Success is in the details
Posted July 24th, 2014 by TAN
If you have arrived at the point in your medical life where it is time to change neurologist, it can seem like an overwhelming process. It really do not have to be. From my experience it is neither daunting nor intimidating and can be the best thing you do for your health.
When I recently had my first appointment with my new movement disorder doctor, it was not simply a matter of showing up on time for the appointment. It was a process that began with first deciding I needed a new doctor. While I am speaking specifically about visiting a movement disorder specialist in this blog post, many of these ideas can be applied to preparing for any doctor visit. The following steps can ensure success transition and communication with your new physician.
1. Start by researching movement disorder specialist within a reasonable drive of your home. Ask for recommendations from people you trust. I asked for recommendations from Kathleen Welker, President of Tremor Action Network, and Cynthia Capresecco, a former movement disorder coordinator.
2. Create a complete family medical history. This is one of the most important tools you can give your physician. I would suggest making it comprehensive. I printed out a sheet that listed my grandparents, parents, siblings and children. Each individual listed their date of birth and if applicable cause of their death and their age at the time. I listed any health issues they had. For example, I listed everyone who had Coronary Artery Disease, Diabetes, and Hypertension. Although these seem to have no direct bearing on neurology, there may someday be research that ties health issues together. It is better for the physician to have a complete picture of the family history rather than just the neurology in isolation. I have made a sample form that can be accessed and changed as needed. You can add or subtract rows as needed to customize for your family. It can then be printed out and taken to your doctors appointments. Remember to include all medical information, not just neurology and whatever specialist(s) you are seeing at the time.
3. Take a complete list of current medications and medication allergies. This list should include the medication name, dosage, and frequency. If not prescribed by the physician you are seeing, you should also include who prescribed it and why. Make a separate list of any previous medications you were on and why they were stopped. It is often helpful to the doctor to know about medications that did not work or had side effects as well as the ones that did work. It is also extremely important to keep a list of any medications you are allergic to. In fact, you should carry both lists with you at all times.
4. List of symptoms. It is not quite Murphys Law but close; whatever symptom you are seeing the doctor for may or may not make an appearance at your appointment. In which case, it is an excellent idea of make a list of symptoms. Not only the symptoms themselves but when they appeared and if they are connected to anything. For example, certain medications can cause an increase in tremor. Be thorough. Err on the side of excess. If you are not sure if something is related, include it. Let the doctor decide whether it should be listed under symptoms or is a separate issue.
5. A printed or hard copy of a map where the office is located. The first time you visit your new doctor make sure you have a hard (printed) copy of the map. Do not rely on your gps or cell phone. On my recent trip, my cell phone lost its network connect just as I exited the interstate into the city of Baltimore. The map I had of the area immediately surrounding the doctors location came in very handy.
6. Any data from if you use tremor applications like LiftLabs Pulse or GE Mind. Print out samples of your readings. It is a good idea to take a sample of your best, normal and worst readings with any notations about the readings themselves. For example where the bad days prompted by too much caffeine, not enough sleep, stress. If you have made your collection of archimedes spirals, for instance in a notebook, take those to show the doctor also. He can make copies of any ones he feels needs more study.
7. Records and tests relating to your visit. You are most likely having records and test forwarded from your previous doctor. If there are any test results from different doctors that are not included, get copies and take them with you. For example if you had any testing for cognitive testing, include those. Since there is debate as to which symptoms are part of Essential Tremor and what are not, it is always better to include all information. Again let the doctor decide what is relevant.
8. Make a list of questions you have for the doctor. Typical questions might be suggestions for non-medicinal ways to help your tremors or other symptoms. You might want suggestions on exercise or physical activities that help deal with tremor. Do not rely on your memory once you get to the doctors office. You can get thrown for a loop by traffic or parking issues and not remember the questions you wanted to ask. Having them written down insures you will not forget them. You should also write the answers to the questions down on the same paper. Once you get back home it is often hard to recall specific details either for yourself or family members. If you have made notes on the answers to your questions, you will be in great shape.
While it seems like a lot of effort to make before even seeing the doctor, it will pay off by the end of the first appointment. Your doctor is your partner in your health, especially when a chronic illness is involved. Invest your time in preparation and your care will go much smoother.
Nannette Halliwell
TAN Blog Editor
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