Alex Gets Examined

As you sit in the waiting room, having completed all the forms and now reading an outdated Time magazine, the office door next to the receptionist opens and a woman calls your name… Alex.

“Hi Alex, I’m nurse Ellen. How are you today? Good. Please come this way, we need to weigh you first. step up on the scale, OK let me adjust the weights. 175 is pretty good weight for your build. Go back down the hallway to exam room 2 and have a seat on the exam table.” [Nurse Ellen follows you into the room, closing the door behind her.]

“Thanks for filling out your health history form. The Dr. will review your information, but first I’m going to take your vital signs. Open your mouth and put the thermometer under your tongue. OK, your temp is normal. Just need to get your blood pressure and pulse, the cuff will feel a little tight as I take your pressure, just relax. Very good, your blood pressure is in the normal range. Looking at my chart it says you are here today for a complete physical, is that correct ? OK, just let me get a gown out of the drawer…Here you go,”… [handing it to you]. “Please undress completely, including your underwear, put on the gown, tying it in back and have a seat back on the exam table. The doctor will be with you in a minute.”

[You proceed to get undressed, standing completely naked in the cool, white room as you slip on the gown and tie it in back at the neck and waist. Then you sit on the exam table, hearing the disposable paper covering crinkle and crunch under you as you get situated, trying to keep the back closed.]

“Knock, Knock. Hi Alex, I’m Dr. Anderson, how are you today? Good. I see that you are here today for a complete physical examination. I’ve gone over your health history and you seem to be in good health. Are here any questions you have before I start? Any problems that concern you that you want me to examine specifically? No? Then let’s go ahead and begin your exam. As I examine you I’ll explain what I am doing as I go long, to give you a better understanding of the exam. I’ve also found that this makes my patients a little more comfortable and helps them relax. Please remain sitting upright.”

“Open your mouth and say aahh…OK. Now I’m going to use the otoscope to look at your eyes, nose and ears….Everything seems fine. I’m going to untie and loosen the top of your gown so I can listen to your heart and lungs. The stethoscope may feel a little cold,” [I reach under your gown and place it on your chest. I’m listening to your heart beat, moving the stethoscope around in three different places. I move to place the stethoscope on your back]

“Take a deep breath, hold it and let it out slowly. Again, good, and again. OK, now slip your arms out of the gown and lay back on the exam table.” [I move to the end of the exam table to pull out the extension, so you are laying flat with your legs stretched out, not dangling over the edge.]

“Next I’m going to examine your chest and abdomen.” [I pull the gown back to expose your chest.]

“Although breast cancer is extremely rare in males I want to check your breast and nipple area.” [You feel me gently and briefly press around your breast and nipple area]

“OK, I’m going to pull the gown back to fully expose your abdomen to examine your internal organs. Relax your belly as much as possible as I feel and push on the different areas of your abdomen. Any pain or tenderness as I push here? Good. I’m feeling your stomach, intestines, kidneys, liver and bladder. Every thing seems fine. Go ahead and pull up your gown and slip your arms back into it. Next I’m going to check the pulse points in your legs, to make sure that you have good circulation.” [Slightly raising the side of your gown, I place the pads of two fingers near the upper corner of your pubic hair, where your leg joins your hip. Then I move down to do the same behind your knee and near the ankle. I repeat this on the other leg.]

“OK, lift your legs a bit as I push the table extension back into the table. Please sit up so I can test your reflexes. I’m going to tap your knee with this rubber hammer to test your reflexes. Good. “

“Next I’m going to perform your genital exam. Before doing so, I’d like to discuss testicular self examination and ask you if you perform monthly testicular self exams? Good, I’m glad to hear that you do. Many young men don’t realize the importance of doing self exams. Boys and men age 15 to 35 are at the highest risk for testicular cancer, so I encourage you to continue to do your monthly self exam, as it could save your life. Do you have any questions about what to look at and feel for when doing the self exam? OK, then step down on the floor and stand next to the exam table, in front of that stool.”

