Get to know gynecology

I’m never particularly nervous the night before a gynecology appointment. Sure, it’s on my mind in some capacity but usually nothing more than “Hm. What should I wear?” I’ll spend a few minutes picking out an appropriate outfit—one with few buttons, a wide neck, something easy to take on and off at 10:15 in the morning and still look good once back in the office. This little fashion show tradition adds some levity to my most vulnerable appointment of the year.

For those who’ve never been and for those dying to know, a trip to the gynecologist means stripping down to my socks, getting my breasts fondled, scooching my ass forward just a teensy bit more, butterflying my legs open, and feeling a doctor insert her fingers into my vagina. All this while being reminded to relax. 

I will admit, a part of my sex drive temporarily dies with each visit to the gyno. Our bodies are all uniquely beautiful but for me the yearly tuneup is a fluorescent-lit reminder of my body’s capacity and limit. Whether it’s the parenting magazines in the lobby, the cord blood donation pamphlets, the model uterus next to the sink or the stucco ceiling I stare up at as a little pressure is applied to my cervix, it all makes me feel a bit blah. 

But honestly, after 15+ years going to these appointments, it truly isn’t that bad. What makes it a not-so-thrilling-doctor-appointment is what makes most doctor appointments not so thrilling: naked + vulnerability = not so thrilling. Or in the case of the dentist, not naked rather, uh, wide open? 

But what I didn’t realize about my annual, semi-uncomfortable doctor appointment was the very uncomfortable history baked into it. 

I recently attended an online class through one of my very favorite sites, Allbodies. The class Race, Gender and American Gynecology was taught by Dr. Deirdre Cooper Owens, one of two Black women in the country running a medical humanities program. I didn’t know what a medical humanities program was until reading the description of the University of Nebraska-Lincoln’s program where Dr. Cooper Owens is the Director. The program is described as an “interdisciplinary program designed to support students' learning about the social and cultural contexts of health, illness and medical care.” The site beckons future students to ”Explore health within a larger context.” 

In less than an hour, Dr. Cooper Owens deftly taught and explored the subject of American Gynecology more than any history or sex-ed course ever dared themselves to. I’ve gotten used to knowing that most components of my everyday life and routine are usually credited to some group of white, male inventors and founders. But when Dr. Cooper Owens invited us to see how the white, male ‘founders of gynecology’ really gained their notoriety and certificates and statues, it was a horrifying reality. 

Enslaved, Black women were oftentimes the subjects for these doctors to perfect their procedures like ovariotomies, fistula surgeries, even the very speculum that is inserted into us every visit. Without anesthesia, and worse, without consent, the bodies of these women were considered a business agreement between their owners and the doctors performing on them. And it goes without saying, it wasn’t their bodies that were celebrated or even portrayed in the textbooks, their images often replaced by illustrations of white women. 

Black women like Matilda Stamper, Lucy, Anarcha, Betsey, and countless other unnamed enslaved women were the test subjects for men who would go on to be honored. The unethical decisions made by these torturers were rarely second guessed since the Black woman was not only viewed as property but viewed as immodest, hypersexual and unworthy of having her pain and humility considered.

I thought back to the reasons I dislike going to the gynecologist. The slight discomfort, the time out of my day, the awkward moment when I confess I didn’t give myself a breast self-examination and, no, I’m not on any birth control. My own personal annoyances suddenly seemed surface and small compared to the trauma of the early stages of this practice. 

Unfortunately, when I’m sitting in the doctor’s office I rarely give any thought to my health within a “larger context.” Rarely am I considering the ‘human’ side of medical history outside of my own experience. Through Dr. Deidre Cooper Owens’ class, I understood why lessons surrounding the larger context of health, especially this one, were so important. The structural problems of medical racism today are better understood when we know their past. How is the barbaric work of our ‘fathers’ disguised today and how can I recognize it, question it and call it out?

Why is that statue being removed? Why are racial disparities in gynecologic care prevalent? Why does Manhattan doctor Dr. Kameelah Phillips refer to her speculum as “Lucy”? 

So relax? Not quite yet.

Buy Deidre Cooper Owens’ book Medical Bondage: Race, Gender, and the Origins of American Gynecology
Race, Gender + American Gynecology is offered free through Allbodies.

