Meeting with Your Health Care Provider - How to Prepare

Meeting with Your Health Care Provider - How to Prepare

The NIH of health defines chronic pain as pain that lasts more than several months (variously defined as 3 to 6 months, but certainly longer than “normal healing”.  Frustratingly for many, this diagnosis provides a plethora of opportunities to visit with not only our primary care physicians, but various other specialists as well (neurologists, rheumatologists, orthopedic surgeons, neurosurgeons, physical therapists, occupational therapists, physiatrists, etc.). I could safely say that for the majority of us going to the doctor, or any other health care provider, is not a favorite activity. I could also say that many of us have headed home (perhaps just walking out of the appointment) only to declare to ourselves, “Ugh! I forgot to ask….!” or ‘I didn’t get information about…!” or “I didn’t tell them…!”  Sound familiar?

This is completely infuriating! Especially after going through all it takes to get to that point. Such as, finding a physician or health care provider we hope will be compatible, making the appointment (making sure insurance will cover it, etc.), looking for someone to take you, waiting for the appointment, (sometimes months in pain, if not longer), getting ready (which is no easy task), getting there (up to several hours for some), struggling with pain as you try to sit comfortably in the waiting room waiting to be called, and then the extended amount of time in the examining room seeking patience from the far corners of your soul that’s now cringing in pain as well! All the while performing calisthenics in the overheated cooped up room to keep the pain at bay, (I KNOW you’ve been there sitting, standing and lying down on the paper bedding with that “WHY do they bother” flat pillow)! Then the physician finally arrives! He’s done; you’re checked out and as you’re walking out you’re remembering what you forgot! This is completely irritating! Yes, indeed! The memories are coming to mind of the times you left exclaiming expletive words that I refer to as ‘therapeutic cussing!”

During the time I was going to multiple appointments before and after my first cervical surgery, I was tired of forgetting to ask things, as well as irritated with having to constantly repeat my health information so I had decided to arrive at the appointment as prepared and organized as possible! Having a basic plan can help make the most of your appointment whether you are starting with a new health care provider or continuing with one you've seen for years. This is extremely important, not only for us, but also for the health care providers we see. Due to their schedule, which limits the amount of time they have to spend with us, we need to go into the appointment organized with a list of problems and questions, as well as provide complete and thorough information for the best chance to leave with all the answers we need, a proper assessment and a treatment plan.

The following tips on how you can organize yourself beforehand will make it easier for you and your health care provider to cover everything you need to talk about and make the best use of everyone’s time.

Before the Visit

• Making the appointment - if doable, make your appointment first thing in the morning or right after lunch to hopefully eliminate waiting.  

• Schedule extra time - it is important that if you think you need extra time that you share this with the scheduler when you call to make an appointment so you can be scheduled to have the time you require.

• Test Results - if you had recent tests completed before the appointment call the office to ask if the results have arrived. If not, ask who you can contact to make sure that information is received on time.

 

·         Write a list – make a list of all your concerns in a notebook to bring with you to your appointment. You can use this same notebook to take notes from your health care providers at your appointments. I usually start mine a week or two before the appointment. (I keep an ongoing list in an app on my phone called AnyList). List all your concerns that are problematic and then prioritize. If you’ve a list of 10 or more issues you probably need to make sure you ask for a longer appointment. Otherwise, narrow it down to the most important. Share how the concerns (for many of us we go for pain) affect your everyday activities. What can't you do because of it? As well as:

o   what you are feeling

o   location

o   type of pain

o   specific times

o   things that make it worse, better

o   how it is affecting you

o   like sleeping

o   eating

o   going to the bathroom

o   bathing

o   dressing

o   sitting

o   standing

o   walking

o   going out in public

o   shopping

o   socializing

o   mood

• Bring ALL your medications – it is important the physician knows what you are taking. Often they ask you to bring all of your medications with you on a first visit, including all the over the counter medications, vitamins, supplements and herbal medicines. You should always carry a complete list of all these items for any emergencies. It should include:
•  name of the medications
• dosage
• how often you take it
• what you take it for
• how long you have been taking it
• any side effects you may be feeling
• prescribing physician

• McGill Pain Questionnaire – The physician’s office most likely will have a pain scale they use and may prefer that. You might want to fill one out ahead of time for yourself so you don’t feel pressured while in the waiting room, causing you to forget something. Many find the descriptions of the various types of pain provided helpful. If you click on the link title McGill Pain Questionnaire at the beginning of this paragraph, it will take you to various other pain scales you may find helpful as well. You can choose any of the charts that works for you, but this one is similar to what many health care offices use.
  

• Keep a pain diary - Consider keeping a pain diary to note how you feel each day. Include:
• what makes your pain worse
• what makes it better
• how long does it occur
• how is it affecting you everyday activities
• What you are doing to try and make it better, such as using a heating pad, ice, Biofreeze, over the counter medications, supplements, creams, stretching, etc.

This will best help the physician, or other health care provider, to come up with a plan of care specific to your needs.

• Bring a notepad and a pen to the appointment – make sure to take notes. Ask them to repeat any information if you need clarification.

• Contact a friend or family member - you may feel more confident if someone else is with you. They can help remind you about things you planned to tell or ask the health care provider, as well as help you remember what the doctor says.

• Insurance card and identification – this is a must! As well as being prepared to pay any co-pays required.

• Medical History – many of us dealing with chronic pain have had multiple doctors’ appointments, surgeries, and other treatments that would be extremely helpful to provide the physician or health care provider with. Keeping a medical history to bring to your appointments is very helpful.  I started going to so many specialists that I got weary of repeating all the information every time. I hand mine over to the nurse when I get there, who gives it to the doctor.  Many have actually used it for a quick review, have thanked me and usually ask if they can make a copy. I keep a copy in my purse in case of emergencies.

Suggestions for what to include in your medical history:

1. Contact information - name, address and telephone number, and birth date at the top

2. Physicians information - names, specialty, contact information, referring physician, dates last seen

3. Diagnoses – Name of diagnosis, physician who gave the diagnosis and date given

4. Medications - name of the medication, dosage, when and how often taken, what taking it for, physician who prescribed it, date started. Be sure to include all over the counter medications, supplements and “alternative” things you are using. They appreciate honesty!

5. Allergies - name of medication, specific allergic reaction (rash, hives, etc.), date occurred

6. Hypersensitivities/side effects to medications - name of medication, specific issue (rapid heart rate, dizzy, nauseous, diarrhea, shaky, etc.) Remember many people have hypersensitivities to medications! YOU ARE NOT THE ONLY ONE! I've heard too many times, “Nobody else has ever reported this!" NOT TRUE!

7. List medications and procedures you have tried for your pain - if worked or not and why. That way they can easily see what has been trialed and know what they may be able to prescribe. Please know that there are many different types of medications that can help pain and often it may take many trials to find the correct one for your situation.

8. Surgeries - name of surgery, physician performed, location, date (include epidermal injections, and other procedures received, location)

9. Tests performed - X-rays, ct scans, MRI's, EMG's, CT Myelograms, etc. where you had it; (Bring the results if you have them). Remember to state if claustrophobic with MRI's. They can sedate you; they do it all the time. There is no need to be embarrassed!

10. Insurance information – make sure it is current

11. Emergency contacts – names, relationship and contact numbers

12. Date last updated - update after every appointments to be sure always current

This article will continue in the next blog post titled, Meeting With Your Health Care Provider – During the Visit