#Going to the doctor

[tightwadspoonies]

How to Get a Doctor to Listen To You (and maintain the relationship you have with that doctor, cause you're gonna need that later)

First, I'll preface this by saying: The system sucks. There is no perfect way to access medical care, at least not in the USA. You've almost always got to play the system at least a little to get what you need.

Should it be this way? No. But it is. So here's how to play the game in order to get the most out of a visit to the doctor (there are very different steps to getting what you need out of a hospital stay, but that's a different post):

So First, Let's Assume You Have a Primary Care Doctor That isn't an Urgent Care or the Emergency Department (if you don't, look below the cut first for some tips on getting one, then come back up here)

First, make a list of your problems, then go at the pace of one problem per appointment. Yes I know this sucks. But please read on.

Reasoning:

Appointments are set up in 15-minute slots, but docs typically are timed to about 5-8 minutes spent in a room with a patient on average (the rest of the time is prep and charting and referring and checking in with other doctors to get advice). This is imposed by the hospital or clinic they are working for- not something they choose. If a doctor took as much time as they needed with each patient they would probably get fired. That means every minute beyond that 5 minutes is a minute being "taken" from another patient (isn't capitalism wonderful?!). And 5 minutes is about enough time to evaluate 1 single medical problem.

So when you're setting these up understand that it is way easier and faster to make a bunch of appointments all at once than making them one at a time (hence the making a list of your problems). You might be able to get one slot per week (after a new patient appointment, which will probably take a long time to schedule, see below the cut), each scheduled for a different problem. Keep in mind though, if you make multiple appointments, no-shows are not taken-to kindly. Too many and the rest of your appointments will be cancelled. If you know you can't make it, call ahead.

So what if you need seen right now for a specific symptom? Go to an urgent care or the emergency department. They are almost never going to be able to solve the problem, but a toradol shot for a migraine now is better than waiting six weeks for a sumatriptan prescription. Plus, an emergency department visit or two where they did something for you establishes a history in the record of your problem.

Does this suck? Absolutely. Is multiple appointments always practical for work/school/transportation/copay reasons? Nope. But that's the system, and unfortunately, if you go into an appointment with 6 problems, as you have probably experienced, you're either going to be asked to narrow it down to what is the most important to you anyway, or you're going to get exactly zero useful things out of that appointment.

Next, be upfront, and do it LONG before the doctor walks into the room.

When you schedule an appointment, they will ask you why you are coming. If you want to be evaluated for Ehlos Danlos, for example, say exactly that. "I want to be evaluated for ___________".

Reasoning:

No one can hold everything in their heads for their entire careers, and doctors use that little blurb of why you are coming to look stuff up before you get there.

If you spring something on them that isn't something they see every day, they will be falling back on a very small amount of information they got a long time ago. If you don't fit that tiny piece of information they have saved on that specific disease, you're probably not going to get a diagnosis.

In contrast, if they come in knowing what they will need to evaluate, they will be able to look up or ask how to do the evaluation beforehand and the evaluation for things like the thing you want evaluated. You're much more likely to get a diagnosis if they're doing the right test and asking the right questions.

Also, say you are looking for a diagnosis if that's what you want, and say why. Say something like "If I come up positive for MCAS, could you tell me? I want to try some treatments and accommodations for it that I can only get through a diagnosis."

Reasoning:

I spent 6 years in therapy before my counselor admitted to me that she thought I had had depression the entire time. Why? Because before Obamacare, having a diagnosis of anything more than the flu one time could leave you un-health-insurable for life. Plus even just a generation ago being sick in any way was something socially unacceptable.

It's still like that, but it's changing.

There's still fear about this in the medical world. Putting a diagnosis on paper that the doctor technically didn't have to used to run some pretty serious risks. Pre- HIPAA (1996) those risks extended to your job and social life too (patient privacy was actually not actually a law back then). Even today, certain health conditions (including things like gender dysphoria or schizophrenia) may be looked at unfavorably in some areas if you're trying to do something like adopt.

So be open about the fact that you want to know, and if necessary, why that information is important to you.

Finally, come up "normal" on screening questions. At the beginning of the appointment, the person who rooms you will ask you a set list of questions. These are called "screening questions" and they include things like "do you feel safe at home?" and "does transportation keep you from getting to appointments or getting medications?"

Reasoning:

Unfortunately, if they find anything they need to talk about when asking these questions, they generally have to address these problems at the appointment, which means time they cannot spend on the problem you're there for.

