Who monopolies the world of Vaginas?

It was 5:30 hrs in the morning, you know the anticipation that you get before traveling to another country? I almost felt that. The special preparation that I did for my departure was a clean apron that I washed the night before. I love to be punctual, so I was half an hour early and was all ready to enter into the world of vaginas or aka the GYN and OBS department.

Working in Ramadan is fun to a certain extent; you get extra hours of sleep and well, if you get lucky you can get some free ifftari as well and It does seem extremely rude to go out for tea breaks deliberately announcing that you are a Non-Muslim, so, according to my plan, I snuck out before entering the GYN department. People who know me also know that I am very punctual with my meals as well!

Who monopolies the world of Vagians? The entire time, when my senior was asking me to make discharge papers, I was wondering why the most successful Gynecologists in Nepal and Bangladesh were Men? Men come to Men doctors when they want to get checked and vice versa but people who can afford, especially those who want to get checked according to rankings, will always prefer male gynecologists.

Where is the feminism? Where is the “we trust female gynecologist act”? Sorry sister, a male doctor’s opinion is worth a thousand then a female one! Then they ask the ultimate question like, when you get pregnant, which doctor would you prefer? You need to pause and think, marriage, babies, that road is far off, let’s just avoid that question. If I were to answer that question, hypothetically, I would always choose a doctor who would understand me, who could bear my personality, who I can trust professionally to do the job, knows when to pull the alert button. “Doctor, you sound diplomatic!” becomes a common response when people ask me stuff. Then I think, gens, why must you show off like that?

Patients are smart these days, with Google, WebMD, the online rankings for doctors, practicing must be a different experience in Western countries but in South East Asia, still patients suffer from minor problems of obtaining medications or being educated about a disease. Among all these difficulties that most of the majorities of the people suffer choosing a doctor for child birth is not a leisure that they enjoy.  The question of who gets to be their future child’s doctor is a futile question that people who enjoy better healthcare can fiddle about.

 

Letter From Mind!

This is a letter, which I wrote before starting off my OBS/GYN rotation during  med school. I don’t know how many of you find writing something down as a motivational tool to study but I found that to be extremely helpful!

Dear Sarnia,

First write a blog post about it, play an instrumental song, makes you more productive. GYN and OBS is full of practical, OSPE, Viva and written. So start of the two things that over –lap, Viva and OSPE and then end up practicing for written. Start of slow, with patience, that’s what you need when you want to start of things, “start slow!”

First day, try finishing two topics and relax, you can’t burden your mind, that precious minds that pops of when a teachers asks you.  Start off one topic and finish it, I have seen you change your mind change from one topic to another, do not do that, it hampers your biological memory clock.

Allow others to be productive in class but never feel scared to ask a question in the class, even if the question is silly. Avoid hate, anger, fear from you mind. These things affect your brain, which is the most precious gift that mankind has ever received. Make sure you do not insult it with foul thoughts of being depressed, alone and insecure.

Life goes on as usual; the only thing that will change is you! The person that you are now, and after a vacation are two separate people. Patience will reward you well!

Yours Sincerely

Mind

Whose Subject Is Gynecology?

“This is your subject” says a male co-med and I stayed silent until he finished his sentence. According to my co-med, Gynecology is a subject only for females med’s.  According to him, the requirement for Male med’s to pass this subject involves learning a few causes, diagnostic criteria’s and management. They claim that GYN is not a subject that they have to deal in the future.

Gynecology is a Greek derived world meaning female disclosure.  Back in the 1822 Jacques-Pierre Maygnier depicts a male physician examining the female genital, it actually shows a “compromise” procedure, in which the physician is kneeling before the woman but cannot see her genitalia. Before the turn of the century and before females got interested into medicine, the regular Gynecologists were males.

Male Meds get discouraged to study this subject because of the patient factor, most women are not conformable with sharing details with them and also they will not give consent for even an abdominal examination. One of the most important factors in learning is dealing and talking with patients, if patients don’t give the same feedback it’s likely that one looses interest in the subject.

