Yini Ongayilindela Ekuqokweni Kwakho Okulandelayo kwe-Ob-Gyn Phakathi—nangemva—Ubhubhane lweCoronavirus

-Delile

• Telehealth Ukuqokwa Kwa-Office
• Kungani Ungase Udinge Ukuqokwa Kwangaphakathi Ehhovisi
• Kungani Ungahle Usuke Ngokuqokwa Okubonakalayo
• Yini Ongayilindela Ngesikhathi Sokuvakasha Kwe-Telehealth Ob-Gyn
• Ongakulindela Ngesikhathi Sokuvakashelwa E-Office Ob-Gyn
• Buyekeza kwe-

Njengemisebenzi eminingi evamile yangaphambi kobhubhane, ukuya ku-ob-gyn kwakungeyona into enengqondo: Ubukade unenkinga yokulunywa okusha (ukutheleleka kwemvubelo?) futhi ufuna ukuthi ihlolwe ngudokotela. Noma mhlawumbe kwadlula iminyaka emithathu kwaze kwafika isikhathi sokwenza i-Pap smear. Noma ngabe yikuphi, ukuhlela nokwenza i-gyno yakho bekuvame ngqo phambili. Kepha njengoba wazi kahle, impilo yehluke ngokuphelele manje ngenxa ye-COVID-19, futhi nohambo oluya kudokotela wezingxenye zezintokazi nalo selushintshile.

Ngenkathi ukuqokwa kweziguli kusenzeka, ama-ob-gyns amaningi nawo ahlinzeka ngokuvakashelwa kwe-telehealth. "Ngenza i-hybride yokuvakasha okungokoqobo naphakathi kwabantu," kusho uLauren Streicher, M.D., uprofesa we-clinical obstetrics and gynecology eNorthwestern University eFeinberg School of Medicine. "Ngokuya ngesimo, sitshela ezinye iziguli ukuthi kumele zingene, kanti ezinye sizikhuthaza ukuthi zingangeni. Ezinye, siyazikhethela."

Kulungile, kodwa kanjani kwenza ingabe i-telehealth ingasebenza ngokuqokwa kwe-ob-gyn, ncamashi? Futhi, ngicela umngane: Ingabe sikhuluma izingxoxo zevidiyo lapho unamathisela ifoni yakho phansi kwezingubo zakho zangaphansi? Hhay kangako. Nakhu ongakulindela ngokuzayo lapho udinga ukubona i-ob-gyn yakho.

Telehealth Ukuqokwa Kwa-Office

Uma kwenzeka ungajwayele, i-telehealth (eyaziwa nangokuthi i-telemedicine) iwukusetshenziswa kobuchwepheshe ukuhlinzeka nokusekela ukunakekelwa kwezempilo ukude, ngokusho kweNational Institutes of Health (NIH). Lokho kungasho izinto eziningi ezihlukahlukene, okuhlanganisa odokotela ababili abakhuluma bodwa ocingweni ukuze baxhumanise ukunakekelwa kwesiguli, noma ukuxhumana nodokotela wakho ngombhalo, i-imeyili, ucingo, noma ividiyo. (Okuhlobene: Indlela Ubuchwepheshe Obuguqula Ngayo Ukunakekelwa Kwezempilo)

Ukuthi uzombona yini udokotela wakho cishe noma ngeke umbone udokotela wakho ngokuvamile kuncike kunqubo yomuntu ngamunye kanye nesiguli. Ngemuva kwakho konke, kunezivivinyo eziningi kakhulu ongazenza ngempumelelo ngocingo noma ngevidiyo. Futhi nakuba kukhona, eqinisweni, isiqondiso esisemthethweni esivela e-American College of Obstetricians and Gynecologists (ACOG), akucacile.

