psychological impact of the procedure, it gives me hope to know there are doctors out there who can and do make the process as easy as possible, and who are teaching the next generation of medical students to do the same.
Sorry you had a bad experience, unfortunately we all have bad days. Hopefully it was just a one off
Unfortunately its only getting worse. 92% of doctors say they were forced to do unnecessary internal pelvic exams on anesthetized women. 61% of those said they know that they did NOT have consent from the patient. Only 47% of them said they were uncomfortable with how their schools handled these exams. 30% of students haven't even read their hospital's consent form. 49% of these students report never meeting the patient prior to her pelvic EUA. (Exam Under Anesthesia)
Its sick. Unethical. And rape.
Thank you for putting this kind of information out there. Every doctor should be taught to follow the same respectful approach you present here. I have never had the courage to go get a smear test, because my last visit to a gynecologist went so poorly I feel like crying just thinking about it. It was a humiliating experience, I left that office trembling and it took several hours for the nausea and tears to subside. Your channel provides the reassuring reminder that it does not have to happen that way. It's nice. :)
I’m please to say that at Warwick we do address this, and I personally teach on the comms skills course to help improve consultations
Jesus it sounds like you’re describing a sexual assault. What could possibly happen at a pap exam that would cause that kind of reaction? Rhetorical question.
@SnorgonOfBorkkad Though it's rhetorical, I just wanted to add a few precisions. :) It was a transvaginal ultrasound. I'd had an IUD put in (by a midwife and that had gone pretty well) and was getting a check-up. The Dr had a student with him, which I didn't mind, but... Neither said hello to me, when they finally spoke it was to sharply ask me to undress, not giving me any privacy, and the examination itself, well... They did not address me at all for over 7 minutes (I was staring at the screen on which the time was indicated) but would go back and forth taking the... "Wand" let's say from each other's hands without even checking in with me. My legs were shaking from being in an uncomfortable position and even though the guy was pretty gentle, it's not pleasant when someone repeatedly grabs an object from somebody else's hand without warning when said object is inside of you. The end of the appointment was a mirror of the beginning. No privacy to get dressed again, no goodbye, nothing. Just a "You're fine, get dressed."
It took me a while to stop writing it off as "Drs do a difficult job, they can't always be polite".
@@lilib.g1816 wow... I get how you didn't just say stop this and walk off, cause you feel vulnerable at that moment but seriously, that is just terrible! I had a bit of a similar experience with an internist (not even a gynocologist). I was there because I had serious nerv pain in my stomach. When he asked me questions I felt like a robot was talking to me behind a computerscreen. And since he was not a gynocologist I was totaly nót prepared for the "take your underwear off and spread your legs" ramming his fingers in me with hardly any introduction or care. I already was in pain so relaxing was pretty much impossible. It seriously felt like he rammed a stick up my vagina! He thought it might be something with my ovary and pointed out where the ovary was, asking if it hurt there. I was like "well that's not the only place it's hurting right now!!". Then I got a minor "sorry" and I had to get dressed again. He basically told me that if it lasted he'd send me to a gynocologist so they could do that exam that you had. I thought hell no after that experience! I was in serious pain for the rest of the day! Anyway, turned out later that the nerv pain actually originated from my back but was emitting to the front so much that it felt like the source was at the front instead of my back.
@@YvieT81 I'm so sorry you lived through that experience... It's atrocious. I hope you're better now. Right now, in France (where I'm from) the main Authority for Medicine is "outraged" that people are circulating lists of "safe doctors", pretexting that all doctors are safe all the time. But then disregard all the negative experiences such as these.
Recently had a testicular and rectal examination. Watched Dr Gills videos which put aside some anxieties. Videos both educational and ASMR filled. Thanks mate, brilliant content
Genuinely really please let you found that helpful 😊
That’s awesome. I know my fiancé has reservations about the male exams seeing that he’ll be 40 next year. I read that after 40 men should get prostate exams? 🤷🏼♀️
I had my first ever Uro check/DRE last week at 45, it was almost literally nothing. 30 seconds of Dr saying "ok, stand up and drop your pants" then some fidgeting up front. Followed by "ok, lean over the table and down on your elbows" then a quick and painless finger in the rear and some probing for about 10 seconds, no pain, no discomfort, just a little weird. My total experience was about 5% of what Women are asked to undergo every year 'just to make sure everything is ok' Quite honestly I'm surprised that Men aren't asked to do these checks every year just the same as the ladies, we all have parts that need to be healthy.
"Ant M" OW
@@DougKremer What’s great is that you actually realize that a digital rectal exam is nothing compared to what a typical gynecological exam entails. Most men don’t understand or won’t admit that.
Knowledge is essential. As a bloke i dont know how girls get to know about this but this needs to be taught in school. Another great video.
