By Madonna Behen
Easier Doctors' Appointments
woman in hospital gown
You've been putting off scheduling your gyno appointment for weeks. The flimsy gown, the stirrups...no matter how many times you've gone, you still feel vulnerable. As tempting as it is, delaying regular medical exams won't make them any better, since timely checkups can catch problems in their earliest stages when they're easiest to treat. Photo credit: Joe Luis Pelaez/Getty
Fortunately there are ways to make exams more comfortable. The first step is to call the doctor's office before your appointment and speak to a nurse or physician's assistant. "Often, it's the fear of the unknown that prevents people from scheduling a test like a colonoscopy, so ask for an overview of what to expect," says Sandra Cialfi, nurse manager of the endoscopy center at Brigham and Women's Hospital in Boston. "We're more than happy to answer all of your questions in advance because it makes our job easier once you're here," she says. Knowledge is power, and that's particularly true when it comes to these often anxiety-producing health screenings. Top medical insiders explain how to navigate four of the most common.
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Ask about estrogen cream. "If you're having vaginal dryness, which can make an internal exam especially uncomfortable, ask your doctor about applying an estrogen cream for a few weeks before your appointment," suggests Lauren Streicher, MD, assistant clinical professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine in Chicago. "Because the prescription cream increases lubrication, it can make the exam much more tolerable," she says. Photo credit: Dann Tardif/Corbis
Relax your muscles. "During a pelvic exam, a natural inclination is to clench your pelvic and buttock muscles, which can make the procedure more uncomfortable," says Dr. Streicher. Just before the exam starts, take a few deep breaths (close your eyes if it helps) and relax your buttock muscles. "Focus on dropping your rear so it's touching the exam table," Dr. Streicher says.
Speak up. If you're extremely uncomfortable-and definitely if you're in pain-during the exam, tell the doctor right away. She may be able to try a smaller speculum (the instrument that allows her to see inside your vagina). "I tell my patients they can say 'stop' at any point, and I will do so immediately to figure out how I can make the exam more comfortable-whether that means proceeding very slowly or going more quickly to get it over with," says Dr. Streicher.
Bring your own robe. "There's no law that says you have to wear the super-thin gown given out at the doctor's office, which can be very uncomfortable, especially if it doesn't fit you very well," Dr. Streicher says. Bringing your own roomy, soft robe from home will go a long way toward making you feel less self-conscious and more at ease.
If just the thought of going to the dentist gives you a toothache, know that you're not alone. Surveys estimate that up to 15% of Americans avoid the dentist due to anxiety or fear. But the longer you delay the cleaning, the more uncomfortable it's likely to be when you do go. "The more plaque buildup you have, the more scraping the hygienist needs to do," says Sonya Mitchell, DMD, associate professor at the University of Alabama at Birmingham School of Dentistry. Not to mention that the longer you have a cavity, the more painful it becomes. Photo credit: Tyler Olson/Getty Images
Ask the dentist to explain what she's doing every step of the way. Knowing what's coming next and why-whether it's two minutes of drilling to fill a cavity, a squirt of water to flush out filling debris or a dose of novocaine-may help you feel more in control and less anxious.
Find out ahead of time what accommodations the office can make. "Many offices have built-in features to help you relax, like piped-in music, TV screens in the exam room or soft 'stress balls' to squeeze while you're getting anesthesia," says Dr. Mitchell. If the office doesn't offer any of these aids, ask if you can bring your MP3 player to listen to music. Seeing how sensitive (or not) the office is to your concerns can give you a clue as to whether this dentist is right for you before you walk in the door.
Be honest about your pain tolerance. There are now so many options to relieve discomfort-including novocaine or nitrous oxide gas (a sedative that you inhale)-that dentists can eliminate pain from most procedures, says Dr. Mitchell. So don't worry about being brave-let your dentist know how sensitive you are. After giving you novocaine, she should make sure you're comfortable before starting the procedure. And if you feel pain at any point during the procedure, alert your dentist ASAP.
