Health Matters: Optimizing your visit to the doctor

I’m sure in this upcoming heat we need some tips on how to stay cool but you can Google that and find those answers quick enough.  Likely, if you are over 30 years old, you’ve figured out the right things to do such as put on sunscreen, drink lots of water, and avoid caffeine  and alcohol (which dehydrate you).  If you are out in the sun, wear a hat, avoid the midday sun, and chill out in the pool.  So you don’t really need me to repeat those motherly pearls of wisdom.  Now if you are over 50 years old, you could probably teach me a few things to avoid the summer time melt down, so let’s talk about something that may be more relevant and useful to you.

What simple things can you do to optimize your visit with your doctor?  Every doctor has a different practise style but the one thing I’m fairly certain of is that we all want to help people in the best way possible.  But how do we do that is the better question.  How do you avoid the breakdown in terms of communication and walk away feeling better about the clinical visit?  Because to be fair, most people don’t know what goes on in the busy world of the doctor’s lives. Having said that, I find people are extremely respectful if we walk in late to see them…I think they’ve figured out we aren’t playing yahtzee or backgammon.

So, here’s the first tip: Try to understand and explain your reason for the visit as clearly as possible. For example, if you have an ailment such as pain, try to anticipate what the doctor might ask.  Here are the things we want to know:

  • When did it start?
  • Where did it start? Was it from the top of your back, mid back, etc.
  • Does it radiate anywhere?
  • How severe is it ?  ( low grade, mid grade, high grade)
  • Is it sharp or dull or mixed?
  • Is it constant, or does it come and go?
  • What makes it better?
  • What have you tried to relieve it?
  • Is it getting better, worse, or the same?
  • Do you have any other associated symptoms with it? Fever, rash, fatigue, vomiting?
  • What do you think it might be?

So a specific example of a patient’s response to a doctor could be:

“Hi doc, you look great by the way, I started to develop a sore throat, about one month ago and it was hurting occasionally, mostly in the morning, but in the last week

it has been getting constantly worse, with increasing severity and it hurts to swallow when I eat. It feels like a dull ache and it keeps me up at night. I’ve been taking Tylenol 500 mg three times a day now for the last 5 days and it doesn’t help. I don’t have a fever and I’ve started coughing up some blood.  I’ve been smoking for 45 years and I’m worried that it might be throat cancer”.

This leads me to my second point: What do you think it might be and what are you worried about?  If you are afraid of cancer, say so. Part of our job is to figure things out, but the other most important part is to address your fears or concerns…the easier it is for you to communicate that to us the easier it is for us to address it.  Clarity requires help from both sides; it’s like sitting in front of a foggy window with the patient on one side and the doctor on the other.   If you clean your side of the window and we clean our side, we both can get a better idea as to what is happening.

Point number three: If you’ve sprained your ankle, take your shoes and socks off.  We definitely will be asking you to do this.  We need to see the source of the pain and examine that body part.  If your knee hurts please don’t wear tight pants that you can’t get past your shins, we will need to look at the knees. It’s much like asking a mechanic to diagnose the clinking noise that’s coming from the engine, you know he is going to open the hood to take a look at the engine.  Too often  I’ve  seen patients surprised that I would want to listen to their lungs when they are complaining of a cough or feel out of breath and they are wearing four thick layers of clothing…we by nature need to examine the part of the body of concern.

The fourth point: Keep a list of all your main medications, medical issues, allergies, and emergency contact persons.  You should have this on you at all times, unless you are swimming. This is a great rule in general because if you are ever in an accident or fall ill and are not able to convey your medical history, the first thing we look for in the emergency room is for any information we can get about you.  Men are notoriously bad for not knowing what medications they are on, even if they are only taking one. Ignorance is not bliss, it can be fatal. We all need to be responsible for our health and keeping this list on our person is a great way to start.  The reality is doctors are not mind readers and if you can’t remember your medications, the only way we will is by looking in your chart (if we are lucky to have it).  In addition, the information may have been changed by another specialist. So the more you know, the more we know and the better we can help.

The fifth point, which reinforces the last point:  Know your medication list.  I’ve said this twice because I can’t tell you how many times I’ve heard people say ,“I’m on the white pill”…The truth of the matter is that there are really a huge variety of white pills.  There is no course in medical school that teaches us the color of the pills, we’re too busy learning how to pronounce their names and what they can do.  As well, please tell us if you are taking any herbal products or over the counter medications.  When you are on more than one medication or herbal product, they can interact in a bad way and we try to minimize that risk.

While we are honoured that you give our memory a tremendous amount of clout, we are certainly dealing with 100’s of pieces of information daily, so any help you can add just saves you and the doctor time. “Help us help you.” Then you can chat about some other pleasant things such as the latest Tom Cruise movie you saw or the last football game you went to, because after all good health is in your hands and good health matters at every age!

Let’s talk again soon,
Dr. Lalit Chawla MD, CCFP

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