I assume it’s on the social part of the curriculum?
We’re taught in school. This video is not exactly brand new information and the letter asking us in for our first smear is expected.
L Lowe you must not be American. Our sex Ed is notoriously bad...
I didn't get taught any of this or what I would experience until I actually had my first smear.
I know you likely won’t see this, but as a 19 year old female your videos have helped me so much.
My only experiences with vaginal exams have been some of the most emotionally and physically painful moments of my life. It’s nice to know there are some doctors out there who actually care and have respect for their patients. I wish all doctors were like you :(
I have had a lot of women very scared about this procedure, and honestly I think that makes it worse IN THE ROOM
I was terrified when I have my first general anaesthetic- it went really well however, and when I went in for my second op, that was all easy 😊
Hence why I hope these sorts of videos can help people with understanding what might happen - although to be fair that wasn’t the initial plan of the videos, but a benefit is a benefit 😊
Never been this early!
This type of videos should be available to all, so people know what to expect. Going to the OBGYN can be scary, even by going multiple times. So checking this videos is great. Thanks so much for uploading and for sharing your knowledge! Peeps, always do your check-ups! 💕
Hopefully people will see it and be helped 😊
Bringing this to my next obgyn appointment. Seriously though, pelvic exams have been traumatic for me so I think this video has given me more confidence to say, “what are you doing” or “ok what’s next” when there is terrible silence at their end of the table.
I tend to naturally fill any available silence.
My lectures tend to be a case of “we’ve got 60mins and a lot to cover... hold on!!”
I think this is really great. To help students but also to help prepare women who are very anxious and don’t know what to expect. I think it makes it less personal, more scientific and you have a better understanding of what’s going to happen.
My doctor always talks to me and tells me what he's doing while he doing it and you're right , it fills the dead space. Awkward silence would be way worse.
AS uncomfortable as it is my doctor does his best to make me feel comfortable but this video was great in showing me his perspective.. thanks Dr. Gill
I think it works nicely for the clinician and the patient 😊
Doctor I watch your lectures from uganda but am one of the best students in the school, good work Doctor
Thank you so much for these videos. Im a GP in Finland and just happened to stumble on these videos few years ago. Of course using them as ASMR purposes first for I have some troubles sleeping. It is inspirational that you make these educational videos too and so that they benifit both professionals and patients too. Go GPs!!!
👍👍 GP for the win 😊
Thanks for the feed back, from another professional it really does mean a lot 😊
I’ve had exams that left me bleeding and terrified to return to the doctor. My current doctor is very sensitive and gentle thankfully (I’ve finally been able to begin attending appointments without anxiety after two years with her, also helps a lot that she has treated my chronic pelvic pain and made the exam itself and many other things far more pain free than it was beforehand.) but it is reassuring to see the other side too from your usual gentle and respectful point of view.
As both a nursing student and a patient I’m always grateful for your videos, Doctor :)
👍
I’m sorry to hear about the chronic pelvis pain. It’s one of those conditions, as a chap, I can empathise with, but can’t appreciate what it must be like
It's clear why these videos will help students, but this is useful from the patient's side, very reassuring.
The two will dovetail as well. There are a lot of patient comments in this video which will help the students learn as well
This is fascinating, I've always wondered what they are looking for at these examinations.
Glad to help 😊
I've had this exam done on me a dozen times and I never got this level of information about what was happening.
I find talking through an examination really helpful for me. esp as is removes that odd silence as you go about doing the assessment
I had one doctor ask me if I wanted a mirror to see my cervix.. I politely declined because I was omg ewwwww. In my head not aloud. 🙆🏼♀️
Italian 28-year-old woman here. I’ve taken smear tests every year since I was 18 but I always feel very tense because the first one was really traumatic and I’m afraid it will happen again. I wish I had a doctor as relaxing and patient as you back then. Keep up with the good work!
Thank you Dr Gill, as a 19 year old aspiring doctor, this and all your other examination videos are very informative. Thank you 🙂
👍
Please learn about proper informed consent, ESPECIALLY when it comes to EUA's! Urology and OB/GYN are famous for breaking down med students beliefs and feelings about/towards informed consent. Please do your research on this. Before heading into rounds...it could save you from grave moral injury.
I got a letter to book my smear today this has put me at EASE
Really pleased to hear that 😊
I absolutely love this type of content from you. Thank you for thoroughly explaining everything using actual terminology but also delving into what everything means. You make this variety of learning tell relaxing, fun, and very easy to retain. 10/10 doctor. ❤
😁👍👍
Again doc, very well made video, professional, well spoken, and a blessing for patients and students. Thanks for investing in the video making :)
👍
This was so informative. Having had exams like this for years, I never knew what exactly my OB/GYN was looking at. During my radiology tech schooling, I was allowed to participate in an HSG exam, and for the first time, I had a look down the barrel of a speculum. And something you mentioned in your video gave me a 💡 moment, so thank you very much for sharing your knowledge!