Meet myLAB Box - Part 2

Welcome back to myREVIEW of myLAB Box! It’s been a few weeks which, no, it didn’t actually take 5 weeks for my results but I did, um, have some issues. Let’s get to it. 

I was sent a myLAB test for HPV. I had just received negative HPV results (Yay!) from my gynecologist but I wanted to see how myLAB did it. As promised, the package arrived discreetly and inside was a darling little box.

I did my own personal unboxing (minus the 1 million+ YouTube views). The contents inside included: packaging to return sample, registration forms, instructions, specimen bag, swab and swab receptacle(?).

First on the instructions was to register the kit. This allows myLAB to notify you once they receive your samples and where you will eventually be notified of your results. Easy, peezy. A quick username and password later, my registration was complete. Time to swab.

The HPV test requires you to insert an enlarged Q-Tip into the vagina and give it a few swabs around the ole gal. Once complete, the sample would go into the receptacle (basically a plastic test tube) and that would be that.

I reread the instructions a few times but was pretty confident about my game plan. I mean, every month I stick tampons up there (Sometimes Super Sized!) so a wil’ ‘waby Q-tip would be a breeze, riiiiiiight? [Note: This is foreshadowing]

I want to warn you that the next paragraph may gross you out.

I stuck the swab inside me and, well, ok, you know how when you push a light switch down, the lights immediately go off? Well, it was like that. But with pee. Yes, I immediately peed myself. I was not expecting the sensation of warm piss dripping down my hand and legs but even more than that, was definitely not expecting the sharp pain that immediately followed. 

When something hurts, I usually try and stop the pain ASAP. But for some reason, pulling out the swab didn’t feel like an option. I was capital Determined to get my sample. But instead of the 360, triple axle, Earth orbiting the moon swab I wanted, I barely made it past the eastern time zone. I slowly pulled the swab out which a) did not feel good and b) didn’t stop the pain. I put the sample in the tube and sat on the toilet wondering what the hell I just did to myself. I was 100% certain the sample was screwed and 200% certain that I just gave myself an instant UTI. Did I just poke…my…urethra?

And that’s exactly what I Googled. I was grateful for the few brave strangers who asked Yahoo Answers the same thing back in 2012. However the strangers who offered ‘advice’ weren’t that helpful, their responses ranging from “How do you even do that?” to “I’m not sure you understand female anatomy.” Cool, cool.

Whether I truly stuck the swab up my urethra, I don’t know. What I do know was that for the next 2 hours it stung like a bitch when I peed every twenty minutes (a much higher rate than my usual every 3-4 hours). Praise Pussy I had some leftover meds and cranberry tablets from a previous UTI scare which seemed to help. I laid on the couch and cursed my never-ending curiosity. I knew I was HPV-free! Why did I even do this?! How did I even do this? The hole is right there! I feared I had sabotaged my body as soon as it got to a good place. I went to bed angry, in pain and fully prepared to piss the bed.

***

The next morning I sat on the toilet ready to burn. Fortunately, there was only a slight ache. I didn’t want to assume everything was back to normal so I popped another cranberry tablet (They’re pretty good once you get past the gross aftertaste).

Through the pain of the night before I had managed to pack up my ruined sample and get it ready to ship. myLAB provides the envelope and paid postage. All you have to do is drop it at the post office or mail box. “Well, here’s something I can’t fuck up.” I thought. I literally live around the block from a post office! This I could do. I brought the envelope (along with a mug of coffee) with me on my morning dog walk. I walked up to the mailbox and…was quickly put in my place. This was not a drop-down opening mailbox. No, my mailbox only had a small opening big enough to fit a stack of letters, not a test tube of cells. I tried to coax it in (that’s what she said) but knew if I pressed any harder, with my luck, it would crack. The post office wasn’t open yet either so, once again, my mission failed. My dog celebrated my failure with a sample of his own, adding a pile of shit for me to pick up and balance. For those keeping track, I was now carrying a bag of shit, a mug of coffee, my envelope with my ruined sample, and a 35lb pound pup.

At this point, I had to get to work. I knew I had some mail boxes by my office. This thing was coming on my commute. MTA meet my DNA.

