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Gynecology Testing Overview:

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed.  Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics.  24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff.   Some of these are discussed in detail in the links in this section.

What to Expect on Your First Visit:

First office visits typically last 45-60 minutes.  Your doctor will review your intake form with you and gather a detailed medical history.  A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors.  Specialty laboratory testing may be recommended.  Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.

First Visit: Blood Test

To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.

Patients are required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.

Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.

First Visit: Urine Analysis

To establish exactly how the kidneys are functioning. Patients are required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hours fasting period prior to the appointment.

A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.

Containers should be clearly labeled with the patient’s names and brought to the clinic at the time of their appointment.

First Visit: Resting ECG for Doctors Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The doctor in charge reports any findings in his medical notes.

Gynecology Testing:

A. Pap Smear

What is a Pap Smear

The Pap test, also known as Pap smear, is a medical procedure that checks for cancer in a woman’s cervix using a metal instrument called a speculum. The speculum will be inserted into the woman’s vagina to gently enlarge its walls so the doctor can see the cervix and to collect cervical cells for laboratory examination. The Pap test can determine if a woman has an infection, anomalous cervical cells, or cervical cancer.

Indications and Contraindications

Women should start Pap smear testing three years after their first sexual intercourse, or at age 21, whichever comes first. Women who have had a total hysterectomy for benign diseases may not need regular Pap tests. However, women who have had a total hysterectomy due to cancer must be screened annually for cervical cancer until they have three normal results. Women may no longer need to have regular pap smears if they older than 65 years of age with at least 3 normal Pap tests and no abnormal results in the last 10 years.

How do you prepare for a Pap Smear Test?

There are no dietary restrictions for a Pap Smear Test. Women should schedule to have their test done when they are not menstruating, most likely around 20 days after your last period. Two days before the test, it is best to avoid douching, using tampons and vaginal creams or deodorants. Also, refrain from sexual intercourse for 24 hours before the test.

How does it feel? How long will it take?

The Pap test is usually painless; however, some women may feel uncomfortable due to the minor pressure and tightness in their lower abdomen during the procedure. You may be able to feel a cold sensation once the speculum is inserted. This part of the test may feel slightly uncomfortable for some women. The Pap test will usually take only a few minutes.

Expected effects after the test:

Pap smears do not have side effects or medical risks. However, in rare cases, some women may experience spotting afterwards. This should only last a day or two.

Special instructions after the test:

After your pap smear, you may continue doing your normal daily activities.

Results:

Normal Findings: A negative Pap smear test indicates that there is no cancer cells found in the cervix. Cells are healthy and normal.

Abnormal Findings: A positive Pap smear test indicates the presence of unusual or abnormal cells in the cervix. Precancerous and cancerous cells like adenocarcinoma cells are present. Evidence of yeast infection, HPV and herpes may also be indicated on a positive pap smear test.

Notes:

False positives and false negatives results can happen. False negative results delay treatment of unhealthy cells. However, having regular Pap tests increases the chance of finding any cell abnormalities.

• Mammography

What is a Mammography?

A mammography is an x-ray examination of the breast. It is used to detect breast cancers, tumors and cysts.

Indications and Contraindications

Women should undergo a mammography if they have the following conditions:

• Ages 40-80
• Women of any age with a history of breast cancer
• BRCA-1 and BRCA-2 genetic alteration
• Lumpy breasts
• Breast skin thickening
• Nipple discharge
• Breast pain

Pregnant women should not undergo a mammogram. Women under the age of 25 with no risk for breast cancer are not recommended to undergo a mammogram.

How do you prepare for a mammogram?

Mammograms are usually scheduled usually one week after menstrual period.  If you will be having your mammogram at a different facility, bring your old mammogram records.

Do not wear deodorants, anti-perspirants, talcum powder or perfume on the day of the exam. You will also be asked to remove jewelries around the neck as this can alter the visualization of the breast.

Fasting and sedation are not required for a mammogram

Inform your physician or radiologist if you are breastfeeding.

How does it feel? How long will it take?

