Being your own best patient advocate

Last summer, Cheryl White, a healthy wife and mother in Canton, Ohio, began experiencing symptoms of a urinary tract infection. After eight months of back-and-forth with her gynecologist, it was determined that she had an ovarian cyst, and one of White’s ovaries was scheduled to be removed.

Sitting at work one day shortly before the scheduled surgery, White’s cyst burst. After she has an ultrasound done later that day, doctors found that the ovary in question was completely fine – removing it would have created a whole new set of problems for White.

Despite the burst, symptoms persisted and White began researching patient reviews to locate a local urologist, the best doctor for her particular symptoms.

“My urologist showed me all of my ultrasounds and medical information from other doctors,” White said. “The other doctors never showed me a thing.”

Earlier this year, White faced the possibility of cancer; now she has been correctly diagnosed with intestinal cystitis, a disease treatable with a diet change and an over-the-counter acid reducer.

White is not the only patient who has ever experienced frustration with a doctor, a misdiagnosis or the health-care system as a whole. Patients face these types of problems every day. The following nine tips will make a routine visit to the doctor less stressful and more beneficial.

1. Find the right doctor for you. This simple step can dramatically decrease your stress.

“You find the right doctor by word of mouth, not in the phone book,” advises Todd Fredricks, a physician who has spent his medical career in southeast Ohio working in family practice and in the emergency room.

2. Be honest. Tell the doctor everything about who you are and how you live, even the brutal things.

“If you’re honest, we won’t have to order expensive tests because we’ll already know what’s going on,” says Fredricks.

3. Tell the doctor if you are not going to do what he/she tells you. Fredricks is a firm believer in letting people do whatever they want to do to themselves but finds it respectful when patients admit they will not be heeding his warnings.

For example, despite knowing that not all will take his advice, Fredricks advocates against smoking. “What you inhale out of your car is cleaner than what you inhale out of your cigarette,” Fredricks says.

4. Write down what you want to discuss with the doctor and bring it to your appointment. Make a list of what’s wrong, what you have tried, what has worked and what has not worked.

“If somebody comes in with an agenda and says, ‘These are the things I want to talk about today and these are my questions’ that is really helpful,” says Katherine Kropf, supervisor and clinician at the Ohio University College of Osteopathic Medicine. “It helps me prioritize.”

5. Tell the doctor what your fear or concern is. Sometimes patients fear cancer, for example, and are waiting for the doctor to rule it out as a possibility.

“A lot of the time people have concerns or worries about what it could be; an important part of the interaction is addressing the patient’s main fear or worry,” says Kropf. “If someone comes in saying, ‘It might be this,’ then they are being extremely transparent with me about what they are concerned about.”

Karl Theis, a chiropractor in Uniontown, Ohio, agrees with Kropf. “We need to figure out what is really bothering patients in their head,” he says. “The goal needs to be getting you back to what you want to do in life.”

6. Know your family’s medical history. Fredricks reminds us of an applicable common phrase: “The apple doesn’t fall far from the tree.”

“Take care of yourself,” says Fredricks. “Don’t smoke. Don’t drink. Know your family history. We could probably knock out 99 percent of people’s problems using just that.”

7. Recognize the nature of our healt- care system. We do not need anyone to tell us that our health-care system has flaws; we do need doctors who can help navigate us through the system.

Kropf explains that in places that have universal health care, a step-by-step diagnostic approach exists with more focus on patient history, the physical exam and lab work. Here, where universal health care does not exist, the nature of medical practice includes a pull for evidence-based diagnoses.

“There is a great fear that you’re going to miss something, that you didn’t do as many tests as you could to figure it out,” says Kropf. “We don’t trust our diagnostic hands-on skills, and we don’t have as much time to listen to patient stories.”

8. Create more time with your doctor. Sometimes paying a visit to the doctor is synonymous with being in a rush.

“Patients struggle with having enough time,” Kropf says. “A lot of people feel it is hard to communicate with their doctor because there are all these barriers: you call and you can’t get a hold of the doctor so you have to leave a voicemail.”

Try creating a new venue where you can speak with your doctor. Kropf has one patient who e-mails questions and concerns for her to look through before the next visit.

“It took some extra time on my part, but I was interested in helping her,” Kropf says. “It gave me more time since I wasn’t trying to push it all into one visit.”

9. Keep your doctor in the loop. According to Kropf, and most would agree, patients like to feel that their doctor is accessible.

“More and more, there is a shift towards using express or emergency cares for immediate needs and using your primary doctor for chronic problems,” Kropf says.

According to Fredricks, the worst place to go with a problem is the emergency room because the doctors do not have time to listen there.

If going to the emergency room becomes necessary, one way to manage using both express and primary doctor care is to keep a running log of tests, surgeries and hospitalizations you undergo and doctors that you visit.

“Because we don’t have a universal health-care record, it is hard to keep care coordinated,” says Kropf. “So, logs are so helpful.”

Cheryl White had to figure these tips out the hard way.

“You have to take responsibility for your own health,” White says. “You are the only one who really knows how you feel; take those symptoms and research – you’ve got to because the doctors are so busy that they may not be listening to you.”

Good Health – In Your Reach

According to Fredricks, a few simple lifestyle changes can keep you out of the doctor’s office. Find out how by reviewing these easy tips:

1. Breathe. “The single most important thing people could do for themselves is breathe – we all need oxygen and deep breathing carries it throughout our bodies,” says Theis.

2. Drink enough water. According to Theis, anywhere from 40 to 80 ounces of water a day is necessary, depending on your size.

3. Get enough sleep. Individuals must decide for themselves with what amount of sleep they operate best. Once that amount is decided, do whatever possible to get it.

4. Look at what you are eating. Just eating at a balance is good enough, says Theis.

5. Manage your stress. According to Kropf, most of the diseases that are present today are because we don’t take care of ourselves; we don’t eat or sleep right and we have too much stress in our lives.

“Know you will never get rid of stress,” Theis says. “Just learn problem-solving skills to deal with it.”

6. Exercise. Moderate exercise, even gardening, is essential in maintaining a healthful life, according to Fredricks.

7. Enjoy your hobbies. Doctors agree that keeping your brain stimulated is essential to wellness.

“In general, anytime I can get someone to do something with diet, exercise, meditation, anything non-pharmaceutical, I’m happy,” says Kropf.