If youdon't feel like lying and think you might have come up "positive" (something needs to be talked about), you have to be extremely clear that you would prefer to make another appointment to discuss the screening test, and today stay focused on the problem you came in for. It depends on the doctor as to whether they are willing to take that risk (and it genuinely is a risk, to them), and you also end up eating up some time.

My wife's opinion is that you know yourself better than a screening test anyway, and sometimes you do have to lie to get what you need.

So, you know, you do what's best for you.

Keep Reading:

Choosing a Doctor:

When you are first starting out looking for a doctor, you will probably have the choice between family practice (either a family practice doctor or family practice nurse practitioner) or internal medicine (your standard adult primary practitioner). Having worked in family practice I may be biased, but personally of the two, if you're looking for someone who is most likely to listen off the bat, it's going to be someone in family practice.

You may also have the option between a private practice and a residency. Of the two, I would choose the residency, because at a residency the docs you see are going to be residents who, 1- just finished up learning about all the zebras and can still remember them, and 2- are not yet jaded. Which if you think you have anything that isn't the most straightforward case of diabetes/heart disease/COPD, that's what you need.

The First Appointment:

So here's the thing. In order to get in with a doctor, you have to do something called a "New Patient Appointment", or NPA. An NPA takes a long time to get (sometimes months) but it is worth it to get a primary care doctor. An NPA is a little longer (usually about an hour or two) and most of that is going to be screenings with a nurse or medical assistant.

Understand that very little will happen at this appointment. It is just for you and the doctor to get to know each other (through a pre-programmed set of questions) and get some background info on you. Sometimes there will be time to address one thing. Use the checkout from this appointment to make more appointments that will fix things.

[sailor-cerise]

Somehow I am simultaneously the best and the worst and slightly above average and not good enough all at once.

According to my brain anyway

[kermitgasm]

pretty sure i have a sinus infection and in this moment i wish i didn’t have to rely on car transportation and i could walk to the doctor cause no one around me is available with their car and i feel like absolute shit.

[mossroott]

every time i go to the doctor and they take my blood pressure they tell me the funny fraction as if it means anything to me...

ahh yes one beighty over fifty or whatever I totally understand what that means for me health

[theidiotwhowrites]

𝙰𝚝 𝚃𝚑𝚎 𝙳𝚘𝚌𝚝𝚘𝚛'𝚜

𝙸𝚗 𝚝𝚑𝚎 𝚠𝚊𝚒𝚝𝚒𝚗𝚐 𝚛𝚘𝚘𝚖

𝙷𝚒𝚜 𝚗𝚊𝚖𝚎 𝚒𝚜 𝙹𝚘𝚑𝚗𝚗𝚢

[delicatepointofview]

.

[nariarts]

Spent a ridiculous amount of time last night obsessively editing my hand written zines in Photoshop to take away any tiny blemishes so they were definitely readable.

Whatever. Understand or don't.

[iridescentalchemyst]

Taking Charge of Your Health

The Iowa Developmental Disabilities Council has a wonderful webinar series about taking charge of your health, presented by the University of Iowa Center for Excellence in Developmental Disabilities. Even though it is specifically written for caregivers of people with disabilities, they do present a lot of good information about how to advocate for yourself and tips for navigating our complex…

[nipuni]

"I am a higher dimension life form, I am a complex space-time event"

A step by step process of this will be available at my Patreon next month, you can find prints of my work at my Store 😊

[forecast0ctopus]

AN-TI-BO-DIES

[thelesbianthespianposts]

imagine: you get your memories back after years of amnesia to find out your whole species is dead and earth doesn’t exist anymore. that the only thing left of your culture is your weird ex and his busted honda civic that barely even works that he stole from the government when he was 13. And he’s been taking members of an alien species for trips in his honda civic and they’re all like “woah it’s so cool” and you get upset because it’s NOT COOL it’s a honda civic, the turn signals don’t even work “wow it can go up hills” yeah OF COURSE IT CAN GO UP HILLS EVERY CAR COULD DO THAT. but they’ve never seen a car before so everything it does is the coolest thing ever. And your ex’s only tool is a fucking screwdriver which is somehow also cool to this dumbass alien species even though it’s a fucking screwdriver so you just look like an idiot screaming about how none of this is even cool it’s actually really shitty but your whole planet is gone so you can’t even prove it but also you’ve had a constant drumming sounding in your head since you were 10 slowly driving you insane. I would become evil too.

