Getting the most out of your checkup
Ask the right questions and don’t be shy about describing your symptoms
Last spring, 64-year-old David Blyth began feeling unusually tired. “I walked just about two blocks from my house and I had to sit down twice en route there and back,” he says. “I thought, ‘Wow, this is really weird!’ ”
The fatigue persisted, but despite a family history of heart disease and the fact that he was a smoker at the time, Blyth didn’t mention it to his doctor. “You just hope it’s going to go away,” he says.
Then, one day at work he began to feel a tingling sensation in his arm.
“I knew that wasn’t good,” he says. He drove himself to the hospital — not a good idea, he now admits — where he was told he was having a heart attack.
“My body was sending me messages and I was ignoring them,” Blyth says. “I was lucky I had a small heart attack because I’m the poster boy for being an ignoramus.”
Fortunately, in Blyth’s case the outcome was good. Doctors inserted a stent to open an artery, which was 70 to 80 per cent blocked. “The instant that stent went in, I felt better,” he says. “I was literally sitting up in the gurney with my hands in the air saying, ‘I’m back!’ ”
But he admits he might not have been so lucky. When you notice a change in your health or energy level, particularly if you’re over 50, you should talk to your doctor about it.
“I should have known something was not right,” Blyth says.
Here are some tips on how to ensure you get the care you need from your doctor. Track your symptoms. Have you ever gone to the doctor to report a suspicious pain, only to find that a) it has disappeared and b) you can no longer remember whether it was on your left or your right side?
Write down symptoms in a notebook as they occur, including where, when and how long they last and exactly what you felt (i.e. the pain was “sharp” or “dull”), advises Dianne Carmichael, a longtime veteran of the health-care industry and a board member with Patients Canada.
Use visual and narrative language to describe symptoms. Instead of complaining that you have a headache, describe what you’re feeling. You might tell your doctor that the pain came upon you like a lightning bolt striking, or that you feel as if a heavy weight is sitting on your chest.
And talk about how your symptoms are affecting your life, as well as why you’re worried. Perhaps, like Blyth, you used to walk kilometres at a time without becoming breathless and now you can hardly walk to the end of the street. Or you’re worried about the pain in your side because your sister had ovarian cancer.
“Make your concerns clear,” Carmichael says.
Prioritize. Doctors usually get paid on a fee-for-service basis and generally a visit is expected to last about seven minutes unless you’re having an annual physical, according to Carmichael. “I have heard of some doctors limiting the number of issues they will deal with in an appointment,” she says. “I would certainly challenge that.”
But, she adds, keep in mind that doctors are not there to socialize and try to raise the issues of greatest concern first.
“Typically, we start with chit-chat, and then we talk about the things that aren’t critical,” Carmichael says. “Then, just before the doctor is getting up to leave we say, ‘Oh, by the way . . .’ and we hit them with the big issue.”
Make a list, she advises, and prioritize it by importance to keep you both on track.
Do your research. Most doctors have no quarrel with patients turning to reliable websites such as those run by the Canadian Cancer Society, the Arthritis Society of Canada, the Mayo Clinic or Web MD to educate themselves, Carmichael says.
“There’s a real movement toward participatory medicine, where pa- tients take control of their own health,” she says. The caveat: Make sure you’re relying on a credible source, and don’t try to self-diagnose. “That’s the doctor’s job,” she says. Overcome your squeamishness. Don’t leave out details you think are yucky, such as blood in your urine or changes in your bowel movement. Says Carmichael: “This is not the time to be shy.” If you don’t actually want to verbalize the problem, she suggests, at least write it down on your list so the doctor can read it.
Bring an advocate. If you’re intimidated by doctors, or you’re expecting a serious diagnosis, bring a spokesperson/note taker. Kate Pocock, 65, regularly accompanied her sister Mary (who died eight years ago at 52) to doctors’ appointments during her battle with cancer.
“The doctor would say something like, ‘The cancer might have moved to your brain,’ ” Pocock says. “After you hear that, you just don’t hear anything else.” Pocock used a tape recorder as back up. Bring your meds and copies of test results. If you’re on one or more medications, bring a list of them, or at least toss them in a plastic bag and bring them along to your appointment, advises Carmichael. “If doctors are going to prescribe something, they need to know what else you’re taking.”
She also suggests asking for copies of tests, test results or emergency room discharge summaries to bring to your GP’s office. “The more prepared you are the better,” she says.
Take notes. Carry a notepad and pen to appointments to remind you of what the doctor says.
Push for answers. “If you feel you’re being dismissed and you’re convinced something is wrong, you need to speak up,” Carmichael says.
Ask if there is somewhere else you can go to get answers or a specialist you can see. “I wouldn’t suggest getting a second opinion for every ache and pain, but if you’re really concerned, it’s important to push for one,” she sums up.