PID?

[ICantThink]

I don't really know where else to go for help on this, and honestly? I'm really scared.

I went to visit my boyfriend last week for his birthday and while hiking we ended up having sex. I came back home and have now been in the ER three times for pain that everyone thought was appendicitis. It wasn't.

I've done multiple tests and last night (my most recent hospital visit) I had to do a pelvic exam and they think it's PID. They're kind of running through a bunch of possibilities since no one really 100% knows what's causing my pain.

Several things on this front: First: I still feel incredibly violated and don't want to talk/be touched since my exam. It was the first time I'd ever had a pelvic exam and needless to say - I wasn't comfortable. But I have no one to talk to about it. My mom blows it off like it's nothing, something that typically happens. Which yeah, sure. It does once we're older. But I wasn't prepared by anyone on what to expect so I was scared and honestly, I cried a lot after.

Second: I do not have an STD and neither does my boyfriend. We have only been with each other and are both each other's firsts and we use a condom every time we have sex on top of birth control. The more I research PID's the more I freak out because it's so uncommon for girls to get them without having an STD. My test doesn't come back for another week or two, and I'm fairly confident it'll come negative, but my/my boyfriends minds are going to worst case scenarios. I just need someone to talk to me about what a PID even is, and if it's possible that I got it from having sex outside? All I'm hearing from people is "You have to have an STD to get it" and it's not helping me.

[Redskies]

I'm sorry you're going through this, ICantThink. It is really scary to have pain and have medics not know why. I'm also deeply sorry that you had such a bad experience with the pelvic exam. It's pretty natural to feel apprehensive about any pelvic exam, particularly our first -it's a new thing, and it's our genitals and inside our body, which is very personal and can feel pretty vulnerable. What should happen is that the person doing the exam talks you through it first, explains if you want them to what they're going to do and why, answers any questions you have, and then checks in with you during that you're okay with them continuing. If that's not the care you got, I'm so sorry, and you should have. Pelvic exams don't cause physical harm, but they can be emotionally loaded - especially in a stress situation where it's needed becasue you're having pain - and it's equally important for medics to take care of emotional well-being.

I've pulled up a factsheet for you on PID that Heather shared with another user: http://www.womenshealth.gov/publication ... sease.html It seems pretty comprehensive to me, but if there's anything you want to know it doesn't cover, do let us know, and I'm very sure one of my colleagues with more expertise on PID than I will be very happy to help you.

I'm not aware that possible PID is considered a risk of sex outside, so even if your health issue turns out to be PID, it's not anything you did wrong. Like the vast majority of health issues, you'd just be really unlucky. I understand it's unhelpful and confusing when people are saying that you have to have an STI to get PID: for sure, PID is most usually caused by an STI, but as the factsheet makes clear, it's possible to get it from other bacteria.

Are you the kind of person who usually benefits from considering worst-case scenarios and realising that you'd be able to deal with them, or are you more the kind of person who gets more freaked out and overwhelmed by worst-case scenarios before you know what's actually what? Your answer to that, I think, will suggest to you how much or how little it's useful and healthy for you to think about PID before you get any actual diagnosis. Either way, this is definitely a time for self-care while you're waiting! Do you already have good self-care strategies you use, or do you need any help with that?

I'm sorry your mom hasn't seemed more supportive about the pelvic exam. For sure, there are people to whom it's no big deal; there are also people who find them challenging or upsetting, for many different reasons. How do you feel your mom usually does at supporting you when you're upset or scared about something? Is there anyone else in your life who's typically good at hearing and supporting you when you're upset or scared?

[ICantThink]

My doctor explained the process of the pelvic exam, and I've heard about what happens from previous doctors and through sex ed, so I wasn't oblivious to what was going to happen. But they didn't once ask how I was doing during it. I had to get an endovaginal ultrasound and had thought that was all they were going to do. So I had my panic about that and had cried because I still felt incredibly uncomfortable by it, and the first thing my mom said to me was asking if I was mad at her and if that's why I wasn't talking to her. She didn't once ask if I was okay, or why I wasn't talking. But immediately assumed it was about her. She tends to do that a lot.

I don't go to her often about things because while I love her, we have completely different perspectives on things. Something I find to be cause for concern or uncomfortable, she doesn't and vice versa. It makes talking to her about things difficult. And after the ultrasound when I found out I also had to do a pelvic exam, she wanted to be in there and got upset with me when I didn't want her there. She has a morbid curiosity - which I also have. But I didn't need or want her being curious and asking the doctors questions that would drag out the exam. It was already bad enough I had a 68 year old male doctor sticking his fingers down there. I didn't need her adding to it. And even now, a day later, I'm still really upset by the whole thing and still don't want to be touched or talk much. I don't know if I'm over reacting, but I'm still just really uncomfortable and feel violated. I know those exams are normal and something I have to do often when I'm older, but I wasn't expecting to have to do it this young. I thought I'd have more time to prepare for it mentally.

