Rx for readers: That first visit...

There are many scary myths about going to a gynecologist for the first time.

By JUDY SIEGEL-ITZKOVICH
Gynecologist office (photo credit: MCT)
Gynecologist office
(photo credit: MCT)
I am 16 and would like to go for a first visit to the gynecologist. My family is secular, but with conservative views. Can I go alone, or do I have to go with my mother? I have a boyfriend I really like; can I get contraceptive pills if I need them without having a gynecological exam?   --R.V., Kiryat Bialik
Dr. Ruth Geist, a gynecologist at Tel Aviv’s Lis Maternity Hospital who heads the clinic specializing in girls and teens, replies:
There are many scary myths about going to a gynecologist for the first time. Surveys have shown that the average age for an Israeli girl to go for the first time is around 17. The earlier puberty begins, the earlier the girl’s first visit the gynecologist.
It is best to make an appointment with a specialist in teenagers; beyond her (or his) professional knowledge, she will be more sensitive to your special needs. You can go to the gynecologist by yourself, if you choose. The doctor is required to protect private information. You decide if you want one or both of your parents to know as well.
You can certainly relate to your gynecologist as a person to whom you can tell anything. She is not your judge; she is the source of information and care. All women go to the gynecologist, so don’t be embarrassed. She has seen and heard everything before.
If you come to ask for contraceptives, you don’t have to undergo a gynecological examination. It is your right to ask for advice without such an exam. You also have the right to ask for another person to be present with you in the doctor’s consultation room.
It is recommended that you ask the gynecologist for a full explanation of the way you will be examined, if you choose to do so. It is important for you to learn, even using a mirror, how your intimate organs are built. If you agree to undergo a gynecological examination, the more relaxed you are, the easier it will be.
My husband is 60 and generally healthy, although he has had an autoimmune disease for around 15 years. He does not receive steroids. He suddenly had a fever and a red and swollen thigh. I took him to an urgent medical care facility, where we were told he suffered from cellulitis and had to get antibiotics by infusion. We were told it was caused by bacteria that entered the skin. We had never heard of this before. We knew about cellulosis, which is dimpled skin due to fat and an aesthetic problem. We presume there is no connection. Who can get cellulitis? How long does it take to go away? How can one prevent it? What are the complications if it is not treated rapidly?   --S.T., Haifa
Dr. Adi Sasson, medical director of Herzog (geriatric and psychiatric) Hospital in Jerusalem:
Cellulitis – or as it is known in Hebrew, shoshana – is an acute infection of the skin and/or connective tissues under the skin.
The infection is usually caused by a common type of bacteria such as Staphylococcus aureus, which penetrates the skin layer via an opening that can be caused by trauma, a local cut, rubbing, itching, scratches or surgery. The infection can hurt anyone, but patients with diabetes, vascular disease or edema are at a higher risk of getting infected.
The accepted treatment is antibiotics against the common cause of infection or others. Failing to give treatment can cause sores on the skin and the development of disease in the tissues under the skin, and even lead to sepsis and death. Observing rules of skin hygiene and ensuring that it does not have openings, as well as treating the background diseases, are the best way to prevent the infection.
I am a 25-year-old married woman with two young children. I am now taking a contraceptive pill. But I am so busy at home that I sometimes forget to take it. Does missing one day really matter?   --V.P., Tel Aviv
Dr. Amos Bar, a senior Tel Aviv gynecologist and author, answers:
A recent international study on contraception, called “Choice,” the Israeli part of which polled 200 Israeli gynecologists and 2,000 patients, found that one out of every five Israeli women has had an unplanned pregnancy, and 16 percent have had an abortion. Thus it is important to follow guidelines for use of contraceptive pills.
It is enough to forget to take just one pill to become pregnant. One should take the whole series each month, but the first pill after one’s period and the last taken before menstruating again are the most critical, and many women do not know this.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538- 9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.