[jackalope78]

Bad Habits to Break, Mine and Yours

I need a place to hold myself accountable, because I do have some bad medical habits that I need to break if I'm going to get a handle on this MS bullshit. But also, I want to complain about some of the reactions I've been getting, so yay! Two things in one post.

I'm starting with the complaint. Please, please, if you know someone with a chronic illness or disability, don't offer unsolicited advice unless you know the person very well and know it would be well received.

When I told the people in my life about my diagnosis I got the same comment from two different people. See, I live on the third floor of an apartment building without an elevator. My MS has progressed enough that it is starting to affect my legs, but for the most part I'm ok with stairs. I'm slow, but I get there. The comment from both of these people was "oh, you might need to move", because again third floor- no elevator. The comment coming from a close friend was appreciated because I hadn't thought of it and he mentioned it like a possibility, something to be aware of. The other came from a guy who is an acquaintance AT BEST and just made me mad, BECAUSE YOU DON'T KNOW ME. It just felt... rude. He doesn't know me well, he has no idea what I'm capable of, he doesn't know how far the disease has progressed. All he knows is that MS is a potentially disabling disease, and without even asking how I'm doing he moved right to the "You can't do things" place, and boy did that make me mad. So if you have thoughts about someone's ability levels, just don't. Unless you're asked, or you are indeed a very close friend, just... keep your opinions to yourself. Shutting up costs nothing.

Ok now me.

Confession time. I am where 'as needed' medication comes to die. I KNOW THIS IS BAD. I absolutely take all antibiotics, but if a doctor is prescribing me something for pain, or something else that will heal on it's own and the medication is just to make it faster/more tolerable, I let it sit in my cabinet. It's bad.

One of the medications that the neurologist has already prescribed for me is something to help with the spasticity/stiffness in my legs. But she wrote it out as 'take 3 times a day as needed for spasticity". My dumb brain took one look at that prescription and went, "but I'm FINE, I've been dealing with the stiffness for a few years now, I don't NEED the medication". So I haven't been taking it.

So, bad habit #1 to break is to let myself take medication that I don't necessarily need, or maybe redefine my personal definition of 'need'. I need to stop white knuckling my way through my illness symptoms. They're real, they're valid, and I can take medication to stop them, so I should.

Bad Habit number 2 is that I hide embarrassing things. I mean, I'm sure everyone does. But I have some symptoms that are embarrassing, and I've had them for a few years now, and I didn't discuss them with my doctor. In fact, and oh my god I'm so mad at myself about this one, I was specifically asked about one of these symptoms and I hedged and kind of lied-or rather wasn't 100% honest- to my Primary Care doctor about it. Now to be fair, some of these symptoms were things that I chalked up to being fat and out of shape, and I didn't want to hear my complaints dismissed with a "have you tried losing weight about it", so I didn't bring it up. I wish I had though, it's possible I could have gotten diagnosed earlier.

Anyway I have an appointment with a specialist today, so this is my goal for today. Be honest with the doctor. Even though it's very embarrassing and I hate admitting to it because I'm an adult, I need to be honest and open about my various symptoms.

With the doctor. Not you guys. Sorrynotsorry.

[sneezingisnotnormal]

When the episode looked like it was just a “kids these days with their tinktonks” and then suddenly the protagonist kills harry styles and then reveals she’s been racist this whole time

[if-im-being-honest]

Currently psyching myself up to book another GP appointment about my mental health hopefully this time something good will come off it

[batsyheere]

Bruce tries to adopt Ellie, who is immediately against it. She keeps throwing him off her trail and he keeps tracking her down. She's honestly concerned, and normally she would handle her problems by herself- but this is Batman.

So when Bruce gets a little too close and Ellie is just so tired... she calls for Danny.

"Mom!"

Cue college student, perpetually tired and overworked Danny "High King Phantom" Fenton appearing from the very shadows Batman normally does himself, seeing the situation and going off at this "clearly older man" chasing his daughter in the middle of the night.

Cue the most elaborate "stop trying to adopt my kid before I adopt yours" series of battles

[sashayed]

If you are in your 20s and depressed I want you to know this: As you age, I promise, you will acquire tools and perspective that will open your world in ways you cannot imagine right now. You will find levels of contentment and joy you never thought possible. You will access a deep understanding and forgiveness of yourself that comes just from hanging out long enough in the same body, and that forgiveness will change everything. Also you may have a regressive depression so intense and long-lasting that it feels like a traumatic brain injury. don't freak out it's normal