When do I need to start getting STI checks and/or pap smears?
December 21, 2010 12:34 PM Subscribe
I've become "sexually active" at a rather late age. When do I need to start getting STI checks and/or pap smears?
I'm a 21-year-old woman. I thought I was asexual for years so to be honest I've never paid much attention to the sexual health kind of stuff and never been to a gyno. Nuns don't get STIs, right?
But, I've been trying to discover my sexuality as of late I've had sex twice with two men, once this summer and once last month. Condoms were used both times and I don't have any STI symptoms so I didn't think much of it, but I told a friend who insisted that I go get tested. Do I need to get tested if I don't have any particular risk factors? And what about pap smears? I was a few years too old to get the HPV vaccine so I presume I need to do that as well.
And, where do I go to do these things? Do I have to pay? I live in a relatively major city in Canada. I am a citizen with a care card but I don't have a student or work health plan.
I apologise for my cluelessness but the Internet is giving me mixed messages and I'd just like someone to lay it out clearly for me. I never imagined I'd ever have sex so it's a whole new mess to worry about.
I'm a 21-year-old woman. I thought I was asexual for years so to be honest I've never paid much attention to the sexual health kind of stuff and never been to a gyno. Nuns don't get STIs, right?
But, I've been trying to discover my sexuality as of late I've had sex twice with two men, once this summer and once last month. Condoms were used both times and I don't have any STI symptoms so I didn't think much of it, but I told a friend who insisted that I go get tested. Do I need to get tested if I don't have any particular risk factors? And what about pap smears? I was a few years too old to get the HPV vaccine so I presume I need to do that as well.
And, where do I go to do these things? Do I have to pay? I live in a relatively major city in Canada. I am a citizen with a care card but I don't have a student or work health plan.
I apologise for my cluelessness but the Internet is giving me mixed messages and I'd just like someone to lay it out clearly for me. I never imagined I'd ever have sex so it's a whole new mess to worry about.
I'd get tested after each new partner. Besides the health benefits, you can know where you got the disease, which can prevent unnecessary phone calls to previous partners. For example, if you were to have sex with two partners and then find out you have crabs, it would be unclear whether the first gave it to you and you needed to contact the second, or if the second gave it to you. It also lets you honestly tell new partners that you don't have any STIs and demand the same from him.
posted by null terminated at 12:43 PM on December 21, 2010 [1 favorite]
posted by null terminated at 12:43 PM on December 21, 2010 [1 favorite]
Any major Canadian city worth it's salt will have some variety of free sexual health clinic. These places are a great place to call and talk with someone confidentially and get some practical advice. These places also generally do free and anonymous STI checks if you think you need one.
Since you mentioned care card, I'm going to go out on a limb and guess that you're in BC? If thats the case then this website has a function to find the nearest clinic, and also has a lot of good advice in it's own right.
posted by sarastro at 12:45 PM on December 21, 2010
Since you mentioned care card, I'm going to go out on a limb and guess that you're in BC? If thats the case then this website has a function to find the nearest clinic, and also has a lot of good advice in it's own right.
posted by sarastro at 12:45 PM on December 21, 2010
Uh, I don't think that 21 is a "rather late age" to become sexually active, but that's just my opinion.
In the US, I think an annual gyno check-up is standard fair that includes a pap smear. I second the "get tested after each new partner" because the STIs *are* out there.
posted by jillithd at 12:54 PM on December 21, 2010 [8 favorites]
In the US, I think an annual gyno check-up is standard fair that includes a pap smear. I second the "get tested after each new partner" because the STIs *are* out there.
posted by jillithd at 12:54 PM on December 21, 2010 [8 favorites]
My doctor just told me that the new rec's are for healthy women, you only need a pap smear every 3 years as long as you're healthy, but you can insist on one yearly and the insurance will still pay for it.
STD/STI checks after each partner, that way you're fully informed.
Have fun!
posted by Medieval Maven at 12:58 PM on December 21, 2010
STD/STI checks after each partner, that way you're fully informed.
Have fun!
posted by Medieval Maven at 12:58 PM on December 21, 2010
I had a pap even though I'd never had sex; they were annoyed and said I should have started at 21 at the latest.