I don't really benefit or freak out from worst case scenarios. I'm fairly confident I don't have any STI and neither does my boyfriend. That for some reason I'm just unlucky enough to have gotten it anyways. It was just something that had crossed my boyfriends mind - he's more of the worst case scenario type person. In terms of self-care, i'm on antibiotics for it. Whether it's STI or other bacteria that causes it, doctors tends to put patients with PID on antibiotics that usually help clear up and get rid of the STI that's causing the pain and issue. Since I don't have one though, it's going to flush out whatever bacteria is causing it and hopefully make me better.

Every visit to the hospital had them running a different test, thinking it was something else. The first visit was possible appendicitis, but it wasn't low enough so they were leaning towards ovarian cysts. The second they were leaning towards appendicitis because the pain had gone lower and I basically had all the symptoms for it, but my CT came back completely normal. The third was when they were leaning towards PID, and if it turns out not to be this, they're going to check for endometriosis (something my mom had.) So even though I'm on antibiotics for PID, there's still a chance it isn't that. Nobody seems to know what's going on with me, and that's the scary part.

[ICantThink]

Also, the link you gave is one I had already been to. I'm more so looking to see how often people get PID from other sources than from STIs. But all I've found really is "it's very uncommon" and "rarely does it happen" which doesn't really help. I guess I'm just the unlucky percent if it is PID. But thank you for finding it.

[Heather]

To be clear, PID is always caused by "bad" bacteria (not the kind we need, or at a level that's healthy and beneficial) moving from the external genitals into the reproductive tract. That's most often bacteria from untreated sexually transmitted infections, but it can also occur due to bacteria from other kinds of genital infections (again, particularly when they go untreated) that aren't transmitted sexually, like bacterial vaginosis or yeast infections or other overgrowths of "bad" bacteria genitally. No one has to have or have had an STI for PID to occur, it's just the most common cause.

[Redskies]

By self-care, I meant taking care of your whole and emotional self - though for sure, taking appropriate medications is a part of that. Things like: Self-Care a La Carte I know it's hard waiting for people to figure out what a health issue is and having lots of tests; do hang in there, and be as good as you can to yourself, maybe with some suggestions from the self-care link - what things there do you like the sound of?

I'm really sorry your mom seems to have been making this more about her, and that she pushed in where you weren't comfortable. So you know for the future, you always have the right to say you don't want her in the room, and you can ask any healthcare staff to help you enforce that.

[ICantThink]

Thank you Heather and Redskies for y'all's help. It made me feel better getting a definite answer from someone. All I've been hearing from other people is "It can be caused by other things, BUT it's mostly by STI." So it's like no answer could just be straight forward, yes it could be from something other than that. So I really appreciate both of your help

I read the article you included (the self-care a la carte) and a lot of the things on the list I already do on a regular basis. But there were quite a few I hadn't thought of. Once again, your help has been very great in making me feel better. I think I really need to work on getting over the uncomfortable feeling I still have from the exam more than anything. But I really appreciate all of your help thus far in making me feel a lot better about my situation! Thanks so much!

[Heather]

What do you think might help you with that?

One thing I can think of is to try and resolve some of the hard feelings you're having with your mother with all of this, as it seems like she may have been the biggest player in your discomfort. Can you talk with her about all of this?

[ICantThink]

Talking to my mother is without a doubt, not possible. Everything I say she takes as me being disrespectful and having attitude. I can't talk to her. The few times I've mentioned how I felt about it, she said I was being dramatic and needed to just get over it. It's made it hard to talk to anyone about it without feeling like I'm just blowing things out of proportion and trying to get attention. I'm basically constantly walking on eggshells because nothing I do is good enough to meet her standards of perfection. I have a strained relationship with both my parents, I have a feeling that isn't going to change anytime soon. But I'm almost an adult, so in a few months they won't have much of a say in what happens to me, which makes things easier to deal with.

In terms of talking to someone, I've been talking to my boyfriend but it's hard to really express how I'm feeling to him without things getting awkward. Not because I don't trust him, but I don't know many boyfriends who want to hear their girlfriend talking about how she felt violated. So that's made things kind of difficult in terms of getting everything I'm feeling out there.