Esitatimendeni sabo esisemthethweni, "Implementing Telehealth in Practice," inhlangano ibona ukubaluleka okukhulayo kwetelehealth, ngakho-ke, igcizelela ukuthi kubaluleke kangakanani ukuthi abasebenza "bakhumbule" izinto ezinjengokuphepha okuphelele nobumfihlo nokuqinisekisa imishini edingekayo. Ukusuka lapho, i-ACOG icaphuna ukubuyekezwa okuhlelekile okuphakamisa ukuthi i-telehealth ingasiza ekuqapheleni ukucindezelwa kwegazi ngaphambi kokubeletha, amazinga kashukela egazini, nezimpawu zesifuba somoya, usizo lokuncelisa ibele, ukwelulekwa ngokulawulwa kokuzalwa, kanye nezinsizakalo zokukhipha isisu ngemithi. Kodwa-ke, i-ACOG iphinde ivume ukuthi kunezinsiza eziningi ze-telehealth, kuhlanganise nezingxoxo zevidiyo, okusamele zifundwe kabanzi "kodwa zingase zibe nengqondo ekuphenduleni okuphuthumayo."

I-TL;DR—iningi lama-ob-gyns kuye kwadingeka liqhamuke nemihlahlandlela yokuthi lizobona nini isiguli ngocingo uma liqhathaniswa nehhovisi.

"Ukuqokwa okuningi kwe-ob-gyn kungaguqulwa kube yi-telehealth, kepha hhayi bonke," kusho uMelissa Goist, M.D., ob-gyn e-The Ohio State University Wexner Medical Center. "Ukuvakasha okuningi okudinga kuphela ukubonisana, njengezingxoxo ngenzalo, ukwelulekwa ngokuvimbela inzalo, nokuvakasha kokulandelelwa kokubelethisa nokwabesifazane, kungenziwa cishe. Ngokuvamile, uma ukuhlolwa kwe-pelvic noma ukuhlolwa kwebele kungadingeki, ukuvakasha kungenziwa. ushintshelwe ku-telehealth, njengokushaya ucingo noma ukuxoxa ngevidiyo. "

Lokho akusho ukuthi okunye ukuvakashelwa kokubelethisa akukwazi ukwenziwa ngocingo noma ividiyo, nokuba namathuluzi ekhaya, njengesigaxa somfutho wegazi, okungukuthi i-Omron Automatic Blood Pressure Monitor (Buy It, $ 60, bedbathandbeyond.com), kanye Ukuqapha i-doppler ukuhlola ukushaya kwenhliziyo kwengane, kungenza ukuqokwa kwe-telehealth kuphumelele kakhulu. "Lokhu akwenzeki ngaso sonke isikhathi, ngakho-ke ukuvakasha okuningi kwe-OB kufanele kwenziwe mathupha," kusho uDkt. Goist. (Okuhlobene: Abesifazane abangu-6 Babelana Ngokuthi Ukuthola Ukunakekelwa Okungokoqobo Kokukhulelwe Nokwangemva Kokubeletha Kube Nje)

Noma kunjalo, uma unemali yokuthenga lezi zinto—umshwalense ungase ukhokhele ezinye noma zonke izindleko—noma ube nodokotela ongakunikeza futhi ukhathazeke kakhulu ngengozi yakho ye-COVID-19 (okungukuthi mhlawumbe awunamasosha omzimba), ungahle uthande ukuhamba ngale ndlela ukhawulele ukuvezwa kwabanye abantu, uyachaza.

Kungani Ungase Udinge Ukuqokwa Kwangaphakathi Ehhovisi

Ukopha, ubuhlungu, nanoma yini enye engadinga ukuhlolwa kwe-pelvic kufanele kwenziwe ehhovisi, kusho uChristine Greves, M.D., udokotela oqinisekisiwe webhodi esibhedlela i-Winnie Palmer for Women and Babies e-Orlando, eFlorida. Kepha, uma kukhulunywa ngezinto ezifana nezivivinyo zaminyaka yonke — nazo ezingenakwenziwa cishe — kulungile ukubabuyisela emuva kancane uma icala le-coronavirus lisendaweni yakho liphezulu noma ukhathazeke kakhulu ngengozi yakho, kusho uDkt. Greves. "Ezinye zeziguli zami zikhethe ukulinda ukuvakashelwa kwazo minyaka yonke ngenxa ye-coronavirus," esho, ephawula ukuthi abaningi bahlehlise lokho kuvakasha ezinyangeni ezimbalwa. (Uzizwa ukhathazekile kancane ngokuphuma lapho uvalelwe? Uma nje ungenakho okukukhathazayo ngokushesha ngezempilo, ungase ukwazi ukuhlehlisa ukuvakasha kwakho mathupha.)

