by Tamer Seckin, MD | Posted on July 30, 2020
When you find the right endometriosis specialist, you need to prepare yourself for your first appointment. Medical records, journals, and an arsenal of questions for which you want answers can help you and your specialist properly treat you. This page will help you prepare for that first appointment. It will also give you a glimpse into what appointments would be like with me so that you have a standard to measure against.
You’ve done your research and have found someone who you believe is going to be the best endometriosis specialist for you. You call them, make your first appointment, and are feeling positive that you have started on the course toward healing. But you still need to be prepared going into that first appointment so that you and your specialist get the most out of it.
Here are a few ideas to help you prepare for that first visit. Following that, I will share with you what a patient who makes an appointment to see me can expect at our first meeting and in subsequent appointments. Not every specialist may handle an appointment the same way that I do; I am sharing my methods simply to give you a standard.
The first appointment takes about an hour. I don’t initially write anything down. I simply let you speak while I listen. It’s normally an emotional meeting, a chance for you to take all the time you need to tell me about the pain, misdiagnoses, previous surgical experiences, and how your circumstance has affected every part of your life. It is through this that we begin to build trust, something that every patient should feel with their doctor.
I will then take some notes and ask you specific questions about everything you just told me to learn everything that I can about every one of your symptoms. How painful is your period? How old were you when the pain started? Does the pain surface before, during, and/or after your period? How heavy is the bleeding? Is it clotty? Have you taken medication for the pain? Do you have a disease you are aware of that could promote heavy bleeding? Have you had any gastrointestinal symptoms? Are you sexually active and, if so, is sex painful? Do bowel movements hurt? These are just some of the many questions I will ask.
The hour-long visit is a full hour of a face-to-face discussion, not fifteen minutes in a waiting room, fifteen minutes filling out paperwork, and thirty minutes together. You need that much time to develop trust, and I need that much time to fully understand your situation.
Your second visit is when I will conduct a very thorough physical exam. I will check for tenderness in the kidney area, and I will examine your abdomen, liver, spleen, and any previous surgical incisions. A lot of those incisions will tell me a story, depending on how long they are and where they are located. I will ask you several questions as I am examining you, questions about pain, miscarriages, your family’s medical history, medications you are on, etc.
I will then conduct a gynecological exam with a female assistant in the room. I will tell you everything that I’m doing as I’m doing it and why so that you are as comfortable and informed as possible. This exam will include me examining your cervix with my finger, moving from right to left and from front to back. This is called a bimanual pelvic examination.
Next, I will ask for your permission to do a rectal exam. As I examine the rectum, I will feel for nodules in the side walls. I will then do a transvaginal sonogram, which will show me the ovaries and the uterine cavity so that I can look for polyps and fibroids that are inside the endometrial cavity, which are the cause of heavy bleeding and clots. Then I will view the uterine muscle walls for the presence of adenomyosis and fibroids, and finally the ovaries for cysts, endometrioma, and adhesions.
When we return to my office, I will explain to you where I think the endometriosis is located, how serious it is, and what needs to be done about it. I will even draw sketches on a board to help you visualize.
If I think you are going to opt to have surgery with me, I will send you for an MRI to further evaluate the tissues and look at the kidney system, and a CT scan to make sure I’ve covered every point in the body that I need to be concerned with. I will also give you the option of consulting with a psychologist, because the pain that this disease carries affects patients psychologically.
The last thing I will do is ask you to meet with other specialists on my team who may also be involved in the surgery so that we are totally prepared going into the operating room with top-level expertise in every respect.
When all is said and done, you will have at least three or four visits with me before surgery. It is my goal to build a relationship with you. This isn’t about getting you in and getting you out. If any doctor treats you that way, you just need to get out. Whether you are going to see your doctor about a minor ache or a major issue, you always deserve the best treatment.
On the “How To Decide For The Right Endometriosis Specialist?” page, you met Melissa. That specialist who she went to in Georgia treated her well, but about a year after one of his surgeries, the aggressive endo she had returned again. She chose to go to a doctor closer to her home in Michigan because she couldn’t afford to go back to Georgia again. He told her he could help her.
When she woke up after surgery, he said, “I couldn’t do anything,” Melissa said. And he wasn’t kidding.
“He opened me, took one glance inside, and closed me. I was in the operating room for like twenty minutes.”
The endometriosis was so widespread that he didn’t feel comfortable attempting to tackle it. That should never, ever, happen to you or any other person.
As you learn more about endometriosis, its symptoms, and treatments available, you will be able to advocate for yourself and get the care you deserve. So many patients are told by people who aren’t specialists in the disease (friends, relatives, school nurses, and even other doctors) that they are overreacting, that there is something wrong that really isn’t wrong, or that the pain is just a woman’s burden.
You know your body better than anyone. Do the research and rad stories from other women with the disease to make the best assessment of your situation that you can. Then find the best person who can help you end the pain you are in. You deserve it.
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