[Sam W]

Hi Icantthink,

I'm sorry your mom interacts with you that way. That can make trying to talk about anything, let alone something sensitive or scary, intimidating. Do you have an other friends or family you'd feel comfortable reaching out to for support?

With your boyfriend, what if you tried writing out what you want to say to him first, before you try to say it? That sometimes makes it easier to clarify what exactly you want to say. And, while I know it might not be a fun conversation, he probably wants to know how he can help you.

[ICantThink]

We spent all morning talking, so he knows everything that's going on with me right now. It helped some, but it didn't erase it. The more I hear my mom tell me I'm being dramatic and blowing things out of proportion, the more I start to think maybe I am? So I think it's more of a psychological thing I eventually just need to get over.

In terms of friends or family I could talk to, not really. I'm a really closed off person that doesn't open up much unless it's to a small group of people I really trust. The issue isn't having people I could talk to though, it's not wanting to talk about something so personal with them. Really, the only people I'd feel comfortable opening talking to about this issue is my mom or boyfriend.

[Heather]

Well, if that's how she responded to your feelings I'm not surprised it didn't offer you much. I'm sorry that that's how this went.

By any chance, do you think you'd have any success asking her to just listen to and respect your feelings, rather than making commentary on if she feels they are valid or not? Because getting the good stuff out of conversations like this with her is really going to be as much about how she responds as what you say, and if she can just acknowledge your feelings and keep her feelings ABOUT them to herself, I think that could go a long way.

Clearly, you are comfortable talking about those feelings here, so we can also just dig more into them if you like.

[ICantThink]

My mom doesn't know how to have a conversation without throwing her feelings out there. She's incredibly blunt and even acknowledges that she says a lot of stuff without really thinking about whether she should or not. She told me last night not to come to her again about it, because she was tired of hearing my drama. She's pretty much taken saying anything about it to her off the table, and the only other one in the house is my step dad. Not really a comfortable option.

Honestly, talking to strangers helps more for some reason. Especially to people who know more about it then I do whether from experience or just being older, so I'd appreciate that.

[Redskies]

Just for the record, I think that was very uncool of your mom. Sometimes parents don't understand what we feel or why we've responded the way we have - because they're different people, after all - or they don't have the ability or knowledge to hear or help: but the thing to do then is to acknowledge the feelings and suggest some other resource or person. Simply brushing you off when you're seeking some kind of support is, well, uncool. You're right, too, that she was being dismissive: calling concern about a health issue "drama" is dismissive.

I don't think you're "blowing things out of proportion". You feel the way you feel, and that's alright. In terms of eventually moving on (when it's right for you, not necessarily right this moment ) and finding some kind of peace about this experience, one thing that's actually likely to help with that process is for you to feel able to feel what you feel for a bit without any pressure to be or feel differently.

How can we best support you? Is there anything in particular you'd like to talk about at the moment?

[ICantThink]

Having never dealt with this kind of thing before, I have no idea what I'm supposed to be feeling - if it's normal or not - and while talking to my boyfriend helped, he doesn't fully understand the situation. He knows what happened, but he's never experienced it himself and he wasn't actually there.

It was nice and helped to be able to talk about everything that happened, from start to finish with him. But he isn't someone who really knows the whole process and what should have happened that didn't. I think I just really need someone who's either had a pelvic exam and knows the fear of it or knows more about it than I do to really talk to about everything that happened. I don't like feeling the way I do, and I don't want to keep it to myself because it isn't helping me to get over it.

[Redskies]

I think there is no "supposed to" here, and there is no "normal".

I think it's likely some of this for you is also stemming from the context: having this exam in a higher-stress situation of an investigation for a current medical issue, and undiagnosed pain, no less. That can sometimes really up the fear factor for any medical test, not just pelvic exams. The other aggravating factor I'm seeing in what you described is the lack of appropriate care and compassion from your mother, both during and since. You told us that you didn't want her there and that she got upset with you about it, was there anyway and behaved in a way that interfered with and lengthened the exam: that was indeed a violation of your personal space, so it's perfectly reasonable that you feel violated.

It's fairly common to feel dislike or apprehension about a pelvic exam, but I'd certainly not say it's automatic to feel fear. It sounds as if you went in with some fear about pelvic exams - do you know what in particular seems or seemed scary to you about them, and do you want to talk about those?

It's sounding as if you're asking for some more personal input and perspectives - I'm happy to do that a little with you if so, just wanted to double-check first.

[Sunshine]

I feel so sorry for you that you have to go through all this.

