“How are you doing today?”
“Good so far. The rest of the day depends on what you tell me.”
“I’ll try my best not to ruin it.” I give her another smile. I quickly learned to find a balance in how I interact with my patients. If I’m too friendly, they might think I’m hitting on them. However, I need them relaxed, so I can’t be cold and methodical. It’s highly likely that before they leave, I’ll have my fingers on or in their bodies, so I need to be careful of how they perceive me. “Why don’t we start with you telling me what brings you here?”
“Well… my husband and I want to have a baby.”
“Okay.” I nod slowly.
“I’ve never had a regular period, so I figured I’d finally get it checked out.”
“I see. When was your last period?”
“July 15… over three months ago.”
I glance up at her periodically as I make notes in her file. She’s twenty-five, but I notice signs of male pattern baldness, and hirsutism—pigmented hair on her upper lip and chin. Add in the irregular period and the fact that she’s overweight, I have a strong suspicion she has polycystic ovaries.
“Have you ever had a pap smear?” I ask.
“No.”
“I’ll get a sample from you today and send that in for testing. I’m also going to have the nurse schedule a transvaginal ultrasound and some blood tests.”
“Transvaginal?”
“Yes.” I give her my full attention. “The probe—it looks a little like a wand—will be inserted into your vagina. You may feel a bit of discomfort or pressure as it moves around, but I’ve been told it’s not painful.”
“Okay.” She returns my smile, relaxing for the first time since she came in.
“When was the last time you had sexual intercourse?” I ask as I make a list of the tests she’ll need.
She blushes, her cheeks turning bright red. “Um… two nights ago.”
I smile, handing her a pregnancy test. “We’ll need to do a pregnancy test also to rule that out.”
“Do you have any idea what could be causing it?”
“Let’s see what the tests say first. Don’t worry yourself by jumping to conclusions. And stay off the Internet for now.”
“Okay.”
“Good. There’s an exam room right behind you with a bathroom. After you take the test, you can undress from the waist down and put on the hospital gown. I’ll be with you in a minute.”
“Thanks, Doctor.”
“You’re welcome.”
After getting the sample for the pap smear and the results from the pregnancy test, I bring her into my office to wrap things up.
“Well, Miss Claire, the pregnancy test was negative.” Her lips curve down into a deep frown. “I know that’s not what you want to hear, but don’t worry. We’ll figure out what’s going on.”
She gives me a weak smile.
“In the meantime, I’m going to prescribe you something to bring on your period.”
“Okay.”
I scan her medical history once more, then write up a prescription. As I hand it to her, I explain the possible side effects.