Accessing Preventive Health Exams by Lorna Smedman, Managing Editor, Inside MS Vol. 16, No. 2, Summer 1998
Another doctor, another clinic, more tests, more questions—who needs it? But people with MS are just as susceptible to cancer, heart disease, stroke, and other major diseases as anyone else. Along with routine monitoring of blood pressure and cholesterol, women should have annual pelvic exams, Pap tests, and, starting in midlife, mammograms. Women who are sexually active should have routine tests for STDs (sexually transmitted diseases), too.
We all know this, right? It turns out that women with MS may ignore their sexual and reproductive health. Women who rely on neurologists as their primary physicians are less likely to get preventive exams. And when women with disabilities go for a Pap or a mammogram, they may face deterrents. Not all exam tables or mammography equipment are accessible.
Special MS Needs
According to Kathy Birk, MD, and Michael A. Werner, MD, women taking immunosuppressive drugs (such as prednisone or beta interferons) should get a Pap test every 6 months since abnormal results may be more common.
If MS is causing sensory deficits, a woman needs to be aware of other changes which may signal the presence of an STD, such as spasms, sensations of pressure, sweating, flushing, or unusual vaginal discharge or odor.
Women who have physical disabilities or use mobility devices will need to explain their requirements when they schedule appointments. Here are some questions to ask:
Is the examination room accessible to your mobility device?
Is the mammography equipment accessible to your mobility device?
Can someone help you move on and off the examination table, and stay with you, so you are not left unattended?
If the standard table position used in the pelvic exam is not comfortable or possible, what other positions might work? Table Manners: A Guide to the Pelvic Examination for Disabled Women and Health Care Providers (Planned Parenthood--Golden Gate, 815 Eddy Street, #300, San Francisco, CA 94109; 415-441-7858) has alternative positions with clear illustrations which you can discuss with your doctor.
If spasticity or incontinence is a concern, discuss this before the exam starts. Schedule the pelvic exam around your usual urinary or bowel program.
Most mammography equipment will allow women who use mobility devices to remain seated during the exam. The Eklund Compression System and the Bennett Contour System were specifically designed to allow for more flexibility and accuracy. The Contour System is available at over 600 sites across the U.S. To check on a location near you, call Trex Medical Technologies at 516-691-6100.