A mammogram usually takes 20 minutes to complete with the breast compression lasting for only a few seconds. During a mammogram, you will be required to remove your top clothing and wear a gown. Your breast will be placed on a platform where it will be compressed for x-ray imaging. It may feel a little painful and uncomfortable as pressure is being put on your breast.  This is necessary for capturing an x-ray imaging of the breast. During compression, you will have to sit up straight and hold your breath.

What are the effects after the test?

The level of radiation is minimal and there are very little risks from a mammography procedure.

Special instructions after the test

You may resume to your normal activities after the examination. Follow your physician’s instructions on how to do a self-breast examination.

Interpretation of Results

The American College of Radiology (ACR) has recommended a standard way of reporting mammography findings:

• Category O: Assessment incomplete; additional screenings/imaging is needed
• Category I: Negative
• Category II: Benign (non-cancerous)
• Category III: Benign (short term follow up is recommended)
• Category IV: Suspicious for cancer (further evaluation is needed)
• Category V: High suspicion of cancer

Normal Findings:

No tumor found, no signs of mass or cysts and any calcifications.

 Abnormal Findings: Presence of lumps, tumors, cysts, masses, calcifications, damaged tissues, and dense areas

            Abnormal findings indicate:

• Breast cancer
• Fibrocystic disease
• Suppurative mastitis

3. Pelvic Ultrasound

What is a Pelvic Ultrasound?

An ultrasound works by sending out high frequency sound waves, directed at the internal body part being examined, and recording the reflected sound or 'echoes' to create an image. The sound waves are emitted from a small, vibrating crystal in a hand-held scanner. The high frequency of the sound means it can't be heard by the human ear. An ultrasound scan doesn't produce high quality images, but it is non-invasive and doesn't involve radiation. It is commonly used to study the abdominal organs, pelvic organs and breast tissue.

A Pelvic ultrasound is an obstetric tool used to evaluate the genital tract for disease and to monitor known pelvic disease.

Indications and Contraindications

A pelvic ultrasound may be performed if a woman is suffering pain during sex, or has abnormal periods, fibroids, cysts or other conditions associated with the female reproductive system.

How do you prepare for a pelvic ultrasound?

An ultrasound scan doesn't require any special preparation beforehand. However, you may need to have a full bladder prior to the scan. It is recommended that you drink 2-3 glasses of water an hour before the test and to avoid urinating. If the ultrasound is to be done vaginally, no water is required before the examination. You will be advised by your doctor regarding this preparation. Items that may interfere during the ultrasound, such as jewelries and other metallic objects, must be removed before the test.

How does it feel? How long will it take?

An ultrasound scan usually takes around 15 to 20 minutes. This test is non-invasive, therefore it is painless. You will not feel anything at all, except for the cold feeling of the gel as soon as it is applied to your skin. In pelvic ultrasound, you might feel a little discomfort from having a full bladder and you might have the urge to urinate. Otherwise, you will feel very little to no discomfort during the test.

Expected effects after the test:

The ultrasound scan is a safe, non-invasive procedure that doesn't pose any known risks, side effects or complications to women and their babies.

Special instructions after the test:

After the procedure, you will be given paper towels (or something similar) to wipe off the gel. You can then get dressed. The scan itself is painless, drug-free and non-invasive, so there is no 'recovery time' needed. You can go about your normal business as soon as you've finished the scan.

Results:

Normal Findings:

• Absence of growth, cysts, tumors, and fluid
• Ovaries, uterus or fallopian tubes are normal in shape, size and position

Abnormal Findings:

• Abscess, kidney stones and pelvic inflammation (pelvic inflammatory disease)
• Abnormal growth of the endometrial lining of the uterus
• Presence of cysts, tumors and fluid
• Shape and size of the uterus appears to be abnormal

Notes:

• A lubricant is used for good transmission of sound waves to and from the body.
• Other names for ultrasound scan include sonogram and ultrasonography.
• You may be asked to hold your breath for a few seconds during the pregnancy ultrasound

The Right Diagnosis and Treatment for Gynecology

Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical’s Personal Approach to Gynecology

Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer’s, Diabetes, Parkinson’s, Multiple Sclerosis, anxiety, depression, and heart disease; the primary objective of our staff is prevention and early detection of disease.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, New York, NY 10017.