Nthing testing after every partner.
posted by SMPA at 1:05 PM on December 21, 2010
Nthing testing after every partner.
posted by SMPA at 1:05 PM on December 21, 2010
Remember that in addition to the standard STI panel, it's a good idea to get a blood test for herpes before/after each new partner. Both HSV-1 and HSV-2 (the two types of the herpes simplex virus) can infect mouth and genitals (HSV-1 prefers mouth, HSV-2 prefers genitals), both forms of the virus can be spread even if you're using condoms, and many people show no signs of infection/don't know that they are infected.
posted by kataclysm at 1:07 PM on December 21, 2010 [4 favorites]
posted by kataclysm at 1:07 PM on December 21, 2010 [4 favorites]
I don't know anything about the Canadian health system, but in the US they recommend a pap smear annually for sexually active women under the age of 30. Though maybe the guidelines were changed recently? Not sure. Personally, I'd probably get tested between partners, and absolutely before having unprotected sex with a partner.
Go see a doctor and ask what he or she recommends. You are asking the right questions!
posted by teragram at 1:08 PM on December 21, 2010
Go see a doctor and ask what he or she recommends. You are asking the right questions!
posted by teragram at 1:08 PM on December 21, 2010
I'm pretty sure the age guideline for HPV vaccines (at least in the US) was originally 26, so you have never been too old for it. I would recommend getting the vaccine (IANAD, just another lady in your age range). You might as well get tested at your annual, especially for things like HSV. You should absolutely be getting pap smears.
posted by elpea at 1:18 PM on December 21, 2010 [4 favorites]
posted by elpea at 1:18 PM on December 21, 2010 [4 favorites]
nuns don't get STIs, but they do get cervical cancer and endometriosis. You need to be going to the gyn whether or not you're having sex. I'm a boring married lady, and for me the guidelines have changed to every 3 years.
posted by KathrynT at 1:19 PM on December 21, 2010 [9 favorites]
posted by KathrynT at 1:19 PM on December 21, 2010 [9 favorites]
Yes, paps routinely whether you're having sex or not! Cervical cancer is more common in sexually active women, but not exclusive to them. Many doctors like women to start with annual pelvic exams, and with pap smears, at age 18, even if they don't intend on being sexually active for years.
Generally testing before each new partner (ideally both of you getting tested and trading results, like in an after school special!), or, as someone said above, at the conclusion of that relationship. I am an old married lady with basically zero risk factors, and they do a full STI panel every time I get pregnant because it's just REALLY IMPORTANT (especially if it can affect the baby!) and you can never be completely positive.
In the US, you could do both your annual (or annual-ish) pelvic exam (including pap) and STI testing as needed at your primary care physician, at an ob/gyn, or at a place like Planned Parenthood. If you have a doctor you already have a relationship with, you could certainly ask your doctor for his or her opinion on how you might best proceed. (STI testing, in the US, is often cheaper and faster at a sexual health clinic than through your doctor, but again, you guys pay for health care so differently than we do.)
(And I don't think 21 is late either.)
posted by Eyebrows McGee at 1:33 PM on December 21, 2010
Generally testing before each new partner (ideally both of you getting tested and trading results, like in an after school special!), or, as someone said above, at the conclusion of that relationship. I am an old married lady with basically zero risk factors, and they do a full STI panel every time I get pregnant because it's just REALLY IMPORTANT (especially if it can affect the baby!) and you can never be completely positive.
In the US, you could do both your annual (or annual-ish) pelvic exam (including pap) and STI testing as needed at your primary care physician, at an ob/gyn, or at a place like Planned Parenthood. If you have a doctor you already have a relationship with, you could certainly ask your doctor for his or her opinion on how you might best proceed. (STI testing, in the US, is often cheaper and faster at a sexual health clinic than through your doctor, but again, you guys pay for health care so differently than we do.)
(And I don't think 21 is late either.)
posted by Eyebrows McGee at 1:33 PM on December 21, 2010
I've always been told you should get checked out before you become sexually active.
You only need a pap smear every three years after you've had a one come back normal, but that's not the only thing the doctor does when you go in for your annual physical. The Doc will check your ovaries, your breasts, and your general well being.
I always make my appointment for near my birthday. Kind of like a present to myself. Make the appointment and go in. It's not a big deal but it is something you need to do.
posted by TooFewShoes at 1:33 PM on December 21, 2010
You only need a pap smear every three years after you've had a one come back normal, but that's not the only thing the doctor does when you go in for your annual physical. The Doc will check your ovaries, your breasts, and your general well being.
