Debra L. Glasser, M.D.
PHOTO BY GLORIA TOWNE
By Debra L. Glasser, M.D.
Something is not right with you and your health. You decide to see your doctor for what is ailing you. This can run the gamut from a rash to coughing, shortness of breath, pain from the neck to the feet, diarrhea, fatigue and lack of sleep. The list goes on almost infinitely.
I say infinite because how someone feels with a condition can be as variable as there are people, even though there are expected patterns doctors are looking for. The doctor who evaluates you is assessing to determine what might be going awry. Tests may be recommended if the diagnosis is uncertain. These tests might be blood work, X-rays, CT, MRI and PET scans to a biopsy or a consultation referral to a specialist, therapist (mental health, physical, occupational, etc.) or perhaps a surgeon.
You proceed with the recommended evaluation because you want to know what is happening and feel better. You don’t put off the suggestions because waiting and allowing a condition to worsen may influence your recovery or even your life.
In the meantime, you wait for ‘the news.’ Stay as calm as you can. Eventually, and hopefully, sooner than later, you have an appointment to discuss the results.
This appointment is essential. Not setting a time to discuss results (even if the results come back negative or normal) is not appropriate because you did, after all, go in for something troubling you. If the first set of tests are negative and you are still unwell (or maybe even if you are well) it is important and valuable to follow-up on them. If the doctor does not suggest you schedule this follow-up appointment, insist on one anyway. As with the initial consultation visit, preparing for this appointment is important.
Suggestions for your follow-up visit
- Bring a support person with you at best; a notebook at least. If the potential results are serious, bring that support person and have your person take notes on everything discussed. You will undoubtedly have questions after the appointment because you won’t hear it all under stress. Our brains are wired to shut down under stress, so it is normal to miss things. You might forget a substantial part of what was talked about. This is why your support person and their notes are so important.
- Bring a list of questions for your doctor. Below is a suggested list of questions. Some or all may be relevant to your situation. Bring a list with you because, as noted above, it is very likely you will forget some key questions. Ideally, you want to leave this appointment with as many of your questions answered so you are not left feeling confused and still in the dark, something I often hear from people after such appointments.
Questions for a follow-up doctor visit:
- What did the test(s) show?
- What is the diagnosis? Get the name of the disease or finding. This gives you a handle for further learning about your condition.
- What does that mean?
- Is it malignant (that is, cancer) or not. How does it behave? Is it very aggressive (Might I die fast?) or is it slow growing?
- Is it a structural abnormality like a torn meniscus? Keep reading.
- Hepatitis? What type? Blocked artery? COPD? Depression? The list goes on…
- Is there a known cause? In some diseases, a cause is known. In many others, not. If known, is there anything I can do to remedy the underlying cause, now and going forward? For instance, you have high blood pressure. Is there something you can do in addition to taking medication? Will it make a difference if I eat less salt, exercise, lose weight?
- How will this disease or defect affect me and the length and quality of my life?
- What do you recommend I/we do about this? Your doctor is your partner here.
- What do you recommend for treatment? Both for the disease itself AND its effects (which could be anything from anemia to pain, fatigue and nausea etc.). Doctors can be very disease-oriented and forget about the symptoms. This is particularly true for cancer when the doctor (in this case, an oncologist) focuses primarily on the cancer treatment, and delegates, or worse, neglects the symptom management (for instance, to a palliative care specialist). Just get clear who is your ‘go to’ for help when needed.
- What should I expect to happen (known as prognosis) if I treat or not?
- What are my treatment options? What do you recommend for me? What would you recommend to your mother who is in my age and state of health?
- What are the effects of treatment both on the course of this disease and side effects?
- What exactly are the side effects and how long will they last? How severe or mild will they be?
- Are there any treatment interactions with my current medications and conditions?
- Will the treatment be curative? If so, what are my chances of cure and what will it take to get there?
- If not, will treatment slow down the course of the disease? If so, what does that mean? Will I live longer and with what quality of life? How much longer? Days, months, years?
- Will treatment buy me time and if so much? And at what cost (particularly in quality of life and side effects)? Financial cost may be a consideration as well and if it is, ask.
- When should we start? How will that go and who will give both give me all the details and be available for me to reach out to at any time I need?
- How often will I see you for follow-up visits? Will you be available when I need guidance or hit a roadblock?
Thank your doctor for answering all your questions.
Take all this information home to contemplate what you have learned. Let your mind and heart digest it all. Consider waiting to decide on a plan of action if you are not sure. It will take longer to integrate what you just learned, if it is serious. That’s OK; you have time, albeit the amount of time depends on the situation. You can wait as long as you need on a decision to treat end-stage knee arthritis until you can no longer handle the pain. You cannot safely wait more than a few days to a couple weeks on a potential cancer diagnosis. Either way, you need to take the time to gain clarity. Ask for support if you need it.
Lastly, thank yourself for taking responsibility for your health, and getting all the information and support you need to make decisions and proceed. This is no small task. Congratulate and appreciate yourself!
Click here for a copy of the healthcare follow-up worksheet!
Debra L. Glasser, M.D., is a retired internal medicine physician who lives in Olympia. Got a question for her? Write drdebra@theJOLTnews.com
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