Kungani Ungahle Usuke Ngokuqokwa Okubonakalayo

Ngokukhethwa kokulawulwa kokuzalwa, abanye abantu bamane bacela incwadi kadokotela, futhi lokho kungaphathwa nge-telehealth. Uma kukhulunywa nge-IUD, noma kunjalo, kusazodingeka ungene ehhovisi (idokodo lakho lidinga ukulifaka kahle — ayikho i-DIY lapha, bantu.) "Ngingenza konke ngaphandle kokuthinta isiguli futhi ngenze ukuhlolwa kwe-pelvic, "kusho isazi sezempilo sabesifazane uSherry Ross, MD, ob-gyn eProvidence Saint John's Health Centre eSanta Monica, eCalifornia nombhali we U-ology. "Mhlawumbe manje ngenza amaphesenti angu-30 kuya kwangu-40 wokuqokwa kwami ​​​​nge-telemedicine."

"Konke kuncike ekukhathazekeni onakho, nokuthi ukhulelwe noma cha," kusho uDkt Greves. Lokho akusho wena kumele ngena ehhovisi uma ukhulelwe. Eqinisweni, i-ACOG ikhuthaza ama-ob-gyns nabanye odokotela abakhulelwe ukuthi basebenzise i-telehealth "ezicini eziningi zokunakekelwa kokubeletha ngangokunokwenzeka"

Yini Ongayilindela Ngesikhathi Sokuvakasha Kwe-Telehealth Ob-Gyn

Umhlahlandlela okhishwe ngoFebhuwari yi-ACOG uncoma ukuthi ama-ob-gyns abe nesofthiwe edingekayo kanye noxhumo lwe-inthanethi lokunakekelwa kwekhwalithi, futhi ukhumbuza odokotela ukuthi ukuvakasha kwabo ngocingo kudinga ukuthobelana ne-Health Insurance Portability and Accountability Act (HIPAA) imithetho yobumfihlo nezokuphepha. (I-HIPAA, uma kwenzeka ungajwayeleki, umthetho wobumbano okunikeza amalungelo olwazi lwakho lwezempilo futhi ubeka imithetho yokuthi ngubani ongakwazi futhi ongakwazi ukubheka imininingwane yakho yezempilo.)

Ukusuka lapho, kunokuhlukahluka okuthile. I-FWIW, akunakwenzeka ukuthi udokotela wakho azokufaka ifoni yakho phansi ibhulukwe lakho ngesikhathi sokuvakasha kwangempela. Kepha bangakucela ukuthi uthumele isithombe kusengaphambili, kuya ngesizathu sokuvakasha kwakho kanye nokuphepha kwesoftware yokusebenza. (Okuhlobene: Ungathanda Ukuxoxa nodokotela wakho nge-Facebook?)

"Kungenye into uma umuntu ethatha isithombe sengalo yakhe ukuze abonise ukuqubuka; okunye uma kuyisithombe se-vulva," kusho uDkt Streicher. Eminye imikhuba inezindlela ezihambisana ne-HIPAA zokuthumela izithombe namavidiyo nge-software yazo, kuyilapho eminye ingenazo izingosi zezempilo ezihambisana ne-HIPAA ezivumela ukushintshaniswa kwamavidiyo nezithombe. Njengendaba kaDkt. Streicher, owenza iziguli zakhe zazi ukuthi akanalo uhlelo oluhambisana ne-HIPAA ngaphambili. "Ngithi, 'Bheka, manje, ngidinga ukubona ukuthi kwenzakalani esithweni sangasese sakho. Angikwazi ukusho ngokwencazelo yakho. Ungangena futhi ngikwazi ukuyibuka mathupha noma uma uthanda ngithumelele isithombe, ungenza njalo, inqobo nje uma uqonda kahle ukuthi lokhu akuhambisani ne-HIPAA, kodwa ngizoyisusa ngemva kokuyibona.' Abantu babonakala bengenandaba. " (Ngubani, kahle-ke, uChrissy Teigen ngomunye — wake wabeka isithombe sokuqubuka kwesinqe ku-doc wakhe.)

