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VERIFIED CONTENTConsultation: dr Tadeusz Oleszczuk, gynecologist-obstetrician
The pandemic has made access to many facilities difficult, as can be seen in the statistics on the increase in the incidence of various diseases. Many women are still wondering if she should see a doctor and get tests done. Among other things, we spoke with an expert, Dr. Tadeusz Oleszczuk, about what the visit to the gynecologist looks like now and how to prepare for it, and to what extent teleportation is able to replace a stationary visit.
Patrycja Pupiec: Doctor, some time ago we talked about cancer - you predicted it would be higher due to COVID-19.
Tadeusz Oleszczuk:Unfortunately, it is very bad. Only breast cancer has increased from 18 thousand. patients up to approx. 25 thousand annually. Currently in our country it is a matter of dramatically lower reporting, lack of education, and an increase in risk factors. There is also a tragic situation due to the occurrence of cervical cancer, which in Europe has fallen out of the statistics at all, because women are educated and apply primary prevention, i.e. vaccinate.
In Poland, however, it is almost 4,000 women every year. Maybe this number is not impressive, but when we think that half of them die - then the view changes a bit. Note that there are countries that have virtually eliminated cervical cancer using modern medicine. In Poland, two thousand women die from cervical cancer every year.
Is it that bad?
It is not only the pandemic's fault, but also the lack of education. Schools do not teach that a woman has a vagina, clitoris or cervix. The child from school does not get the information - I have to check myself regularly because I may die. I can get vaccinated and HPV won't make me get cervical cancer. This is what civilized countries do. They educate and apply modern medical achievements. It is cheaper, but also the drama of cancer is avoided. Life expectancy in these countries is increasing. In Poland, it is decreasing.
Girls are not told that once a year you have to have a cytology, breast ultrasound, you should protect yourself against HIV or HPV if you have sex. Vaccination against HPV viruses is effective and none of the vaccinated in the world has developed cervical cancer.
Due to the pandemic, policymakers in the gynecology area recommended canceling all scheduled procedures and outpatient visits, except for emergencies. Many women still believe that I can go to a specialist only when it is a last resort.
To be honest - if someone still thinks so, they will pay for it with their he alth, risk a lot. Others are already paying - currently almost 75 percent. new cancer cases are diagnosed in advanced states. A small lump in your breast will not wait until it's time to see your doctor. After that, these months of delay cannot be made up for.
So if a woman feels something is wrong, she absolutely has to go and check it despite the pandemic.
Yes, absolutely. The more that 80 percent. these changes will not be cancer, but if there is, we will save lives by starting treatment early. The policymakers managing the pandemic scared many people, but most centers still work normally, send out invitations to free mammography - these projects were still ongoing and are ongoing even now.
The nature of the cancer is brutal - you don't get tested, i.e. you skip prophylaxis, then you reap the rewards. This is reflected in the current sad statistics. Failure to diagnose cancer in an early enough state means taking away the chance for effective treatment and 100 percent. cure. There is also little awareness in our country that preventive examinations are essential.
The woman excuses herself with "lack of time", cheats that "maybe it will pass by itself". It may also be fine, but there is always a chance that a woman may be sick and only a proper examination will confirm or rule it out. Without research, there is no diagnosis and treatment.
Have you noticed that in a situation where there was a large increase in infections, patients canceled or missed appointments?
Yes, there were windows - some patients canceled their visits, others did not. There were limitations, but I was working normally and my patients showed up in the office. The women did not know if they could come to the clinic because on TV they said "stay at home", so what to do? Of course, work has changed, because we had to take care of our own safety, but also of our patients.
In those days of limitations there was the possibility of teleportation. It's just that you can't do the test by phone. Now, preventive examinations are performed as usual and you should report. Cytology, breast ultrasound, thyroid gland, mammography or MRI - this is the basis.
Exactly - what does a visit during a pandemic look like today?
First of all, patients cannot have a companion and are thereonly allowed on their visit to avoid crowds. Of course, during a stay at the clinic, everyone must have a mask, has a measured temperature, and can use disinfectants. Before each visit, the office is disinfected. The patient comes at a certain time so that there are not many people waiting in the waiting room.
How has your job changed with the pandemic? Has she arrived?
The first wave has started and there is already waiting for the visit, because it's not like you can sign up right away, but now you have to wait about 3-4 weeks. The graphics are full, but now I also notice that more often than before, individual visits are canceled because the patient has fallen ill and is in quarantine.
Do the patients complain of problems with getting more specialized examinations?
Here are several planes that connect to each other. The system of the entire he alth service in the country is a problem, because the doctor has a certain pool of tests that he can order under the fund. What's more, sometimes you have to go to the referral, because a referral from a private visit is not enforced in NHF facilities. So everyone should take care of themselves to undergo preventive examinations in advance.
Recently I had a case where I referred an insured patient for an MRI from a private office. She had high oncological markers and a suspicious lesion, but no one wanted to refer her to this study under insurance. She was sent from a family doctor to a gynecologist, endocrinologist, surgeon, oncologist. He wastes time despite paying premiums. In the end, she had to pay for the examination herself, but is already receiving treatment.
The patient, instead of being at the beginning of this system, is at its end, he is left to himself. Today, the patient has to take care of himself, supervise his diagnostic and treatment course. Ultimately, I myself pay for my research in a private network of laboratories, for specific blood tests, assessing cancer risk parameters. I privately make onpackage, do I check genetic mutations.
