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Questions for your OB/GYN

by Mary Ann Romans

How being prepared can make all of the difference in your care These days, the average amount of time you will get with your doctor can be a mere 10 minutes, according to Dr. Kathleen O’Banion, a Cooper University Hospital OB/GYN. “You better make it count,” she says. “While any doctor would rather sit and talk with you for an hour, they are required to see four to six patients during that hour.”

Other modern concerns, such as keeping an online database of care and maintaining electronic access, can also take up some of that valuable patient time. “It breaks my heart that we can’t sit down for a long time to chat with a patient,” O’Banion says. Fortunately, she has some important advice for any woman on how to make the most of the time.

Making it count
Because your appointment time may be limited, asking the right questions and having the right information to share with your doctor may make all the difference in the care you receive. Women should be proactive with taking ownership of their health, O’Banion urges.

“It is very helpful when a woman knows about her own care,” she says. “It is important for you to take responsibility for what you want to discuss and be prepared to let your doctor know up front, right away, at the beginning of the appointment. This way, your doctor can address any issues or let you know that you should make­­ an additional appointment.

“Just try to be organized with the questions that you do have. Don’t hesitate. Speak them and then write them.”

O’Banion recommends that every woman come armed with at least two things when visiting her OB/GYN: supplies to take notes, and the answers to some common questions about her health. “Only about one in 10 women can give me their accurate history,” she says. “Keep your own records and bring them with you, especially if you are transferring from another doctor.”

Questions you may be asked
Before your next visit, O’Banion wants you to make sure that you can answer the following questions for your own doctor.
• What was the date of your last period, and do you have a regular menstrual cycle?
• What is your family medical history? You should not only know what diseases run in your family, but also the ages of diagnosis.
• What is your own history, if any, of sexually transmitted disease?
• What is your history of vaccinations? Have you had the hepatitis B vaccine?
• When was your last mammogram and where was it performed? What about a bone density test or a colonoscopy? While these last two may be covered by your general practitioner, your OB/GYN may also want to know if you have been screened.
• What medications have you taken in the past that did or did not work well for you? Do you have any allergies?
• What do you want to discuss (Contraception, menopause, etc.)?

Questions you should ask
Because concerns and health issues naturally change as a woman ages, Nicole Parone, RN, MSN, APN, of PennCare for Women in Cherry Hill, points out that your stage of life may determine the questions you should ask. She offers the following guidelines for questions all women should ask.
• In her 20s: Should I have STD testing/pap testing/HPV testing? What birth control fits my needs? Should I consider being vaccinated against HPV? What measures do I need to take to prepare for a healthy pregnancy?
• In her 30s: Along with pregnancy questions, how does my family history affect what I should be tested and screened for?
• In her 40s: How can I expect my periods to change as I enter into perimenopause?
• In her 50s: How can I expect menopause to affect me?
• In her 60s and beyond: Why is it still important for me to continue with annual gynecologic exams even though I am not still menstruating?

Guidelines and answers to common questions
How often should you get a mammogram? “Most health care providers tend to follow the guidelines set forth by the American College of Obstetrics and Gynecology, who recommend annual screening mammography be offered to women beginning at age 40,” Parone says. “Of course, if a patient’s family history dictates, she may be advised to begin screening sooner.”

What if you are called back for an additional screening? O’Banion says it is usually “no big deal. Your mammogram may have just created a question, and the doctor needs more information about it. For example, dense breast tissue may make it too hard to see anything, so your doctor may want to use another screening method.”

What are the side effects of birth control? “Fortunately, over the years it has been realized that we can achieve the same effectiveness of birth control of the past while using far less medication,” Parone says. “I always tell my patients beginning a new birth control method to anticipate symptoms like minor headaches or nausea as their body acclimates to the medication over a few weeks. However, if taking that medication is not improving your quality of life, then we should talk about changing to one of the many other options that are available.”

How soon after stopping birth control can a woman get pregnant? “A woman may ovulate and therefore be able to conceive immediately after stopping some types of birth control, so it is important not to stop until you are definitely ready to become pregnant,” Parone says. “Although some women occasionally experience irregularity of their periods once they come off birth control, this is often because they are reverting back to their body’s own natural rhythms, which the birth control had been masking. Whether you have been on birth control for 10 months or 10 years, it will not affect your ability to become pregnant.”

Women should also be prepared to discuss new guidelines for pap testing, which have changed recently.

“Although some patients may be candidates to extend the pap test interval to three or even five years, it is still important to have an annual exam,” Parone says. “The pap is only a screening test for one type of cancer and a small part of what is done at the exam.”

O’Banion agrees. “Just because you don’t need an annual pap does not mean you should not to come in for annual exam. In fact, the pap is the least important part of the exam.”

Resources

Cooper University Health Care
One Cooper Plaza
Camden
1 (800) 8-COOPER
CooperHealth.org

PennCare at Cherry Hill
409 Marlton Pike E.
Cherry Hill
(856) 795-0587
PennMedicine.org/Cherry-Hill

Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 4, Issue 8 (October, 2013).
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