Urologists are often found to be nice and serious but at the same time they have a strange crookedness. You can be in a situation where you will have to tell things which even you might not think of telling yourself and therefore patients are not very comfortable speaking with urologists and they used to speak in a nice way such as ‘Doc, I got some thins along with my thing’.
There is an old joke which says that students, who often finish last during the examination of a medical school, are often called as ‘doctor’. However, if the same student reaches somewhere on the top list along with his other colleagues, then they do not take him seriously and might call him ‘urologist’.
Urologists are considered to be the clowns of a class and they do not seem to take anything seriously but rather takes everything including studies lightly but somehow they end up topping the list in any competition.
Medicine is an academic career where a doctor deals with the most private issues of a patient which even the patients at times fear discussing with doctors. That is the reason why these doctors are often known as unique or a quirky group.
When a medical student becomes a Neurosurgeon, they ask some interesting questions regarding the origin of a human thought or about the neurobiological associations of a soul, whereas when a medical student turns out to be a urologist, they ask some stupid questions such as ‘why would anybody wish to do that for a living?’
Urologists usually provide a completely different treatment. They often spend all day trying to do something or the other which would embarrass their mothers. Most of the patients they come across immediately drop their pants during some part of the conversation. That takes a little bit of time to get used to it.
However it has been a known fact that urologists are considered to be the happiest and highly regarded physicians and therefore it is worth the call.
GET READY TO GET AN APPOINTMENT WITH THE UROLOGIST.
It does not matter what usually takes you to the office of a urologist, the moment you enter, you will be asked to fill a detailed form where you will require filling up your whole medical history before your appointed meeting with your urologist.
Since the questionnaire will be lengthy, these questionnaires can even be mailed to your email id before you take an appointment so that you do not waste time waiting it at the doctor’s office.
There are two sets of information that are required to be filled by the patient before meeting the urologist. The first information that is required to be filled and which your urologist requires to know is to find out the reason why you have taken an appointment with the urologist.
The second question will be to find out whether the patient is having any Medicare or any other insurance service providers which will pay for the patient’s treatment.
In case a patient is having Medicare or any other insurance service providers then there are a bit of regulations which will be required to be followed and another set of documentations which are not actually required but it might be required in order to meet with the federal guidelines.
The first question put by the urologist might be something like ‘what is the reason why you have come here’. If it is a problem regarding erectile dysfunction, some patients will immediately report it to their doctor. The most commonly found answers to the question are ‘personal problems’, ‘consultation’ or ‘prostate problems’.
First time patients might find it bit embarrassing dealing with these questions and therefore a complete questionnaire might just do the trick as those patients who are reluctant to speak out can at least pen it down and their doctors will know the problem without even the need to question them.
But there are some patients who provide fake problems or concerns regarding themselves and only when the doctor ask them if there is ‘anything else apart from these illness’ that they mumble from their mouth something relating to erections but it comes from deep down their breath.
In case the doctors never ask such patients this particular question then there are chances for the patient to be diagnosed for an altogether different disease.
The next process is to gather some medical information. Most of the physicians usually group such information in a standard fashion.
Medicare requires all the details of a patient in a standard format since the last 10 years. Though not many of the patients might have applied for Medicare insurance service providers, it is considered to be the most powerful economic force in the health care.
The information that has to be provided to Medicare will help generate sufficient information regarding a patient and his history of the illness known as PHM (Past Medical History) and even Past Surgical History (PSH).
While filling up the form, it is required for patients to mention the list of their past illness, list of their hospitalizations, whether any operations have been conducted on them or whether they have been affected due to their current health.
All the medications and the allergies are all listed and flagged down by the doctors for any future references when it comes to prescribing their patients any medicines.
There is also ‘social history’ column which has to be provided by the patients which will ask them for their marital status, smoking or drinking habits, occupation etc.
Then the final set will ask certain questions about other different parts of the body organs which will provide information whether the patient is having a weak knee, a weak heart or even a weak erection.
The questions that are put forth regarding a specific complaint of the patient will help answer any of the below mentioned qualifying factors –
1. Location – Where exactly is the problem?
2. Duration – Since how long have this problem been bothering you?
3. Timing – Is the problem continuous or is it irregular?
4. Quality – Could you describe your symptoms?
5. Severity – How severe is your problem?
6. Context – Under what circumstances does the problem occur?
7. Modifying factors – Did you have any previous treatment?
8. Associated symptoms – Apart from the current problem, is there any other problem you have noticed?
Accepting the fact that the patient has come to regard erectile dysfunction, we will be able to answer all of the below qualifying questions very easily.
1- Location – Penis.
2- Duration – Since a very long period of time.
3- Timing – Very bad.
4- Quality – Very poor.
5- Severity – Severe enough for discussing the problem with a professional.
6- Modifying factors – I do not have any associated symptoms yet.
Once all the above information has been obtained, the doctor will then check for any specific concern for which the patient has visited his clinic. If it is regarding erectile dysfunction, it might require a bit of counseling.
Alternatively, the doctor can also get the required information if he can check for the patient’s sexual history which he might have written on the questionnaire provided.
Almost all the information is available in the questionnaire and therefore a doctor usually does not miss out on any of the information that is required.
Many urologists have prepared their own forms or questionnaires based on the importance and the need for knowing the problems faced by their patients with erectile dysfunction which will also allow them to focus on only the main issues and which they feel is more important to be known from their patients.
Anybody goes to watch a movie, comes well prepared. He knows why he is there and which movie he wants tickets for. He may have money ready. If he is feeling hungry, he would go straight to the concession stand and buy something.
