|
 |
|||
 |
 |
|
|
|
For Women: "What should I do before I see the doctor?"Telephone first, to make sure that the clinic is open at a time convenient to you and whether an appointment is necessary. Don’t wash or pass water for at least 3 hours before seeing the doctor. Either of these could flush away the germs and make it difficult for the clinic to find out what is causing the problem. "What happens when I see the doctor?"Let’s assume that you are visiting a specialist or a sexual health clinic in the UK. In other countries the circumstances may be different, but the same basic principles are likely to apply. You will first be shown into a waiting room, usually a separate one for each sex. Initially you will be seen by a nurse, health adviser or doctor and asked some questions about your general and sexual health. This will include questions about your sexual activities, whether with a man, woman or both etc. You may find these questions embarrassing, but it is important that you answer the questions honestly to help staff find out which tests you need. The person asking the questions is only interested in finding out what may be relevant to your health and they are obliged to keep the information that you provide confidential. You will be asked to undress, partially or completely, in a private room or cubicle and to lie down on an examination couch, so that you can be examined. If the doctor is a male, there should be a female nurse also present. If not, you can ask for one. Naturally you will be feeling embarrassed at having an intimate clinical examination. However, specialist clinics are doing this all the time and their interest will simply be the professional one of investigating your health. The doctor will first examine you generally, looking for any rashes, swollen glands, lumps in the breast, etc. With your permission a small blood sample will be taken for testing for syphilis (usually routine for all patients) and, where indicated, for hepatitis B and C. A urine sample will also be requested. Any tests to be performed should be explained to you so that you can give your full consent. In the UK, you will not be tested for HIV without counselling and without your specific permission. An external and an internal examination of the genital region will then be performed. Normally a device called a speculum is inserted into the vagina to gently open the passage so that the neck of the womb (the cervix), the most frequent site of infection, can be directly examined. Several samples of fluid / discharge from the cervix and genital area will then be taken with a cotton bud; this is quite painless. You may also be offered a routine cervical smear test if you haven't had a recent one, particularly if you are an older person. The clinical examination usually takes from 5 to 10 minutes, after which you will be asked to dress and wait a short while. At a specialist clinic, there will be technicians or trained nurses available to immediately carry out some rapid tests on the specimens you have provided. This usually enables the clinic to start your treatment straight away. More sophisticated tests will generally be sent to a specialist clinical laboratory, with the results available up to a week later. Once the preliminary tests have been performed, the doctor (or other health specialist) will have come to some conclusions and will tell you in private what she or he thinks is the matter with you (if anything) and what treatment is necessary. This is your opportunity to ask any questions that concern you. If it is thought that you have a STI or that your partner may have been at risk, you will be asked to request your partner to attend the clinic, so that you both may be treated. Clinics are good at suggesting tactful ways of doing this and this site makes some suggestions.
If you think it is going to be too difficult to tell your partner for any reason, for example it was a casual sex partner, you can get a "contact slip" from UK and other sexual health clinics. You send this to the person concerned, or you ask the doctor or nurse to do it for you. The contact slip explains that the person concerned may have been exposed to sexually transmitted infection and suggests that they make an appointment with a doctor or clinic for a check-up. Your identity and infection are not disclosed. Treatment is normally given immediately. You will be asked to come back in two to three weeks and requested meanwhile to abstain from sex. This is important because antibiotic doesn't work immediately. On leaving the clinic you are likely to be glad it’s over but, paradoxically, also glad that you went. After all, you will probably have received peace of mind in addition to any expert treatment and advice. On the second visit the results of the more detailed laboratory tests will be available and the doctor will be able to assess whether treatment has succeeded. On this second visit, a genital examination may not be necessary, depending on what was initially found. "Will my general practitioner or physician be told?"Treatment at a special or sexual health clinic is confidential. Your normal doctor will not be informed without your permission unless it was your doctor who referred you to the clinic in the first place. "Are there alternatives to an internal vaginal examination?"An internal genital examination may be embarrassing, but it offers you the greatest certainty that an infection hasn’t been missed. If you have a problem with this, depending what laboratory tests are locally available, it may be possible to test for some infections using a self-collected urine sample or genital fluid from a tampon previously inserted into your vagina. This opportunity for less invasive testing is less likely to be available at non-specialist centres. Ask your chosen health care adviser about this. "What if I don’t want to see a male doctor?"Clinics are increasingly understanding on this issue and many are likely to have female doctors on their staff. Ask if you may see a female doctor. You may need to make an appointment for a particular time. [MEW] January 2008
|
