Transvaginal Ultrasound really necessary? - Women's Health Message Board

Coding777 · 06-06-2009, 08:47 AM

I recently visited the gyno. and to start off I wore my own gown. It had easy access to all the necessary parts and the paper gowns she had leave a lot to be desired. When she came in she was not happy about the gown and showed me the gowns she had for "big" girls and tried to get me to put this on over the gown I was already wearing. I told her that the paper gowns made me uncomfortable and I did not want to wear them. She still tried putting the gown on over mine. Which it isn't even a gown, it is a paper triangle that you wear like a poncho and the sides are open. It leaves me feeling exposed and uncomfortable. Any way we discussed how my periods were more regular now and that she wasn't even going to write me a prescription for the medication that I take to start my period if it does not show up on it's own since I had not needed it for 2 years now and we were almost finished with the exam and I casually asked her if she could actually feel anything when she did the manual exam because I am a chunky girl. She said yes, she could feel but she has to push hard because she is trying to feel through this (and she grabbed and shook the lower part of my stomach which she then had me hold up. She said that everything was find She then wanted to know if I had ever had any pain and I said no, only sometimes on the right side when it is time for me to ovulate. She then said that she was going to schedule me for an ultrasound. I told her that I did not want a transvaginal ultrasound because I had one previously before I started seeing her and it was painful. She said, well that won't happen here. I told her I was not having any symptoms and I did not want the transvaginal ultrasound and she told me to get dressed and we would discuss it. I went out to the front and she had already written the Rx for both an abdominal and transvaginal ultrasound. I told the lady at the front desk who was trying to schedule the procedure that I did not want the transvaginal ultrasound and she threw the scheduling book down and said I don't know what more I can do for you then. I told her she could schedule me an appt. for next year. As she was doing that she said, "I don't know what your problem is" and I politely told her that I did not need her personal opinion. About this time the doctor came back through and she wouldn't even look at me. I asked her if I could just have the abdominal ultrasound and she said yes but they would note that I would only allow a limited exam and the procedure would not be complete. I scheduled the abdominal ultrasound to take place at her office. I have seen this doctor for 14 years, never had an abnormal pap smear and my periods have improved. I am sure had I not asked if she could feel anything she would not have even mentioned this ultrasound. On the Rx for the ultrasound it states that she is ordering the test due to right sided pain and oligomennorrhea. This is not correct as I do not have right sided pain and I have no other symptoms. Is this procedure medically necessary? I am thinking of finding a new provider and just wanted to get some opinions from others as to how you would have handled this situation. As I said, I have seen this doctor for 14 years and have never had a problem like this and she has never mentioned an ultrasound before.

Kszan · 06-06-2009, 09:26 AM

While I definitely agree that there was some unprofessional behavior going on there with that visit, I'm still trying to understand why you're so reluctant to get a transvaginal ultrasound? I end up having to get those done like a couple times a year because I keep getting endometrial polyps that keep coming back and subsequently need to be removed.

Here's the problem with ONLY getting the abdominal ultrasound... It misses a lot of details that the transvaginal ultrasound will be able to pick up. And if your doctor suspects some issue, particularly ovarian, it will be a lot easier to see what's happening with a transvaginal than it would be with a regular abdominal because there wont' be hardly any detail at all.

I know these tests and procedures are uncomfortable but you owe it to yourself for your health to get this stuff done to ensure you are getting the best possible care. And the only way the doc can provide you with the best possible care is to explore all of the options in terms of what may be wrong, and then decide on treatment.

A doctor wouldn't require an ultrasound for no reason. I'm sure she suspects something going on and that's why she wants to do it. So what you should do is get the abdominal AND transvaginal so that she can see what's happening and confirm what she may already know based on the manual exam.

Coding777 · 06-06-2009, 09:45 AM

I have no symptoms, no pain, my periods are what are considered normal for me. I do not have the right sided pain that she noted on the Rx for the procdedure. I do not know why she is scheduling this exam for me. She did not state that she felt anything during the exam and in the 14 years I have been seeing her she has never even mentioned the need for this when I told her about pain I was having about 3 years ago. I do not think that this procedure is medically necessary.

Thisby · 06-06-2009, 04:55 PM

Quote:

Originally Posted by Coding777

She then wanted to know if I had ever had any pain and I said no, only sometimes on the right side when it is time for me to ovulate. She then said that she was going to schedule me for an ultrasound.

There you go. You even write right here that you told her you have pain sometimes on the right.

Quote:

Originally Posted by Coding777

I do not think that this procedure is medically necessary.

You are perfectly allowed to think this, just remember that she is the doctor and if you want her to keep being your doctor, you should probably agree to it. If you refuse, it would appear to her you're just being difficult first with the gown issue, and then this.

She may seem unsympathetic about the gown thing because millions of women have their yearly examinations wearing those silly gowns and most get through it without a word. It really is nothing. Imagine your only other choice were to have the exam entirely naked. Makes her little gown sound pretty good by comparison? The embarrassment is just something you have to will yourself to handle. Mind over matter.

As for the transvaginal ultrasound, I've had about 10 of them and not a one hurt even in the slightest, so you'd probably have to explain how it hurt, because I can't imagine.

Anyway, if this procedure is being paid for by someone other that you, think of it as a good way of making sure everything is fine. I would only consider arguing about it if you're paying out of pocket. Then I'd want to be sure it was necessary.

Coding777 · 06-06-2009, 05:46 PM

Ovulation pain is not something that I would consider to need medical evlauation. It happens midway during my cycle as I am sure happens to million of other women. She has never mentioned this test before even when I told her 2 years ago that I did have pain on my left side occasionally. She stated this was probably just a functional cyst and it would go away as my cycle progressed. As far as someone else paying for it, yes I have insurance but to have an unnecessary procedure just because someone else is footing the bill is irresponsible not just by the doctor but by the patient as well. I am a medical biller and coder and if people just realized the fraud and deception that goes on by having these "medically necessary" procedures for profit you would be outraged. I would gladly donate this procedure to someone without insurance who truly needs it.

As far as the gown goes, it should not matter what you wear as long as all the necessary parts are accessible (which they were). It is just a matter of doing things her way. I feel that doctors are providing a service which we pay for and their customer service should be just as good as any other business we go to. If the doctor doesn't want me to feel comfortable (which this should be their main concern) I can find another provider ,they are a dime a dozen. Just finding a good one takes a little time.