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How best to present yourself to get the most out of a drs appointment?

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pen
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Post  moominamy Thu Feb 18, 2010 8:44 am

This question came up in dizzyflowers thread and I thought it would be really interesting to concentrate a thread on this point. So, how do you try and present yourself? Does it help? Have you had more (or less) successful drs visits if you tackle things in a different way?

My reply to that post so I don't have to retype....

Hmmm, it's a very good question. How is the best way to present yourself??? To be honest I'm not sure. I wouldn't put on a big 'act' of any sort or try too hard to come across in a certain way. I'm trying to think what I do. I think I am just me!

For a typical appointment I would prepare well for it (what I want to get out of it etc), usually have a written list of questions and points to raise. I report back on the results of trying what was suggested last appointment, give a summary of how I've been since the appointment, then go through any other things I want to bring up (obviously the dr does their bit too, I don't monopolise the whole appointment!). I guess I try to be time efficient and concise to get as much out of the appointment as possible.

Some days I can burst into tears at an appointment, but I try not to if I can help it. If I'm having a 'good' day and so seem more upbeat I'll mention that this is a good day and not typical. I've usually taken some codeine to get me there in the first place and I mention this and the fact that I very rarely take it otherwise, so it will give a slightly false impression of how bad it is.

I think this would make a good thread in itself, so think I will start one as I'm also interested in how we all deal with this dilema.

Take care

Amy

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Post  pen Thu Feb 18, 2010 8:48 am

Bit of a cop out, but Triptan hatching so cut and paste from the other thread.


I think its a dilema. Dammed if you do....
I have been at the docs and been quite stoic and held it all together so that I can make a good account of myself.
Not be a babbling pain riddled anxious fool.
Seems they decide I'm not that bad.....

I have burst into tears, and the worst time was when a GP turned to my husband and said.
"All I am seeing here is a lot of anxiety".

I have gone in alone and wished I had someone to turn to to back me up.
I have taken him with me, and then find I still do all the talking and he says nothing..... rabbit

I dont know how to play it. I am apparently articulate (so they told me when I did a lot of radio stuff), but does that help or hinder?Very Happy
We need all the help we can get.....

Rolling Eyes

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Post  HeelerLady Thu Feb 18, 2010 9:43 am

Hmm this is interesting. I agree that putting on an act isn't going to get you far - nurses and docs can usually see right through it (like the conversation about pain scale and 10). Part of this depends on if it's a new doctor or one that has been seeing you for a while.

If it's a new one - well this can be a bit tricky. They haven't seen you at your worst (we normally aren't that fortunate to be walking in on a 9.5 day) and I'd be very specific in answering their questions and if what you have isn't working, perhaps exaggerate a bit (no drama-queening however) but they need to know that the current isn't working for reason x,y and z. Perhaps write down what avenues you've already tried and the outcome (worked for a while, untolerable side effects, didn't work). Yes it should be in your chart but I swear they don't read them. I've learned when the nurse asks why you are here - give her/him the very basics. 9 times out of 10, the first words out of the doctors mouth is "so what brings you here today". If you've given the basics, and they've read it you can expound upon it and it saves your breath if they haven't. Be honest and if you are in a bad day...it's okay to let it show (not like you can normally help it) they need to see the worst of it.

A regular seen doctor - well in theory you should have a repore with them. I know this isn't true for everyone but they should be able to tell by looking at you how well you are doing. Pain is a hard thing to hide (I've been trying and it's written plain as day all over my face). I never exaggerate as it only seems to cloud it. Granted I've had doctors take me seriously and have never had to convince them of symptoms or side-effects. So someone else who's had difficult doctors to deal with may have another take on this.
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Post  pen Thu Feb 18, 2010 9:47 am

And how do we approach the whole medication didn't work/don't want to take it.....
I am one of those I expect trying patients for whom thus far nothing has worked.
Also refused the last preventative.... affraid

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Post  HeelerLady Thu Feb 18, 2010 10:05 am

Well - I've tried everything so far. I also keep a migraine calendar and take that in. They know which dates I started what and I usually don't have to say it's not working - they look at the calendar and know. I also call a lot (I swear his nurse has my vital contact number memorized). I've had so many not work well (and it's helped prove the point that I am very sensitive to medications and dosing) and I don't tolerate things that make me miserable. If I feel homicidal, can't function or have something that drastically interferes with my day to day life, I call. They usually go to the next plan or want to see me asap.

