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A Surgical Outpatient Appointment
What to expect at your clinic visit
Seeing a doctor of any kind for many is a daunting experience but when the doctor introduces themselves as a surgeon of one kind or another it is not unusual for patients to be especially anxious.
The surgeon (and often the attending nurse) should do their best to put you at your ease before first explaining who they are, what they do and why they have been asked to see you, usually by your GP but often by another specialist doctor.
The consultation begins with questions about your present condition particularly related to symptoms and effects these may have on lifestyle. These questions will normally be tailored to the nature of the underlying problem. The answers to the questions often go a long way towards the surgeon making a diagnosis and determining the need for investigation or treatment. Questioning then moves on to your past medical and surgical history, family history, current medications and allergies.
You will then be asked to loosen or remove some clothing at the discretion of the surgeon and lie on your back on an examination couch. The abdomen, groin and where appropriate genitalia will then be examined by hand. Other examinations may include the chest, hands or legs if necessary. For those with bowel or anal complaints you will be asked to roll onto the left side with the knees raised towards the chin for a rectal examination. A gloved, lubricated finger is inserted into the anal canal and rectum; it is usually a little uncomfortable but should not be painful.
Subsequently a tube called a proctoscope (10cm long) or sigmoidoscope (25cm long) may be inserted to view the anal canal and rectum respectively. A small amount of air may be pumped through the scope to inflate the bowel and give a clear view of the lining. Once again the investigation is a little uncomfortable but should not be painful. There is no reason why after these procedures you should not be able to go about all your normal daily activities unrestricted. Other examinations carried out may be of the vagina in women where appropriate and whilst standing when a hernia is to be assessed. Dip stick tests of a urine sample may be performed.
At this point your surgeon will have formulated a plan for your investigation or treatment. Investigation may include endoscopy of the upper or lower gastrointestinal tract (OGD, flexible sigmoidoscopy, colonoscopy), radiological investigation (Barium enema, CT scan, ultrasound, MRI scan) or blood and stool investigations. Treatment plans will be dependent upon the conditions encountered and range from simple advice to plans to perform major surgery.
At all times your surgeon will explain the need for each part of the consultation and the rationale for investigation and treatment. They will give you the opportunity to ask any questions and be delighted to answer them. Try not to leave the consultation with anxieties or questions unaddressed. If this should occur then do not hesitate to contact your surgeon’s secretary to make arrangement for them to contact you by phone or see you in person. A permanent record of your consultation, usually the letter written by your surgeon to your GP or referring doctor, can be sent to you at your request.