The dreaded “cancer check”

I still have one more post to write about Vienna, then I want to tell you about my brother’s visit, but WordPress have changed something on the media library page and now uploading photos from my home computer is excruciatingly slow (even worse than before), so here’s something else for you…

Recently, I went for my second ever smear test in Germany – referred to here as the Krebsvorsorgeuntersuchung, or cancer prevention check. (No, I hadn’t been neglecting my health before last year… I just found it easier to get such things done in England!)

Tux the nurseIf you are a woman in Germany and you’ve ever been on an expat message board or even spoken to someone who moved to Germany from an anglophone country, you may have heard some horror stories about this cancer check. I know I had! From the scariness of the chair to being made to strip completely naked in a cold room… I had heard it all. So when I went for my first cancer check appointment last year, I wasn’t exactly looking forward to it (not that anyone ever looks forward to a smear test, but you know what I mean). Now that I’ve had my second one, and it again turned out not to be so bad, I thought I would write a little report on my experiences. Obviously, I can only tell you about my experience with my doctor, and I can’t promise that you won’t end up with some weirdo who does make you strip off, but hopefully this will at least give you some idea 🙂 Please feel free to close this window now if you’re not interested in reading about women’s sexual health… and the fun that is trying to pee in a small plastic beaker without the benefit of a penis!

So, we’ll start with the urine sample. When I’ve been for smear tests in England, I’ve been given a sample container in advance and told to fill it and bring it with me to the appointment. This may happen here, too, but at my particular Frauenarzt (=gynaecologist), you’re expected to provide your sample on arrival. Which sort of makes sense, I suppose. At least they know it’s fresh (eew, that sounds wrong!). Last time, I didn’t actually read the little sign on the wall. I knew you were supposed to try and catch mid-flow pee, but I didn’t actually feel like I had to go last time and was worried I wasn’t going to be aple to produce a full sample (sorry, sorry! This is so TMI), so I just put it all in there. This time, I noticed the sign (come to think of it, I’m not sure there even was a sign last time). It didn’t tell me anything I didn’t already know, but it did make me laugh. The sign told me to let the first portion of urine go into the toilet, catch the next portion in the beaker and then let the final portion flow into the toilet again. In German, obviously,,, but the word used was die Portion, which I only know in the sense of an actual portion, as in “eine Portion Pommes, bitte” (a portion of chips pleased). I have no idea whether it’s normal to refer to your wee as coming in portions, but personally I found the idea hilarious 😀 Once you’ve finished peeing, you have to place the beaker (which you should have labelled with your name before peeing in it!) back in the little cupboard where the empty beakers are kept. There’s a second door at the other side of the cupboard for the doctor’s assistant to remove the little beaker.

Next step is getting your blood pressure taken. The doctor’s assistant does this, and at this point will also ask when your last period was. This information all gets written down on a little card for the doctor, then you get to go and sit in the waiting room. I was also given a form with a list of additional services (such as an ultrasound of the womb) that I could have if I paid for them. I chose to just go with the stuff that’s covered by my (public) medical insurance.

The chair is less scary looking in real life!
The chair is less scary looking in real life!

Once the doctor calls you in, the appointment starts with a (fully-clothed!) consultation at the desk. The doctor will read what the assistant wrote about your blood pressure, etc. and ask you whether you’ve been having any issues or problems that you want to talk about. If it’s your first time, they will presumably also explain what’s going to happen – I got the “this is what I’m going to do” talk in England. Consultation over, it’s time for the actual check. First you will be asked to remove the clothing from the lower half of your body. My doctor’s surgery has a tiny changing room for this. Once your bottom half is naked, it’s time for the chair. It looks scary, and it’s not exactly my favourite position to be in, but it not as uncomfortable as it looks! The first time I went, I mentioned that we don’t have such chairs in England and I felt a bit awkward. The doctor’s response was “Yeah, I can understand that but it makes it easier for us to get a proper sample the first time round than if we just do it with you lying on a bed”. Makes sense! And you’re really not in that position for long. I won’t go into detail about what happens in the chair because I’m sure most people reading this know how a smear test works…

The next step is the part that surprised me last year. If you’re 30 years old or above, after the actual smear test the doctor will ask you to put the clothes from your bottom half back on and take off the clothing on the upper part of your body. Then she does a breast examination – just by feeling and looking, but if you’re willing to pay there’s also the option to get an ultrasound of your breasts done. Technically, I was only 29 the first time I went, but I got my breast exam anyway… I was literally days away from my 30th birthday, so I suppose they thought why delay it for a year for the sake of a few days. As far as I’m aware, the smear test in the UK doesn’t involving having to bare your boobs, so that confused me a bit. But again, it goes by quickly and you just have to remind yourself that the doctors do this every single day. No embarrassment necessary!

Aaand that’s pretty much it. Once the breast exam is done, you put all your clothes back on and, if there’s nothing else you want to discuss, you’re good to go. I always ask for a new pill prescription before I leave to avoid having to come back another time. And if you don’t hear anything within two weeks, the test was fine and you’re all done until the following year. (Some doctors may contact you if the test was clear as well… mine doesn’t).

Phew… okay, that’s enough about my sexual health! Back to regularly scheduled Confuzzledom programming!

In which I contact a Frauenarzt all by myself

Now, that is a scary Halloween costume. (part ...
My doctor is not this scary… (Photo credit: partymonstrrrr)

It’s that time again… when I reach the final week of my pill packet and suddenly realise it was the last one in the box and I really need to make an appointment to get some more. Usually, I make the appointment with my Hausarzt (General Practitioner). We have an agreement where I tell him I’ll go for my smear tests in the UK and he gives me my prescription, no further questions asks. Unfortunately – not for the first time – my Hausarzt is on holiday right when I need him. I seem to have a knack for wanting an appointment when he isn’t there… and he’s not going to be there until after I need the pill again. Roughly a week after, to be precise. Normally, this is my cue to get Jan to start calling round doctors for me (I like my Hausarzt because I can make appointments online… no need to attempt to spell my name to nasty receptionists!) but I’ve barely even seen him since we were on the train together on Sunday, and certainly not for long enough to have a real conversation!

It was time to bite the bullet and find myself another doctor! After some googling for Frauenarzt Karlsruhe (a Frauenarzt is a gynaecologist, by the way… and is where I’m supposed to go for the pill) I decided on one that’s a) close to my house and b) had a website that came equipped with an e-mail address. I sent an e-mail explaining the situation and received a reply within two hours:  Of course you can come by and get a prescription for the pill. Just drop by with your health insurance card – on Tuesdays and Friday we’re open til 7 p.m. (I had said I can only do 5:30 onwards due to work). Oh, and usually we would then make an appointment for a consultation and cancer screening at that point. How do things stand with you?

The Frauenarzt chair of doooom!
The Frauenarzt chair of doooom!

I had to take a deeeep breath before hitting  reply.  I can come by on Friday to pick up the prescription. As for the screening stuff… usually I get it done in England becasue I don’t have a gynaecologist in Germany, but it’s been three years and I’m not going back home any time soon so maybe I should get it done here. (What I didn’t say was that, actually, it was three years in October… my dad opened the reminder letter for me, but I haven’t been back to England since… Germans expect you to have it done every year (and every six months if you’re on the pill!! Excessive much?!) so I didn’t want to alarm her more than I assume she already will be…). There hasn’t been a reply to that e-mail so far, so I don’t know yet whether I’m actually going to have to get a smear test done in Germany. I’ve heard scary stories about nakedness and the horrible chair though (no lying down on a bed like back home for German women!)… wish me luck!