I always make my appointment for near my birthday. Kind of like a present to myself. Make the appointment and go in. It's not a big deal but it is something you need to do.
posted by TooFewShoes at 1:33 PM on December 21, 2010
Pro-Tip: In the future, consider having everyone get tested before you engage in sexual activity. What it takes from spontaneity it returns in peace of mind. Talk to your doctor about sexual activity and which precautions they counsel against STD and unplanned pregnancy. Consider an FWB arrangement with someone desirable to minimize your risk (and hopefully maximize your fun).
Finally, stop telling yourself you're at a "late" age for this; it sounds to me like this is the perfect time for you.
posted by Hylas at 1:37 PM on December 21, 2010
Finally, stop telling yourself you're at a "late" age for this; it sounds to me like this is the perfect time for you.
posted by Hylas at 1:37 PM on December 21, 2010
I started getting paps at 14 (before my first sexual encounter) as part of my annual physical. It's still a good idea to get them, but you may not need them as frequently. My physician noted that the (provincially set) guidelines are now every 3 years if you're not sexually active or in a monogamous relationship, but she was personally still recommending annually for them.
Of course you don't pay - this is basic primary care! You should, however, start looking for a primary care physician and get annual complete physicals - I'm guessing you don't have a primary care physican (also known as a family doctor sometimes) because this person will do your pap along with all other basic check-ups: probably schedule bloodwork for you to get a baseline reading on your cholesterol, gluecose, etc; they do a breast exam, check blood pressure, etc, etc.
I don't know what province you're in because you're anon, but often the website for the professional association will give you a list of physicians that are accepting new patients in your area: Alberta Example. Then it's just a matter of trying them until you find one you're OK with.
posted by Kurichina at 1:40 PM on December 21, 2010
Of course you don't pay - this is basic primary care! You should, however, start looking for a primary care physician and get annual complete physicals - I'm guessing you don't have a primary care physican (also known as a family doctor sometimes) because this person will do your pap along with all other basic check-ups: probably schedule bloodwork for you to get a baseline reading on your cholesterol, gluecose, etc; they do a breast exam, check blood pressure, etc, etc.
I don't know what province you're in because you're anon, but often the website for the professional association will give you a list of physicians that are accepting new patients in your area: Alberta Example. Then it's just a matter of trying them until you find one you're OK with.
posted by Kurichina at 1:40 PM on December 21, 2010
Yes to a PAP and yes to the HPV vaccine. I had a cancer scare do to HPV and the peace of mind you will get is totally worth the price if it's not free. Take care of your vagina, it's precious. Think of it like taking your car into the shop. Things can need a tune up, even if the car/vagina has been sitting idle for a long time.
Also, 21 isn't a late age. I wasn't really interested in sex in my teens, either. I also had the HPV vaccine in my 30's. If you want it, your doctor won't stop you. I had to pay for it out of pocket and it cost me about $200 in the end.
posted by Foam Pants at 1:48 PM on December 21, 2010
Also, 21 isn't a late age. I wasn't really interested in sex in my teens, either. I also had the HPV vaccine in my 30's. If you want it, your doctor won't stop you. I had to pay for it out of pocket and it cost me about $200 in the end.
posted by Foam Pants at 1:48 PM on December 21, 2010
Get the HPV vaccine, and go see your obgyn once per year for STD tests and pap & pelvic. Some doctors are now suggesting doing a pap only once every 2-3 years, but it's good to get into the habit of just going in annually for the STD tests and birth control conversations and such anyway.
posted by Eshkol at 3:54 PM on December 21, 2010
posted by Eshkol at 3:54 PM on December 21, 2010
You will likely have to pay out of pocket for the HPV vaccine, but if you go through PP you may be able to pay less than going through your doctor. Keep in mind that things like vaccine prices/whether you have to pay vary from province to province.
As for getting a blood test for HSV 1 and 2 after every partner, that's probably overkill. The majority of people have been infected with HSV 1 (generally known as oral herpes, but you can contract it genitally as well) by adulthood and a walloping 25 percentage of adults will have HSV 2 (AKA genital herpes). This reported percentage is likely lower than the real percentage (some put it closer to 50%) since many people will never exhibit symptoms. The HSV blood test will not tell you the location of your infection either, and it really becomes a moot point when oral sex comes into play.
