HPV

I used to love this time of year.  The kids were actually excited about back to school shopping.  I was excited about back to school exams.  School physicals were really fun.  Other than some apprehension about “shots,” many of the kids looked forward to coming to the office.  In the early years, there was even time to practice a little magic and there was a TCBY on the corner near my office that gave me prescription pads for free frozen yogurt for kids receiving shots.  The trade, one shot for 1 TCBY, went over really well. School physicals were $5 with summer specials coupons.  Hard to believe, isn’t it?

Preventative care was the heart and soul of my practice.  While recent articles have implied that physicals are useless, they are wrong.  Having the time to review diet, exercise, family life, safe sex, immunizations, etc. was invaluable.  Reviewing the kid’s vaccination status and discussing the benefits of Gardisil, an HPV vaccine, was critical.  Today, we need to discuss Gardisil.

HPV is best described by the word, “nasty!”  Its cardinal sign is venereal warts that grow on the genitalia and elsewhere.  It is one of those presents that you never want to receive as, once you have it, it tends to recur on a random basis. To make matters worse, when a young man or woman has it, I have to inform them of a list of rules and information that is truly earth shattering. I also have to worry that my patient will become suicidal and more than once, I’ve had to put kids on suicide watch.

Me – “Johnny, you have venereal warts on your penis and in your pubic area.  They are caused by a virus called HPV. They are contagious.  You will need to let any future sex partner know that you have them.  Condoms will protect others from lesions on your penis but not from those in your pubic area.  Some individuals will clear the virus but you can’t count on that.  As to the ones present today, I can freeze them, and hopefully, they’ll go away.  There are other ways to destroy the warts including coating them with acid and using an immune modulator cream.  (Coating your penis with acid sounds fun, right?) Oh yes, one last thing. Some strains of HPV are associated with cancer.”

Now, do you understand why young patient might contemplate suicide?  Yep, it’s easy to see how that could occur.  What’s not easy to understand is why parents refuse to protect their children against HPV.

Parent – “Is it mandatory?  I’ll think about it and discuss it with my husband.”

Me – “While it’s not mandatory, it is very necessary.”

Parent – “My daughter is only 17.  She’s not sexually active and won’t be.  We raised her right.  She’ll be a virgin when she gets married.”

I wanted to ask the mom if she knew what the definition of a virgin was but didn’t.  Just in case you don’t know, a virgin is the ugliest kid in first grade.  Unfortunately, it’s not LOL time. Kids are becoming active an earlier and earlier ages. Instead, I replied:

“Hopefully, her husband-to-be won’t have HPV.  It would be a cruel joke if she maintained her virginity only to get HPV on her wedding night!”

The TV commercials were tear jerkers, ending in a teenager asking, “Mom, dad, did you know I would get cancer?”  I had three patients with HPV related cancers.  One would have been too many, three was miserable. They were older adults who did not have access to the vaccine.

You can read more about HPV on Mayo Clinic’s site.  Please discuss this article with your children.

Here’s your music for today and a joke.

There is a cucumber, a pickle, and a penis. They are complaining about their lives. The cucumber says, “My life sucks. I’m put in salads, and to top it off, they put ranch on me as well. My life sucks.” The pickle says, “That’s nothing compared to my life. I’m put in vinegar and stored away. Boy my life boring. I hate life.” The penis says, “Why are you guys complaining? My life is so messed up that I feel like shooting myself. They put me in a plastic bag, put me in a cave, and make me do push-ups until I throw up.”

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