Having your breast tissue squeezed between two metal plates is never going to be a walk in the park. But there are steps you can take before and during this cancer screening to make it more bearable. Photo credit: Jupiterimages
Choose a center that does only mammograms and sonograms. Before your doctor fills out the referral, ask her to send you to a facility that specializes in breast cancer screening, since it's more likely to have the newest machinery and technicians who have more experience doing the tests as comfortably and accurately as possible, says Melissa Nissen, lead technologist at the Breast Imaging Center at Montefiore Medical Center in New York City. Breast imaging centers also often have equipment built to accommodate women with larger breasts, which means less discomfort.
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Relax your shoulder and chest muscles. The technician has to firmly and evenly compress your breast between the metal plates of the machine to clearly see all the breast tissue. Tensing your shoulder and chest muscles (which often happens unconsciously) can make the discomfort worse. Just before the technician compresses your breast, inhale then exhale, and drop your shoulders.
Ask if you can take an OTC pain med about an hour beforehand. Dr. Streicher recommends 600 mg of ibuprofen. But never take it without checking with your doctor first to make sure the pain med won't interact with another drug you're taking or exacerbate any other health issues. Another move that can help minimize discomfort: Schedule your exam a few days after your period is over when your breasts are less likely to be sore.
Stay with the same technician. "If you have a good experience, at the end of the mammogram request that technician for the next one," says Nissen. It will be noted in your file. If this is your first mammogram at this facility, tell the scheduling office, and ask for someone who's good with beginners.
Anyone who's had a colonoscopy will tell you that the procedure-in which the doctor inserts a colonoscope, a thin, flexible tube with a small camera, so he can check your colon, the lower part of the small intestine and rectum for suspicious growths or cells-isn't the worst part. (After all, you're sedated.) What most people dread is the preparation, which starts one day before and involves drinking a gallon or so of salty fluid to clean you out. Photo credit: Steve West/GettyImages
Follow the prep directions to a T. Don't try to shorten the prep time. You'll likely find yourself nauseated by trying to drink too much at once. "If the directions say to start drinking at 5 P.M., but you don't start until 7:30, you may not clear your bowel fully for the test the next morning," says Cialfi. If the doctor doesn't feel like he can see enough, you may have to reschedule the test-then go through the prep all over again. There is another prep method that involves drinking what some people think is a better-tasting solution called magnesium citrate, but you may also have to use an enema. Discuss with your doctor which way is best for you.
Refrigerate the drink. Pick up the prescription solution from the pharmacy in time to let it chill in the refrigerator an hour or so before you have to start drinking it. "When the fluid is cold it's easier to tolerate and often tastes better," says Cialfi. Using a straw can also help stop nausea since it will slow you down and dull the taste. If you become queasy, take a break and keep drinking after the feeling passes.
Don't have a heavy meal before the prep or right after the test. It's tempting to load up on filling foods since you won't be eating anything for the next 24 hours, but if you eat sparingly for a day or two beforehand, it will make the cleaning-out process easier, says Cialfi. "The less you put into your body, the easier it will be to eliminate it," she says.
Stay hydrated. Drinking lots of water the night before will help you feel better before and after the test, Cialfi says.
MADONNA BEHEN is a health writer in Saratoga Springs, NY.
I give myself a prize afterward-a special meal or item I've always wanted. -JEANA FORS Woodhul, IL Photo credit: Stockbyte/Thinkstock
I make appointments first thing in the morning so there's less waiting. The night before I write a list of my symptoms, medications and any questions or concerns I have so I feel prepared. -BARBARA LEVI JAMES Clifton, NJ
I take a relaxing book to read while I'm waiting so I don't focus on the tests or exam. A friend of mine takes some of her quilt squares to knit. -MAGGIE KILKENNY Arlington, TX
I get a good night's rest the evening before and if possible, my husband or a trusted friend comes with me. Having someone along can help you stay calm as well as reiterate information. -GINA KREIGHBAUM Berea, OH
I schedule my appointments so that I don't hit rush-hour traffic driving there, because that just makes everything more stressful. -CINDY KOSS via Facebook
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Original article appeared on WomansDay.com.
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