If you use protection every time you have sex, you should be able to get away with getting tested every 6-12 months for STIs (unless you have symptoms, lots of partners, broken condom, etc.) You should be tested after every unprotected encounter. This includes the HIV test which should be repeated six months after an unprotected sexual encounter. Do not assume that if you are having blood tests as part of your STI testing that HIV testing is taking place. You must request and/or give consent to be tested for HIV.
Have fun, be safe, keep informed. Do not assume that a partner has been tested simply because they do not tell you otherwise. Take responsibility for your own sexual health and ask your partners if they have had STI and HIV testing. Do not assume that if they say yes it is safe to have unprotected sex.
posted by Felicity Rilke at 4:05 PM on December 21, 2010
As for getting a blood test for HSV 1 and 2 after every partner, that's probably overkill. The majority of people have been infected with HSV 1 (generally known as oral herpes, but you can contract it genitally as well) by adulthood and a walloping 25 percentage of adults will have HSV 2 (AKA genital herpes). This reported percentage is likely lower than the real percentage (some put it closer to 50%) since many people will never exhibit symptoms. The HSV blood test will not tell you the location of your infection either, and it really becomes a moot point when oral sex comes into play.
If you use protection every time you have sex, you should be able to get away with getting tested every 6-12 months for STIs (unless you have symptoms, lots of partners, broken condom, etc.) You should be tested after every unprotected encounter. This includes the HIV test which should be repeated six months after an unprotected sexual encounter. Do not assume that if you are having blood tests as part of your STI testing that HIV testing is taking place. You must request and/or give consent to be tested for HIV.
Have fun, be safe, keep informed. Do not assume that a partner has been tested simply because they do not tell you otherwise. Take responsibility for your own sexual health and ask your partners if they have had STI and HIV testing. Do not assume that if they say yes it is safe to have unprotected sex.
posted by Felicity Rilke at 4:05 PM on December 21, 2010
I've become "sexually active" at a rather late age. When do I need to start getting STI checks and/or pap smears?
Now.
I started getting annual exams at the OB/GYN when I became sexually active. As far as I know, that's the typical rule of thumb. When you go for your annual, be sure to ask about STI testing. The pap smear is par for the course (this will screen you for HPV). Usually when people ask for "STI tests" they mainly mean HIV, though you should ask for Chlamydia and Gonorrhea as well.
Agree with others that you really only need to get new STI tests at visits where you've had new partners since your last visit. However, I know quite a few women who caught an STI from a regular partner who'd picked something up while cheating. So an annual test wouldn't be a bad idea even if you're in a long term relationship.
posted by Sara C. at 4:58 PM on December 21, 2010
Now.
I started getting annual exams at the OB/GYN when I became sexually active. As far as I know, that's the typical rule of thumb. When you go for your annual, be sure to ask about STI testing. The pap smear is par for the course (this will screen you for HPV). Usually when people ask for "STI tests" they mainly mean HIV, though you should ask for Chlamydia and Gonorrhea as well.
Agree with others that you really only need to get new STI tests at visits where you've had new partners since your last visit. However, I know quite a few women who caught an STI from a regular partner who'd picked something up while cheating. So an annual test wouldn't be a bad idea even if you're in a long term relationship.
posted by Sara C. at 4:58 PM on December 21, 2010
And it's not too late for the HPV vaccine - I believe you can get it before you are 26.
posted by KateHasQuestions at 6:19 PM on December 21, 2010
posted by KateHasQuestions at 6:19 PM on December 21, 2010
Ugh to all the misinformation in this thread!
Yes, paps routinely whether you're having sex or not! Cervical cancer is more common in sexually active women, but not exclusive to them..
Eyebrows, this is just plain wrong. Cervical cancer is virtually always caused by sexually-transmitted strains of HPV. That makes it exclusive to people who have been sexually active at some point.
Many doctors like women to start with annual pelvic exams, and with pap smears, at age 18, even if they don't intend on being sexually active for years.
