WHAT TO EXPECT AT A GYNAE VISIT

Please arrive 15 minutes before your scheduled appointment to complete a registration form. It is normal to feel nervous about your first visit! Dr Krick has a gift for making her patients feel more relaxed and at ease.

Dr Krick’s first consultation is around 45-60 minutes. You are welcome to bring along a support person. Dr Krick will ask a lot of questions about your medical, surgical and gynaecologic history. Some questions may seem personal, such as questions about your menstrual period or sexual activities. All questions serve the purpose of guiding Dr Krick to ascertain your health, risk factors or any symptoms of illnesses. And remember, your consultation is confidential.

The examination involves both a general physical exam and gynaecological (pelvic) exam.

During the general exam Dr Krick will also perform a breast exam and teach you how to do regular self-checks of your breasts at home.

During the gynaecological exam Dr Krick first looks at your vulva. She then examines your vagina and cervix with the help of a speculum. This part of the examination is uncomfortable but not painful (if you have never been sexually active you will not require this unless there is a specific problem to look at). A non-painful Pap smear is also done during a speculum exam.

To check your internal organs, Dr Krick will place one or two gloved, lubricated fingers into the vagina and up to the cervix. The other hand will press on the abdomen from the outside. The examination is completed with an ultrasound of your pelvic organs.

FEE STRUCTURE

Please contact Tanya for our current fees. The practice is contracted in with Netcare and Discovery Classic Medical Aids only. In-room consultations/procedures need to be settled on the day of service and claimed back from your medical aid. In-hospital consultations/procedures are billed to the medical aid directly.

PLEASE NOTE: MEDICAL AIDS REQUIRE AUTHORISATION BE OBTAINED FOR NON-EMERGENCY ADMISSIONS/PROCEDURES. IT IS THE PATIENT’S RESPONSIBILITY TO OBTAIN THIS AUTHORISATION. FAILURE TO PROVIDE AN AUTHORISATION NUMBER MAY RESULT IN A PROCEDURE/OPERATION BEING POSTPONED OR CANCELLED. THIS PRACTICE CHARGES ABOVE MEDICAL AID RATES AND YOU MAY BE LIABLE FOR A CO-PAYMENT, DEPENDING ON YOUR MEDICAL AID PLAN. OUR OBSTETRIC DELIVERY FEE DOES NOT INCLUDE THE ANAESTHETIST, PEDIATRICIAN OR HOSPITAL FEE. PLEASE ASK US FOR ASSISTANCE IN OBTAINING QUOTATIONS FOR THESE. ALL PATHOLOGY OR RADIOLOGICAL INVESTIGATIONS ARE CHARGED FOR BY THE RESPECTIVE LABORATORY OR RADIOLOGY SERVICE. YOU WILL RECEIVE AN INVOICE FROM THESE SERVICE PROVIDERS SEPARATELY.

AUTHORISATION

You are expected to obtain an authorisation from your medical aid for the procedure and hospital admission. You will be given all necessary documentation to facilitate the authorisation process.

PLEASE NOTE: DR KRICK CHARGES ABOVE BASIC MEDICAL AID RATES. DEPENDING ON YOUR MEDICAL AID PLAN, YOU MAY HAVE TO PAY A CO-PAYMENT. PLEASE ASK US TO PROVIDE YOU WITH A QUOTATION BEFORE THE PROCEDURE. KINDLY NOTE THAT THE ANAESTHETIST, PEDIATRICIAN (IN CASE OF CAESAREAN SECTION) AND HOSPITAL CHARGES ARE SEPARATE FROM DR KRICK'S FEES. PLEASE ASK US TO HELP YOU WITH OBTAINING QUOTATIONS FOR THESE.




HAVING SURGERY

Dr Krick has admission and operating rights at Netcare Christiaan Barnard Memorial Hospital and Mediclinic Cape Town. Unless your surgery is an emergency, we will try our best to accommodate you with a date and time convenient for you. This is also influenced by theatre and operating team availability.

BEFORE SURGERY

You should not eat or drink anything for 6 hours before your allocated surgery. Small sips of water are allowed up to 2 hours before.

PLEASE NOTE: IF YOU DO NOT ADHERE TO THESE RESTRICTIONS, YOUR SURGERY WILL BE CANCELLED AND RESCHEDULED FOR ANOTHER DATE. REGULAR MEDICATIONS FOR HIGH BLOOD PRESSURE, DIABETES, EPILEPSY ETC. SHOULD BE INGESTED WITH A SMALL AMOUNT OF WATER AT YOUR REGULAR MEDICATION TIMES (AT LEAST 2 HOURS BEFORE SURGERY). BLOOD THINNERS AND NON-STEROIDAL ANTI-INFLAMMATORY DRUGS, AS WELL AS CERTAIN HERBAL AND OVER-THE-COUNTER PREPARATIONS NEED TO BE STOPPED SOONER. PLEASE DISCUSS ALL OF THESE MEDICATIONS WITH DR KRICK DURING YOUR CONSULTATION. YOU WILL BE ASKED TO SIGN A CONSENT FORM FOR THE PROCEDURE BEFORE YOUR SURGERY. THE PROCEDURE WILL BE EXPLAINED TO YOU AND COMMON POSSIBLE COMPLICATIONS WILL BE SPECIFICALLY HIGHLIGHTED. RARE COMPLICATIONS MAY OCCUR BUT YOU CAN BE CERTAIN THAT YOU ARE IN EXPERT HANDS WITH DR KRICK. PLEASE DISCUSS ANY CONCERNS YOU HAVE PRIOR TO SIGNING CONSENT. IN SIGNING THE CONSENT FORM YOU ACKNOWLEDGE THAT YOU FULLY UNDERSTAND THE PLANNED PROCEDURE AND POSSIBLE COMPLICATIONS WHICH MAY ARISE, NECESSITATING FURTHER ACTION.

