Patient resources

What to bring to your first visit

• Every old report: blood tests, scans, discharge summaries and operation notes. Clear photos on your phone are fine.
• The medicines you take, or their strips, including thyroid, sugar, BP and hormone tablets.
• The date your last period started, even roughly, and how long your cycles usually are.
• For a pregnancy visit: the home test result and any earlier scan reports. See pregnancy care.
• For a fertility visit: your partner's semen analysis, if done, and any AMH or tube test (HSG) reports. See infertility treatment.
• For a second opinion on surgery: the scan that led to the advice, and the advice in its exact words. See hysterectomy and its alternatives.
• A written list of your questions; three or four is plenty.

Pregnancy visit schedule

Keeping a period diary

1. Mark day 1: the first day of proper bleeding, not spotting. Cycle length is the number of days from one day 1 to the next.
2. Note how many days you bleed and how heavy: pads per day, clots, flooding, changing at night.
3. Note pain: which days, how bad from 0 to 10, painkillers taken, and days missed from school or work.
4. Note anything between periods: spotting, white discharge, breast tenderness, pimples or mood changes.
5. If you are trying to conceive, note the days of intercourse and any ovulation-kit result.
6. Bring the diary, or screenshots from the app, to the visit. Even one month helps.

Before a scan or blood test

• Fasting sugar (FBS) and lipid profile: nothing to eat for 8 to 10 hours; water is fine. Book the test for the morning.
• Pregnancy sugar test (OGTT): come fasting, drink the glucose, then wait for the timed samples. Allow 2 to 3 hours.
• Thyroid (TSH), HbA1c, haemoglobin and AMH: no fasting. FSH and LH are done on day 2 to day 5 of the period, so tell the clinic when it starts.
• Early pregnancy scan through the abdomen: a full bladder. Drink two or three glasses of water an hour before and do not pass urine. A transvaginal scan needs an empty bladder.
• Pregnancy scans after 12 weeks: no preparation. Eat normally.
• Pap smear: not during a period. Avoid intercourse, vaginal creams or pessaries for two days before. See Pap smear and cancer screening.
• Bring previous scan reports every time, so measurements can be compared.

Preparing for surgery at the affiliated hospital

1. Decision at the clinic. Dr. Ragavi explains the operation, the alternatives, the risks and the recovery; the consent form itself is signed at the hospital. Ask everything now.
2. Pre-operative tests. Blood tests, an ECG and an anaesthetist's check a few days before; a physician's opinion if you have BP, sugar or a heart condition.
3. Insurance. Share your policy details as soon as the date is fixed so the hospital can start pre-authorisation. Cashless applies only to the hospital procedure, not to clinic visits.
4. Fasting. No food for at least 6 hours and no water for 2 hours before the operation; the anaesthetist gives the exact times and says which regular tablets to take.
5. Admission. Usually the evening before or early on the day. Bring all reports, the medicine list, ID proof, the insurance card and loose clothes.
6. Attender. One adult stays with you, for paperwork, the pharmacy and the journey home.
7. Discharge and follow-up. You go home with a discharge summary, medicines and wound-care instructions. The first review is at the clinic, Madipakkam or Thalambur.

Questions worth asking your gynaecologist

• What is the most likely cause of my problem, and what else could it be?
• Which test will change what we do, and which can wait?
• Can tablets be tried first, and for how long?
• If surgery is advised: keyhole or open, days in hospital, time off work, and any effect on periods or a future pregnancy? See laparoscopic surgery.
• In pregnancy: is anything high-risk, and what does that change? See high-risk pregnancy care.
• After 40: are hormone tablets an option for me, and for how long? See menopause care.
• What should make me call you before the next visit?
• How do I reach you between visits, and what is WhatsApp for?

After a delivery or surgery: warning signs to call about

• Fever above 100.4°F (38°C), or chills.
• Bleeding that soaks a pad in an hour, passes large clots, or gets heavier instead of lighter.
• The wound turning red, hot, oozing or opening, or pain that gets worse.
• Discharge with a bad smell.
• Pain or swelling in one calf, or one leg larger than the other.
• Breathlessness, chest pain, or coughing up blood.
• A severe headache, blurred vision, or a fit after delivery.
• Not passing urine, or burning when you do.
• A hot, red, painful area of the breast with fever while feeding.
• Feeling very low, unable to sleep even when the baby sleeps, or unable to cope. This is common, treatable, and it counts.