Face to face with your doctor? With just a few minutes to explain your concerns, be examined, and hear about your options? That can be daunting.
Here are some pointers for holding up your end of the conversation, encouraging collaboration, and getting the most from your appointment.
Describe your symptoms quickly and clearly.
“When I describe my symptoms, it often seems that my physician doesn’t really hear them but rushes to fit them into some diagnosis that he’s seen in the past,” complains Nancy Todd, 70, of New York City.
Chances are, that’s exactly what’s happening. Studies suggest that a doctor will often start forming a diagnosis within the first 30 seconds of hearing your complaint—and before he or she hears all the facts. Worse, a doctor often sticks with that original hypothesis even if subsequent information doesn’t fit.
So you need to tell your story quickly, clearly, and sometimes forcefully
» TELL ALL. It often takes a constellation of symptoms to get a clear focus on a health problem, so mention all your complaints, even if you don’t think they’re connected or if some seem relatively minor. For example, someone who complains of neck pain affecting the left arm may be referred for surgery for a slipped disk—unless he or she says the pain only occurs during exercise. That symptom could indicate a clogged coronary artery and the need for angioplasty, in which physicians inflate a tiny balloon inside the artery to crush the obstruction.
» ESTABLISH A TIMELINE. Put your symptoms into chronological order, since knowing which ones came first can often be the decisive factor in arriving at a workable diagnosis. If necessary, jot down all your symptoms and bring the list with you.
» BE SPECIFIC. Instead of complaining vaguely about pain, rate it on a scale of 0 to 10 (with 10 being the worst). Describe the quality of your pain or discomfort. Is it dull and aching as with tooth pain? Or is it a painful pressure, as if an elephant were sitting on your chest? Does the pain radiate or spread into adjacent areas? How long has it hurt, and how often does it hurt? What makes it better? What makes it worse?
» TELL IT LIKE IT IS. Don’t minimize or trivialize your complaints. If you dismiss abdominal pain as “probably just gas,” your doctor may be tempted to agree, even if you’re secretly worried about ovarian cancer. A few reassuring words or an appropriate test could put your mind at ease. And don’t attribute problems to “normal” aging—especially problems involving depression, dizziness, forgetfulness, or sexual dysfunction. There may be an underlying, treatable disorder—at any age.
Ask these key questions about your options:
» HOW QUICKLY DO I HAVE TO DECIDE? Unless you’re suddenly faced with a life-and-death decision, you’ll probably have days, weeks, or even months to decide on a treatment. Even for a serious illness like cancer, there’s usually time to schedule more than one visit with your doctor, and even with other doctors, if you want.
» WHAT HAPPENS IF I DO NOTHING? While many conditions, such as diabetes and high blood pressure, can become worse if not treated, others can be carefully monitored, with treatment starting if the condition worsens. For example, “watchful waiting” can be an appropriate approach to prostate cancer for many men.
» WHAT ARE THE OTHER OPTIONS? There are often equally effective treatments, in which case it’s best to choose based on your priorities. For women with early-stage breast cancer, for example, a lumpectomy (the surgical removal of a portion of the breast) can be as good as a mastectomy (the removal of the entire breast) in preventing the spread of the cancer. People who put a high priority on preserving their breast may opt for a lumpectomy while others may find it reassuring to have the breast removed entirely.
» WHAT ARE THE GOALS OF THE TREATMENT? Be sure you know why you are undergoing a specific procedure. For instance, in one survey, many angioplasty patients thought that the procedure to unclog coronary arteries would help prevent a heart attack, but in fact it only helps ease chest pain.
» WHAT ARE THE RISKS AND BENEFITS? Get a clear sense of how often the recommended treatment helps people and how often it harms them, too. And consider what the risks mean for you. For example, how would you feel if one of the side effects of treatment was sexual dysfunction?
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