He’d empty their bladder if he thinks the film will be lengthy enough to cause discomfort. Someone even brings a sweater, because the theater may be too cool.
If only men and women came to the doctor’s office so well geared up. Many come lacking their required medical information available. They anticipate that the doctor would make suggestions about their health care without having to supply the essential information to do so.
In Gordon’s case, the pill that made him “deathly ill” was nitroglycerin. The reason he vomited the time he took it was that he was having a heart attack. He no longer used regular nitroglycerine, but took it daily in a sustained release form.
He wasn’t allergic -just clueless. The prescription he demanded without an examination or gathering of any history was for Viagra.. Had this been dished out as requested, he could have easily died in bed later that night. Fortunately for Gordon, Dr. Brown did his homework before fulfilling his demands.
An insufficient track record can deliver devastating results. If Dr. Brown had not determined that Gordon took nitroglycerin, its interaction with The blue pill might have been fatal.
The failure to comprehend that one of his testicles had been removed for a tumor that caused endocrine abnormalities meant that the man was operating on essentially no testosterone.
The other testicle had burned out, so he was technically an eunuch. Despite the fact that we know that testosterone isn’t completely necessary for an erection, it is involved in the big picture.
Thankfully, the doctor acknowledged this when the patient finally slowed down enough to have a simple examination. A prescription for testosterone replacement therapy fixed the problem swiftly and for good -except that “it cost too damned much,”
Upon check-in, provide information you need to the office staff. Have your medical history details available and ready. If any tests have been executed prior to that time that are related to this visit, you should definitely ask the staff to make sure that the results axe on your chart rather than waiting until you are face to face with the doctor.
When considering any doctor nowadays, you must also know your insurance status.
THE GENERAL EXAMINATION
Despite the fact that an evaluation of the penis might be the only thing estimated, keep in mind that no penis is an island. Your physician will begin the evaluation before you perhaps even know it.
He will probably note your weight, build, etc. Specific body forms are associated with syndromes which may not result in severe medical problems, but might affect erections. If these syndromes are suspected, more tests may be suggested.
The body of a weightlifter is likely to make the physician curious about steroid use. Down the road, he will be particularly watchful of testicular size if he thinks you use steroids, as they may shrink the testicles dramatically. Perfect pecs coupled with tiny testicles will be a sure free gift that anabolic steroid use is perhaps the problem.
The neck may be reviewed for thyroid abnormalities that could have an effect on all around health and erections. A cursory heart and lung assessment may be carried out to make certain that the individual is capable of having and using erections.
An abdominal evaluation to test for tumors or hernias is part of a general physical examination as well, even though they don’t have an effect on erections. Last but not least, the blood pressure and pulse are checked to see if there is any severe systemic disease.
THE GENITAL EXAMINATION: DROP EM
Men love dropping their pants- except in the urologist’s office. All of a sudden, modesty increases. Make an effort to get over it. In the end, the office visit is to assist you to drop ’em more frequently, so this short-term humiliation is worth it.
Your penis is reviewed for external lesions, or for indications of venereal diseases. The foreskin is rolled back in uncircumcised men so that the doctor can assure there are no tumors and to examine the health of the glans penis. The base is palpated deeply by squeezing it between fingers to check for Peyronie’s plaques.
A mans testicles are analyzed mainly for size and tumors. Small gonads indicate that low testosterone could possibly be the main problem. If they appear big, it will always be due to fluid around them.
This fluid may well be a small collection of sperm (called a sperifiatocele) or just body fluid (called a hydro cek). An accumulation of varicose veins in the scrotum is called a varicocele and may be connected with a low sperm count. A lacking or undescended testicle might also be a clue to a hormonal imbalance.
It is essential to drop your pants sufficiently. Some males will try to merely pull your penis through the zipper. Remembering that half of the entire penis is situated inside the body in the first place, the doctor can only gain access to just one-fourth of the penis if you just pull it out through the zipper.
The testicles won’t be accessible at all in that environment, so pull your pants and underwear down at least to the mid-thigh. Let the doctor do his work so you can move on to therapy.
THE RECTAL EXAMINATION
This is the biggie, the part of the urology appointment men hate the most.
As uncomfortable as many males still find it, the rectal evaluation ought to be carried out annually on all men of sufficient age to have significant disease that could be detected by doing so.
That typically implies rectal or prostate cancer, so the suggestions are often to begin developing a rectal check-up after the age of fifty. Black men should start five years earlier depending on the increased risk of prostate cancer.
It’s not rocket science, but there are a few things that help make the rectal examination more bearable. Very first, gradually get over any anxiety or embarrassment.
Admit it, the urologist sees basically every patient’s backside sooner or later, and yours isn’t considerably different, Not one is beautiful.
The actual reason to get over the anxiety is that uneasiness makes the pelvic floor muscles tighten up and decreases the pain threshold which means the doctor has to push harder to get a gloved finger into the rectum, and more pain sensations will subsequently be sent to the brain.
Some men object about the quantity of lubrication used on the gloved finger. Don’t. Lube can do a lot more to reduce pain than anything else the doctor can do (except being gentle, which should be a given).
The lubricating jelly is water-soluble, so washes or wipes off effortlessly. Motivate him to use as much as required.
Last but not least, your body position is really a big factor. Most men (and some doctors) don’t know that the finest position for a rectal examination is standing up with the legs a little bit apart. Hovering over an examining table with the knees slightly ‘bent will allow your elbows to be placed at the edge of the examining table.
This puts optimum bend into the waist, reducing the distance the doctor must reach inside to be able to examine the. prostate. The shorter distance signifies he pushes less-which is undoubtedly in everyone’s welfare. In obese men, this is the only way the urologist may be able to feel the entire prostate.