The First Visit
At a first exam, the client will meet with a support worker who will do a health history and talk briefly about what has brought the client to Links. The support worker will answer any questions or address any concerns the client may have.
The support worker will describe the first exam and will be present during the exam, if necessary. The client will be introduced to the health care professional, who may be a physician, nurse/midwife or a nurse practitioner. After the health care professional speaks with the client, he/she will ask the client to sit on the examining table where he/she will listen to the client's heart and lungs. The client will then lie on the table and the health professional will examine the breasts to be sure there are no lumps or irregularities and instruct the client on how to perform the exam herself. It is recommended that a woman examine her breasts monthly.
In order to examine the uterus and ovaries, the health worker will ask the client to place her feet into metal stirrups at the bottom edge of the examining table and push herself down to the end of the table, knees bent and spread apart. It may seem awkward, but it should not be painful. The professional will tell the client exactly what he/she is doing, first putting on rubber gloves and checking the outside of the genital area for anything unusual. A speculum will be gently inserted into the vagina so he/she can see the cervix. This should not be painful.
The professional will be looking for any sign of irritation, inflammation of the vagina or unusual discharge. In clients over 21, a pap smear will be done by using a long Q-tip-like stick to gently scape some cells from the cervix, with will be sent to a laboratory to check for abnormal cells. If any precancerous cells are found, they can be safely treated. A test for chlamydia and gonorrhea will be done using another swab. Testing for sexually transmitted infections (STI's) is done during the initial visit and as indicated thereafter.
During the last part of the exam, the health professional will do a bi-manual examination, inserting one or two gloved fingers into the vagina. The other hand will be placed on the outside of the abdomen. In doing this, the practitioner can feel the size and shape of the uterus and ovaries. He/she will be looking for growths, swelling or tenderness. This may feel a little uncomfortable, but it should not hurt. The entire exam takes on about 5-10 minutes. When it is completed, the client may discuss any issues with the the practitioner and ask for further explanations or instructions. The support worker will spend as much time with the client as needed.
