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HEALTH TIPS
This section features tips aimed at helping you make the most of a v isit to the doctor's office.
TO PREPARE FOR THE VISIT
Take a moment to identify the main reason for the visit--just a regular checkup, in preparation for a procedure, new complaints, etc.
Then decide what are the main goals that you want to accomplish with the visit--have some questions answered, obtain more information, have the doctor address a complaint, etc.
Then make a list, first describing your main goal for the visit and then listing any questions you might have.
If the reason for your visit has to do with complaints that occurred over a period of time (such as irregular periods, headaches, etc.) try to write down when the problems occurred and any factors that you think may have played a role (like increased stress, taking new medication, etc.).
If you find an article in a magazine or on a Web site and you would like to discuss it with your doctor, make sure you contact his/her office in advance with this information. This allows your doctor to become familiar with the material and, possibly, schedule more time for the visit.
Before leaving for your appointment always call the doctor's office to make sure the appointments are running on schedule. This way you avoid wasting your time in the waiting room.
THE VISIT
There is no such thing as a "silly" question. Always ask for an explanation or clarification. Your doctor should always accommodate you.
If you don't feel comfortable having a discussion with your doctor while you are disrobed, in the examining room, do not hesitate to ask for some "face to face" time either before, or after the physical examination.
If you feel nervous about any part of the physical exam, let the doctor know in advance. Also, suggest what he/she might do to help you relax--warm the speculum before a Pap smear, warn you that a prostate exam is about to start, etc.
Ask for handouts or pamphlets on the subject that interests you. They can provide valuable information and also serve as a reference in case you have additional questions.
If you find yourself in a situation in which you are unable to afford a drug recommended by your doctor, let him/her know about it and ask for help in obtaining it. Although not widely publicized, Pharmaceutical companies run "financial-aid" programs and your doctor should be able to assist you with this matter.
THE EXAMINATION
Most doctors follow a set formula when obtaining a History and performing a Physical Examination.
Becoming familiar with this formula will allow you to better anticipate your doctor's questions and to better communicate your complaints.
Of course, each visit to the doctor's office may have a particular aim, and the doctor will have to tailor the History and Physical Exam; however, the basic formula will be the same.
Bellow is a presentation of this formula, and some suggestions for the patient.
THE HISTORY FORMULA
CHIEF COMPLAINT:
this is the main reason for your visit
the complaint may be a new complaint (e.g., a fall off a bicycle), a follow up for a chronic problem (e.g., adjusting the dose of insulin in a diabetic), or no complaint at all (e.g., an annual check up)
this is one of the most important pieces of information you give to your doctor, so be concise and to the point. In this way you focus your doctor's attention and you provide invaluable help for him/her in investigating your problem
HISTORY OF PRESENT ILLNESS:
this part mostly applies to new complaints and to follow up visits
for a New Complaint describe in detail when the problem started, what are its main characteristics, if you think it is associated with something or if someone else in your family has the same problem, what makes it worse, what makes it better,etc.
for a Chronic Complaint make sure you have a list of all the medications or treatments you had, and what helped and what didn't
PAST MEDICAL HISTORY:
give a list of all the medical illnesses/problems you had
PAST SURGICAL HISTORY:
give a list of all the surgeries you had
FAMILY HISTORY:
this mostly applies to your first degree relatives (parents, siblings, children)
give their age, any significant medical problems, if dead or alive and, if known, any family history of cancer, genetic disease, etc.
OBSTETRICAL HISTORY:
this, obviously, applies to women
give information regarding your past/present pregnancies
the quick formula for this is FPAL, where F=number of full term pregnancies, P=number of preterm (before 37 weeks) pregnancies, A=abortions and L=living children
GYNECOLOGICAL HISTORY:
again, this applies to women
give age of first period/ length of cycle/ duration of your period
also if sexually active or not, sexual preference, use and type of birth control, any history of Sexually Transmitted Diseases and treatment for them, etc.
ALLERGIES:
make sure you let your doctor know of any drug/food/environmental allergies
IT IS VERY IMPORTANT to describe YOUR EXACT ALLERGIC REACTION; there is a great difference between having a stomach upset when taking an antibiotic and being unable to breath properly
any problems you might have had, in the past, while receiving anesthesia are also important to mention
CURRENT MEDICATIONS:
provide a list of medications that you are currently taking
it is always very helpful if you know the dosage
if you are using any Herbal Remedies, please make sure to let the doctor know
Once the History part of the visit is over, the Physical Examination follows.
Before that starts, if you feel that the doctor did not ask you something that you consider important or relevant, this is the time to bring it up. Again, this will help focus the doctor and it will allow you to convey important information, towards the beginning of the visit (as opposed to bringing it up as you are about to leave, when it might be interpreted as less important information, or the doctor has already started to shift focus to the next patient).
The Physical Examination starts with a set of Vital Signs (blood pressure, pulse, etc.) and includes an examination of all the major organ systems.
Of course, depending on the specific reason for your visit, the doctor may perform what is known as a "targeted physical examination", concentrating on the organ system of interest.
Copyright 2001-2004 GHO. All rights reserved.
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