Did it hurt
I love those light bulb moments when things “click”
James, you're first class as always brother. A real gentleman. Keep up the great work my friend.
🙏
I've always wondered what my cervix looked like. So informative. Thanks Dr. Gill!!
It makes life so much easier when we can visualise these things
Thank you for all your educational videos. As an APRN student, no textbook would demonstrate this examination. Thank you for your professionalism presentation and suggestions.
You're very welcome! any other areas I can help with?
WOW !!!!! Now I know what actually happens during my vaginal examination and exactly what happens when the speculum is open as well as what it looks like inside my body !!!!!
I've always wondered what it was like in there and just how it looks . Thanks for such a WONDERFUL video , it was so informative .
👍👍
i really wish American doctors were more like you, Dr. Gill.
donttalktomebye tall, soft spoken, and dashing?
Greg Stewart yes, but also considerate of the sensitivity of these types of exams and encouragement of physicians to talk and empathize with their patients.
donttalktomebye I don’t think it has much to do with the country, but mostly with the person and whether they’re considerate or not. A*hole doctors can be found anywhere, believe me!
True. But don’t forget we can all have a bad day. Ok, I’m intentionally underestimating, but 6000 pts a year is possible for some doctors.
It is different to be 100% on form that that number of interactions.
Don’t forget that might grow if you reduce the number for face to face consultations and increase the number of telephone conversations
Dr James Gill of course. But I’ve worked in costumer care in the past (thank god those days are over!) and then you deal with complaining people a LOT and you’re still supposed to stay customer friendly every day. If dealing with people is not your thing then don’t become a doctor and especially not a gynaecologist for that matter. Imo there is no excuse for acting like an insensitive robot, but unfortunately I’ve already met a few..
One of the stranger videos I’ve used to Relax it must be said...
🤣
LMAO
WAHAHAHAHAHAHA
Jjajaja, it just also happened to me! His voice is so relaxing that even watching something like this cause some strange pleasure, even when I'm not interested in learning this, and I don't understand speaked english very well.
This doctor has a very soothing and relaxing voice .
Wow ...... I was raped as a 16 year old virgin, got pregnant and lost my baby at 6 weeks. I’ve obviously never had any kind of examination but I swear to God this doctor would put me at ease
I’m so sorry to hear about this
I’m sure that any doctor would be able to help with any problems you’d be prepared to talk about
Sorry to hear that.❤
Thank you very much! you might just save my failing exams. coming from an online med student learner who is trying to digest through words and imagination
Again, outstanding content and video! Even though I’m not a physician it is extremely important to disseminate this type of content. Keep it up!
👍 hopefully it will mean people are more open about their bodies if they know more about them 😊
This video needs to become more well known so more doctors in the states do so well and kindly
Thank you, if you feel so, I’d be grateful if you’d consider sharing the video 😊
I'm in WHNP school and some of the PMHNP students are struggling with pelvic exams. I feel comfortable, being an L&D RN for many years. I found your video and shared it with my classmates to alleviate their fears. This is very informative; thank you, Dr. Gill! :)
as a woman who grew up without a strong maternal presence, I learn a lot about my own body from videos like this. thank you for making this!
I’m glad it was useful. Your GP male or female will always be happy to discuss these things with you 😊
You're really just doing all the fun ones in a row aren't you
I only have access to the kit for a short while.
@@DrJamesGill understandable. It's cool that you have access to these at all to raise awareness for these learning methods. :)
😂 😂😂😂😂😂
Yea making video and earning money with that having lot of fun😂😂 want a life like him
@@nitinrai8443 ध्रुव राठी को क्यों follow कर रखा हैं तूने?
Nicely done. Wish I’d known these videos were here. I definitely would have recommended my students watch you. Actually I still wish more of the seasoned professionals would watch you and brush up their skills and bedside manner.
Glad it was helpful!
My Lord, this is phenomenal. VERY helpful. Thank you so much!
Edit: And, as someone already mentioned, I love the running commentary.
This was a great insight, I've learnt so much. UA-cam is such a huge learning resource, not that I need to know specifically about any of this, but it feels good to learn. So thank you Doctor👍🏻
Learning is great, and very healthy for the brain
Excellent instructional procedure for nurses whom perform these procedures in clinical settings
It's amazing how a doctor so young is basically a practical application and clinical skills professor on UA-cam.
Thank you for your videos! I watch them for relaxation purposes only, but holy moly have I learned so much!!
Great 😊
This has been very insightful. I have always been scared to go to the gynecologist and getting screened. This has definitely helped put my mind at ease! Thank you!
