Play exam form

Here is a play exam I have come up with, in the form of a "patient information leaflet". The scenario is a patient joining a new primary care clinic and receiving an especially thorough "baseline" exam. All the procedures are realistic (the ultrasound is called a "hydrocolonic sonography", which I've posted about on the forum before), except that a vibrating massager is used to simulate the ultrasound probe. The exam is heavy on the enemas as that's my favourite bit, but it doesn't neglect the rest. Let me know what you think. I haven't performed this (or indeed any play exam) yet, due to lack of a suitable patient (if you're interested and in the UK drop me a PM 😉).

Initial assessment (female)

When you join the clinic the doctor will perform a thorough, in-depth examination so a comprehensive picture of your current health can be obtained.

Before your exam: The exam will include an ultrasound evaluation of the colon, which requires that your bowel be free of fecal matter. In our experience preparation at the clinic using enemas is both safer and easier for patients than the use of chemical laxatives. However, you will need to stop eating and go on a clear liquid diet at least 18 hours prior to your examination. i.e. if your exam is at 10am you must not eat after lunch the day before.

Due to its in-depth nature the exam will take 4-5 hours in total.

What the exam entails:

. The doctor will first take a thorough medical history.

. You will be asked to change into a gown, at this stage you may keep your panties on if you prefer, but you should remove your bra.

. The doctor will carry out a general head to toe examination. This will include:

. An ear, nose and throat examination

. Taking your lood pressure

, Taking your temperature. This will need to be done rectally as this is the most accurate method.

. Listening to your chest and abdomen with a stethoscope

. Palpation (pressing on) your abdomen.

. A neurological (reflex) examination

. Checking your spine and the range of motion in your joints

. The doctor will now carry out a breast examination. This will include applying gentle suction to the nipples in order to check for any discharge.

. You will be asked to remove your underwear and place your legs in stirrups to allow a pelvic examination and pap smear test to be performed. You will also be given a rectal exam at this stage.

. After your pelvic exam you will be prepared for your colon examination. This will consist of several large volume cleansing enemas until your returns are clear. 3-4 enemas are usually sufficient, but more may be required in some circumstances. Prior to your enemas the doctor may administer a smaller enema (fleet) and check your rectum for any contraindications to the exam by insterting a small, lubricated instrument called an anoscope. The doctor may ask you to expel your enemas into a bedpan, to allow the results to be checked.

. Following your cleansing enemas an inflatable retention nozzle will be inserted into your rectum and your bowel will be irrigated with a saline solution to remove any remaining small pieces of fecal matter. It is important that you take as much solution as you can during each irrigation cycle as your colon must be completely filled to ensure a thorough cleansing and accurate examination. The doctor will massage your abdomen during this procedure to help minimise any cramping or discomfort.

. Once you are no longer passing any fecal particles your bowel will be filled with saline a final time and an abdominal ultrasound performed. The doctor will then ask you to hold the saline inside you while the nozzle is removed and a vaginal ultrasound performed to visualise the rectum and anus. Once this has finished you may expel the saline into a bedpan.

. Finally the doctor will administer a soothing suppository to minimise any irritation following the procedure. You will also be given a probiotic to replace any beneficial bacteria the preparation proceure may have removed.

. You will be allowed to get dressed and the doctor will discuss the results of the tests with you.

After-effects: As your colon has been cleaned out it may be several days before your next bowel movement.

I like this alot

Wow! I can honestly say that sounds like it could be fun.

Kudos!

While the format of the Play exam is good, it clearly shows a preference for the administration of enemas which may not be to everyone's liking. As well as the use of saline can result in sever cramping,bloating and may cause a burning sensation ( especially if hemorrhoids are present). However the use of probiotics is a welcomed and thoughtful addition.

I can't send messages as I need to have earned a few points by posting in the Forum until I am 'allowed' to send personal messages. Otherwise I'd love to talk the Play Exam form through ))

Sounds like a great exam

While the format of the Play exam is good, it clearly shows a preference for the administration of enemas which may not be to everyone's liking. As well as the use of saline can result in sever cramping,bloating and may cause a burning sensation ( especially if hemorrhoids are present). However the use of probiotics is a welcomed and thoughtful addition.

Thanks. It does indeed show a preference for the administration of enemas, but then I'd only contemplate this exam for someone who had a preference for receiving enemas, and actually substantial experience with them as well - it would be somewhat extreme for a first enema experience*. It would be very easy to edit the enemas out of this exam (that's the nice thing about play exams, as there's no medical need involved you can swap them around based purely on patient preference - it could just be a general abdominal/vaginal ultrasound with no need for enemas at all).

As for saline - are you sure you are not thinking of hypertonic saline (normally phosphate based) as used in fleet enemas? That can indeed cause the sensations you describe. I was proposing isotonic saline, which actually, from personal experience, is an even gentler enema than plain water (to the point where it can be difficult to get rid of because there is so little urge to expel). The point of using it here is to prevent electrolyte imbalance, which I would worry about given such an extensive series of enemas. The probiotic is actually a "real life" addition as well - after such a through clean-out the replacement of beneficial bacteria is probably a good idea.

* If I was going to give someone their first enema experience in a play exam it would be more along the lines of a home visit for abdominal pain/bloating, followed by a diagnosis of constipation after a thorough exam, treated by one or two very gently given warm water enemas.

I've gone online and typed various searches in Google like "Ob-gyn patient history", etc and been able to find Word and PDF forms online. You can then download them and edit them as you see fit in order to make your scenarios more realistic. There's nothing like the nerveous tension while the patient fills out the form in the waiting room...

Http://www.zity.biz/index.php?mx=blog;ox=showblog;id=629#page2257

Excellent!.

I have wanted a Male Exam form for ages and this seems ideal.

Thank You

Yes it does sound good. It could be adjusted for patient preference 😉

One thing to add is:

"After the examination you will go the the nurse, who will give you whatever injections are needed."