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I'm not a huge fan of fruit leathers, but this turned out super good! And, really, you can't go wrong with blackberries, mint and rum.

Monday, July 27, 2009

Greening your pelvic exam

I ran across this post the other day and was surprised to learn that there was such a thing as a disposable plastic speculum. For those of you who have no idea what I'm talking about and the image to the left doesn't ring a bell, a speculum is the thing a doctor inserts in a woman during a pelvic exam, during a pap smear and for generally taking a peek around the ol' puddietat. My experience has always only been with a metal speculum, the kind that gets autoclaved and reused countless times on other unsuspecting victims, er, patients.

A plastic speculum seems to be a giant waste of plastic and a wholly unnecessary one at that. If you think about it, the minimum recommended number of pap smears over a woman's lifetime is something like 23. Add in other pelvic exams and the number is much higher.

As a snapshot, there are currently 150 million females living in the US. If all our doctors used a disposable plastic speculum, that would be 3.5 billion speculums going into the landfill by the end of all our lives. Wow, what a legacy to leave behind, huh? If this sounds like a weird thing to focus on, it's really not, because it's something that has a relatively easy to acquire alternative - the stainless steel speculum. The one that was routinely in use before cheap plastics came along.

So, what to do about this? Well, the next time you get a pap smear, talk to your doctor about your preference for a metal speculum. If you are concerned about it being cold, they can place it in warm water beforehand (that's what my doctor does). Discuss your concern for medical waste. There are some things we can't reuse (IV tubing for example), but this one seems like a no brainer. Plus, there's less risk of it cracking or breaking. The last thing I want are shards of plastic lacerating my lady bits. Finally, the plastic speculums tend to not slide as easily as the stainless steel variety, thereby necessitating more lubrication or resulting in a more painful pelvic exam.

If you are a guy reading this, you aren't off the hook either. I'm sure you have a mother, sister, wife, daughter or female friend in your life that could use some educatin'. And, nothing really brings family and folks together better than getting some helpful tips about pelvic exams from a dude.

What kind of speculum does your doctor use?

24 comments:

camelama said...

Also? Plastic = sharp edges. A doctor tried to use one on me once but I stopped her, ran my finger down the large tab, and found a sharp edge from where the two halves came out of the molds and were joined together!!!! OUCH! Who wants THAT inside them?! Sure, the metal can be cool, but cool doesn't hurt ya! :) Plus, newer exam tables have very small, efficient heater trays inside them where the metal speculums are stored, the aide/nurse/whoever turns it on before they lead you into the exam room, and it's all warm when the doc is ready!

Terra said...

Wood?! Please tell me there is no such thing. I've never heard about a warmer before, I always get the old, "This might be cold" routine. I guess she is holding out on me. Wonder if there is a difference in who uses plastic more between midwives and doctors.

Toria said...

After years of the cold metal ones, I have to say I really appreciate the plastic ones. If I ever get offered a choice, I'll definitely choose to the anti-green plastic option.

Sarah said...

I'm curious what the breakdown is between new plastic and autoclaving metal. I'm guessing metal is still better, but autoclaving is pretty energy-intensive.

Farmer's Daughter said...

Never heard of the plastic ones, but I guess it's not surprising. Everything is disposable these days. Funny thing is, people probably think it's "cleaner" than the metal one.

Also- I would be concerned about the plastic breaking down if a petroleum based lubricant is used and what chemicals are leached during the (albeit short) exam.

Chile said...

I've never seen the plastic ones, either. And it's been years since I've had to endure a cold exam. Seems most offices warm them now....or maybe it's just because I prefer a female doctor or nurse practitioner for this exam.

Notwasted said...

As much as I hate the metal ones I couldn't even imagine using a plastic alternative. I'd be terrified of it breaking or cracking while..inside.

Anonymous said...

Well, since you brought it up, how do they clean the reusable ones then?

Crunchy Chicken said...

Anonymous - They autoclave them:

"An autoclave is a device to sterilize equipment and supplies by subjecting them to high pressure steam at 121° C or more."

rachel said...

The amount of waste in the medical world is stunning. I think there is a group called Physicians for Social Responsibility who addresses this.

De in D.C. said...