Thank you. I hope you are able to get the screen now 😊
@@DrJamesGill I've message my primary care physician for a recommendation so I can get screened! 🙂
Generally speaking, most men would prefer to be examined by a male doctor and likewise a female by a female doctor. I suggest all of you in the medical profession keep that in mind, as it will eliminate a lot of humiliation and embarrassment for the patient.
I think most people would prefer care when then need it as a priority.
Personal preference is ALWAYS supported and adhered to, however it comes secondary to expediency
Yes... I generally go to female gynecologists, but this week I'm going to a male gynecologist for the 1st time... Like Dr. Gill said, when it comes to a crucial situation you just prefer care
I didn't found any female endometriosis specialists/surgeons in my area, ended up scheduling with a male gynecologist this time bc I need to get an excision surgery urgently... And I'll also get the pelvic exam since it's been 2 years
But most of the appointment will be endo focused (I know things are really bad rn), so I feel things will go well... Will just talk about image exams and plans for that surgery
Sometimes you just have no choice... And I'd rather have my endo under control than being extremely debilitated all the time (like I currently am rn)
These videos are so helpful as a woman i feel comfortable in having a pap smear now
That’s great to hear. I’m glad it helped 😊
I understand a lot of women are terrified of the Speculum because sometimes it can be painful. Getting screened regularly for Cervical Cancer, especially if you’re sexually active, is important. 20 minutes in the clinic once a year or once every 3-5 years will potentially save you from 5+ years of intensive chemotherapy and other treatments because you got Cancer.
Yes, I get that it’s uncomfortable and awkward and embarrassing and sometimes downright painful. Most Doctors who perform these exams are professionals and are simply doing their job in looking after our health. The intention is to help us, to keep us healthy, not to cause harm and pain and distress. When the speculum hurts, say something!! It might be positioned incorrectly or it’s too big.
I was terrified for years before I decided to book it. I booked it in October and got it done. It was my very first one, and I was 28! I’m 29 now.
Dr. Gill, at my last Cervical Smear Exam I was so traumatized and actually physically hurt by it that I now cannot bring myself to go to any of my following annual ones where I'm invited vis the NHS.
Mental Health wise I suffer from Anxiety & Panic Disorder and unfortunately I have also been a Type 1 Diabetic for 25+ years now as well as battling a lifelong rare & chronic disease - CVS (Mitochondrial/brain/gut disorder) that causes me chronic pain to name but one of my daily symptoms. So at this smear exam, despite taking some Anti-anxiety medication before-hand at the advice of my GP, I was super anxious, very nauseated and felt very vulnerable. Despite these emotions I actually do have quite a high pain threshold/tolerance which I believe I've developed gradually over the last 8-10 years in having to deal with daily chronic pain and awful flare-ups from my disease. So my fears around this particular exam were wholly psychological to me in the sense that physical pain was the very last thing on my list of fears that day. Having had Cervical exams done previously I knew what to expect in a physical sense. Things seemed to begin ok. I had somewhat adjusted to the initial mild shock of the coldness of the lubrication combined with the very cold metal of the Speculum. However, once the nurse began to widen my cervix I felt a very sudden deep and sharp pain that escalated so quickly I actually cried out aloud for her to stop. However her response was something to the effect of that she was almost there, the hard part was over with and that it would now only take her seconds to complete the swabs. The pain did not stop or ease and I cried entirely throughout the rest of that procedure gripping the side rails of that bed so tightly that I cramped up my hands,fingers and my neck too. As soon as she removed the Speculum I began to bleed and the pain, whilst dulled slightly by the removal of it continued. I was still in agony. She appeared quote shocked at my affect and my sudden blood loss and only then asked me about how bad the pain was. I asked her to go help find me some things I could clean myself up with including sanitary towels which seemed so strange to me as having a Contraceptive Implant in my upper arm for so many years, the sight of blood pooling out of me below was shocking to see & experience. After sorting myself out as best I could whilst still weeping, upset & visibly shaking, I asked her what had gone wrong as I knew that this was just not right at all. She told me that I hadn't relaxed enough & had tensed up my muscle walls inside which was her explanation to my severe pain. She also said it was common for some women to bleed a little after this type of exam but again I knew that to be incorrect also as this wasn't spotting or a little blood. I had soaked through my gown, the sheets on the medical bed and had already bled through my firsy sanitary towel before I even got dressed properly. Feeling like she wasn't taking me seriously despite the obvious blood loss & pain I was in I asked her could it be down to the fact that I have a tilted womb (to the left) which I've had for 20 years & was not only known to my GP & in my notes but also something I had made her aware of just before this exam. She said no & that makes no difference, she then told me to go home, take 2 paracetamols and rest a while. I was in so much pain leaving the exam room I asked out at reception to call me a taxi home for what normally was around a 10 minute walk for me. I continued to lose blood for a few days after, likening it to a very heavy period I suppose but it had been years & years since I'd had an "authentic" one of those. The pain played out the same way, gradually decreasing in soreness over several days. I never ever want to experience that ever again & I'm still unsure as to what actually happened to me that day but I know I should be having regular tests. I would greatly appreciate any advice you could offer me. Sorry this was so long!!
