Restless nights. Maybe just a little sense of anxiety. Sigh. “It’s gotta be done,” you tell yourself.
It’s time for your “annual” gynecology visit.
Maybe you will see a specialist (gynecologist), another primary care physician, a nurse practitioner or a physician assistant. You recall that a thorough gynecology examination could take up to 30-60 minutes or more. Your experience with doctors and gynecology appointments tells you that sometimes visits go smoothly, and sometimes they don’t. Either way, “It’s gotta be done.”
Whenever there is travel to a medical appointment, physical and mental preparation is key. Here are a dozen pointers from an OB-GYN on how to prepare for your gynecology appointment.
- Call ahead and speak briefly to a nurse about any mobility restrictions that you have and share what assistance you may require during the visit (dressing, transferring, positioning, a lowered exam table, etc.).
- Share any history you may have of discomfort, pain, or difficulty with tolerating pelvic exams. Share any history of problems with autonomic dysreflexia.
- Let the office know if you have a preference or requirement for a male or female provider. Most offices will be able to honor your request, if possible. An office chaperone or assistant should be present for all exams regardless of the gender of the provider.
- On the day of your appointment, take all of your medicines like you normally would.
- Some folks really like to ‘clean up’ everywhere – everywhere – before a gynecology visit. Cleanliness is encouraged, but do not cancel your appointment so you can clean up better. Vaginal douching is not recommended by most gynecologists.
- You can be on your period and have a gynecology visit, and you do not have to abstain from intercourse to prepare for your appointment.
- Your provider may discuss your lifestyle choices, vaccinations, screening for chronic medical conditions and cancer, contraception (or family planning), and testing for sexually transmitted infections. This is not meant to be nosey. This is your provider taking good care of you.
- Bring a supply of personal care accouterments to the appointment (catheters, bowel/bladder care items, wipes, drinks, snacks, etc.) and prepare for the unexpected.
- Wear easily removed clothing, if possible.
- Be prepared for the office staff or provider to ask how they can best help you during your visit. Take the opportunity to educate – this will help you and those who come after you.
- You may bring a companion with you for your visit. Companions are not required to help you with transfers or positioning or to assist with examinations. The provider’s office should provide any assistance needed during your appointment.
- Be prepared for a general check-up, a breast exam, a Pap smear, a pelvic exam and/or a rectal exam. You will have to move or transfer to a table or surface so you can lie on your back; side-lying exams are sometimes possible. Your legs will need to be kept apart for the pelvic exam either by using secure leg rests or staff assistants. A pelvic exam usually lasts less than a minute or two. Breathe deeply and try to relax.
Well, that about covers most of the basics of preparing for an “annual” gynecology appointment. I’m sure this list can be refined and made even more helpful.
Dr. Robert Fuller is a board-certified Maternal-Fetal Medicine subspecialist practicing medicine and training medical professionals as an Associate Professor at the University of Virginia. His clinical interests include the management of complex, high-risk maternal conditions and complications of pregnancy. He lives in Keswick, VA, has been married 31 years and has six children, two dogs, a cat, a small tractor, and a henhouse full of chickens.
The purpose of this space is to discuss healthcare topics relevant to women with paralysis. Some topics and questions are difficult to address, and this much-needed forum will help to provide reliable information and infrastructure to the community. Women’s healthcare is often under-represented and under-supported; how much more so for women with paralysis!