Maybe, but those doctors are not practicing evidence-based medicine (and are, in my opinion, bad doctors). It's more likely that they were following outdated guidelines and/or they believe their patients are lying to them about being sexually active. The current US recommendations are to start pap testing at age 21 or three years after first vaginal intercourse. I would actually suggest you wait a couple of years for a pap test since the first time you had sex was last summer. It's necessary to wait because it's too soon for you to get a meaningful result. Cervical abnormalities from HPV take many, many years to progress into cancer if they're going to (usually they don't), so if you test too soon, it doesn't work.
posted by Violet Hour at 10:32 PM on December 21, 2010 [1 favorite]
Yes, paps routinely whether you're having sex or not! Cervical cancer is more common in sexually active women, but not exclusive to them..
Eyebrows, this is just plain wrong. Cervical cancer is virtually always caused by sexually-transmitted strains of HPV. That makes it exclusive to people who have been sexually active at some point.
Many doctors like women to start with annual pelvic exams, and with pap smears, at age 18, even if they don't intend on being sexually active for years.
Maybe, but those doctors are not practicing evidence-based medicine (and are, in my opinion, bad doctors). It's more likely that they were following outdated guidelines and/or they believe their patients are lying to them about being sexually active. The current US recommendations are to start pap testing at age 21 or three years after first vaginal intercourse. I would actually suggest you wait a couple of years for a pap test since the first time you had sex was last summer. It's necessary to wait because it's too soon for you to get a meaningful result. Cervical abnormalities from HPV take many, many years to progress into cancer if they're going to (usually they don't), so if you test too soon, it doesn't work.
posted by Violet Hour at 10:32 PM on December 21, 2010 [1 favorite]
(Also, women in Canada don't see gynecologists for routine care. Pap tests are done by GPs. A healthy Canadian woman might go her whole life without seeing a gynecologist, or maybe only use an OB for pregnancy. I say this because if the OP thinks she has to have a GYN, it is a specialist visit and will take forever on the Canadian healthcare system.)
posted by Violet Hour at 10:38 PM on December 21, 2010 [1 favorite]
posted by Violet Hour at 10:38 PM on December 21, 2010 [1 favorite]
Cervical abnormalities from HPV take many, many years to progress into cancer if they're going to (usually they don't), so if you test too soon, it doesn't work.
A pap test can show cervical abnormalities long before they progress to the point of cancer. Catching cervical abnormalities very early on is a good thing, not an excessive/"bad doctor" thing.
posted by Sara C. at 4:13 PM on December 22, 2010
A pap test can show cervical abnormalities long before they progress to the point of cancer. Catching cervical abnormalities very early on is a good thing, not an excessive/"bad doctor" thing.
posted by Sara C. at 4:13 PM on December 22, 2010
Sara C., catching cervical abnormalities early on is fine. What I'm arguing against is catching them before they have time to resolve on their own or even develop at all. Testing fourteen-year-old virgins (as suggested upthread) is insanity. Testing a mere six months after first having sex (as you are suggesting the OP do) is too soon to get a meaningful result from a pap test. She's very likely at this point to get a false negative or false positive.
posted by Violet Hour at 5:43 PM on December 22, 2010
posted by Violet Hour at 5:43 PM on December 22, 2010
Also, this:
The pap smear is par for the course (this will screen you for HPV).
is incorrect. Pap tests do not screen for HPV. HPV testing is not routinely done in the US unless you are over 30 or are following up on an abnormal pap (and it's not done enough even then, which is unfortunate--an HPV test can determine whether an abnormal pap test is a false positive or not).
As far as I know, HPV testing is available in Canada but not part of routine care and not always covered on a care card.
posted by Violet Hour at 5:51 PM on December 22, 2010
The pap smear is par for the course (this will screen you for HPV).
is incorrect. Pap tests do not screen for HPV. HPV testing is not routinely done in the US unless you are over 30 or are following up on an abnormal pap (and it's not done enough even then, which is unfortunate--an HPV test can determine whether an abnormal pap test is a false positive or not).
As far as I know, HPV testing is available in Canada but not part of routine care and not always covered on a care card.
posted by Violet Hour at 5:51 PM on December 22, 2010
I'm not suggesting that OP run to her nearest doctor to have a pap test this very moment. But, yeah, in the US the recommendation is that you start having "well woman" exams annually starting when you become sexually active. I'm not sure what the approach is in Canada, but if your doctor does not think a pap smear is warranted, she or he is welcome to not order one. There are many other things an American doctor examines and tests for during a typical annual exam*.
