Five steps to communicate your medical problem in 5 minutes or less
You have a very few precious minutes to convey your health issue to your healthcare provider, and who knows if they are really listening.
Think in terms of reading a cartoon, it tells a story in a few images. And that is what you want to do with conveying your message. You only have 10 – 15 minutes total with your healthcare provider to provide the information concisely so he/she can make a determination for next steps.
Does your mind go blank?
How often have you had an appointment and either your mind went blank, or you remembered the most important thing just as your healthcare provider was heading out the door. It’s almost like watching a commercial, when they say “Wait… there’s more..”
My story and the steps I took to communicate it
I am struggling with a labral tear (that is essentially like a gasket around the hip socket that holds your hip bone in place). I know that it’s a tear because I had an MRI. What I told my primary doctor sounded more like a herniated disc in my back. Of course, as a nurse, I try to self-diagnose. So he ordered an MRI.
My new five step approach
I decided to take a new approach in preparation for my orthopedic doctor visit. I will use a five step approach. Why? My primary physician is a concierge physician and has time to talk with me and explore my symptoms. The orthopedic doctor, on the other hand, will be rushing from one patient to another and I will need to be concise.
Drafting a document is helpful because I wrote it over two days and realized that I had left several items out. I am convinced that this approach should be used every time you go to your healthcare provider.
If you have questions, list them out. If you have symptoms, describe them.
Here’s my five step approach
1. History of the injury or illness
May 28th – Evening before ½ marathon. Went to bed and awoke with pain in my lateral left lower leg 8/10 pain level. Got out of bed in the am and my leg gave way. I could not walk on my leg without pain in my left hip and left lower back, radiating to my lateral left lower leg and into my upper foot. Also, numbness of lower leg and foot. No thigh pain or numbness.
Took Advil throughout the day and just tried to keep walking or laying down. It got better through the day, but left hip still ached. Over the next several days it improved, but left hip still aches.
June 2nd, tripped on my yoga sticky mat and caught my 2nd toe on my left foot. It was severely bruised and swollen. Unable to put shoes on for several weeks. Left leg is weak with continued hip discomfort.
June 17th same thing as May 28th, left lateral leg pain at night. I was limping and experiencing left hip and knee pain. I did play 9 holes of golf, but found I had to use my clubs as a walking stick as we walked the course with a roller cart. It was painful at the end of the round.
June 21st called my primary physician, Dr. A. to report that I had lower back and hip pain with radiating pain and numbness down my lower left leg. I asked if it could be a lumbar disc issue as I injured my back many years ago. A four-day prednisolone pack was prescribed. Provided relief after 2 days.
2. Current status (how are you feeling today)
Today, my left leg continues to be weak. Left hip pain/ache persists at a 4/10 pain level. Left lateral knee pain continues with numbness across top of foot. Second toe still hurts. Left leg feels loose in the socket and has felt that way for several months. Left toes tend to point outward when walking.
3. Past history
History of left sided injuries:
Left knee injury (45 yrs ago) from skiing (crossed skis tips in deep powder and fell). No treatment just ice and ASA.
Possible herniated disc (lower back) from lifting an ICU patient (450 lbs). Sciatic pain on left, was out of work for 6 weeks.
Right hip has ached for 40 years and feels tight in groin. No treatment in years, continue to work on stretching and strengthening. Cortisone injection about 35 yrs ago.
4. Activities I normally do
I train and run for half marathons. I run right side dominant and often catch my left toes during runs. I have been trying to lead with left leg and work on strength and balance on both legs with a focus on the left. Have not run since May 29th.
I teach fitness classes daily M-F for 1-3 hrs/day.
I golf, generally once a week if I can.
I blog and the pain worsens when I sit at my desk
In Sept and Oct and am scheduled for two half marathons. In Sept I am also attending a 5 day golf school.
Can I still run and will it cause any further harm or damage?
Are there any limitations on what I can do? Golf OK?
How it played out at my visit
My physician appreciated the document and said it was very helpful. Additional x-rays taken at the office showed some hip arthritis and bone spurs.
He answered my question that I am allowed to run and he will prescribe physical therapy. He said that I may experience pain, but doubts that I will do further injury. He will see me back in 6 weeks.
All of that was a total of no more than 10-15 minutes with the physician. A brief exam, but the exam was targeted toward the areas of complaint and were well described in a brief document.
The only other suggestion was to get an MRI of my back, which he gave me a prescription for. I looked at it and told the medical assistant that I had already had the MRI of my back and brought the results with me. She went back to ask the doctor and it was an OOPS moment on his part. He came back in the exam room when I stated, “fastest MRI on record, huh.” It was in my record, he just didn’t look at it. Yes, I can be a smart ass. He looked at the report and said, yes, slight bulge in L3 & L4 (which is what I said when he examined me and we were talking).
Moral of this story
If I had not had my records and really reviewed my own history prior to the visit, I would have likely ended up with another MRI.
Doctors don’t always pay attention to what you say (yes, I said my MRI showed bulges at L3 and L4). Did he read anywhere that I was a nurse – don’t think so. Did he care – don’t think so. I was just another 67 yr old with a tear that is “typical for aging people.” Next Patient, please.
If you take away anything from this story it is
1. Write it down and give it to your doctor and have a copy for yourself
2. Ask questions. What do you expect to get out of the visit. For me it was will I do any additional damage if I run, work out and golf.
3. Let your healthcare provider know what your future goals are. Mine are running half marathons and golfing.
4. Never feel shy about asking more questions and asking for clarification. I had him show me the x-rays, the bone spurs, asked him how he interpreted the MRI results.
We must be our own advocates!
Why? Because our minds go blank as soon as we go into that exam room.
In good health!
You can find another blog post I wrote on this subject