Pen, you are in a different situation as you have been fighting this a lot longer than I have. The only words of wisdom I have for you is to try meds. But let the doctor know that you will try it, but if it has untolerable side-effects that you will either be calling or will stop using it. The only reason I say this, is because you have been doing this so long. I'm sure you've tried just about everything out there with little to no success. But the question is when...and has your body changed since you last tried it? I'm just thinking if your systems have changed you may respond to things differently than you did before. And there is a possibility that they have refined the medication in a way to eliminate side-effects and boost efficacy. I just say this as in the past I've taken a straight ritalin and a longer acting ritalin and they acted completely different. Straight - intolerable, long acting - had to cut the caffeine habit but worked like a charm.
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Post  pen Thu Feb 18, 2010 10:30 am

Thank you for this, you make valid points. I wish I could be more brave.
I will try. As for calling, I don't have that option I'm afraid...He doesn't take calls.
I have had 3 neuros and none of them have.

I do think its the fibro making me so intolerant.
I cant even have a sniff of alcohol any more.
Its not a headache thing, makes me feel really unwell.

Appreciate your pearls of wisdom.

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Post  HeelerLady Thu Feb 18, 2010 10:57 am

Hmm, must be a difference in our health care systems. I never talk to the neuro directly - I talk to his nurse and she goes to him with the question/concern and then calls me back. Unless you are dying here, you will rarely get a doctor on the phone (usually they tell you to hang up and dial emergency anyway). Bummer...wish this was an option for you. Sad It really does help with the treatment - although there are times I called the nurse with just general questions as she talks to so many patients sometimes she has ideas on how to deal with things. I've noticed that in my chart they have records of all the phone calls too.

I hope you start to feel better in general. Being ill all the time just brings you down and makes life that much harder. Sad

One other question, is fibro fibromyalgia(sp?)? Just wondering...
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Post  pen Thu Feb 18, 2010 11:04 am

One other question, is fibro fibromyalgia(sp?)? Just wondering...

Yes it is. Fibro or FMS just quicker to write.

I dont know if my neuro has a nurse, never seen one or had one mentioned, I must try to find out.
He used to reply to the odd email, but now not.

P

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Post  alli Thu Feb 18, 2010 11:53 am

With my new Neuro I tried going in with a list of questions etc, and I got the impression that she just thought I had anxiety and was exaggerating what was going on. This was on a good day, meaning little pain but lots of emotion. My next appointment was with a migraine. I was dragging my leg, my facial pain was flaring, I couldn't find words, the usual migraine symptoms. I could see her attitude change and she now takes my pain seriously.

So I'm not sure what the best thing to do is. My last neuro listened from the start but he retired. I'm happy the new one now that she takes me seriously. But it is annoying that you aren't taken seriously when you are having a good day. And that it takes them seeing you as a mess to understand why you are seeing a freakin specialist!

Alli
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Post  LG Thu Feb 18, 2010 12:45 pm

I go in honest. I go in desperate. I go in dressed in jeans and a nice sweater with minimal make-up. I take no medication and hope for the best, they see what they get. It works wonders. The desperate thing gets my doc every time. He/She acts fast and gives me whatever drug/treatment anything I want/they think may help me. My NP was so worried she even told me to call back in two weeks after the appointment for a phone consultation to check up to make sure I was okay.

I just go in positive, optimistic and most importantly willing to try anything. I do sound desperate..yes I do. I tell them give me everything under the sun, I'll go to the pharmacy and fill it all and try it all. I'm not scared to try new things and I think this helps the process along. I try to hold back tears but when I'm talking about how migraines are ripping apart my life, its hard.

Hope this helps you guys because it helps me. Man, my doctor treats me good and I am thankful for it. I hope they never give up on me because I know i'm a difficult one.
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Post  theresae Thu Feb 18, 2010 1:32 pm

pen wrote:And how do we approach the whole medication didn't work/don't want to take it.....
I am one of those I expect trying patients for whom thus far nothing has worked.
Also refused the last preventative.... affraid

thats a tricky one pen, in the ward i work in the consultants will often refuse to progress with a more advanced/expensive treatment until the patient has given all things a go, almost in a tick list order, unless of course the meds will make patient ill,

and with my gp she always says give it a good go,(preventative) at the highest dose you can tolerate b4 crossing it off and moving on to next one, so thats what i have always done,

there have been times when i have had to battle with the side effects when i first try a preventative, its not easy, stomach cramps, leg twitching, mood swings, varying degrees of hair loss, loss of taste, loss of hearing, seeing things out of the corner of my eyes that wasnt there, fatigue, appetite changes, forgetting everything and havin to write it down, skin itching,

now i know some people on here refuse to be a guinea pig and i support their point of view, but for me daily, constant migraines have become too much to bear, and so i am prepared to go down the route of trying all that i can.
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