Friday, July 24, 2015

Do Your Homework Before Your Doctor's Appt! Be Prepared!

Any long time reader of my blog knows that I am a Boy Scout, AND previously a Girl Scout. 
Both have the motto:  
Be Prepared!

When you make an appointment to see your doctor, you usually have a specific issue in mind. Either it's an appointment for a physical/wellness visit (often required by work) or you have a problem or two, or three, or four. Your physician has no idea why you are there.  Usually we get a cryptic "Chief Complaint" written at the top of the chart by the medical assistant. These can include the following: "Wellness visit" or "sore throat" or "suture removal" or "knee pain" and the like. When we walk into the room, we assume that that is for what you are being seen.

YOU need to inform your physician why are you there at the very beginning of the appointment. 
A wellness visit is anywhere from 30 minutes to 45 minutes (depending on the doctor) and does NOT include care of new medical problems. It should cover routine health maintenance issues. These include lifestyle counseling, immunizations, screening tests for sexually transmitted infections, Pap smears, mammograms, Bone densities, and colon cancer screenings, and genital and prostate examinations.
Routine follow-up visits are anywhere from 10 minutes to 20 minutes, depending on the physician, and depending on the problem you bring to him/her.
Most physicians are not trained on how to limit their appointment visit times
Docs feel bad telling their patients they only have 15 minutes and they can't address all of their issues in one appointment. Patients on the other hand, often want to get as much as they can for their 15 to 20 minute dollar. They try to cram as many problems as they possibly can into that 20 minutes. This is unfair to the physician and to the patient. 
Physicians need to give the amount of time required for each problem in order to do a good job BUT also feel the pressure to stay on time for their patients
Patients on the other hand often are unaware that they are inconveniencing another patient by making their doctor run over time, AND they personally hate to be put into an exam room half an hour late for their own appointment.
You see the difficulty, don't you?
Successful Doctor's appointments require planning by you, the patient.
 If you're going to do this right remember that your physician can only manage one to three problems well in that short period of time depending on the difficulty of each problem. Also, your priority of what's the most important problem and the physician's, may be  diametrically opposite. For example, you may not think much of the pain in your chest when you take a deep breath and be more worried about your knee pain. Your physician however, it is definitely more worried about the chest pain when you take a deep breath. 
Physicians are trained to look for life-threatening problems and to deal with those first. 

You also need to be prepared with your medication list complete with dosages and how often you take your medicines. Walking into a physician's office for a follow up without knowing what medications you're on is dangerous. Physicians know that a patient may have seen multiple doctors. Medications often get changed at the cardiologist's office, pulmonologist's office, or by an interchange required by insurance. You need to be prepared by bringing an up-to-date list of your medications with you to each and every appointment with each and every physician. Even better is to bring the bottles with youDon't forget vitamins, herbs, supplements, and inhalers and injectables (think insulin).

When you move to a new city and have to get a new doctor you need to also be prepared with your medical records. If you haven't been able to get records copied and sent to your new physician, at least have the physician that you used to go to give you a copy of your face sheet from your electronic medical record. This should include your past medical and surgical history, family history, allergies, medications, immunizations, and health maintenance tasks like mammograms bone densities colonoscopies etc. Don't forget that your DENTIST needs these records too.
If your doctor doesn't have and electronic medical record, ask for copies of your immunizations, and preventive services flow sheets. This should include your last mammogram, prostate exam, PSA (if done), Pap smear, bone density, and colon cancer screening. YOU can write up your OWN past medical/surgical/family history. Write down if you ever smoked, how much and for how long. If you drink alcohol, how many drinks a week do you have? Do use use any prescription or street drugs for recreational use? Let your doctor know!
In summary:
  • Know how long your appointment is 
  • inform your physician in the first minute of the multiple medical problems that you are bringing to him/her, 
  • respect the time limit, 
  • know your medications, 
  •  AND 
  • if you see a new physician, bring a snapshot from your old physicians electronic medical record to inform him or her of your past medical history.


Tuesday, July 7, 2015

Strawberry Jam, Hobbies, Retirement, and Your Legacy

It's that time of year again.
It's the time when the local fresh fruits-strawberries, blueberries, peaches, apricots, etc., are coming into or just going out of season.  That means it's TIME TO MAKE JAM!

Last year I got a tad carried away with canning and pickling.  I found out that my office manager worked for a Michigan farmer at a local farmer's market on the weekends. She convinced me to try the strawberries from Kenny's farm.
The difference in the flavor and color of farmer Kenny's strawberries compared with the (now I know) CRAP from the grocery store was incredible.

So, I made strawberry, blueberry, apricot, peach, peach melba jams, bread and butter pickles, refrigerator pickles, dill pickles, lactose fermentation style pickles. It got ugly.

Hobbies keep me sane. Okay, sort of sane.

Alright, they keep me busy.

So here is the thing I've noticed:
When my patients retire, if they don't have a hobby or any interests outside of work, they get depressed. Their spouses, who DO have hobbies, get mad at them because the new retiree is looking to their spouse to keep them entertained. They follow their partners around the house saying things like, "Whatcha' doin'? Can I help? Want to go do something? Can you make me lunch?"

There is resentment, anger, and divorce or at least, miserable retirement.

Here is my advice:

Get a hobby. Make cakes. Go camping and hiking. Start fishing.

It's important to your mental health, and your marriage/partners/friends. It makes you more interesting to be with and talk to. It keeps you busy.

Set a schedule daily. Get up at the same time every day and go to bed at a reasonable hour.
Don't watch TV or play computer games all day.

I (obviously) make jam. I quilt. I write. I procrastinate on all of them, but when I finish, I have an amazing sense of accomplishment. I also have a sense of the past and of the future. When I make a quilt, or a photo-book,  a novelty birthday cake, or write a story, that is something that will be left behind when I die so no one forgets me--for a while, anyway.

(Okay, they won't have the cakes or jams left behind. I don't want people to save those. Maybe they can remember how I made those and keep the traditions going for future generations-instead of getting ptomaine poisoning from eating decades old jam)

 My ego feels better when I know that I've left a legacy of memories/objects/recipes/stories/quilts behind.