I was in a similar situation a few years ago - got PID even though I was in a monogamous relationship with my first sexual partner who had also never had sex with anybody but me and we had never had sex without a condom. To this day I don't know what bug got me and how it made it's way into my body, but it happened. And I remember the pelvic exam on that occasion being way more painful than usual.

I've had my issues with pelvic exams anyway but have since figured out how to get through them. I'd be happy to share some of that with you in case you have to have another one some day and are interested. Of course there's no guarantee that what helps me will help you, but I thought it couldn't hurt.

Anyway. The situation with your mother sucks. And it's totally understandable that you feel bad about all this. Take good care of yourself, 'kay?

[Heather]

I'm racing through today, but I wonder if it might be helpful to hear from someone who has NOT found sexual healthcare exams traumatic who is also NOT dismissive of your experience.

In case it might, I'm someone who has had them regularly for around 30 years now and with the exception of one healthcare provider not telling me before they did something in an exam that I always need to know is happening so it doesn't trigger assault trauma, they have always been no big for me, even as a survivor of more than one sexual assault, no less.

But at this point, especially working in the field, I can also narrow down why that probably is:
• I grew up spending more time at the hospital where my Mom worked than in our apartment, so all kinds of healthcare, including super-gory stuff was very normalized for me. Same goes with illness or potential illness being something very normal for me rather than something I have big fears about.
• I was never forced to have that kind of healthcare: it was always a choice for me (a necessary one for good health, but a choice all the same).
• I never had someone who wasn't providing that healthcare in the room with me unless I asked them to be and wanted them there.
• I have generally felt very comfortable with my genitals and not shy about them.
• Having someone else or even more than someone else engaged in any way with my genitals is also something that even early on, I had more experience with than most people my age at any time.
• I have had very good luck with healthcare providers, even in public health, and my exams have usually been done in the best ways they can be, with a lot of clear communication and a provider I felt good about.

That's just off the top of my head, but those are also all things we know DO have impact on sexual healthcare for people, and where we know that those factors being radically different tends to result in negative experiences.

I hope you can see is how situational and conditional it is when it comes to how people feel about and experience these exams. Probably, if it's so no big for your Mom, it's because she hasn't been you and had the experience with this you have, she's just perhaps not thinking about you as much as herself (which sounds, sadly, pretty obvious also in the way she is interacting with you: it's one thing to say you have no filter to your kid, it's another not to be working really hard to get better with that and taking responsibility when your lack of skill or ability with that hurts them in any way).

I hope you can also see that your experience wasn't about you reacting in any way that isn't valid, being a baby or a drama queen, or anything like that. You can see in my list up there a few places, if not all those places, where your experience was radically different, so it being negative is pretty much a given.

[ICantThink]

I knew what a pelvic exam was from hearing about it and reading up on it some, so I wasn't completely uneducated on what would happen. But it wasn't a normal exam from what I could tell. I knew I had to do it in order to find out what was wrong with me since they had done every external exam there was (CT, blood work, urine, etc) I knew it was invasive and the female nurse told me it's usually uncomfortable but shouldn't hurt at all.

I've only ever been with my boyfriend, and nobody has seen me naked or anything of the sort other than him. So it felt uncomfortable now having three different people having their faces down there in the span of 30 minutes. I had to do an endovaginal ultrasound, thankfully the tech was female, but it was still incredibly invasive. I cried after that because I had never done that before and really didn't want to, but I needed to. I thought I was done after that.

I was told I could request a female to do the pelvic exam by a really nice male nurse who had done my iv, but when we got in there they told me "that's not possible. You don't get to choose." I had gone from having a female tech, who was somewhat understanding and let me take my time before she started, to a 68 year old male and an inconsiderate nurse.

I didn't get scared because of the exam, I knew somewhat what to expect, the female tech made it easier and I needed to do it to find out what was wrong. I got scared when they became incredibly inconsiderate of my feelings and didn't explain what they were doing. When I say inconsiderate, I don't mean they made jokes that went against my personality or something small. The female nurse that was in there with me kept grabbing my hand assuming I wanted her comfort when I didn't, I didn't know her and if I wanted comfort I would have had my mom there. Every time I dropped her hand, she'd pick it up again and not let go. She forced my knees apart because I guess I'd subconsciously go to close them or would move too much and all the doctor had said would happen was the usual exam. The clamp goes in, they take a swab, done. So when he pulled the clamp out I assumed I was done, but the nurse snapped at me when I tried to sit up and the doctor then said he was going to put his fingers inside me and push on me to find out if I was in pain. I hadn't agreed to that, and no one had told me that was going to happen. I wasn't in the slightly bit okay with it, and that's the part I can't get over. I can't get over having the nurse hold my knees apart while some really old guy slid his hand down my thigh before sticking his fingers inside me without my permission. Yes I had agreed to the exam, but that was because I needed it in order to find out what was wrong. Nobody told me that was going to be part of it. Nobody asked if I was okay at all during the entire thing. Nobody asked if I wanted a female doctor to do it. And after the exam when I was allowed to go back to my room, I curled into a ball and cried.

