New Smptoms: Obtaining a Timely Diagnosis

"Mr. James, I understand you are having problems with your stomach. Tell me what has been going on," Dr. Brown says as he walks in the door.

"Well, I have this pain in my stomach. I'm not sure how to describe it. It started about 2 weeks ago - or was it three or four weeks ago. It comes and goes. I don't know what else I can say," Mr. James replies.

This may be a little exaggerated, but patients' reports to their doctors are often not much better than the above scenario. The doctor has little to go on and then starts with questions he's been trained to ask. He may or may not ask all the right questions and possibly end up ordering numerous tests to try to diagnose Mr. James' problem.

What can Mr. James do to provide his doctor with better information, potentially decrease the number of tests ordered and likely receive a timelier, more accurate diagnosis?

The Most Important Thing

The most important thing Mr. James and any patient or caregiver can do is document symptoms as they occur. It's a simple thing to do. Why are we not likely to do it? Is it laziness? Do we think we can remember the details; therefore, it's not necessary? Do we think it won't help much?

Laziness – it is more about habit and not having an overall management system for our medical care than it is laziness.

Memory – we all think we will remember details well enough to tell our story, but in truth we are not likely to remember much more than 50% of the details including the best way to describe the symptom(s), how we felt or the day / timing associated with each occurrence.

Helpfulness – the more information we give and the more accurate it is the more likely the doctor will be able to make an accurate diagnosis and recommend the appropriate tests, if needed, and a treatment plan.

If your doctor is unable to make a diagnose immediately, take the following steps:
• Obtain copies of all test results & doctor appointment notes.
• Do research; if you have not already done so, on your chronic conditions and medications you currently take. You my find a better way to communicate your symptoms or that your new symptoms are connected to them in a way your doctor may not have considered
In the event you still can't obtain a diagnosis, listen to your instincts:
• Get a second opinion
• Ask for a referral to a specialist
• Change providers if you feel your current provider has reached the limits of his or her abilities, says you are anxious or that your problems are all in your head.
To learn more go to www.savvypatienttoolkit.com

Family Medical History Tree: Six Reasons to Have One

As medical science continues to discover disease-related genetic links, it is important for you to be armed with your family medical history.

The more complete your personal and family medical history, the more clues you can provide your clinicians as you help them piece your story together to make a diagnosis.

A Medical History Family Tree will assist you and your healthcare team in the following ways:

• Helping to make a diagnosis
• Assessing your risk of developing conditions other family members have
• Determining tests needed to monitor for those conditions
• Determining lifestyle habits that are right for you
• Identifying the risk level of other family members
• Determining if you are at risk of passing a condition(s) to your offspring

The most important family members to include are your parents, siblings and your children. By talking with relatives, you can share things you’ve each learned about conditions you have in common. You might even realize you need seek care for symptoms you’ve ignored or to be tested for a condition that is more prevalent in your family than you thought. Talk with your relatives or send them a survey. Once you’ve assembled the tree share it. You never know who or how it might help one of your family members.

To learn more go to www.savvypatienttoolkit.com

Use Over-the-Counter Drugs Wisely

According to the United Health Foundation, 178,000 hospitalizations a year are caused by misuse of over-the-counter (OTC) drugs. Antacids can neutralize some medications, rendering them inactive. Aspirin and other anti-inflammatory drugs will prolong bleeding time and can cause internal bleeding or liver damage if taken too long or in quantities larger than recommended on the label.

More and more prescription drugs are now available as OTCs. That doesn't mean they are any less risky to take than they were when prescribed. It does mean you need to educate yourself to use them properly if you choose to use them.

Here are some basic guidelines to follow:

• Only use the drug for its intended purposes - do your research and understand what you are taking and why.
• Use the drug properly - follow directions that accompany the product regarding dose and frequency.
• Take only one drug with the same active ingredient at a time.
• If you have questions or doubts about taking the drug, speak to your pharmacist.
• Check with your pharmacist to be sure the drug will not interact with other medications you take.
• If you experience side effects, contact your health care provider.
• Be sure to include all OTCs you take when you tell health care providers the medications you take.

Medications are medications. Don't be lulled into thinking that because you can buy them without a prescription they can be used casually.

Doctor Shortage Coming: Be a "Doctor's Pet"

Remember when you were in school and no one liked the teacher's pet. That person was taunted, teased and picked on. You can now be your doctors' pet and not have to worry about peer pressure because in today's health care environment it's a good thing to be.

