Jean M. Bouquet, DO, is an Assistant Professor of Family Medicine and Co-Director of the Urban Underserved Track at the Rocky Vista University College of Osteopathic Medicine. He is the founder of the Bouquet Speculum, an innovative and FDA-cleared medical device that helps to screen women for cervical cancer. Dr. Bouquet also started the Cure Cervical Cancer nonprofit. The following blog post was written by Dr. Bouquet about his journey to creating the Bouquet Speculum.
My name is Jean Bouquet, and I was a family physician in Missouri and Colorado for 28 years. I am now an assistant professor at a medical school in Colorado where I continue to do research with the medical students on the Bouquet Speculum TM in all parts of the world, including Planned Parenthood and the countries of Cameroon, Chad, Uganda, Zambia, Kenya, Pakistan, Jordan, Ecuador, Guatemala and the Dominican Republic.
Fresh out of medical school and training, I was employed in a federally-funded Medicaid clinic in Missouri. Every last Friday of the month, I was assigned to the "Pap Clinic" where I would perform between 30 to 50 Pap tests in an afternoon to screen for cervical cancer and precancers. Although I was well-trained and gaining experience, I was frustrated and worried about the lack of accuracy in screening with the 2-bladed speculum due to poor visualization of the cervix. Additionally, I observed that depending on the woman's body type and parity (number of births), the examination often took longer than expected, requiring removal of the speculum, placement of a condom on the speculum to prevent lateral vaginal wall collapse, and repositioning of the patient if they had a "tilted" uterus. Furthermore, many women complained about the "torture device" in reference to the 2-bladed speculum, and were fearful of having a Pap test due to warnings from friends and family or previous uncomfortable experiences."
About 15 years ago, I was speaking with my sister while developing and researching a better vaginal speculum. She was very concerned because she had been diagnosed with Stage 3 cervical cancer and was facing a complete hysterectomy at age 36, and she wanted more children. I asked her about her last Pap test and she responded that she had been very diligent about her screening and that it had been a year ago. The doctor had missed the cervical cancer in prior years! This is more common than we think, as cervical cancer takes about 5 years to manifest from a normal Pap. My sister was not obese or overweight and had only one vaginal birth. I couldn’t understand how cervical cancer was missed every year for the last 5 years.
I doubled my efforts to produce a speculum that would improve the visualization of the cervix to increase cervical cancer detection and aid in any procedure that required a vaginal speculum. Additionally, I wanted this speculum to be easy to use for everyone and provide less discomfort during the speculum exam. After almost 2,000 years with very little change to the bi-valved vaginal speculum, the Bouquet Speculum TM has arrived! It offers improved visualization and ease-of-use for the provider and less discomfort for the patient.
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.
The Pumani bubbleCPAP was designed to meet this need for Malawi and is now widely available through Maternova. We had a few questions about post-research phases of the Pumani bubbleCPAP which we posed to Jocelyn Brown, inventor of the Pumani bubbleCPAP, and Molly McCabe, Director of Product Management.