|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
|
Pace ASCUS review
From: Edward Zabrek, M.D. (stork@flash.net)
Tue, 01 Sep 1998 17:53:33 -0500
- Messages sorted by: [ date ][ thread ][ subject ][ author ]
- Next message: Edward Zabrek, M.D.: "Latest Tech Review-Sony/Etak GPS"
- Previous message: Edward Zabrek, M.D.: "Re: iMAC"
The PACE ™Protectors: Part II in a series of ACOG PACE™ module reviews (Note: The initial review can be found at: http://www.obgyn.net/technology/articles/zab_0813.htm)IF YOU A.S.C.U.S, WE CAN EXPLAIN IT!
I don’t know how your patient’s are, but when ever I get back a diagnosis of “A.S.C.U.S”, and try to explain it too my patients, I get more blank stares than trying to explain to dog that he has got to go the vet for 5 days of boarding. PACE™ has done all of us a tremendous service (not to mention a great favor) in their interactive production of Abnormal Pap test Result:ASCUS.
Now, instead of “trying” to explain what even the inventors of the term have difficulty in doing, I merely tell them to “sit down, and watch this video. I’ll be happy to answer any questions for you once you have finished.” Amazingly, very few of my patients who have seen the video have any questions at all. They also get complete information on abnormal pap smears, and appropriate modes of therapy for their individual situations.
This module has saved both me, my staff, and my patients a lot of time, anxiety, and confusion with this very confusing subject.
Below, you will find the main text of the program that is presented to the patient.
Abnormal Pap Test Result: ASCUS v1.0
PACE Patient Response Sheet
Thank you for viewing "Abnormal Pap Test Result: ASCUS." This is a summary of what you heard and saw when you viewed the program on 8/11/98 at 11:30 AM.
You gave your name as Pap Ascus. You gave your age as 17.
You indicated that you already are aware that the Pap test is not 100 percent accurate.
You indicated that you already are aware that the Pap test has saved thousands of lives as a screening test.
You indicated that you already are aware that the Pap test is valuable even though it is only an indicator of possible problems because it is the best method for finding conditions that lead to cervical cancer.
You were told that your Pap test indicated that you MAY have a problem.
You were reminded about how the Pap test was done and how the results of the test were determined.
You were told that the test results told your doctor about ONLY those cells that were collected during the Pap test.
You were reminded that the Pap test is not completely accurate. It is possible to get false negative results (when abnormal cell changes are reported as normal) or false positive results (when normal cell changes are reported as abnormal). In addition, a positive Pap test may inaccurately report the actual degree of abnormality in the cervical cells.
You were told that your doctor will probably perform additional tests to make sure that your result is not a false positive.
You were told that there are three kinds of abnormal Pap test results: ASCUS (Atypical squamous cells of unknown significance); Dysplasia, sometimes called SIL; and cancer.
You were told that your Pap test revealed atypical cells (ASCUS). The cells look abnormal but it is hard to tell exactly what is wrong with them. Sometimes, ASCUS suggests an infection in the cervix or vagina. Infections are common in women during childbearing years. Once the infection is treated, the Pap test often returns to normal.
The patient needed help in order to continue viewing the program.
You were told that HPV or Human Papilloma Virus can cause this Pap test result. HPV is usually passed on during sexual intercourse and can cause genital warts. Some types of HPV are potentially dangerous because they are linked to cervical cancer.
You were told that abnormal Pap test results can be caused by an infection, but more often than not the reason why a Pap test shows atypical squamous cells is not known.
You were told that abnormal Pap test results might have to be followed up by a more sophisticated diagnostic test or procedure to gather more information. What happens next is dependent on whether this is your first Pap test with this result, or a subsequent one.
You indicated that this is your first abnormal pap test.
You were told that in most cases ASCUS can be treated with medications. This treatment is typically followed by another Pap test in about 3 to 6 months, but you may be asked to repeat the test sooner than that.
You were told that sometimes a doctor will ask that you have another Pap test to make sure the results of the first test were correct; if the second test indicates an abnormality, you will be asked to undergo a diagnostic procedure.
Sometimes you will be asked to have a diagnostic procedure--a special test used to confirm the results of the Pap test--right away.
You were told there are two diagnostic procedures that your doctor can use to determine what your abnormal Pap test means: colposcopy and biopsy. They may be done at the same time or one may done and not the other.
You were told that colposcopy is a procedure often done before a biopsy; colposcopy allows a doctor to look at your cervix using a special magnifying instrument with an attached light. This allows your doctor to detect problems of the cervix that cannot be seen without this magnification.
You indicated that you do not know where your cervix is located.
