GYN Annual Exam
GYN Annual Exam
GYN Annual Exam
Every woman should plan to see her doctor once a year for a physical exam. During the yearly exam, many correctable medical conditions can be identified in their early stages and treated, preventing more complicated illnesses down the line. You want to consult a physician who sees you as a complete person, not just a "Gyn Exam." All your systems are involved in your total health, and all should be considered.
The first part of your annual exam should include your "History." You will probably fill out a detailed sheet which looks for clues as to your health status, such as Have you lost or gained weight? Are you sleeping well? Have you been feeling depressed? Are you having headaches? Has your vision changed? Are you having chronic sinus problems or a sore throat? Have you noticed any lumps in your neck or other areas? Are you short of breath? Does your chest hurt? Do you do breast self-exams (hopefully), and if so, have you found any lumps or other irregularities? When was your last mammogram? Have you been having abdominal pain or bowel irregularities? When was your last period, and was it normal? Have you ever had pelvic inflammatory disease (PID)? Are you having hot flashes? How are your joints? Do you have calf pain? Have you ever had a blood clot? Have you had any surgery since your last exam? All these questions and more are very important.
The second part of the exam is your "Vital Signs." Have you lost height, perhaps due to osteoporosis? Has your weight changed? Most often we have a tendency toward weight gain as we get older, but problems such as thyroid conditions or diabetes could be behind weight change. Maybe you need a weight loss diet and exercise prescription. What is your pulse? Is it too fast as in overactive thyroid or heart problem? Is your heart irregular? You may need an EKG. Finally what is your blood pressure? We all know that the long term effects of high blood pressure are serious, and you may need medicine for this.
The next part of your exam is the actual physical. Do your eyes, ears, nose, and throat appear normal? Are there any lumps in your neck, abnormal sounds in your carotid arteries, or enlargement of your thyroid? How do your lungs sound? Are there any wheezes or other abnormal sounds? How does your heart sound? Are there any heart murmurs, or is there any evidence that your heart is enlarged? What does your abdomen feel like? Are there any areas of tenderness, as in over your gall bladder or spleen? Looking at your back, does the spine appear straight or is there a developing curvature as in osteoporosis? Are you tender over your kidneys? How do your legs look? Are there varicose veins or ankle swelling? Are pulses full and strong at the ankle-foot junction, and are the reflexes in your legs normal? The next part of the exam is the breast exam. The physician will examine you both sitting and reclining. He will look for any unusual dimpling, lumps, unusually tender nipples or nipple discharge. He will feel carefully under your arms for any swollen or hard lymph nodes. At this time he will advise you as to whether you are in the age group to have a mammogram, or whether your breast findings are such that a mammogram would be advisable. There is a certain amount of radiation involved in a mammogram, so this decision needs to wisely be made. The physician will decide if you need to be referred to a surgeon for a biopsy or lumpectomy.
The next part of the exam is the Gyn exam. The physician will examine your external genitalia to look for any growths, cysts, or areas suspicious for cancer. Then the clean speculum instrument with a clear lubricant will be inserted which allows the examination of the vagina and cervix. Once again the physician is looking for any evidence of abnormal tissue or infection. He will gently take a scraping of the vaginal canal of the cervix for the Pap smear, and of the opening of the cervix. These scrapping will be put in a glass slide and read under a microscope by a pathologist. In certain age and risk groups will take cultures from the same area to screen for Chlamydia or gonorrhea. This is very important to prevent PID. The physician will do a "bimanual exam", with one hand on top of your abdomen and two fingers of the other hand in the vagina. That helps screen if you have any pain, mass or any anatomical shifting. This allows him to tell if the uterus or ovaries are enlarged or hardened and if further testing such as if you have any pain or an ultrasound is needed. If the cervix is tender to back and forth movement, this could that suggest PID is present. The final part of this exam is usually a digital exam of the rectum. The physician will look for hemorrhoids, abnormal growths (remember, Farah Fawcett died of cancer of the anus), and will do a slide test for occult blood from the rectum.
Finally, the physician will recommend laboratory tests. Many physicians recommend annual HIV tests an RPR for syphilis, and test for Chlamydia, and Gonorrhea but you can work this out with your doctor. He may recommend a blood count to look for anemia or other blood problems, and often a complete chemistry screen will check everything from liver function to cholesterol. If thyroid trouble is suspected he may recommend a T3, T4, and FTI. Again, all of this for discussion based on your age group, your general health, history, and physical exam.
So, there you have it: the annual female exam results could take several days to a week toreturn from the laboratory. With this information in hand, you can plan your health activities for the coming year. Hopefully you will be more informed after asking all your questions. The goal is that you are your own best health advocate, and that you will make wise health decisions for yourself in the upcoming year. We seem to end every one of these articles with a single caveat: "An ounce of prevention is worth a ton of cure!"
John Drew Laurusonis
Doctors Medical Center
www.doctorsmedicalctr.com
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