Peer pressure also seems to play a vital role, those that dare to show interest in this subject is often teased and humiliated afterwards.  Most meds do not prefer to study gynaecology so meticulously because they state that female patients won’t come to them for check up in the future. It’s likely due to the religious beliefs of the women especially in our part of the world, which discourages them to make visits to male doctors for GYN related reasons.

What will male med’s do in an emergency call? If they are left to deliver a baby on their own, you cannot back out and say that I didn’t work hard in my GYN at that time. Most meds don’t understand the implications of Gynaecology in the MBBS course.  If one is placed in a remote village; it’s likely he/she will have to be the pathologist, gynecologist, and general practitioner all at the same time.

I often see my male co-mates carry their big Davidson book to the GYN ward. Medicine is a prime subject of MBBS but ignoring GYN is not a wise decision to make.

What male medical students should do is always hang around with the female meds in the ward. 90 % of what you see during the ward can actually help you learn the subject.  Also visualizing the work of a female co-med can help you comprehend the work at hand, in the future. Giving up is not an option, you need to create a rapport with the patients, if she sees your constant presence in the ward; she might give you a proper history after all. Your motive in the first few days is to gain confidence of the patients.

Famous male gynecologist like Dr. Bhola Rijal from Nepal and Dr. T.A. Chowdhury from Bangladesh, are clear-cut examples of how males have succeeded to become gynecologists. GYN is a subject that is equally important for both sexes and it is as vital as medicine.

Eventually one has to deal with child-birth or assisting in a cesarean section or even assisting in MR procedures on an every day basis. Ignoring and humiliating this subject by calling it a study for female medical students just shows ignorance and if you want to succeed as a good doctor you need to treat GYN well.

Man’s Bliss Becomes A Source For A Woman’s Pain!

“Oh! No madam, oh! No madam, not any more, not any more, I won’t do it! “. This is a typical cry of women who came to the gynecological ward at our hospital for a Dilation and Curettage procedure.

I have been patiently waiting for a patient to do this procedure, once you visualize procedures like these, chances are you don’t have to memorize paragraphs, just a recall of what you saw ,can do the job.

I was very much enthusiastic at the start but gradually went into a semi-shock state.

First of all, it’s the genital that we are talking about, ” Mulier est hominis Confusio” meaning  ‘Women is mannes joye and all his bliss”.  It’s the most sensitive part of any human being.  When people tamper with it, like when they want to do abortion of any sort, they create opportunities for the doctor to insert several metallic instruments into the man’s bliss area and beyond.

The litholomy position, whoever discovered the position definitely knew how to expose all the sensitive parts of the female genitalia. Imagine what happens when a metallic rod like instrument is inserted in your vagina, cervix and to the uterus and its contents are removed by a device that sucks out any implanted fetus that remains of.

When asked why she did it, it was a really simple answer; she just did not want a baby at the moment. She is in her 20’s. Why did you marry at such a young age? Her husband’s family came to ask for her hand, her parents agreed and hence she became the wife of Mr. X.

She is giving her grade 12 examinations later this year. Before she leaves on discharge, she is requested to avoid any coitus for a period of 15 days. Will they listen?

Couples, Couples, please be intelligent when it comes to having sex! Unwanted pregnancy and early removal of product of conception can makes it difficult to conceive in the future.

If women can’t control their ovulation by OCP, it high time men helped, use barrier even when your women is in Oral Contraceptive Pills regimen. In most of the cases that I have seen, women lose their compliance gradually over the years.

It’s high time; men were encouraged to help women to avoid any unwanted pregnancy. If your love your spouse or girlfriend, start with avoiding any unwanted pregnancy.

Gynecology does not freak’s me out; in fact, I have been interested in it, for myself, for my friends and family. I am trying all my best to learn as much as they offer from teachers.

It’s the patient that shocks my heart, they scream, they complain of uncontrollable pain despite the pethidine drip, it must hurt like hell.