Admittedly I'm not quite 30 yet, but I've been having my regular lady exam for over 10 years now and have never had a metal speculum used on me. And this is at three separate practices! I'll have to ask about it when I go in for my next Ob appt. in a couple weeks.

Dee Dee said...

Wood speculum?!? Yikes.

Thistle said...

I know my doc uses a metal one because it's always COLD! However, I've written a few articles on waste in the medical system, and the problem with autoclaves and re-sterilization techniques is that they also require a TON of energy... autoclaves need to be heated to very high temperatures and often the solutions used to further sterilize instruments are full of nasty chemicals, which aren't great for the environment or your body, either. Hence the disposable plastic. And a final reason doctor's offices are making the switch from reusable metal to plastic: Cost. It costs a lot more to pay a team of people to pick up the used specula, autoclave them, reseal them and deliver them back to the office than it does to simply get another shipment of disposable ones. Sad.

Anonymous said...

You can actually buy your own steel OR plastic speculum for about 10 dollars. Couldn't you just bring it in with you and that would take care waste either with the disposable plastic or the autoclaving?

Lisa Sharp said...

Every time I have gone it's been metal. I have one in a few months (joy!), we will see if they still use them.

Martin said...

Disposable plastic is an unstoppable force in health care. Besides the economics and the convenience for the doctors, patients will usually prefer the idea of something that has never been used on another person.

One important point that you may have thought was off topic or too obvious to mention is that being conscientious about preventative health care is a green act. Crisis medicine is very wasteful and polluting. Ask for metal, ask for plastic, but please get exams at the recommended frequency. This advice comes from a man who has NEVER had a prostate exam.

Anonymous said...

I am sure that there are other things that be green instead of instruments used for the pelvic exam. It is lame how you are nitpicking the issue about how bad it is for the environment. It is perverse and sick to have guys broach the topic with other females considering since its a sensitive topic.

Maeve said...

Anonymous @3:21pm: I think you need to chill a little. Really, it is pretty wasteful if you think about it. Sure, there are plenty of other things to worry about, but that is an awful lot of plastic and I don't want anything scratching in there. If you think about it, they probably don't recycle them either.

I'm kinda curious about whether or not I could bring my own. Then you don't worry about other people having used it before. Yeah, it should probably be cleaned between uses, but it won't have to be autoclaved if you're the only one using it.

Anonymous said...

I've been getting pelvic exams for over 12 years, in multiple different practices in multiple states, and metal has never been presented to me as an option. But frankly I don't care, and I'm going to stick with plastic.

Aren't there multiple stories in the new right now about patients being exposed to HIV and hepatitis due to improperly sanitized equipment?

Mrs. Spit said...

I do have to confess, that one of the reasons some docs use plastic is because they actually light up (I know it sounds gross). Having a good light source matters, because it really does help them visualize both the cervix and the vaginal walls, helping them locate a variety of STI's, strange orientations, and it helps them see where they are scraping on the pap, which means better results.

Having said that, I wonder if they could create a plastic that could be autoclaved.

Anonymous said...

As someone who performs pelvic exams for a living, I totally support talking to your practitioner about this. Most places that routinely use plastic specula keep a few metal ones around too. And how awesome would it be for someone to bring in their own speculum for the exam? Why not?

But I also wanna say that you should do what feels most comfortable for YOU!

Amber said...

REALLY? greening your pelvic exam. Come on. No Thank you. One they reused over and over. GROSS. I would rather have a clean one thank you. AND I have also read an article where the metal speculum actually hid a woman's tumor whereas plastic ones are see through and tumors would not be hidden. Come on ladies use plastic and ban the metal. Plastic is better for your health

NJacana said...

I recently had a pelvic; she said it was my last one, won't have to do pap smear anymore because of my age. It was also the first time for plastic and it hurt like hell, like it pinched inside. I pulled back at the first insertion and she had to stick it in again, and it hurt again, and there was blood when I went home.

Nicole said...

I think I may be the only one who hates metal speculums, not because of comfort, but because of the gross factor. Those things are WASHED AND REUSED. I don't give a crap how many times they autoclave those things, having something put inside me that has touched the disgusting and infected vaginas of several hundred other women is just downright sickening.

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