You asked to see a diagram showing the cervix and other parts of your reproductive system.
You were shown an animation of the colposcopy.
You were told that a colposcopy is usually done in your doctor's office. Sometimes your doctor will send you to a clinic or to another doctor for the procedure.
You were told that colposcopy is a safe procedure; You might have a burning sensation from the vinegar solution, but this should go away soon. You were told to contact your doctor if the burning sensation does not go away.
You were told that if the doctor sees something during colposcopy which requires more investigation, you will be asked to have a cervical biopsy. In this procedure, small pieces of tissue are removed from your cervix. A routine biopsy is usually done in the doctor's office or clinic.
You were told that a routine biopsy doesn't take much time, and causes only minor discomfort such as mild cramping or a pinching sensation.
The patient needed help in order to continue viewing the program.
You were told that there are two types of cervical biopsy. In a punch biopsy, a small piece of tissue is removed from the cervix. In the other, called an endocervical curettage, a small instrument is used to gently scrape tissue from inside the cervix.
You were told that the tissue sample will be sent to a lab for examination by a specialist, and that these results may not be available for several days. You were told that the results of the biopsy will determine what treatment, if any, is appropriate for you.
You were told that it is common to have some bleeding following a biopsy. Sometimes a liquid designed to stop bleeding is applied to the biopsy area. If this is done, you will probably experience a thick dark discharge for a few days.
You were told that if you experience heavy bleeding--for example, bleeding as heavy as a menstrual period--you should call your doctor.
You were told that appropriate treatment for your cervical disorder will depend on the type and severity of your problem.
If the disorder is due to infection, it can usually be treated with antibiotics or other medications.
Minor surgery might be used if the disorder is restricted to the surface of the cervix. Genital warts can be treated this way.
You were told that minor surgery of the cervix is designed to remove the affected tissue and leave a clean surface free of abnormal cells. You were told that minor surgery of this kind does NOT remove the cervix.
You were told that there are a number of ways that abnormal tissue is removed from the surface of the cervix in the affected area.
Cryotherapy uses an instrument to freeze the affected tissue so that it is destroyed. This is commonly done in a doctor's office, takes only a few minutes, and does not require an anesthetic. You may experience mild cramping during the procedure and can expect a heavy watery discharge for about two weeks afterwards.
Loop Electrode Excision Procedure (LEEP) uses a thin wire electrode in the form of a loop. A safe level of electric current is passed through the loop to separate the abnormal area from the unaffected area of the cervix. If the equipment is available, LEEP can usually be done in your doctor's office and takes only a few minutes.
During LEEP, a local anesthetic is usually required. Occasionally, troublesome bleeding occurs which may require stitches. You are likely to have a mild discharge for about two weeks following the procedure.
An advantage of LEEP is that the tissue removed is not destroyed so LEEP can be used for biopsy as well as for minor surgery.
You were told that there are other methods of treatments such as electrosurgery or laser surgery that are sometimes used to treat this condition and remove abnormal areas of the cervix. Ask your doctor about these methods if you would like further information.
You were told that the choice of procedure will depend on the type of abnormality that you have and your doctor's recommendation. You were told that each procedure has some risks as well as some benefits.
You asked to speak with your doctor about the things you learned in this program.
You were told that your doctor has additional information available if you wish.
Thank you for watching this program. Please sign one copy of this printout to be kept with your medical records. You will receive another copy to keep.
This is a true record of what I saw and heard in the program called Abnormal Pap test Result:ASCUS.
ACOG PACE™ Sponsored Dialogue:This program is designed for women whose Pap test indicates atypical cells of unknown significance (ASCUS).The patient is quizzed about her knowledge of the Pap test: Is it 100% accurate? Has it saved thousands of lives? Is it only an indicator of possible problems?The Pap test is identified as a screening test, and false negative and false positive results are discussed. Next, the three main types of abnormal results are listed, and the patient advised that her result indicates ASCUS. The reasons for ASCUS are then discussed, including infections, HPV, and unknown causes.Circumstances which put women at higher risk for ASCUS are described such as history of HPV, HIV, multiple sex partners, and smoking.Two diagnostic procedures are reviewed: colposcopy and biopsy (punch and ECC).Treatment options are highlighted, including repeat Pap tests, medications, cryotherapy and LEEP.The risks of biopsy and minor surgery of the cervix are given.The patient is informed that most women with abnormal Pap tests of this type can be treated successfully.
- Next message: Edward Zabrek, M.D.: "Latest Tech Review-Sony/Etak GPS"
- Previous message: Edward Zabrek, M.D.: "Re: iMAC"
|
Return to |
List Requests to TechTalk-request@obgyn.net Last Updated |