And I personally think a pap smear would not be unusual or unwarranted within the first year of having penetrative sex. Especially since HPV can be transmitted through other sex acts, whether a condom was used or not. If you had oral at 15, 21 would be plenty long enough for cervical abnormalities due to HPV to show up.
Again, maybe it's right, maybe it's not. That is for her doctor to determine. But the doctor can't determine that if she doesn't go.
*In the US, hormonal birth control is available by prescription only, which requires a doctor visit. Usually doctors will not prescribe birth control without a gynecological exam. I'm not sure if pap smears are routine at that first exam or not, but this probably is a factor in why Americans typically associate "first penetrative sex" with "start dealing with reproductive health issues with your doctor".
posted by Sara C. at 7:35 PM on December 22, 2010 [1 favorite]
And I personally think a pap smear would not be unusual or unwarranted within the first year of having penetrative sex. Especially since HPV can be transmitted through other sex acts, whether a condom was used or not. If you had oral at 15, 21 would be plenty long enough for cervical abnormalities due to HPV to show up.
Again, maybe it's right, maybe it's not. That is for her doctor to determine. But the doctor can't determine that if she doesn't go.
*In the US, hormonal birth control is available by prescription only, which requires a doctor visit. Usually doctors will not prescribe birth control without a gynecological exam. I'm not sure if pap smears are routine at that first exam or not, but this probably is a factor in why Americans typically associate "first penetrative sex" with "start dealing with reproductive health issues with your doctor".
posted by Sara C. at 7:35 PM on December 22, 2010 [1 favorite]
Canadian here. My doctor told me to start getting pap smears one year after any sexual activity. I'm presuming that oral sex would count in that, but judging from the original post I doubt she was having oral sex at 15.
posted by vanitas at 9:39 PM on December 22, 2010
posted by vanitas at 9:39 PM on December 22, 2010
If you had oral at 15, 21 would be plenty long enough for cervical abnormalities due to HPV to show up.
Agreed, but there's no reason to think the OP had oral sex at 15, so it's not relevant to her situation.
Again, maybe it's right, maybe it's not. That is for her doctor to determine. But the doctor can't determine that if she doesn't go.
No, it's not for her doctor to determine. It's for HER to determine. Her doctor can make a recommendation, but ultimately the decision is up to the patient, and she's getting a lot of incorrect info.
Usually doctors will not prescribe birth control without a gynecological exam. I'm not sure if pap smears are routine at that first exam or not, but this probably is a factor in why Americans typically associate "first penetrative sex" with "start dealing with reproductive health issues with your doctor".
Yes, and that sort of paternalistic, manipulative crap is exactly what I'm worried the OP will end up with. There's NO RELATIONSHIP between the safety of using birth control and a gynecological exam, but you'd never know it, given the behavior of many doctors and patients. The only medical test needed to prescribe birth control is a blood pressure check:
Pelvic exams not required for Rx
Most doctors giving pap test too often
No Strings Attached
posted by Violet Hour at 11:47 PM on December 22, 2010
Agreed, but there's no reason to think the OP had oral sex at 15, so it's not relevant to her situation.
Again, maybe it's right, maybe it's not. That is for her doctor to determine. But the doctor can't determine that if she doesn't go.
No, it's not for her doctor to determine. It's for HER to determine. Her doctor can make a recommendation, but ultimately the decision is up to the patient, and she's getting a lot of incorrect info.
Usually doctors will not prescribe birth control without a gynecological exam. I'm not sure if pap smears are routine at that first exam or not, but this probably is a factor in why Americans typically associate "first penetrative sex" with "start dealing with reproductive health issues with your doctor".
Yes, and that sort of paternalistic, manipulative crap is exactly what I'm worried the OP will end up with. There's NO RELATIONSHIP between the safety of using birth control and a gynecological exam, but you'd never know it, given the behavior of many doctors and patients. The only medical test needed to prescribe birth control is a blood pressure check:
Pelvic exams not required for Rx
Most doctors giving pap test too often
No Strings Attached
posted by Violet Hour at 11:47 PM on December 22, 2010
This thread is closed to new comments.
What Canadian city are you in? Most will have a Planned Parenthood, which is a good place to start. They will certainly refer/educate you as needed. I'm in Toronto and I go to the Bay Centre for Birth Control (as recommended to me by someone on MeFi).
posted by cranberrymonger at 12:41 PM on December 21, 2010