Time with your doctor is short. It's hard to build a relationship with them. Guess what? That time is likely to only get shorter. Baby boomers are aging and contracting illnesses, health care coverage for all Americans is on the horizon – maybe…the article "Shortage of Doctors an Obstacle to Obama's Goals" in the April 27, 2009 issue of the New York Times is questioning how that dilemma will be solved.

But, have you ever thought about what is going to happen if suddenly the doctor/patient ratio is widely expanded? Appointments will be hard to get and are likely to become shorter and shorter. Will you be among the patients who:
• Are unable to answer many of the doctor's questions because you can't remember or just don't know the answer?
• The doctor has to tug and drag information from?
• Are in the 50 – 65% who do not follow the treatment plan prescribed? In the doctors minds those patients who don't are considered non-compliant patients and it is safe to assume they are not among the doctors' favorite patients.
I think you get the picture. Put yourself in your doctors' shoes. How would you feel throughout the day if:
• Appointment after appointment you tried to get solid information from each patient and couldn't?
• You made recommendations to help your patients prevent problems or improve their health and they made little or no effort to do so?
• You laid out a treatment plan only to find your patient stopped the treatment without consulting you, leading to complications or more severe illness.
As consumers, we buy certain products because the company is successful in telling us how their product is better than the competition. This is called differentiation. In very much the same way, we need to differentiate ourselves in our doctor's mind in order not to get lost in the crowd and give us an edge in getting the time and attention we need to get the care we want and deserve.

Imagine being a breath of fresh air in your doctor's day because you:
• Come armed with the information they need and don't have to hope they asked all the right questions to get the information they need.
• Have a personal health record set up for fingertip access that contains your detailed medical history and you can answer their questions within a few seconds.
• Ask good knowledgeable questions.
• Are knowledgeable enough to make joint decisions for your treatment plan and the doctor knows you will follow through - are a compliant patient.
Don't you think he or she will be happy to see you and increase the likelihood you will get just a little bit more time and attention?

Remember, our docs are only human and certainly enjoy a person they can interact with effectively and efficiently. From personal experience, I've seen changes in my former doctor's demeanor and my own appointments, as I became a savvier patient.

Imagine seeing and hearing this - With hand on the doorknob, the doctor turns around, smiles and says, "This has been a great appointment!" That's what my new internist said at the end of my first appointment with him. Five years later when I told him we were moving, he said, "I really hate to see you leave. I've really enjoyed having you for a patient."

It wasn't my imagination working overtime, when he came into the room for each appointment; he seemed to take a deep breath as he sat down and relaxed into a very unrushed session. It was as though he was taking a break. I always received the time I needed and felt I received a thorough evaluation of my needs and concerns. I enjoyed similar relationships with my specialists as well.

Now, my husband and I are building our new medical teams in new location. Here are some of the comments we are hearing as we end our first appointments with each new doctor:

"Gosh, I wish all new patients came this well prepared."

"I've never had the luxury of seeing the results of 10 years of medical tests on a patient much less in an easy-to-review format. This is so helpful."

"Thank you for bringing the records from your previous doctor. We often have to request them two or three times and sometimes never get them."

"People just don't realize how hard it is for us to care for them when we don't have the information we need. You've provided everything I could possibly need."

Differentiate yourself. Stand out in the crowd. Become your doctor's pet and be proud of it. You'll be amazed at the difference it will make for you and your care.

Five Reasons to have an Appointment Advocate

You aren't seriously ill. Why do you need to take another person / advocate to your appointments? Below are five major reasons and what he or she can do to help you get better care.
1) Research shows you immediately forget one-half of what you are told at doctor appointments. Your advocate can:
a) Take notes for you. It is very difficult to take notes and interact effectively with your doctor at the same time.
b) Prompt you from questions or concerns on your prepared list.
2) When in good health, your advocate will be a note taker and prompter. However, when very ill or receiving news, such as cancer, effective interactions diminish. In both cases:
a) It is very difficult to think clearly, ask questions or remember the answers or actions you need to take going forward.
b) Your advocate can interact with and / or for you and take notes.
3) Your advocate can be an encourager and provide positive reinforcement to help you stick with difficult treatment or lifestyle changes.
4) Two heads are better than one.. You may have two or more conditions with vague and hard to describe symptoms & / or take numerous medications. Your advocate can help you:
a) Recognize symptoms & piece information together. She will hear what the provider says, can share her observations and participate in asking questions.
b) Assess your options and be a sounding board for decision-making after your appointment.
c) Recognize when you may be creating your own medical error(s) by not taking a medication properly or following your treatment plan.
5) Your advocate will have the knowledge to care for & fight for you when you can't do so for yourself.