MY 'OUTER SPACE'

cst group 9
members : bhavani, era, zubeq, zubir, nana, ishani, aliah, adris, jud, zawir, parvin, shashu.
facilitator : Dr. Akmal
time : 5-7 p.m
rate : 9/10

s1 : greet the patient and introduce yourself..(my name is..... n may i know your name please? what brings you here today?)
q1 : when is your last menstrual period?
q2 : when do u get ur menarche?
q3 : what is the duration of your menstrual cycle?
q4 : how long is the duration of your period?
q5 : amount of blood loss??(how many pads per day? fully soak or half soak?)
q6 : do u have any vaginal bleeding in between ur cycle?
q7 : do u experience any pain during menses?(dysmenorrhea)

s2 : ok,i would like to ask quite personal and sensitive questions regarding your sexual life(skillful approach, make the patient feel comfortable n start with light questions)
q1 : are you married?
q2 : how many children you have?
q3 : do you feel any pain during sexual intercourse?( inclusive post coital bleeding)
q4 : any vaginal discharge?
q5 : ask about previous medical problem during pregnancy/breastfeed/neonatal jaundice
q6 : r u trying to conceive?(use of contraceptive devices n pills)
q7 : any medications?
q8 : any past history?q9 : sosial history( do u smoke? do u drink?)
q9 : systemic review

s3 : finally summarize your findings to the patient.


CASE 2(vaginal examination counseling)

me : assalamualaikum, my name is Aliah n i would do the vaginal examination today. May i know your name please?
era : erm my name is Nana(laughter)
me : okay mrs nana, i would 1st explain to you the procedure of the vaginal examination, n if you have any questions, you can just ask me okay.
era aka mrs nana : okay
me : 1st thing that i will do is by inserting a speculum, a device use to open your vagina and cervix for inspection.
era aka mrs nana : it is going to be painful???
me : well it wont be any pain but there will be a slight discomfort to you but you can stop me at anytime if you feel uncomfortable, okay?
mrs nana : okay
me : 2nd procedure is pap smear.

interuption~
Dr Akmal : mrs nana, do you know what is pap smear??
mrs nana : err no
Dr Akmal : so y dont u ask the doctor??
mrs nana : owh ok.
Dr akmal : Aliah, i cant hear your voice clearly
me: owh ok ok(raising my voice)

cont~
me : A Pap smear (also known as the Pap test) is a medical procedure in which a sample of cells from a woman's cervix (the end of the uterus that extends into the vagina) is collected and spread (smeared) on a microscope slide. The cells are examined under a microscope in order to look for pre-malignant (before-cancer) or malignant (cancer ) changes.
mrs nana : is it going to take a long time?
me : no..A Pap smear is a simple, quick, and relatively painless screening test.
mrs nana : okay
me : 3rd is the digital bimanual examination. it is done to check any abnormality in the pelvic organ such as uterus and ovary. im going to insert my fingers to palpate your pelvic organ.
mrs nana : is there going to be an infection?
me : it wont as i will be using a glove and practice hygiene. so i think that's all. thank you
(fuh lega)

it was an enjoyable session. Dr Akmal pun sporting n siap puji lagi : i wonder y this group mcm tak malu2 utk tanye the sexual history, because the previous group mcm ade barrier.(kami : hehe)..korng dah prepare ke???(kami : nooooo)..gud gud..mcm mane nk make the patient feel comfortable during the private part examination?? kene bercakap or berbual dgn patient utk distract die so she wont feel shy..(kami : oooo)

parvin : how can you remember all the steps n everything??
Dr Akmal : 1st is practice, 2nd is practice and 3rd is practice(smile)