Lokhu akusilo uhlelo oluphelele, noma kunjalo. "Inkinga ngezinto ze-vulvar akulula kangako ukubukeka kahle," kusho uDkt. Streicher. "Lapho othile ezama ukukwenza ngokwakhe, ngokuvamile akusizi ngalutho. Udinga ukuthola othile ozomsiza, ukuze akwazi ukunweba imilenze yakhe futhi athole umbono ohloniphekile lapho." Futhi noma ngabe umthwebuli-slash-partner wakho kungu-Annie Leibovitz wangempela, angase adinge isiqondiso esincane uma kuziwa ekuthatheni izithombe zakho eziyimfihlo. Vele uthathe kuDkt. Streicher, osanda kukhombisa isiguli kanye nomyeni waso izithombe zezokwelapha ukuze azame ukuchaza ukuthi yini ebeyifuna ezithombeni zabo. Futhi okuhle akwenzile ngoba “ungene lapho wathola izithombe ezinhle,” usho kanje.

UDkt. Greves uthi ubeneziguli ezithatha izithombe zamaqhubu bese zizithumela kuye ngephothali evikelekile. Kodwa uthi "akaphikisani" nokuba neziguli empeleni zikhombise izingqinamba zakhe ngesikhathi sokuvakasha kwe-telemedicine "inqobo nje uma bezizwa bekhululekile ukukwenza lokho." Ngakolunye uhlangothi, "akungenzi lutho kimi ukuthola ividiyo enyakazayo, ekhanyayo yesitho sangasese" kusho uDkt. Streicher. (Bheka futhi: Ungasinquma kanjani isimo seSikhumba, amaRash, namaBumps ku-Vagina Yakho)

Ngokuvamile, ukuvakasha okuningi kwe-telemedicine kuthatha imizuzu engaba ngu-20, nakuba kungase kuthathe isikhathi eside uma uyisiguli esisha, ngokusho kukaDkt. Goist. Ngesikhathi sokuvakasha kwakho, uzokhuluma nodokotela wakho ngezinto ezikukhathazayo futhi bazozama ukukuxilonga noma bakweluleke — njengoba nje wenza lapho ungena ehhovisi. "Kungafana nokuvakashelwa ehhovisi kodwa, kunokuba sihlale esihlalweni esingakhululekile sehhovisi, isiguli singakwenza lokhu ngokunethezeka nokuphepha kwendawo yaso," kuchaza yena. "Iziguli eziningi ziyakuthokozela ukuba lula kwalokhu kumiswa mayelana nokuzifaka ezinhlelweni zazo ezimatasa. Futhi, uma izivakashi sezivunyelwe ukungena emahhovisi, lezi zikhathi ezimisiwe zisusa lowo mthwalo ekutholeni umuntu ozomnakekela."

Ongakulindela Ngesikhathi Sokuvakashelwa E-Office Ob-Gyn

Yonke imikhuba inemihlahlandlela ehlukile ebekiwe, kepha amahhovisi amaningi anezinyathelo ezintsha zokuqapha.