My sample and I rode the train together in silence. At this point, despite being biologically connected, we were 100% over one another. I got off at my stop and, considering the chain of events, wasn’t too surprised when I discovered police performing random bag checks. I pondered what details I would give them and what they would be spared. They didn’t give a second glance. Point for me?

Didn’t matter. Whatever points I earned were lost when I then absentmindedly brought the sample with me to the office right to my desk. I somehow completely forgot to walk by the multiple mailboxes on my journey. Was brain damage a byproduct of urethra damage? Should I keep it in the fridge with my lunch? What if there’s free pizza in the cafe and I don’t eat my lunch? I’ll definitely forget it! I kept my sample close.

‘Eight hours’ later I made my next and final attempt. “See you in Hell, stupid sample.” I said to no one.

***

In conclusion, myLAB Box is a good product…that is not for me. I cannot (and should not) be trusted with foreign objects. myLAB did end up sending me another test to try, (gonorrhea and chlamydia) and, I will say, collecting a urine sample is indeed much easier:

Despite my own lack of timeliness, the results did come back as quick as myLAB said they would, so there is a level of convenience. But I would still feel more comfortable leaving the logistics to someone else. It’s why I don’t buy clothes online: If a bathing suit didn’t fit, I would never return it. I kept forgetting to leave the apartment with my urine sample and again had trouble finding a big enough mailbox. Your samples should be put in the mail within a few days and I found myself cutting it close.

I love any product that promotes safe sex and taking control of one’s body. I’m happy to live in a world where myLAB exists. But for now, I think I’ll continue to do my time at the doctors and clinics I’m fortunate to have in my neighborhood. And hey, for those who have their hand/eye coordination and USPS skills mastered, do it up!

Meet myLAB Box - Part 1

Despite my commitment to never going back to school, I have recently been taking a lot of tests. However, these tests don’t involve cramming the night before. Okay, well, I guess technically cramming is involved but it’s a very different kind of cramming, and honestly, if you’re cramming things in the bedroom, you might want to take a step back and reevaluate the situation. 

Needless to say, the tests I’ve been taking are of the STD variety. You may have read my review of the Crown Heights Sexual Health Clinic a few months back but recently I learned of a new way to keep yourself safe and tested: myLAB Box. 

According to the company, myLAB Box is a first-of-its-kind service that delivers STD screening solutions to your doorstep allowing you to keep private things private. While I’ve done a fair share of things to my pussy, I’ve never tested it for things beyond the scope of UTIs and babies, both which involve the easy (yet messy!) task of peeing on a thing. What would I have to do to test other things? And what other things could be tested myself? 

Well, if you use myLAB Box, a lot! The at-home tests included on the site include chlamydia, gonorrhea, HIV, genital herpes, hepatitis B, syphilis, hepatitis C, and everyone’s favorite, HPV. Some are combined into combination boxes like the V-Box which includes tests for all things vagina: yeast infections, bacterial vaginosis, trichomoniasis, chlamydia and gonorrhea. Or the Boomer Box which tests for common STDs and hepatitis C. According to the site, hepatitis C has a 40% prevalence in the “Baby Boomers”(born from 1945-1965). Plus, there are boxes specific to fertility and hemoglobin levels or gluten sensitivity. 

So who’s behind the box? 

Lora Ivanova, the CEO of myLAB, used to work at an e-commerce retailer, second-largest to Amazon in global sales. Not exactly ‘sexy’ but she says “I had worked passionately to help provide positive shopping experiences for millions and with myLAB Box, I saw an opportunity to do this in a sector that truly made an impact - healthcare. I wondered, why was it that in the age of convenience which affected everything from consumer goods to dating was healthcare failing to adapt?”

Lora’s upbringing in Europe, focused on regular checkups, self-care, and wellness education, had her questioning how “with less than 15 days between vacation and sick time a year, when are Americans supposed to find the time for an exam?” As someone who’s wondered about ‘something weird going on down there’, I agree that the added time and cost making and waiting for an appointment to get it checked could certainly add to the stress. 

I am fortunate to live in a city with doctor options out the ass; Urgent Cares, Planned Parenthoods, etc., an appointment is usually just a quick train ride away. myLAB Box is not meant to replace those. Ivanova says, “We consider free clinics a vital part of our care ecosystem but they remain limited by geography and funding, which as we know has been an acute challenge to scaling their reach.” We’ve seen the news: Planned Parenthood taking cuts, medical services becoming harder in certain states. “We need an alternative that can reach every household regardless of income, gender, age or location.” says Ivanova.

