Navigating the World of Health Care (pt 2): The first Steps to Getting Help

In Part 1, we discussed the idea of being sick. It’s a scary place to be, and it’s important to have a clear mind when seeking medical care. In Part 2, we will guide you through the first steps of seeking answers.

“What could it be?”

Whenever we get new a troubling symptom, usually out of nowhere, such as chest pain, stomach pain, difficulty breathing or numbness in parts of your body, or infections that aren’t heeling, or discomfort and pain after an injury, it’s hard to think straight.

Sometimes, you’ll have a symptom that can be pretty severe while it’s happening, but happens so intermittently, you it’s hard to establish patterns. You can’t even remember when it first happened. Doctors can be dismissive if you can’t provide much more info than “it hurts when I…”. It is common to see several doctors before one will actually try to figure out the problem, even if it’s severe.

steth

Doctors are so jammed with patients, you’re lucky to get 10 minutes of time with one. And when you do, you have precious few moments to get your history and your reason for being there. And when it comes down to it – medicine is just a job. One we attach noble intents to, but still a job, done by a regular person with the same stresses, emotions, frustrations, flaws and potential to make mistakes as everyone else does.

Many people end up seeing several different physicians in search of answers, but being able to answer these questions will help your doctor out, in the ER or in the office. I’ve come up with a checklist for you to follow when going to see the doctor, because symptoms often don’t perform on cue, and it’s hard to get the doctor to understand the whole story.

DOCTOR CHECKLIST
1. When did the symptom(s) start? Does it ever go away? For how long?
2. Describe the nature of the symptoms. For example, is the pain sharp, dull, aching or cramping? Or, is your cough deep and wet, or irritated and dry?
3. When you have the symptom, how long does it last? Is it intermittent, or does it last for long periods of time?
4. What makes it worse? What makes it better?
5. What do you think brought it on?
6. Had there been any changes to things you are taking/eating/doing when it started?
7. Does it keep you awake at night? Have you missed work or school because of it?
8. Have you ever been treated for it before or something similar?
9. What medications are you on, and for what reasons?*
10. What other medical problems, surgeries or diagnoses have you had in the past?

*It’s also  important to have a recent list of your medications and diagnoses ready whenever you see a doctor, whether it’s in the ER, a new general practitioner, or a specialist. It’s all important info to share with your doctor. Use an Excel spreadsheet, or a simple text document to write it out. Make several copies and update it when necessary. Here’s a sample for you (click to enlarge):
samplemedlist

Barriers we put up to getting the right care

Sometimes, we try to think our way out of seeking care. “I don’t want to charge my insurance,” “I don’t want to pay the co-pay,” “I don’t have insurance,” “I’m too tired.” “I’m too busy.”

Think about it this way – if you truly feel that what you are feeling is not normal, and it interferes with any major life activities, such as breathing, walking, talking, eating, using the bathroom, etc., it’s an INVESTMENT in yourself to seek care.

Regardless of your condition, don’t let your mind get in the way of getting medical care for something that is really affecting you. It’s never stupid to seek care. Just remember that there is a system – though not perfect – to assess your condition and provide the appropriate services.

Your health can get worse, land you in a  hospital ward or needing expensive treatment, and cost you more in the long run, if you don’t get it taken care of as soon as possible. It will also save you a lot of unnecessary worry. I say this not to scare you, but to recommend that prevention and early detection is better than any cure.

Denial/Evasion/Procrastination

Something has come along suddenly. You’ve suffered for three or four days already, but don’t do anything about it. Finally, it’s Friday afternoon at 4pm. You consider calling your doctor’s office, but they’ve closed already. You try reason with rising panic. “Maybe I’ll see what happens tomorrow.” The symptoms continue, and you get increasingly nervous. You Google everything you can to find out what it might be.

You question yourself, “How serious is this and can I make it through the night or weekend?I don’t think I can. Can I? Gosh this feels really wrong. I think I need to go the hospital…” You shake it off and try to sleep, hoping that you’ll feel better in the morning. But you don’t.

Can you wait? Or do you need help now?

Can you wait? Or do you need help now?

You stress about making that decision – the ER is a big deal.

“Am I really that sick? Surely there are sicker people there.”

You consider waiting until Monday when you can call your doctor. You also probably don’t feel like sitting for hours in a crowded ER waiting room while feeling so awful.

As the day goes on, you’re feeling worse and worse. You get to the point where you are scared for your life, and you probably have fifteen internet diagnoses hanging around in your mind.

So you need to make a decision – are you stable enough to last the next few hours or days, or do you need help, NOW?

Unsure of who to call

  • If you are stable enough to wait until the next morning, call your doctor immediately.
  • If they cannot fit you in and think that you are stable enough to do so, they might suggest going to a walk-in clinic.
  • If any of your major systems are not functioning, you have a bad injury, you have unbearable pain, high unrelenting fever, and cannot wait until the next day to see a doctor, absolutely, go to the Emergency Room. NOW is the time to either Call 911 or call a friend or family member to take you immediately.

NOTE: the ER shouldn’t be used to manage long-term conditions or replace the General Practitioner relationship. Many people do use the ER because they lack health insurance. If this is the case for you, please contact your local social services department to find out if you qualify for local programs, contact individual doctors for sliding scale payment plans, and look online for reduced or no-cost medication programs from pharmaceutical manufacturers.

Previous experiences that cloud our judgment

I have found that people have funny relationships with doctors: they either revere or hate them.

  1. Don’t let your feelings from past experiences cloud your mind. You are seeing this doctor for this problem. Give him or her the benefit of the doubt. They are there to help you.
  2. Some people have had doctors literally save their lives and don’t mind telling everyone.
  3. Some people are so close with their doctors that they invite them to parties, weddings, their kids’ bar mitzvahs and baptisms.
  4. Other people swear that they smoked and drank every adult day of their lives and at 75, never saw a doctor once, and are healthy as a horse (until now), so why go now?
  5. Some people put their physicians on pedestals, singing their praises, and still others mutter under their breath at the mere mention of a particular doctor’s name.

No matter the relationship, no matter what feat of intelligence and perseverance or mistake or lack of skill an M.D. has in a patient’s eyes and heart, a doctor is a human being just like you and me. During part three, we’ll navigate some of the key players in the medical world. It might help you see things a bit differently. At the very least, take the emotion out of the equation.

The moment of truth, or a lot of unanswered questions

No matter when you do end up on your way to the doctor or ER or walk-in clinic or witch doctor, you’re bound to doubt yourself. When you’re sitting there, waiting to be evaluated, you don’t know whether to pray it’s nothing, or to pray that it is something and fixable, and that you’re not imagining it.

Do not let the bureaucracy of the process prevent you from seeking answers. You may not get answers the first time around. Doctors often play a game of “what it isn’t” – something you may meet in the ER. You may feel like the doctor isn’t listening to you, or taking it seriously enough, but they are trying first to rule out major conditions. This requires us to be our best advocates, asking lots of questions and not being satisfied with “I don’t know”.

Personal note: I’ve been through this process too many times to count. I’ve been angry, sad, tired, worried, and just plain desperate. Being a patient means being patient, and being your own best advocate. If you stop looking for answers, so will everyone else. Unfortunately, doctors aren’t mind readers, fortune tellers, or perfect. They are just people doing a job that requires a high level of mindfulness and accuracy. You are partners in your healthcare, and that requires you to do a lot of work – from seeking out caregivers, following treatment plans, and staying on top of everything.

Now that you’ve decided to take your first steps, in Part 3, we will next discuss Emergency Care.

Advertisements

What are your thoughts?

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s