I’m so sorry this happened to you and the person treating you that way was completely unprofessional and denying of your pain. I am not in the medical field whatsoever but do you think it may be because of the size of the speculum? If she chose one too large it might have caused you the pain?
I have similar issues and the doc said I was being ridiculous. I hate having them done due to the last experience.
I would love to see a response to this. Btw that woman was a complete a*hole the way she reacted to you! I'm just curious though, I'm assuming nothing abnormal came out of the pap smear that could have explained the bleeding?
@@YvieT81 Hey, thank you for commenting ❤ Yes, my test results for that came back completely normal, no abnormalities/anomalies etc. Whilst of course that was good news it more firmly validated to me that it was the actual physical exam and how she performed that procedure which caused my physical pain, my heavy & prolonged blood loss and my sheer distress of it all at the time. Suffering already with mental health issues as I explained I am confronted with an almost PTSD type response each time I get a letter telling me I'm due for another one. It has also placed extra fear upon me because I know they are very important tests to have done and I should be going and having them but I absolutely cannot because of what happened to me. So now I'm left afraid that something could be wrong but I don't know about it. Thank you for your supportive words. I appreciate them ❤
I'm so sorry to hear you went through that. Well, in my particular case I forced myself to watch this video and though I'm a fan of Dr. Gill and how nice he explains things, it just reinforced my denial of going. In my case I'm 32 years old, never had sex before and never been to a gynecologist, let alone have one of these exams. I can't stand the idea of a stranger looking at me down there, touching and the fact that they have to have something inserted in me. I never even looked how a speculum would look like cause I was afraid that I would find it horrible and convince me to never go. Now I saw this and said "ok... you gotta go one day, for your own good and your health, take a look and understand it, maybe it's not so bad, all women do it".... i can safely say the sight of the speculum shocked me and, no matter how big or small, metal or plastic, did nothing but terrify me. My mind has completely shut down and is like "nope. That's it. I'm never going. Ever". And I know it's wrong, I know I have to do it at one point but right now my mind is winning the battle and refuses to even consider going some day. I kidd you not, I still have chills. Even though Dr. Gill explained it so nicely i just find it too invasive and it terrifies me that it might be painful. And I know you may be wondering... but no, I never had a traumatic experience that could be the reason for this fear. And no, the fact that i never had sex isn't because of religion or trauma... I wasn't lucky to find someone who makes me feel comfortable. I need therapy, I know hahaha
Interesting to see it from the other end for a change! My doctors have speculums with the light built in to them.
That sounds great - but probably not disposable?
My last smear was quite an uncomfortable experience, the nurse struggled for about 15mins to find my cervix causing me quite a bit of pain as she dug around with the speculum and eventually gave up with some frustration directed at me.
I had to return to see a specialist doctor who did it very quickly. She told me that the main reason that some cervical exams can be such a horrid experience, is that often when performing them the nurse/doctor simply neglects to check on the position of the cervix with their finger (as you showed) before inserting the speculum.
It’s always painful, but the experience needn’t be harrowing.
👆👆 hence why bi manual exam first, and speculum second 😊
These examines always give me anxiety but this helps make it more science based and thus, calming. Will you be doing a breast exam explanation?
Yes, waiting for that to arrive.
@@DrJamesGill so basically you're saying you're waiting for your fake boobs to arrive? 😂 Sorry couldn't help myself!
Legend says Dr Gill is still waiting on his fake breasts
I would love to be like this - specifically in my upcoming OSCEs. I think an upbeat and interesting personality is what patients need to make embarrassing procedures less so.
There were several things you mentioned here that weren’t done during my first smear and it was so painful 😣 it’s put me off slightly having my next one, I’ll still go but I’m dreading it!
Please do go. They save lives. Perhaps mention the problems you had before the next one
Ask to speak to the person who will be doing your smear beforehand to discuss all the things that were missed last time. Also if you have any pain or feel uncomfortable at any time you should speak up and they should stop immediately!
It's really important to find a doctor you're comfortable with, and it's OK to "shop around," as it were. I've gone to the same doctor for the past few years because I feel heard and I'm at ease. It's all very natural, and you should never have to feel embarrassed or uncomfortable in any way.
When I found out that I had very large fibroids I was so scared.. I chose to have the hysterectomy done and although recovering was terribly painful, it was worth the pain. My quality of life has greatly improved.
