INITIAL WELL WOMAN VISIT

Regardless of the type of psychotherapy you are seeking at our practice, all clients are required to begin treatment with an Initial Well Woman Visit. This exam includes an overall health assessment and physical examination. Without a comprehensive evaluation of a woman's current overall health condition, a full diagnostic mental health approach cannot be achieved. WE ARE INVESTED IN TREATING A WOMAN'S TOTAL HEALTH!

During this initial appointment an opportunity to discuss and assess your readiness to begin psychotherapy will take place.  This is a perfect time to build a trusting relationship with Dr. Petrongelli.  Her ability to deliver effective care depends on you providing complete and honest information during this meeting time.

                                                 Physical Assessment and Testing

Every woman has individual health needs. As we customize care for each woman individually, an the initial visit may differ in terms of duration, examination findings and testings being ordered.  A health screening for Initial Well Women Visits, includes the following, but not limited to, the following: 

Health history - This includes developments/changes in your health history. Includes questions about your current medications, allergies, supplements, recent surgeries, mental health history and/or mental health testing, previous/recent travel destinations, job and relationships.

Vital signs check - This includes taking a blood pressure reading and checking your heart rate and respiratory rate. Your blood pressure should be checked at least once every year, or more often depending on your health history.

Visual and physical exam - This includes a review of your appearance for signs of any potential conditions. Parts of your body that could visually indicate any existing health issues will be addressed. Vital signs, height, weight and BMI are recorded. 

Laboratory testing - Available for testing: Complete Blood Count, Complete Metabolic Panel, Thyroid Screening, Vitamin D Level, Hormonal testing (lab testings may vary depending on insurance coverage).  These panels test your blood plasma and can indicate issues that exist in your kidneys, liver, blood chemistry, and immune system.  These tests help detect irregularities in your body influencing your overall physical and mental health. 

Note: Other laboratory testing may be indicated, such as, diabetes screening, cortisol levels, hormones, endocrine levels. 

Screening test history - Available for testing: This includes providing previous dates and results for CT scan, MRI, Mammograms, Pap smear, pelvic exam, cholesterol test, and osteoporosis screening. If indicated, these screening tests can be ordered by our office. 

• Mammogram:  In women with low or average risk for breast cancer,  a mammogram is recommended yearly between the ages of 40 and 74. Earlier and more frequent testing may be recommended based on your personal history and family history of breast cancer. 
• Pap smear: The pap smear is a screening for cervical cancer. Women should begin screening at age 21.  After that, subsequent screenings are recommended every three years, as long as the woman has a healthy immune system.  After 30 years old, pap smears are recommended once every five years, until the age of 65.  After age 65, the majority of women no longer require a pap smear.
• Pelvic exam: This can be done with or without a pap smear.  A pelvic exam includes examining the vagina, cervix, and vulva for signs of a sexually transmitted infection (STI) or other conditions.
• Cholesterol test: Most women should begin regular cholesterol checks at age 45.  If you have a history of or genetic predisposition to diabetes or heart disease, you may need to begin cholesterol checks as early as age 20.
• Osteoporosis screening:  Bone density scans should begin around age 65. They may begin sooner when and if certain medical conditions indicate testing. 

During your treatment planning phases, all information obtained from this exam will be considered and influence your overall mental health treatment plan. 

Any additional medical records, testing results and health histories from other health care providers (e.g gynecologist, family practitioner, internal medicine, or other specialist) may be necessary. A client can either provide these records or our office can request a release of the records with patient authorization. 

Note: Breast Exams, Pelvic Exams or Pap Tests will not be performed as a part of the Well Woman Visit. A client's individual medical history of these examinations will be discussed.  If a client is experiencing concerns, abnormal symptoms, or risk factors within these body systems, the need for an assessment can be further discussed.  If our practice is unable to accommodate the proper screening exam, appropriate medical referrals will be provided. 

                                                  Mental Health Assessment

This is an evaluation of a client's social/emotional state;  how a client is thinking, reasoning, and remembering (cognitive functioning).  There are two parts of this assessment, as follows:

Mental evaluation.  Questions about your thoughts, feelings, and behaviors are asked.  Details may be asked about your symptoms in more detail, such as how they affect your day-to-day life, what makes them better or worse, and whether and how a client has tried to manage them on their own. 

Cognitive screening and evaluation.  Additional service, not included during initial exams. During the assessment, a client's ability to think clearly, recall information, and use mental reasoning will be examined.  Tests of basic tasks, like focusing your attention, remembering short lists, recognizing common shapes or objects, or solving simple math problems may be given. Clients will be asked to answer questions about their ability to perform daily responsibilities, such as caring for themselves, family obligations, and how they function at work. Further cognitive assessments are available within our practice using Cambridge Brain Sciences. (see additional section)

Genetic screening and evaluation. Additional service, not included during initial exams. Our practice offers pharmacogenetic testing through Genomind. This testing offers gene-drug interactions based on an individual's genetic composition. A through review of a client's health history and symptoms are the standard approach to treatment. Genetic testing can be recommended to further compliment customary treatment interventions. (see additional section)