Chapter One: Getting to Know You Let's Discover the Juicy Secrets About the Person Who Controls Your Health: You
Most people think they communicate with their doctors just fine. Better than fine, in fact. Fantastic. Given that most of the communication consists of nodding or a request for antibiotics, there's little to find fault with. That's the problem, of course. Most patients don't do a great job of communicating with their doctors because patients often give us too little pertinent information to go on (remember, just like the detective, we're looking for the facts). At the same time, they may also give us too many distracting or off-topic details. It reminds us a little bit of what a mechanic must think when we try to explain a noise in our car. We're not sure when it started, we're not sure what makes it worse, we think it's a whining sound but aren't sure...We bet this becomes a tedious monologue for those earnest professionals trying to help us.
An almost identical conversation goes on in doctors' offices every day. To be accurate, the parallel exchanges often concern befuddled male patients. There's a reason that women aged thirty to sixty are the prime decision makers about health care in the United States. Most of the guys they love either have no clue about their health needs or wouldn't see a doctor unless they had blood shooting out of both ears.
The goal of this chapter is to make sure you know the details and numbers in your health profile that you really need to know -- those stats and specifics that are crucial to you and your doctor. We always see health books and well-intentioned magazine articles that tell you to compile so much stuff, we get winded just reading the list. The average person would have to take a week off from work and probably hire a bounty hunter to get everything recommended. You don't need to do that, but you do need to assemble a thorough health history so that you'll have a body of evidence to use when working with your doctor. A big part of being a Smart Patient is knowing how to compare new evidence (such as new test results) against the old. Like Sherlock Holmes, even though something may seem elementary to everyone else and not worth asking about, you need to press on with your questions and your investigation.
We'll make compiling your health history simple enough to do, but we won't oversimplify the tasks so you lose accuracy. It's a small time investment that could save your life, so get started right away.
You Love Us? Ditto
The first sign of a Smart Patient is that telltale document they produce during their first visit, or even their fiftieth. It's a portent of a beautiful partnership -- that is, when it's not a form they need signed for their job, or a note asking one of our office assistants about their dinner plans. If we're lucky, it'll be their health profile. It's the sign of a patient who means business, one who will challenge us to be at our absolute best and who won't waste time and money on redundant and unnecessary efforts (which can lead to errors). To create the perfect health profile, circa early twenty-first century, flip ahead to appendix 2, Sample Forms, and find the forms labeled Your Health Journal. Make copies of them, or rip them out if that's handier. The forms are also online at www.jcrinc.com and www.realage.com.
Fill them out.
Finished? Everything? You're done. That is, if you don't have any questions, and you're sure it's all correct. Just bring those forms to your doctor along with a baggie filled with every medication, vitamin, herb, or whatever else you take regularly (in their original bottles). Store copies of the forms in a fireproof safe, and update them yearly or whenever a piece of key info changes. Everyone's happy.
What's that? It wasn't that simple? You don't know all the info by heart or have it filed neatly in your credenza? Now, that's woefully human of you. If you're like most of our patients, you've never compiled your important health info before, and you may not have the foggiest notion of where to find much of it -- or even if it exists at all. Even with using the forms as guides, your records may be so scattered that you don't know where to start.
Let's take it from the beginning.
Start in Top Form
Fill out all the easy stuff on the forms labeled Your Health Journal, such as your birth date, address, your doctor's contact info, your pharmacy, your insurance info, and everything else listed. As you may suspect, this will be your master form, the one you perhaps store on your computer, and give out whenever necessary, including when you visit a new medical professional or step foot in a hospital. (Take at least two copies, and always give one to the admitting nurse who welcomes you to your bed.)
This form won't just make your life easier, it'll prevent a severe case of hand cramps from rewriting half of this info dozens of times in the future. And bypassing twenty occasions that require you to blearily check boxes before you've had your morning coffee (and having another fallible person decipher that scrawl) is a no-brainer way of reducing errors.
Under the section entitled Your Health Now, write down every significant ailment or condition that you have right now. This would be the place to list ongoing conditions such as diabetes, hypertension, psoriasis, depression, back pain, and the like. Don't include anything you had years ago but don't have now; that goes in a different place. Be certain to include anything that you're taking medication for, even if the specific symptoms are gone; for example, if you're controlling your high blood pressure with medication, list high blood pressure. Next to each condition, list when you were diagnosed, what medication you're taking for it, if any, and any other relevant info. If you're not sure if it's relevant, jot it down. That's why your doctor's office assistant has Wite-Out.
In addition to those mentioned above, here are a few more examples of conditions that are significant:
- Heart disease
- Heart murmur, or any other
- heart irregularity
- Multiple sclerosis
- Nerve paralysis
- Cancer of any form
- Gingivitis (gum or periodontal disease)
- Kleptomania (just making sure you're paying attention)
- Gulf War syndrome
- Alcohol or other addictions
- Sexual dysfunction
- Paraplegia or quadriplegia
- Sleep apnea
- Vision or hearing loss
- Parkinson's disease
- Liver disease
- Post-traumatic stress disorder
- Dementia or frequent memory loss (for example, can't recall name of close friend or relative)
- Multicythemia veragis (just kidding)
- Here are some that are probably not significant:
- Dental cavities
- Sore lower back after shoveling heavy snow
- Varicose veins
- Toenail fungus infection or athlete's foot
- Forgetfulness (for example, can't remember where keys are, or where you were when Luke and Laura married on General Hospital)
- Sunburn prone or can't tan
- Insomnia before job interviews or court sentencings
- Cat allergy
- C-SPAN addiction
- Turkey neck
- Repeatedly date or marry losers
Now list your past significant ailments and conditions in the next section, noting when you were diagnosed and what happened. Then list all the details about the medications you're taking (all pills or tablets or anything that you regularly ingest, inject, insert, or otherwise consume regularly, whether it's prescription or over-the-counter (OTC) drugs, herbal supplements, vitamins, etc.). We'll say this again, but in addition to having this form handy when you see your doctor (in your pocket or the office file cabinet), always bring the actual bottles of all those medicinal consumables, too. It's important.
Checklist: We Ask, You Answer
For any condition or ailment you include on your list that you're still dealing with, write down and be prepared to tell the doc the following:
- What caused this?
- When was it diagnosed?
- How are you treating it?
- Has it gotten better or worse?
- When did it first begin to noticeably improve or worsen?
- What makes it better?
- What makes it worse?
Don't Know Much about Genealogy
On pages 52 and 53, you'll also find the Smart Patient Family Tree. Flip to it and sharpen a pencil. This Smart Patient Family Tree is designed to bring joy (and longevity) to your life. The solid lines sprouting outward from you to your siblings, and downward to your parents, aunts and uncles, and grandparents represent blood-relative connections (not by marriage). You'll notice a dashed line going to your spouse, which represents a non-blood relationship. The reason you need to include your spouse is that he or she lives with you (at least we hope so). That means you share the same environmental exposures and, likely, similar risks. You serve as each other's personal coal-mine canary. One of you may get nauseous from the toxic waste buried under your house years before the other one. (Just kidding! You'd likely be afflicted simultaneously.) Also, even though you don't share DNA (at least not on most school nights, anyway), your spouse influences your health far more than your aunt Sadie in Perth Amboy. Auntie may have a cholesterol count that would bring a Guinness World Records rep to her door, but she isn't filling your day-to-day life with cigarette smoke, bacon, Pabst Blue Ribbon, and lost-sock argument...
--This text refers to an out of print or unavailable edition of this title.