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my doc has never examined me yet. about to have surgery my doc has never examined me yet. about to have surgery

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  #1  
Unread 01-15-2004, 05:06 AM
my doc has never examined me yet. about to have surgery

I'm having lots of pre-op jitters for this upcoming lap on Monday. And this one just bothers me. I've been seeing this dr, a pelvic pain specialist, since July, 03. In all that time, she's never prodded my abdomen, never given me a pelvic or anything. The only time she's even checked the incisions for the 3 surgeries she's done is to remove the stitches that refused to dissolve. Here I am, 4 days pre-op for a lap to check for more endometriosis, and again, she's never checked me. She's asked lots of questions, and is genuinely concerned. She takes me seriously, and hasn't yet discounted any of my pain, but never a physical exam. She never even checked the vag. cuff after my hysterectomy.

Should I be concerned? Should I ask for a check before she takes me to the OR?


Or am I blowing this out of proportion?

Ya know, with this upcoming surgery, being #5 in 7 months, I'm feeling very frustrated that my body isn't cooperating with me, and just behaving itself! I just want to get better and put this whole nightmare behind me!

Laura
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  #2  
Unread 01-15-2004, 06:15 AM
my doc has never examined me yet. about to have surgery

Laura,



As you know, we are surgery buddies ....I too am having lap surgery on Monday. It was not a pelvic exam that led me here. I have been keeping track of my pain and communicating that to my doctor and given my history of endo, its a logical that the lap is the next step.

Pelvic exams aren't all that telling for endo, except to try to mimic our pain .........who needs that when the laparoscope will show all on Monday? Spare yourself this worry.

Right now, I am trying to just stick to my "to do" list as getting my busy family prepared for me to be out of commission is an undertaking.

BTW, I am treating myself to a pedicure on Friday ... no polish. Just going to have them sand off the rough spots. Do something nice for yourself between now and Monday!
  #3  
Unread 01-15-2004, 09:02 AM
my doc has never examined me yet. about to have surgery

I would be concerned considering that this is your 5th surgery in 7 months... to me that indicates that you are still having pain so that indicates that the 4 surgeries previous to this did not help??? So perhaps the doctor is not on the right track? Or maybe a second opinion is in order?

Obviously I am not a doctor but I have had multiple surgeries for endo. In the past, my doctor always waited months before we determined whether or not the surgery helped or not... The most successful surgery I had at relieving pain was done after a conscious pain mapping and it was a good 3-4 months before I noticed I was feeling better. At first I felt worse but my nerves in the area were just so hyperactive from the years of pain it took them a while to calm down.

I recently had a consultation with a Gyn and Gyn/Onc at Mayo. I was there to consult on the possibility of a presacral neurectomy. The doctors wanted to make sure that they did a very thorough pelvic exam to try to determine as best as possible before surgery where the problem was coming from... they were particularly concerned about whether my continuing problem might be myofacsial in nature or nerve damage.... The one doctor really poked and prodded in an effort to determine if I had pelvic floor myalgia or abdominal wall myalgia as my primary problem. He was also trying to determine where the worst pain was coming from so it could be noted as a place to look during surgery.

There are so many things that can cause pelvic pain and if 4 surgeries in 7 months have not helped I would think a second opinion might be a good idea.

Best of luck whatever you decide

((hugs)))

Sarah
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  #4  
Unread 01-15-2004, 09:10 AM
my doc has never examined me yet. about to have surgery

maybe i have an attitude problem, but if a doctor is not willing put his/her hands on my body, i have a BIG problem with that. that's why i ditched the first "pain specialist" i went to.

IMHO

Fluffy Lemur
  #5  
Unread 01-15-2004, 10:35 AM
my doc has never examined me yet. about to have surgery

Fluffy:

I did not read Laura's post as an indication that her doctor did not want to touch her, just that her doctor does not think much is to be gleaned from a pelvic exam ... all things considered.

I find it very frustrating for a doc to poke around on me to find the pain only to say "well, you know I can not tell you what is wrong without scoping you". Which leads me to the question "so what was all that about?".

So what my doctor and I decided together is that we are going for the definitive look. Lets NOT put Michelle through an exam for nothing.

He's the first truly empathetic doctor that I have had. I wish I could clone him as a lot of sisters seem to be lacking a doctor they can partner with ... someone who REALLY listens and REALLY cares about their well-being.

Laura:

I don't want you to have any regrets. Call your doctor's office and discuss your concerns, if this is continuing to bother you. Peace of mind is a big priority!

PM me if you want to chat. I don't have my e-mail hooked up to this site anymore becuase DH and the kids will read them (joint mailbox) and I want to preserve your privacy.
  #6  
Unread 01-15-2004, 11:07 AM
my doc has never examined me yet. about to have surgery

JMHO: I wouldn't be concerned that your doc hasn't done a pelvic before the scope. As Michelle said, there isn't much they can tell until they get a look inside. I am going back to my gyn for some ongoing problems soon and I hope she doesn't put me through a pelvic exam needlessly.

However, I would be a little concerned that your doc didn't check things post op. Seems to me there might have been a problem (with healing or something) that they could have detected.

Good luck with your lap and do let us know how it turns out!
  #7  
Unread 01-15-2004, 11:29 AM
my doc has never examined me yet. about to have surgery

I do agree with Michelle and Billsweetie that a pelvic exam is not always needed. My doctor who I have known for a long time often does not do a pelvic when I see him for the pain...

THat said though, I still find it odd that she has NEVER done a pelvic exam or examined your abdominals and pelvic floor and she is a pelvic pain specialist. Both pelvic pain specialist I saw did very thorough physical exams the first time in order to try to differentiate (as I mentioned) whether this was an internal problem or a myofascial problem... or both.... and also try to determine possible involvement of the bowel and bladder. There are so many things that can cause continuing pelvic pain besides the viscera that after 4 surgeries in less than 7 months I think I (and this is just me) would want someone elses take on whether I was headed in the right direction.

I am just letting you know what my gut says when I read your post... to me it raises a red flag... not so much the no exam but more the recommendation for a 5th surgery when the 4 previous ones appeared not to have helped (assuming they were all surgeries to try to resolve a pain issue)..... I think I would be looking for a second opinion before going under the knife again.
Or perhaps looking for someone who can do a pain mapping so they can identify the painful item without having to go in a 6th time.

Keep in mind that none of us are you... you know the doctor first hand and know what has happened in detail over the last several months. Since you posted here with this question it makes me wonder if you are uneasy and if your gut is telling you something isn't right. Like Michelle mentioned, you could call and talk to your doctor and perhaps that will ease your mind... or perhaps getting another opinion. I have found in the past when my gut tells me something isn't right it usually isn't.

Best wishes for whatever you decide to do. Keep us posted and let us know what happens. We are all just trying to help based on our different life experiences... but in the end you need to decide what feels right for you ... not what any of us said you should do.

((hugs))

Sarah
  #8  
Unread 01-15-2004, 12:31 PM
my doc has never examined me yet. about to have surgery

If you are not comfortable with this ask her why. Explain to her that you want to know where she is coming from to better help you understand what is going on.
That is just my opinion.
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