So what does a myLAB Box cost? 

Well, each box is priced differently, but on the site, myLAB provides an at-a-glance view of how the boxes compare to the services of other providers.

By selling direct to consumers, myLAB box says they can offer exceptional service at half the cost of conventional lab tests. Not to mention, the extra benefit of reducing the fear and stigma some face when getting tested, could be considered priceless. If you do test positive for anything, myLAB offers access to free telemedicine consultations, claiming to work with some of the best experts in the United States. This also includes the added convenience of prescriptions. “It's that simple.” says Ivanova.

 Would myLAB Box be the simple solution for my own box? I was about to find out...

Getting tested at the Crown Heights Sexual Health Clinic

When it comes time to be a responsible, sexually active person, the feels and fun of sex seem to come to a screeching halt at the idea of getting tested. The phrase ‘getting tested’ is not sexy. Nobody likes a test. Test is pass or fail. Test is ‘Fuck. Did I study enough?’

It’s why I feel so lucky to live a barely 8-minute walk away from the Crown Heights Sexual Health Clinic. New York City offers 8 clinic locations throughout the boroughs where you ‘can get low- to no-cost services for sexually transmitted infections (STIs), including HIV’. I’ve visited this location only twice, but each time has been a stress-free and, yeah I’ll say it, enjoyable experience.

I’m sure no two visits are alike, but I hope that by getting an inside look into mine, those of you nervous about getting tested will feel empowered to make the healthy decisions towards your sex life that you and your partners deserve.

---

As with anything in New York (and anything that is free), it is important to arrive early, arrive patient and arrive with the mantra of ‘This may be awhile.’

The Crown Heights Sexual Health Clinic opens at 8:30 and they won’t open their doors a minute earlier. A line will start to form outside as only the doctors and nurses arriving for the start of their day are allowed in. It was snowing on the morning I chose to go which was probably to my benefit, because when I arrived at 8:20, there was only one other woman outside ahead of me. I felt like a winner already.

The guards opened the doors promptly at 8:30 for the now 4 of us. There’s a slight pressure to run up the stairs to the 2nd floor where the clinic is located, but no need. People respect the order of the line.

When you enter, there will be numbered forms sitting on a table and clipboards if you wish to feel fancy. Yes, I equate clipboards with fancy. Being 2nd in line, my form was #2 and before sitting down I remembered to stamp them in the non-ironic Time Date Stamp Machine. Yes, they still exist and the city of NYC has found a way to use them. Don’t be scared. Shove it in and take a seat.

The waiting area feels more like a freshman year homeroom than a health clinic. Instead of ‘Hang in There’ or ‘Rules of the Classroom’, colorful PrEP posters and ‘No insurance, no problem’ reminders decorate the walls. On the window ledge lives an assortment of pamphlets, condoms (male and female) and l believe even lube. My first time at the clinic I watched as a patient rushed to the ledge and began stocking up. I respected his love of free shit.

The completion of your paperwork depends on what brings you in. A variety of questions are asked: Did you receive a letter or call asking to come in? Have you been sexually assaulted? Have you taken drugs? Been with someone who’s taken drugs? Would you harm yourself if you tested positive for HIV? Date of your last period? Are you showing any symptoms? Since I was there only for STI and HIV testing, I answered N/A for most.

You won’t be tested right away but once things get moving, it’s a steady progression. The people are there to work. I think about the start of my own work day: mosey into the office, flirt with a colleague here, flirt with a colleague there, get my coffee, take a selfie in the bathroom and then finally open my computer twenty-five minutes later. These people don’t have that luxury and at 8:38, number 1 was called. Some music started playing lightly in the background, Aretha Franklin’s ‘I Say a Little Prayer’ to be exact. Perhaps too appropriate a song to be playing but either way, it worked. At 8:43, when there was now 6 of us in the waiting room, 2, aka me, was called.

In the first room, a nurse looks over your completed paperwork and double checks everything is completed accurately. She asked me again what brought me into the clinic, when was the last time I had sex and wanted to make sure that I was able to wait the 30 minutes for HIV results. It’s ok if you can’t, they just recommend that you do. She sent me back to the waiting room to wait for my number to be called again.