I remember what it was like 30 years ago. The patient came with the problem, so the process began - research, diagnosis, treatment. And now? First you have to go to the family doctor for a referral, then look for a specialist, wait for the appointment … It all lasts, and it shouldn't be. In oncology, it is necessary to assess the risk and perform specific preventive examinations resulting from it.
To what extent can teleportation replace a visit to the gynecologist and can it be at all?
Unfortunately, today I see victims of teleportation more and more often. Yesterday I had a patient whohas been suffering from recurring infections every few weeks for over a year, which means that he will heal one, and in a moment he has another. This woman has already had a few teleports, and through a telephone visit or a chat, it is impossible to examine the patient, see what the problem looks like.
The doctor decided about the treatment based on the history and symptoms that the woman reported. Unfortunately, when she appeared in the office, it turned out that this diagnosis was completely different. Teleporting will never replace physical examination.
Teleporada is a substitute for a visit. It works best when the patient needs a periodic referral, wants to extend the prescription or ask for something else that she does not understand. But most problems cannot be done without testing, and it is impossible to make out of it over the phone or computer, and certainly to see what is "inside". Unfortunately, it is impossible to diagnose or treat effectively using only telepaths.
Which group of patients most often uses this form of contact with a doctor? Are they mostly young patients?
At all ages, mostly they ask for a prescription or a referral. Sometimes they want to ask how to modify the treatment and when to do further tests.
How should a woman prepare for a pandemic visit?
She should definitely not show up much earlier, but come to the agreed time. You may not take an accompanying person with you. He must also have a mask. Of course, if she has symptoms of infection such as temperature, sore throat, etc., she will probably not be allowed to visit as her temperature is still being measured and a he alth questionnaire is completed.
Preliminary infection risk assessment is carried out at the entrance. Just like it is even at airports. The sanitary regime is in force.
I don't think it's easy to be pregnant and give birth during a pandemic, right?
Yes, of course it is a bit different in every hospital, but most of the limitations are the same. A big blow for this group of patients is the lack of or problems with visits, joint visits or the partner's participation in childbirth or pregnancy ultrasound.
Many pregnant women are still afraid of the COVID-19 vaccination because they are concerned about their safety and that of their children. Why should a pregnant woman get vaccinated?
First of all, there is nothing to be afraid of. The legal procedures for approving vaccines have now been completed. I recommend vaccination not only for COVID, but also for any vaccinations that can be done during pregnancy. Thanks to vaccination, both the mother and the fetus are protected. After giving birth, the baby is still therehe has had antibodies from his mother for six months.
There are cases in the world where a pregnant woman fell ill and died after giving birth. The current variants mean that even newborns have to be treated in intensive care for viral infections. There is a pandemic, the next wave is rising - not vaccinating today means a high risk of severe illness and death.
I had pregnant patients who did not want to be vaccinated. It's a choice, but in their case, everything turned out well, but pregnancy is a specific condition - if you have diabetes or allergies or glucose tolerance disorders, your body is much weaker and you are at risk of a severe course.
It is safe to get vaccinated from the second trimester of pregnancy. Education is the key. Vaccination during pregnancy is normal in other countries. Scientific evidence shows that it is good and safe. That's why I encourage you as much as I tell my patients - it's not worth the risk, you just need to get vaccinated for yourself and your baby.
The problem is that unvaccinated people contribute to the increase in viral transmission, but they also have a hard time getting infected and unfortunately have a very high risk that they will require assisted breathing and oxygen therapy. The prognosis is worse.
These are very unpleasant situations when a girl crying came, who had started diagnostics and treatment for three months in order to try to get pregnant. There will be no effort, however. A week ago, her husband, 31, died from a friend whose father was in quarantine. The girl says that after the funeral all his friends went to get vaccinated. She said that maybe he saved someone's life in this way.
gynecologist-obstetrician Tadeusz OleszczukGynecologist-obstetrician with over 30 years of experience. Author of the books "What the gynecologist will not tell you" and "Calm your hormones".
www.tadeuszoleszczuk.pl
fb.com / drtadeusz
Read other articles from the StrefaKobiety series:
- First visit to the gynecologist: what can you expect?
- Ignorance or maybe ignorance? Why do women die of cancer?
- 20 percent couples deal with infertility. Mostly not the fault of the woman
- Last menstruation and menopause. How to prepare for it?
- A woman must be he althy before starting contraception
- How to take care of intimate hygiene to avoid infections?
- Allergies - where do they come from? Allergy to semen and condoms
- Gynecologist banning abortion: Let's not condemn women to suffering at risk of losing he alth and life
- Pain in the intimate areas. Is it normal to feel pain?
- Sexually transmitted diseases. How to take care of your safety?
- Polycystic Ovary Syndrome (PCOS), or when the body and mind suffer
- Breasts. What about their appearance should worry us?
- Are you pregnant and afraid to vaccinate against COVID-19? Expert explains why it is worth doing this
- Why is it so long to be diagnosed with endometriosis?
- Endometrial cancer, i.e. a cancer in which lifestyle is important
- Why are uterine fibroids mostly only monitored?
- Gynecologist: People are afraid to name the basic elements of the reproductive system, let alone know what the physiology of the cycle looks like