It’s been several hours since I viewed that procedure, but it is still revolving in my head, her screams, her crying, and her decision. The very thought of inflicting pain on a women makes me sad!

I Guess You Discussed This With Your Doctor? Flaming Planning Series ( II )

Oral Contraceptive Pill (OCP ) is widely used in the western world and even in Nepal. It is one of the methods of prevention of contraceptive that manipulates the hormonal system.

The basic functioning of the OCP is to provide extra dose of hormones like estrogen and progesterone to the body so that the normal process of ovulation comes to a halt.

Ovulation is the process of the development of ovum (The male equivalent to sperm). Without the ovum, there are less chance of fertilization and hence forth no pregnancy.

There are several ways in which OCP acts. Some of them include:

• It decreases ovulation

• It brings changes to the cervical mucosa, producing a thick mucus plug so that sperm cannot enter

• It brings changes in the endometrial wall so that it becomes unfit for implantation

• It also interferes with the motility of the fallopian tube ( A tube that transports the ovum from the ovary to the uterus)

Before you take OCP on your own, you doctor must have mentioned some instructions like :

• You must take it on a regular basis, like after brushing your teeth in the morning or before sleeping everyday starting from the 5th day of menstrual cycle.

• If you forget to take a pill on a day, please take that pill whenever you remember and also take the regular pill as advised for that day.

• If you miss two consecutive pills then you will have to use barrier method of contraception and take the rest of the pills as advised. Please continue taking the pills even if you experience some bleeding.

• You must do a follow up examination after 3 months after taking the pills for the first time, then six monthly afterwards. The doctor will have to monitor your Blood Pressure, breast and pelvic organs.

• After the 21 days of taking OCP, for a period of seven days, Iron tablets also called Dummy Tablets are advised to be taken to prevent from getting anemia, during this time you experience periods which is called the withdrawal bleeding.

• During the pill intake, active bleeding may occur which is called Break through Bleeding. Please mention to your doctor about this, this indicates that you need pills which have a higher concentration of estrogen /progesterone.

Most of take OCP for contraception but it has some non contraceptive purposes as well.

Let’s look at some of them:

• Protects you from benign Breast Disease
• It can be used in PMS ( Premenstrual Syndrome )
• It can be used when you have painful menstruation ( Dysmenorrhoea )
• It can be used when You have a disease called endometriosis ( the presence of functional uterine mucosa in other places )
• It can be used in Dysfunctional Uterine Bleeding (DUB)
• To regulate menstrual cycle.

OCP is contraindication (Not wise to use when):

• When the female is suspected of being pregnant
• Age of the female is more than 40 years
• Has a undiagnosed bleeding from the vagina
• If you have a history of heart diseases
• Severe Hypertension
• Have the habit of Smoking
• Liver diseases including Chronic Liver Disease
• Migraine Headache
• Four weeks before elective surgery
• It is also Contraindicated in teenagers because there epiphysal cartilages have not completely matured at that time

Why Do You Do If You Fall In the Above Mentioned Category?

There are several methods of contraception’s, so don’t panic If You can’t use OCP.

What are the Adverse Effects of OCP?

 Weight Gain
 Nausea (the period before vomiting when you feel like vomiting ) and Vominting
 Break Through Bleeding
 Reduced Menstrual Bleeding
 Absence of withdrawal bleeding

• Certain Cardiovascular effects : Hypertension, Atherosclerosis, Coronary Artery Disease ( the arteries that supply the heart )

• Metabolic Effects : Diabetes ( Non Insulin Dependent Diabetics )

• Hepatic Effects ( Liver Effects ) : Jaundice

• Psychological Effect: Episodes of Depression. Take Vitamin B6 ( Pyridoxine ) To avoid this

• Infertility Effect: Ovulation returns within 3 months after you stop taking the pills. If you use the drug for a period of 10-12 years then there are chances of infertility.

Use OCP wisely and consult with your doctor about any differences in your health and habit of yours.

Enjoy the Freedom of being Not Pregnant. You have the right to live your life on your terms.

Happy Fertility Loss Girls!