[As you do so, you watch me as I go over to the counter and get the supplies ready for your exam, grabbing a pair of gloves and setting the tube of K-Y Jelly next to the exam table. As I approach you, you watch as I slide one of my hands into a thin, rubber examination glove. As I sit down on the stool in front of you, rolling it in closer to you so that I am now eye-level and inches away ….]

“OK, please stand with your feet shoulder width apart and raise your gown above your waist.” [As you raise your gown to expose your sexual anatomy to my sight, I pull on the other exam glove, letting it snap.]

“I’m going to start by examining your penis and you’re going to feel me touch you now. I’m going to look at your penis all over to check for sores, rashes or bumps.” [I’m visually examining your shaft and head, lifting it up to see all sides.]

“Now I’m going to look at and feel the head of your penis. Do you ever have any discharge from your penis? Good, now I’m going to examine your urethral meatus.” [You’re feeling me spread the opening of your penis as I hold your shaft and place my thumbs on each side of the slit and gently pull back, to spread apart the opening].

“Now I’m going to examine your shaft. You’re going to feel me touch you from the base to your head.” [Using my thumb and index and middle fingers I place them around your penis, gently squeezing as I feel along your penis, moving from the base to the tip of the head.]

“Next I’m going to examine your scrotum.” [You’re feeling me touching your scrotum as I visually inspect it, lifting it up to examine the sides and underside.]

“Next I’m going to examine each testicle and your spermatic cords.” [You’re feeling me roll each testicle between my fingers, checking for lumps and pain or tenderness. I’m feeling along each side of your scrotal sac, from the top of each testicle to near the base of your penis, checking your spermatic cords.]

“Now I’m going to check for hernias.” [You’re feeling my finger being pushed up into the top of your scrotum, alongside the base of your penis and into your inguinal canal and inguinal ring.]

“Turn your head and cough. Again.” [Now you feel me push my finger into the other side.] “Cough. Again.” [I remove my finger then roll the stool back…] “OK you can lower your gown now.”

“Next I will perform your rectal and prostate exam. Please untie the back of your gown at the waist and turn around and face the end of the examination table. Now go ahead and bend over, leaning across the table so your chest is resting on the table with your arms out in front of you. I’m going to first examine your anus.” [You’re feeling me spread your cheeks apart as I visually examine your anus and perineum.]

“Next I’m going to examine your rectum.” [I reach over, grab the tube of K-Y Jelly and squeeze a generous amount onto my index finger. You’re again feeling me spread your cheeks apart.]

“The jelly may feel a little cold at first, please bear down for me.” [Now you’re feeling my finger as it penetrates your anus. I pause briefly, then push my finger in as far as it will go.]

“You’re going to feel my finger as I sweep it over the walls of your rectum, checking for growths, polyps and cancer.” [You’re feeling my finger as it moves inside of you, from top to bottom and to both sides.]

“Next I’ll examine your prostate. You may feel a strange sensation, often it’s like a need to urinate.” [You’re feeling my finger press your prostate, as I move it over your gland several times, checking it’s size and firmness. I withdraw my finger from your anus and rectum and remove the rubber glove.]

“OK you can stand up now and turn around. I need to check for any discharge from your urethra after doing the prostate exam. This will rule out any possible infection that may exist in the prostate. Please stand in front of the stool and raise your gown above your waist.” [As you do I slip on a new exam glove with a snap]. “I will again examine your penis.” [You’re feeling me touch the base of your penis, applying pressure with a downward stroke, as I strip your penis to produce any discharge. I repeat this action two more times].

“OK, no discharge and everything looks healthy. You can lower your gown now.” [I roll the stool back, stand up and remove my exam gloves.]

“That completes your physical examination. You are in good health and I found no problems. Go ahead and get dressed and stop with the receptionist on your way out.”

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