Case 1: 24 y/o female presents to clinic for lab review. She had her annual exam and pap smear last week. Very sweet girl, in a long term relationship with her boyfriend of 3 years. On birth control.
Tested positive for gonorrhea.
"I don't understand how that happened..."
Unprotected sex. Case closed.
Case 2: 16 year old female presents to clinic with nausea, vomiting, stomach virus' x 2 weeks. History positive for smoking 1ppd and occasional marijuana use.
Last menstrual period: 2 months ago.
"Do you think you could be pregnant? Did you take a pregnancy test?" I ask.
"I did a few weeks ago and i was positive, but turned negative so I figured I wasn't pregnant."
"Well it is positive today. Congratulations."
She looks at me stunned.
"Do you think you can stop smoking?"
"Yes, I want to do all I can. I don't want to have a miscarriage like last time."
A tear falls from her eyes. I hand her kleenex.
"Is everything okay?"
"Yes it will be, just a little stunned."
"Is the father still in the picture?"
"No we broke up a few weeks ago."
I proceed to counsel her and give her a script for prenatal vitamins and some recommendations for her morning sickness.
Case 3: 55 y/o male presents to clinic with pain during urination. Urinalysis is negative for urinary tract infection.
While getting the basic history, I ask if he is sexually active. He looks down and says, "I lost my wife a few years ago and was not sexually active...until a few weeks ago. I met this girl and we really clicked. I thought we'd be together for a while. We did not plan to have sex but it just happened. Since it wasn't planned, we did not use protection. We are not together anymore. Do you think I may have caught something?"
So we test him for gonorrhea and chlamydia. A few days later he returns for results - he is positive for chlamydia...and treated. "I have learned my lesson" he says. I certainly hope so.
Sex, lies and madness. Sex can be such a beautiful precious thing - but boy can it be dangerous and life altering.
As always, some details are changed to maintain confidentiality.