I’m further adding that I still have my ovaries so as not to put me in immediate menopause. Plus the stress on my adrenals would be too much having to rely on them for sex hormones. Lol- I still get physiological symptoms but without the obvious issues I still know when it’s “my time of the month” 😆 anyway I’m done now. 🤓
wow it was AMAZING thank you so much. I am Family Nurse Practitioner student in US.
You are so welcome!
I support your channel from North East India 🇮🇳🇮🇳🇮🇳🇮🇳🇮🇳🇮🇳🇮🇳🇮🇳
👍 thanks for joining us 😊
I wish all docs were so knowledgeable. I lived in Delhi India and once had to go through a vaginal exam. It was a nightmare, so painful.
Great educational video 🙌🏽 I like the idea of coating speculum by inserting it in bag and rolling it around
These are the little tips that you pick up on placement in training 😊
Never been to this channel before, but i was curious. I've been putting off doing this exam because I'm scared. This was actually quite calming. Maybe I'll be able to say yes next time my dr suggests it.
This was great thank you so much I have come to your videos as I go through the chapter in the nurse practitioner program
Very useful videos, especially for the more intimate examinations. It takes the fear factor away from these appointments.
How would you know? Have you had your legs spread for a pelvic?’ Do you actually think a silly video “takes the fear factor away” in real life. Lol. Typical man’s clueless commentary.
I have extreme issues with this for several reasons, to the point I have to be slightly sedated. But knowing what's supposed to happen and seeing it from a perspective other than being the patient actually makes it a little less horrifying to think about.
@@doyouhearthepeoplesing2At the time I was told I had to have it done for certain reasons and I was like 16 so I just believed it. And I VERY nearly lost an aunt to cervical cancer so I try to be good and get that kind of checkup when suggested so hopefully that doesn't happen to me.
Thank you for this video! As a middle-aged woman, I have had a few of these examinations but I was never explained why they needed to out fingers in me and press my stomach. A question: when you open a speculum, are you able to lock it in a non-fully-open position, or are there just two positions for it: fully open and fully closed?
I have also 'ranked' my doctors by their bedside manner, professionalism and their skills (sorry). I recently had a small procedure done in which a speculum and a catheter were used. The speculum and the catheter didn't hurt AT ALL and I barely felt them!!! In my eyes he is now a superstar physician, Ironman, Spiderman and so on!!! A little later I had another thing done with similar tools and gosh she was rough-handed!! I grunted of pain and discomfort when she used the the speculum and the catheter. Both doctors were kind but only one of them is a superstar in my eyes...
Doctor, if you are able to make examinations as comfortable and painless as possible while being kind, appropriate and professional, I promise you, you too will be a superstar in the eyes of your patients (maybe you already are)!! I actually asked to see the male obgyn for the second time because my first experience with him was so good.
They should make every doctor at my PCP office watch this.
Well, you can certainly show them.
@ Hahaha, I think they would take offense, unfortunately.
I would flatly refuse to let my family doctor do this test on me. Nope, oh hell no....
Out of interest, if you’d gone to the doctor with a problem, let’s say intermittent vaginal bleeding, and they said a pelvic exam was needed (which is quite likely) why wouldn’t you be happy to proceed?
Genuinely curious, as I might be able to learn how to help and reassure a similar patient
@@DrJamesGill For me personally I was sexually assaulted as a child and I know that is more cause to get examined but due to the trauma I freak out really REALLY bad!
So if I can avoid it I do.
Also I don't know much about Europe but so far with my experience in the U.S. the gynecologists I've met have never asked if I've been through any sexual trauma in the past before trying to examine me and the catch 22 is I'd be hesitant to tell them even out of my own volition because I worry that I'll be pressured into doing something I'm mentally incapable of handling. (Yes I am going to therapy.)
In the U.S., metal speculums are often used, particularly in gynecology clinics, because they come in a greater variety of sizes and shapes and can provide better visualization in certain cases. The metal speculums usually sit on a special warming pad to ensure they are at a comfortable temperature for the patient.
Thank you for this.
Makes me much less nervous to go in for a first smear.
That’s great to hear. Medicine can be really worrying for patients, hopefully with some of these videos it will reassure patients as to what is going on 😊
I am 65 and have given birth twice, so I have had many of these. When I was 25 I went for my normal pap and the doc called and said it showed a bit abnormal. Said we would wait, but I said "no" and asked him to refer me to a specialist ASAP. I went to the specialist and he said I had cervical cancer and wanted me to have surgery in less than a month! I did and they removed my cervix, uterus, and one ovary through my vagina. Then my daughter, at age 28 died of ovarian cancer in 2006. Ovarian cancer is cruel and her time spent in the end stages of her life was painful, slow, and disabling. Anyway, had I not pushed my GP back then, I would have died with a 2-year-old and a 9-month-old left behind! Go with YOUR gut feeling...or change doctors! Right, Dr. Gill?