I still don't want to be touched, especially there by anyone. I usually am a really sarcastic person that makes sex jokes with friends or my boyfriend, but I haven't. I dodge them like it's a virus. My boyfriend and I are doing long distance so we do the sexting either over text or skype dates to try and make things normal as possible, and I've been avoiding that as well. He's understanding and hasn't pushed and even wants me to take my time getting back to feeling like myself again. So I'm trying to whole baby steps thing, instead of jumping right back into how things were. But I'm having a hard time even doing that. I feel dirty almost. Getting turned on feels weird and I don't like it, and if I even think about doing anything sexual my mind goes back to the exam. I wanted to try and make things back to normal last night with my boyfriend but I got scared to even take my own underwear off and started crying because my mind went back to what happened. I just want things to go back to normal and to stop thinking about it.

Sunshine,

The doctors lost my exam results so I might have to go back in soon and do it all over again, which I'm not at all looking forward to. It's nice to know someone else had a weird PID moment. Even if your tips don't help me, I'd be interested in hearing them to at least try. I know when I get older I have to do them every year or so, and I don't want this experience to be what I expect every other one I get to be like. Thank you for your comment though, it made me feel better about the situation in terms of PID.

[ICantThink]

The thing is, my mom and I had to do a required physical before we could move for my step dads job. I have no idea why, but whatever. It was no big deal for me. But they required my mom to get a pelvic exam done, even though she had a hysterectomy several years before, they still wanted her to do one. She threw a huge fit about it and told them she considered it to be rape because it was against her consent and they were putting something inside her she didn't want.

So from her huge reaction to having to do one herself, and her telling me in the past every time she's had one it's hurt or the doctor makes her uncomfortable, I have no idea why she's blowing me off and not even listening to what I'm saying when it came to mine.

[Heather]

I really hope that writing all that out and looking back at it can make as clear to you as it is to us that of COURSE you are feeling the way you are. I'd be surprised if you weren't.

Obviously, the next step is to see if you can't figure out what you need to resolve it. It sounds like one thing you might need is some patience with yourself, and leaving room for it to be okay not to be sexual right now, okay to be upset with your Mom right now, and okay to just feel how you feel. I also want to add that people experiencing trauma with healthcare isn't that unusual, so if you have any way to access any mental healthcare, it's certainly something many counselors can help people through.

[ICantThink]

I've been thinking about going to a counselor since I've gone to one in the past and it helped. The issue with that is I'm still a minor so I can't do it by myself. I'd have to tell my mom about it, and since my parents are divorced she'd have to inform my dad about it as well. Stating why I was going etc. Which I find to be really stupid, but it's court ordered. There's no way around it. Which makes it hard to go to someone to talk to that isn't family or friends. That's one reason I came here, it's a place my mom doesn't know about and where I can talk/get advice on things I'm dealing with.

[Redskies]

In most places, you aren't required to tell a parent/guardian about any mental healthcare you're getting, and nor do you need their permission, no matter if you're a minor. So, this should be something you can seek out yourself, if you want. Do you need any help with how to get started?

[ICantThink]

The way my mom is, she'd find out and then be pissed off about it. We all have a gps thing on our phones so I can't turn it off without her asking questions. I'm already having a tough time dealing with the move and long distance thing, so I could play it off as it being that. She doesn't have to know specifically what I'm going to be talking about, I just need to tell her something so she can inform my father about it. It's really kind of stupid

[Heather]

Are you going to see a healthcare provider about your reproductive health again? If so, one way for you to go about the mental health support would be to ask them for a referral and explain why. Hopefully, next time you have one of these appointments you'll feel able to advocate for yourself and ask for privacy from your mother in the exam room, but in the event you don't, asking for this help with a healthcare provider there will probably mitigate her behaving poorly about you needing that help.

And really, I keep getting the sense that something is just really not okay at home for you. You don't have to say more about that if you want, but it sounds to me like even apart from this recent event, you could probably use a counselor for support and help.

But, of course, if you feel like going around her and telling her this is about something else is the only way for you to get the care and support you need, then it's not like that isn't okay.