Not so much a physical as a very thorough exam, my first appointment with my former OB/Gyn was very involved. This doctor was measuring the degree of my prolapse, so following the normal abdominal palpating and pelvic exam, he raised the head of the exam table, inserted a finger or two into my vagina, and asked me to bear down like I was having a bowel movement.
“Push, push, push!”
It was very strange, and probably the most embarrassed I have ever been in an exam. But he diagnosed me with a grade 3 prolapse… fun fun… and explained that, someday in the future, we may want to discuss hysterectomy options.
My second most thorough exam - again, not a physical - was with a neurologist during the second trimester of the pregnancy of my fourth child.
I cannot remember exactly when it was - maybe in February or early March - I woke one morning and the world was spinning so tilt-a-whirlishly that not only could I not stay on my feet, I worshipped the porcelain god several times because the nausea and the movement I was perceiving was so intense, I could not keep anything down. Naturally, my husband took me to the ED, and it was not long before I had IV fluids, antiemetics that did absolutely no good whatsoever, and a vertigo diagnosis.
But when you are pregnant, diagnosing WHY you have vertigo gets interesting because there are diagnostics that they do not want to use for fear of causing problems to the baby, etc., of course. And medications can be tricky for the same reason. There were a lot of risk vs benefits discussions and eventually I was referred to the head of neurology following an MRI.
The neurological exam that I had was actually really cool, although difficult because of the intractable dizziness. I had to do these little “exercises” so that he could assess the cranial nerves one by one, my proprioception, etc. Normally, they would be very simple for someone to execute - for example, I had to stand still with my eyes closed and hold my arms out straight in front of me for 39 seconds to see if my arms drifted. With my eyes closed, I had to touch my ear, my nose, my chin, the repeat with the other hand. I had to look may the eye chart and answer some questions about what I could and could not see, then he assessed my visual tracking very carefill, very much like during a yearly eye exam… but it took a lot longer because there was a lot of repetition.
All in all, the first exam took about an hour. It was difficult because my balance was off. But he showed me some exercises I could do to help slow the spin, prescribed some meclizine, stated I was unsafe to drive or go to work until receiving medical clearance, and scheduled me for a one-week follow up.
The follow-up visit was much more successful, as the vertigo was much better by then. I was able to complete all of the exercises and he finally said, at the end “there is no neurological reason why you have vertigo, nothing shows up on your labs, so we are going to chock it up to the high probability that crystals in your ears are being troublesome.”
I had the vertigo for three weeks - the first three days it was constant, with little to no relief. But eventually it cleared and I learned some techniques to slow the roll. Every now and then I do get a twinge, but it has not been handicapping to the degree that it was at that time.