ANAESTHESIA

Dr Krick works with experienced anaesthetists who keep you safe and pain free during your operation.

The anaesthetists fee is separate from Dr Krick’s. Please enquire which anaethetist has been assigned to you to get a quotation from their offices.

  • Southern Anaesthetics: 021 762-6277 (Jan or Linda)

  • Cape Anaesthetics: 021 683-9244 (Sharon)

  • Molteno Anaesthetics: 021 447-2999

AFTER THE OPERATION

Pain – It is expected to have some pain around the incision site as well as the operative area. You will be given excellent pain relief (either as injections, suppositories, tablets or a combination). Certain medications (opioids) may cause nausea & constipation, hence us weaning them off as soon as possible. You will also be provided with stool softeners to counteract these contipatory effects.

Vaginal Bleeding – Depending on what procedure you have done, you may have vaginal bleeding for about a week following surgery, however this too should get progressively lighter. Your normal menstrual period after surgery may be out of schedule.

Medications – You can re-start your regular medications following surgery. We may also prescribe a blood thinning injection to prevent blood clots while you are still in hospital.

Going Home – Timing of your discharge home will depend on your general condition, support at home, pain control, bowel and bladder function. You are usually discharged from the hospital on the same day or the following day after laparoscopic or hysteroscopic procedure, and in 2-3 days after an abdominal or vaginal procedure.

Driving – You may not drive for 24 hours after a general anaesthetic. General medical advice  is that you can drive when you have no pain, are not using any pain killers and able to press your foot hard on the floor without any pain in your body. Please contact your insurance company to find out when you are allowed to drive following surgery in terms of your insurance cover.

Work – After a minor procedure (e.g. hysteroscopy) you usually feel able to return to work by the next day or 2. You will be able to return to work in 2 weeks following laparoscopic or vaginal surgery and in 6 weeks following abdominal surgery. You should avoid heavy lifting and intense household duties for 4 weeks following surgery.

Exercise – Walking as soon as you can after surgery aids healing. Once your wounds have healed you may restart exercising slowly. The general rule is: “listen to your body”. Gentle exercises can be restarted as soon as you are comfortable. If your body tells you to take it easier, listen to it. Avoid high impact exercise for at least 4 weeks following surgery.

Sex – You can resume sexual activity as soon as you have stopped bleeding and have no discomfort. If you are trying to fall pregnant you can resume trying to conceive following your next menstrual period.

Post-operative Care – Dr Krick will see you in the hospital following surgery and will advise you on when to schedule a follow-up visit.




WARNING SIGNS

Please contact Dr Krick, your GP or the emergency unit if you develop any of the following symptoms after surgery:

–  Severe vomiting, fever
–  Pain that is increasing in intensity and is not controlled by the prescribed pain killers
–  Persistent vaginal bleeding, which is becoming heavier or smelly vaginal discharge
–  Pus, swelling, increasing redness around incisions
–  Pain/burning when you are passing urine or inability to pass urine
–  Collapse, dizziness

HPV FAST FACTS

Human Papilloma Virus (HPV)

  • Human papillomavirus (HPV) is the name of a group of viruses that infect the skin and mucous membranes.
  • There are more than 100 different types of HPV. Certain types of HPV cause warts, some types of genital HPV are linked to abnormal cell changes on the cervix that can lead to cervical cancer.
  • HPV can be contracted from one partner, remain dormant, and then later be unknowingly transmitted to another sexual partner, including a spouse.
  • It is estimated that 80% of sexually active people have some or other strain of HPV in their lifetime.
  • In most cases, the virus is harmless and the body clears most HPV infections naturally.
  • However, some high-risk strains of HPV, if not cleared, can cause cervical cancer. The majority of women with an HPV infection will not develop cervical cancer, but regular screening is crucial.
  • Cervical cancer most commonly takes 10 years to 20 years or more to develop; women who are no longer sexually active should continue to be screened.
  • Cervical cancer is completely preventable if precancerous cell changes are detected and treated early, before cervical cancer develops.

HPV Vaccine

  • Two vaccines (Gardasil and Cervarix) are currently available in South Africa to prevent infection with certain types of HPV known to cause cervical cancer.
  • They significantly reduce the number of women who develop cervical abnormalities that can lead to cancer. Gardasil also prevents infection with the two HPV types that cause 90 % of genital warts.
  • It is important to keep in mind that the vaccine works best if given before sexual activity begins. Some studies have shown that the vaccine may help fight already contracted HPV, but these studies are ongoing.
  • Some also worry that the vaccine may have serious side effects, but studies have clearly shown that the available HPV vaccines are very safe.
  • The vaccines need to be given in 2-3 doses depending on the individual’s age.