If you don’t have a family doctor, contact your local chapter of the College of Physicians and Surgeons in your province. Most have a list of doctors taking on new patients.
British Columbia: www.cpsbc.ca
Try to arrive at your doctor’s office a few minutes early. This gives the doctor’s staff time to do some preparation with you. Typically, this involves taking your height, weight and blood pressure. You will receive a gown and should change out of your clothes, including your bra and underwear. This allows your doctor to perform a head to toe examination. You will often be given a drape to place over your legs like a blanket.
Most physical exams involve the same basic elements, although all doctors have their own style and method.
Your doctor will ask a number of questions about your health and lifestyle. This helps focus the exam if necessary. The doctor is interested in any previous medical problems, serious illness, hospital admissions or surgeries. List all medications, supplements or over-the-counter products that you are taking. Let your doctor know of any allergies or if you have reacted to medications in the past. Your doctor will be interested in the health of close relatives like your brothers, sisters, parents, aunts and uncles. If any diseases run in your family, tell your doctor so that you can be monitored properly for similar conditions.
Your doctor may ask about school, and your relationships with your family and your friends. Expect questions about your menstrual cycle or period. Your doctor will also ask about habits – good or bad – that may affect your mental and physical health. Your sleeping and eating habits, how much you exercise, your sexual practises, accident prevention, smoking, alcohol and street drug use are all possible topics.
Remember, your answers are completely confidential. Your doctor will not judge you. Being honest during the interview helps your doctor provide the right advice and care to keep you healthy.
Once your interview is finished, the doctor will examine you. Depending on the doctor’s preference, a chaperone may be present for part or all of the examination. The exam will likely include some or all of the following:
You might feel embarrassed or uncomfortable about the pelvic and breast exams. However, if you know what to expect, this part of the exam can be just a routine part of your regular health screening.
If you are relaxed, this exam should not be painful. If it is, say so. Causing discomfort is the last thing the doctor wants to do! Generally, the whole process is finished in less than a minute and a half.
You will be asked to move your bottom so that it lines up with the end of the table. You may be asked to put your feet into stirrups. The stirrups just serve to keep your legs and feet out of the way.
First, the doctor will examine the outside of the genitals to see if there are any sores or rashes. Then, depending on your history, you may require a speculum examination to look at the walls of the vagina and your cervix, which is at the end of the vagina and is part of the uterus. The speculum, either metal or plastic, is an instrument that looks like a duck’s beak. It is used to help the doctor see inside you properly. The closed speculum is inserted gently into the vagina. This might cause a sense of pressure, but should not be painful. Then, the speculum is carefully opened to allow a view inside the vagina. If you are sexually active, a cotton swab may be used to take a sample from the cervix to check for infections like chlamydia and gonorrhea.
In the past, the next step in a sexually active patient would have been a Pap test to screen for cervical cancer. The recommendation before late 2009 was to do this screening a year or so after first sexual activity. New recommendations advise Pap screening at age 21 or three years after the first intimate encounter (which includes oral or finger activity involving the genitals) – whichever occurs later. Since everyone is different, your doctor will suggest what is best for your situation. If a Pap test is recommended, the doctor will use a small brush and a spatula to take samples of cells from the cervix.
Depending on your history, the doctor may examine your uterus and ovaries. As these cannot be seen through the speculum, both hands are used in a procedure called the bimanual exam. Your doctor will insert two gloved fingers into your vagina and place the other hand on your belly. Between the hands, the doctor will feel for abnormalities in your uterus or ovaries. You might feel some mild pressure, but not pain.
A breast exam may be done during your physical. Your doctor will look at your breasts to see if they are symmetrical while you are seated and lying down, with your arms overhead and on your hips. The doctor is checking for skin changes, nipple changes, or nipple discharge. Next, your doctor feels for swellings in your armpits, and uses the pads of the fingers to check the breasts for abnormal lumps.
After your examination, the doctor will discuss any problems found during the history and physical exam. Recommendations may be made based on your visit. You will be given information or instructions on next steps if investigation or treatment is required. If you have any questions, be sure to ask.
If tests such as a Pap smear or swab were done, the results will be available at your doctor’s office within a week.
The entire physical examination usually does not take more than thirty minutes out of your year. Be sure to book this important appointment as part of keeping yourself healthy!