What should my doctor and i discuss at my very first ob/gyn appointment?

Depends: What do you want from the visit? Why are you going to the appointment? Depends on your age and your issues. Be open to any and all options. Is it for birth control, is if for becoming sexually active and responsible, are you concerned with a condition or disease or infection? Go n with some general questions and concerns and see where you end up. Don't overwhelm the doctor. There is a limit.