I'm sorry for your loss. I'm glad you demanded to be seen by a specialist. I'm so tired of doctors just saying we'll wait. I push too. Did you have any symptoms before you found out by the specialist?
@@Gaibreel My MAIN symptom was frequent, almost constant, scant bleeding That is why he wasn't worried about it, You know, I didn't fit into the textbooks that he had in med school! Crazy, but I never do seem to be the norm! LOL!!.
I'll be honest, I came to educate myself and feel more confident for my upcoming smear, but the comments have definitely deterred me from making the appointment!
You should book it. If you can book a doctor who specialises in women’s health/gynaecology always opt for them, especially if it’s your first time.
They have a few different sized speculums, don’t be afraid to ask for a smaller one if you’re uncomfortable. A lot of women have no issues, I personally always experience pain (nothing unbearable). Tell them if it hurts. It will likely be over in a few minutes, if not sooner if you’re lucky.
Some women can’t relax their muscles from anxiety/discomfort etc. You can request a light relaxant/sedative but you’d need to talk to your doctor about it.
Please do book it. Remember the nature of the internet, people tend to comment more on negative experiences
THOUSANDS of smears are done a day. I’m not saying they are pleasant, but the vast majority are just a simple procedure with no issues.
These are important tests, please do book it
Book it but if you feel the doctor is not being respectful.. call them out on it. You have the knowledge from this video. Use it.
Your voice is so soothing.
Still way too freaked out to get one done, but it was really nice to see what actually goes on. Gives a lot more perspective besides hearing other people talk about how much it hurt or how uncomfortable it was
Most of Russian gynecologists never mind patients comfort.... for me to visit a doctor is like to have an appointment to the hell.
And I think, that’s great to have such explanation and taking care of patients comfort and feelings.
we are in the profession of caring for people. that is much more than just examinations and giving medications
PSA is still used and determines probability for prostate issues for early intervention if need be. The normal is under 4 ng/ml. But yes you are correct, the only way to monitor is through a biopsy. For the female inspection, I think you missed speaking about Chlamidia which from I understand has an array of symptoms and often show no symptoms. So upon inspection and releasing your patient and basically providing them a great prognosis, you may indeed have let them go for the same reason they walked in. I think the chlamydia lab test doesn't provide the same results for all people and many laboratory results will be false negative. You may need to get with a laboratory to see if that's still the case today.
With chlamydia the patient will have come in for a reason, it isn’t routinely just checked on GP land, however it IS in the GUM clinic.
Part of the best care is ensuring the patient is in the best place, and that is from ensuring a good history.
Maybe we need to do a video on HOW to take the histories ?
Under the guise and explanation of examinations ‘for only cervical cancer screenings, and in males early prostate detection isn’t reliable’. The textbook exam and as-performed checked a whole lot more here on this female model than just collect the cervical pap:
Bi-manual exam checking for masses in pelvis, uterus, ovaries, sensitivity, visual cervical exam, external genitalia exam, and as specified here in the US is a recto-vaginal exam and sometimes separate full rectal exam.
And in my experience males get NONE of this unless we exhibit issues and bring it up ourselves, repeatedly, to our physicians. I’m 45 and only just now have I had my first ever male urological exam and only because I sought out a urologist for issues, after my general practitioner (whom I see on a regular schedule every 6 months) didn’t seem interested in examining or referring me after I reported issues multiple times. The Urologist listened to me, examined me, and confirmed there are some definite and ‘very concerning’ issues. Any sort of routine exam of the degree of the ‘cervical cancer screening’ would have found these problems potentially years ago. It’s looking to be gradual onset cauda equine syndrome symptoms from a back injury many years ago, which I hope aren’t permanent.
Guys need wellness visits too, but we don’t get them.
The channel has finally hit it's peak!
Thank you for this video, i admit to be very uncomfortable about doing that examination but i know we women must, it can save our lives.
Totally
Thank you for the tips at the end of the video. Helpful and well done video.
Glad you found it useful. What others topics would you like to see?
Helpful video thanks, had my first smear this week and it’s nothing to worry about at all, slight discomfort for about 5 seconds and then done. Definitely an important examination and could save your life.
Also I have ectropion myself so interesting to see what this looks like in examination 👍
Thanks for the positive story. I think it’s important to show how the experience is broadly positive for most 😊
@@DrJamesGill Not EUA's. They are just predatory...in the name of teaching med students how to do a manual internal exam. Your average patient isn't going to be sedated, so therefore its an inaccurate representation of the procedure in real like.
Really excellent explained sir.
You explain every point😊❤.
Eeeeeeeehhhhhhhhhhhhhhhh...... what’s up doc? I took female anatomy in college. Incredibly informative. I think I was 1 of about 10 in a class of 60.
Speculums are either metal or plastic . And they can be warmed before procedure .
