Two weeks ago I had my annual physical. It was comprehensive and if you want, I will tell you all about it but last week it was my wife’s turn and this is her story. We arrived early and after telling the receptionist who she was and which doctor she had an appointment with, my wife was handed the clipboard with the 5 pages of questions that told everyone else in the waiting room that soon, she would be wearing nothing but a gown.
About ten minutes later, the nurse comes out and calls my wife’s name and we follow her back to the little room where she takes her weight and height. As we then proceed down the hall, I am hoping extra strong that the first exam room is already occupied because the guest chair sits next to the exam table in that room as opposed to being at the end of the table in the far room. We turn the corner, and someone must have been smiling on me because the first exam room door was closed.
We go to the far room, sit in the two chairs and start chatting with the nurse about things in her life. The nurse asks my wife a few questions about her medications, health and checks to be sure that the doctor takes care of all my wife’s gyn issues as well. She is unable to find the last time a pap smear was done and we tell her the doctor doesn’t do one because she had a hysterectomy. She says they only do them every three years now and I knew that it had only been two since her last pelvic exam.
Then the nurse took her blood pressure. She then opens a drawer on the exam table and removes a gown and drape and hands it to my wife. I am almost floored by the next thing the nurse says, something that she has never said before to either one of us. She tells my wife to remove her clothes, BUT she can keep her underwear on and put the gown on. I remarked that last week I had to take everything off and the nurse said it is different for the men. I am inwardly becoming disappointed in the direction this exam is headed.
The nurse says the doctor will be here in a few minutes and leaves the room. I help my wife get undressed and fold her clothes, and as I reach to unclasp her bra, my wife says that the nurse said it could stay on even though I though she meant just her underpants. My wife puts the gown on, sits on the table and finishes completing the questionnaire. After a while we hear a knock on the door and the doctor enters. She greets us and has a seat on the rolling stool. She spends a long time going over blood work she ordered and some of my wife’s medical issues.
Satisfied with the discussion, she picks up her otoscope and proceeds to check my wife’s ears, nose and mouth. Next, she got her stethoscope and listened to her lungs and heart. The doctor then asked her to lie back and she lifted the gown up to the bottom of her breasts at the same time she covered my wife’s lap with the drape. She proceeded to palpitate her abdomen as well as listen to it with her stethoscope. In a surprising move, she lifted the gown and bra above her breasts and started to do a breast exam. I say surprising because I did not expect her to do one after having done one at her last appointment a few months ago.
I am watching the doctor as she slowly works from the outside and makes small circles with her fingertips working in toward the center. I interrupt the conversation going on between the two women and ask the doctor a question that I have been wondering about for a while now. I asked her if she thought my wife’s breasts were abnormally lumpy because I think I would have a hard time telling if there was a real lump to be concerned about. The doctor tells me that her breasts are quite normal and that I would feel a definite pea sized hardness when I lightly pressed between the breast and the rib cage.
She then spends the next few minutes demonstrating how to do a good breast exam. I thank her and she tells my wife she can sit up and the doctor asks her if she has any problems “down below”. My wife says no and I am again disappointed that it looks like the exam is over. I ask the doctor how often she thought “down below” should be checked out. She said that there is a variety of opinions.
Surprise number two, the doctor says that since my wife still has her ovaries, it wouldn’t hurt to check things out. She tells my wife to take off her underpants while she pulls out the stirrups. I help my wife remove her underpants and she sits back down and the doctor puts her feet in the stirrups and instructs her to scoot down. The doctor says she doesn’t have her bright light and then starts looking through the drawers of the table and then in the cupboards of the room looking, I presume, for a lighted speculum like she has used in the past. Not finding one, she again retrieves her ototscope and sits on the stool between my wife’s legs. I never sat back down so I am standing right behind the doctor this time.
The doctor then proceeds to give me an excellent running commentary of what she is looking for and at as she exams my wife’s exterior genitalia. She then separates her labia and says she is looking for growths, discoloration and abnormal discharge. Satisfied with her findings, she stands up and puts some lube on her fingers and introduces two of her fingers into the vagina. She showed me where the ovaries should be but because of the age of my wife, and possible her size, she said she could not feel anything. She said everything seemed fine and then helped my wife get off the table.
She said she ordered some more blood work and an ultrasound and would see her in three months. The doctor then left the room and I helped my wife get dressed again. An exam that I thought was going to be one of the least revealing turning into one of the most intimate and even more importantly, the most informative from a purely medical standpoint that I have ever attended with my wife.