• Lindela ukuhlolwa kwefoni ngaphambi kokuvela. Iningi lodokotela okuxoxiswene nabo ngalo mbhalo bathi othile ovela ehhovisi lakhe uzokwenza ingxoxo yocingo nawe ngaphambi kokungena ehhovisi ukuthola ukuthi ubungozi bakho be-COVID-19 bukhona manje. Ngesikhathi sokuxoxa, bazokubuza ukuthi ngabe wena noma ilungu lomndeni wakho nibe nezimpawu ezithile noma nihlanganyele nomuntu onecala eliqinisekisiwe le-COVID-19 eliholela ekuvakasheni. Yonke imikhuba yehluke kancane, noma kunjalo, futhi umkhawulo walowo nalowo ungahluka (okusho ukuthi, yiliphi elinye ihhovisi elingacabanga ukuthi liyenzeka cishe, elinye lingakhetha ukwenza mathupha).
• Gqoka isifihla-buso. Lapho ufika ehhovisi, izinga lokushisa kwakho lizothathwa futhi unganikezwa imaski noma ucelwe ukuthi ugqoke eyakho. "Sinqume njengomtholampilo ukuthi sifuna abantu abafake izifihla [zezokwelapha] phezu komamaski abazenzele bona ngoba asinalo ulwazi lokuthi izimasiki ezenziwe ekhaya zigeziwe yini nokuthi isiguli besikade sizithinta yini usuku lonke," kusho uDkt. Streicher. Noma ngabe kwenzelwe ekhaya noma kunikezwe wena, zilungiselele ukugqoka okuthile ngaphezu kobuso bakho. "Ngokwesiko lethu, awukwazi ukungena ngaphandle kokuthi ugqoke imaski," kunezela uDkt Ross. (Futhi khumbula: Kungakhathalekile ukugudluka komphakathi, kuhle Ngiyacela gqoka isifihla-buso—kungaba esenziwe ukotini, ithusi, noma enye impahla.)
• Ukungena kungenzeka kungabi nezandla ngangokunokwenzeka. Isibonelo, ehhovisi likaDkt. Streicher, izisebenzi zedeski elingaphambili zihlukaniswa ukuhlukaniswa kwe-plexiglass, futhi emsebenzini kaDkt. Goist, kunezithiyo ezifanayo endaweni yonke ukuze kuvikelwe iziguli nabasebenzi. Futhi, kwezinye izinqubo, ungagcwalisa amafomu akho esiguli kusenesikhathi futhi uze nawo.
• Amakamelo okulinda azobukeka ehlukile. Njengasehhovisi likaDkt. Goist, lapho ifenisha ihlukaniswe kakhulu ukuze kugqugquzelwe ukuqhelelana komphakathi. Okwamanje, eminye imikhuba isikhohlisile umqondo wegumbi lokulinda ndawonye ngokuthi ulinde emotweni yakho uze waziswe ukuthi igumbi lokuhlola selilungile. Akunandaba ukuthi ulinde kuphi, ungahle uthande ukuza nezinto zakho zokufunda njengoba amahhovisi amaningi, kufaka phakathi uDkt. (Bheka futhi: Konke Odinga Ukukwazi Ngokudluliswa KweCoronavirus)
• Kanjalo namagumbi okuhlolwa. Futhi bazoba nezikhala eziningi ngokwengeziwe. “Igumbi lihleliwe ngakho udokotela uba kwelinye ikhona kanti isiguli sikwelinye,” kusho uDkt. Streicher. "Udokotela wenza umlando wesiguli kusuka ezinyaweni eziyisithupha ngaphambi kokwenza ukuhlolwa." Ngenkathi i-ob-gyn "isondele" ngokusobala ngesikhathi sokuhlolwa kwangempela, "imfushane impela," uyachaza. Ngokuya ngomkhuba, abasizi nodokotela nabahlengikazi bazothatha umlando wakho wesiguli bese behamba, kunezela uDkt. Streicher.
• Amagumbi azokhishwa ngegciwane phakathi kweziguli. Amahhovisi odokotela abelokhu ehlanza amagumbi phakathi kweziguli, kodwa manje, emhlabeni we-post-coronavirus, inqubo iyanda. "Phakathi kwesiguli ngasinye, kufika umsizi wezokwelapha asule yonke indawo ngesibulali-magciwane," kusho uDkt. Streicher. Amahhovisi asazama ukubeka isikhala sokuqokwa kweziguli ukuze kushiywe isikhathi sokubulala amagciwane kanye nokugcina iziguli zingahlali egumbini lokulinda, kusho uDkt Greves.
• Izinto zingahle ziqhubeke ngesikhathi. "Silinciphisile inani leziguli [isiyonke]," kusho uDkt. Streicher. "Ngaleyo ndlela, kuneziguli ezimbalwa egumbini lokulinda.

Futhi, zonke izenzo zihlukile futhi, uma ufuna imininingwane ethile ngalokho okwenziwa yihhovisi lakho le-ob-gyn, mane ubashayele kusenesikhathi ukuze uthole. Phela odokotela bathi lezi zinguquko zizoba khona isikhashana. “Lokhu kuwumkhuba wethu omusha wokuza ukuzosibona, futhi kuzothatha isikhathi eside,” kusho uDkt. Ross.

Buyekeza kwe-