You had done a great job explaining what will happen and a good job demonstrating, although even as a man and watching I still felt nervous.
The part about commentary/consent is absolutely phenomenal and regardless of what exam or which gender it is for I feel that is something
all doctors should do and be made mandatory. Please don't treat patients as test dummies and even if it is our twelfth time for the exam it
should still be communicated.
I do have both one concern and question, how come the speculum is inserted vertically but then turned horizontally? What major factor would
there be in form of viewing the cervix? As the process of turning it horizontally and opening it seems to cause to much pressure and possibly
pain as when it is open it is almost cone shaped and viewing the female anatomy the fully open speculum seems as if it crushes the urethra,
bladder, and prostate of the patient. Do you feel the design or the speculum should be redesigned with more comfort or while placed vertically
in couldn't the doctor simply expand it while it is vertical and still see and examine the cervix? The pressure on the labia walls seem better for
expansions
When you eating out and they bring out the speculum and ask you to pass the cervical swab.
I'm sorry I wasn't mature enough to avoid making that joke.
And for the love of God, warm that speculum a bit before inserting it. Once had a doctor who did not do that....believe me, cold metal is NOT nice😱
Completely!!
All male doctors should have the humiliating female experience of: stirrups, spread legs, penile swab and anal speculum exam plus DRE prostrate exam and testicle palpation.
They have no idea how exposed and stupid women feel in that ridiculous position. Any male Drs willing to do that once a year?
I don’t quite understand that
@@DrJamesGill All male doctors should have the same awkward experience that women endure:
Naked, paper sheet, feet in foot rests/stirrups, legs spread, a penile swab, a rectal exam with an anal speculum, and prostate exam via digital rectal exam. Also, palpitation of the testicles. With a chaperone.
Then they might have just a hint of understanding how exposed and vulnerable women feel in that humiliating position.
I agree that it is a difficult procedure for many people to perform, and having the anatomy and experience would undoubtedly improve things, but I’m not sure I agree with the sentiment.
I’ll never given birth to a baby, but I firmly believe that all appropriate painkillers should be offered and encouraged
I’ll never have a period, but I’ll never dismiss dysmenorrhea.
Moving away from the female complains specifically, I’ve never broke a hip, but when I’ve dealt with those patients, painkillers has been a number one priority, and when I’m doing a nerve block directly into the groin, being conscious of how that patient is feeling exposed and frightened is hugely important as I’m putting the needles in.
Having empathy doesn’t mean KNOWING the experience, but being able understand and share those feelings.
Fantastic, respectful video as always! I can see from the comments that I'm not the only one with these sorts of questions, so I really hope they can be addressed in the future: what sort of steps can doctors take to minimize potential re-traumatisation to women who have either been abused, or have had bad experiences with these types of exams in the past? I know more than one person who either hasn't ever had a test done or hasn't had it done in years for these reasons. What can a patient who is worried about these things to do advocate for themselves during the exam?
I’ve dealt with a few patients like that. It takes time. Sometimes just coming in for a chat about what we MIGHT do.
Took several consultations but we got it done. Care, let the patient set the pace, and lots of communication
i really like the way u talk,your voice is a miracle
Me too !! 🙂⭐️🙂
Found this in my recommended videos. Gotta say... one of the weirdest ASMR videos I've seen but 10/10 good job
🤣👍
Wow. I learned some new things. Well done.
Glad it was useful 😊
This is so good! Thanks alot Dr James ❤️ Much love from Srilanka❤️
Idk how this ended in my recommendations but well, every days you learn something new... Weird but thanks
I loved how he utilized lady’s “modesty,” when referring to the covering sheet for the exam 👌🏽
Yes indeed, he s a gentleman
That should be expected; looking out for the patient’s privacy and dignity.
One good tip is to touch the woman’s inner thigh with your hand prior to interesting the speculum or fingers, it reduces the startle or the tools. Also, wiggling their toes helps to relax the pelvic floor muscles and reduces discomfort.
I’ve truly tried and tried to research and understand but I am absolutely terrified to get a pelvic exam even the thought of it almost brings tears to my eyes .. I know that as a women I have to have it done but I can’t bring myself to do it
Lots of things are often worse in our minds than reality. I am terrified if the dentist - had issues in the past - but have now found a dentist I trust.
Don’t get me wrong, I still grip the chair, and tense up in the most ridiculous fashion, but it is never as bad as I fear now
Talk to the person doing your smear, your worries are valid, they will be able to help
that's really useful video. thank you so much
Glad it was helpful!
Good work Dr. Gill
thanks
I dig those berry colored trousers, Doc! 👍🏼
I’m quite enjoying the “scrub life” again. No ironing 🤣☺️
Dr. Gill makes the clothes look good.
Amazing video and calm tone. Thank you Dr.Gill