Know your DIAGNOSIS!
GEORGE Bernard Shaw says ‘Beware of false knowledge; it is more dangerous than ignorance.’
Some years ago there was a baby girl born to an anxious mother waiting for her precious daughter. The baby was born with significant birth defects and had to be immediately rushed from Mandeville to the University Hospital of the West Indies (UHWI). The weather was bad, so although she should have been airlifted she had to be transported by car, wrapped in cotton and foil to keep her warm, carried by a nurse and her aunts. She very quickly had surgery done but remained in hospital for almost three weeks. Her hair was shaved off and IV’S placed on the side of her head. They even had to cut both her ankles to get to her veins. By the time her mother was well enough to visit her in hospital she could hardly look at her baby because all the tubes and wires broke her heart. The baby girl eventually went home and grew into a cute, chubby little one with a beautiful head of hair.
I was that little baby.
Growing up, my family referred to me as the “miracle baby” because of all that I went through.
I was told by my family that I was born without the umbilical cord (navel string) attached to me; there was a big hole in my belly that the surgeons closed. It was this story that drove me to become a doctor. Since I was four years old I would say, “I’m going to be a baby doctor so I can help babies, just like how the doctors helped me.” I have always been VERY proud of my story and would show off my scar where my belly button should be.
In medical school I would almost boast about how sick I was at birth, and that I was “born without an umbilical cord”. Fortunately for me, I was able to trace my docket in the Health Records section at UHWI. I discovered that I was born with a rare condition. I was, in fact, born with an umbilical cord, contrary to what I had always believed. After learning my actual diagnosis I can only imagine how foolish I came across to my colleagues and teachers!
I’m sure there are many people who misunderstand their diagnoses and go about telling others they have “xyz” when it really is “wxy”. This may seem trivial to some but to your doctor those two may be very different. It’s important to know the correct diagnosis because you want your doctor to treat you appropriately by prescribing the relevant medications and ordering useful tests and investigations. No one wants to do an ultrasound when what you really needed was a simple blood test.
If you or your child has a chronic illness that requires frequent doctor visits for check-ups and necessitates you being on medications long-term, it is VERY important to know the names AND doses of the medications you are on, and whether you take them correctly. We need to know the doses of the medications to evaluate if they are working well for your condition. Do we keep the same dosage because it’s effectively keeping your blood pressure down? Or do we increase the dosage? We can’t increase the dosage if we don’t know the dosage you are currently taking.
There have been many occasions when, while I am seeing a parent and child, I formulate my diagnosis and treatment plan, and tell the parent the diagnosis. When I ask if he/she understands the answer is,
“Yes, doc”. Then, a few minutes later, a nurse comes to me asking me to explain to this parent what is wrong with their child.
I get it. There are countless reasons you may want to leave my office — you’ve been there for hours, you want to catch the pharmacy before they close, your ride is waiting on you, or you just don’t want to admit that you don’t understand — but please let us know if you are confused or have any questions. We want you to be aware of what is going on with your health. We want you to understand why you need this blood test, and these four medications. We want you to feel confident that our treatment plan will help you.
I try as much as I can to follow up with questions like “Do you have any questions?” “Tell me what you understand based on what I told you”, “Do you want me to go over anything?”
Speak up if you don’t understand. There is no shame in enquiring about the health status of yourself or your loved one. Write down your questions you want to ask and bring it to your appointment. Ask for the diagnosis and medications to be written down (legibly). Bring a trusted relative or friend along as a second ear. Ask why you need to see this specialist when we refer you.
While I can’t promise that we can answer every single question you may have, I can promise that we will try.
Dr Tal’s Tidbit
It is important to know and understand your diagnosis and medications. If you misquote your diagnosis to your health-care provider it may affect your treatment course (to your detriment). Feel comfortable to ask your health-care provider any questions you may have about your health.
Dr Taleya Girvan has over a decade’s experience treating children at the Bustamante Hospital for Children, working in the Accident and Emergency Department and Paediatric Cardiology Department. Her goal is to use the knowledge she has gained to improve the lives of patients by increasing knowledge about the health-care system in Jamaica. Dr Tal’s Tidbits is a series in which she speaks to patients and caregivers providing practical advice that will improve health care for the general population. Email: dr.talstidbits@gmail.com IG @dr.tals_tidbits