At 8:53, my number was called again. This time I was led to a different room and I realized this room held the provider of music.

“Ah, so you’re where the music is coming from?’ I said.
“Yeah.” she laughed turning it down.
“Oh I don’t mind.” I reassured.
“Yeah, it’s too low.” she said and turned it up a few notches. Lionel Richie’s ‘Easy like Sunday morning’ played. The Crown Heights Sexual Health Clinic soundtrack was entirely too good.

This nurse had the job of confirming how I would get my results once available. She provided a unique ID and set up a pin for me to use online or on the phone. She gave me a form to complete if I decided to use insurance but never once asked for payment, an insurance card or my job status. She also had the very important job of showing me how to correctly collect my urine sample.

Don’t you just piss in a cup, Carolyn? No! It is so much more than that! Yes, the process starts by first peeing in a regular, plastic cup. But then you are given the great responsibility of transferring pee from that cup to a test tube of sorts. But be careful! Your pee cannot be under this line or over this line. It has to be right in between!! It’s Price is Right’s Range Game but with pee! Your prize? Sweet, accurate results, baby.

At 9AM I was in the bathroom trying to play the Pee Game, except, I couldn’t pee. ::cue Price is Right loser horn:: I knew soon 3 and 4 would most likely be needing to collect their own samples, so instead of hogging the room, I left and stood outside chugging water. I was glad I did because it was then the counselor made his way to the waiting room for a welcome greeting.

This man, whom I’ll refer to as Sam, looked equal parts English teacher, basketball coach and winning poet. I imagined him at night sipping red wine on a seedy underground stage spitting words of beauty. His welcome was no boring, ‘Welcome to the Crown Heights Sexual Health Clinic, take a number’  greeting. It was the real deal. It was improvisational, it was informative, it was entertaining, it was a part of him. He was the speech. The speech was him.

“Don’t have insurance? Don’t worry. We don’t rock and roll here at the Crown Heights clinic. We’re Beverly Hills. You’re safe.” Did I know what this meant entirely? No. But did I 100% stand behind it? Of course.

Sam kept us updated when it was discovered they’d be down a doctor due to inclement weather. He assured us that this wouldn’t disrupt the day for any of us. “You’re all here for different things but I want you to be able to make an informed decision! I’m from the 60s and 70s. I’d be the one sitting on the train, no one telling me to get off.” ::snaps:: Yes Sam, yes.

The laughs from Sam gave me the extra push I needed to pee where I laughed again when I saw myself in the mirror. There I was bent over the sink, holding a now yellow tube, carefully squeezing until the perfect amount of urine trickled into a test tube. I looked like I was posing for a ‘science class’ stock photo.

At 9:15 I was called in for my bloodwork. I don’t faint or vomit during blood work but I do get a little goofy, talkative and silly. “Well did you eat?” she asked. I didn’t. She playfully scolded me and I apologized. A good reminder that there are no snacks at the clinic.

Her directions were simple: “Make a fist and don’t faint.” She complimented my easily visible, blue veins. What can I say? Phlebotomists love me! She checked in throughout the whole extremely quick process of drawing my blood, which I appreciated, however, it was the finger prick which got me feeling goofy. I felt my wooziness kicking in just as she finally got her sample. Phew. She sent me back to my seat to wait for the HIV results.

At 9:40, dear Sam called my number and invited me to his office, chatting with everyone along the way. “Have a seat.” he said. “Nothing to worry about, your HIV test came back negative and the rest of your results will be available in 7-10 business days but let’s be honest it will be 7. It’s 2019. We just have to say that.” I thanked Sam and told him he needed a raise. I left the office at 9:42, where they were calling number 11.

From arrival to finish, an hour and twenty minute experience. I’ve spent more time than that in line for Van Leeuwen ice cream. A major round of applause for all the employees. I left feeling good, grateful and Google review ready. This place deserved all the stars.

I encourage everyone to get tested however and wherever you feel comfortable. If you’re nervous to go alone, ask a friend, heck, ask three friends. Celebrate your responsibility with coffee and scones after. This process (and your results) should be a topic of conversation that I hope becomes easier and easier to discuss. Because, like Sam said, you’re safe in Brooklyn and I’d like to keep it that way.