I don’t think she knows what’s coming…

In 12 hours, I will be at the endocrinologist’s office attempting to figure out why my body isn’t cooperating with my diet and fitness regimen. She probably has no clue who is about to arrive on her doorstep.

I am not a patient woman, and I have high expectations. Telling me that I have to work harder when I’m already tracking obsessively and maintaining an average daily calorie deficit of  1,000 is only going to go so far. Telling me that there are no options will fall flat. I have to balance this expectation and hope with an appreciation and respect for the endocrinologist’s expertise. So I’m doing something that is fairly typical for me: going in prepared. I have an agenda that I hope will allow me to best communicate my concerns, expectations and my personal commitment to being a good patient and doing what I need to do to obtain optimal health and wellness. I’m arming myself with the following:

1. An easy-to-scan summary of key health/diet/weight highlights from the time I was in high school (just before being diagnosed with PCOS) to now.

2. My monthly summaries (January to today) that show daily exercise, calories burned, calories consumed, calorie deficit and percentage of calories from carbs, fat and protein. It also has a weekly weight update.

3. A list of questions. Because this is the first meeting, they’re pretty general for now. They include:

  • what will she assess (I’d like leptin & cortisol levels checked, in addition to T3 & T4) and what’s her game plan?
  • how likely is it that the inflammation is PCOS/obesity versus something else (birth control use, metformin use, autoimmune disease)? And how can we determine that?

4. A list of my symptoms.

5. The forms the endocrinologist’s office sent me (family history, personal history, insurance information, list of medication and supplements, etc.)

6. Blood work results from my PCP.

I also have back-up:

  • My specific training calendar
  • A few sample days of my daily eats
  • A weight graph that shows my gains and losses from January 2007 to now.

Many people express frustration at their experience with a doctor’s office. Just this morning, the Today show ran a segment on frustrations with a pediatrician–top concerns included long wait times and inattentive docs. Docs were equally irritated by patients’ lack of preparation and tendency to ask questions at the very end of the appointment.

If you have an important doc appointment coming up, here are some tips to make it as helpful and efficient as possible:

1. Arrive on time. If you are late, you’re potentially allowing the doc to take in another patient while he or she waits for you to show. It also means you’re contributing to the doctor running late. If your doc’s office chronically runs late, call 30 minutes ahead to see if they’re taking patients on time and if they say they running late, find out when you should arrive.

2. Come prepared. If you are a new patient, you will have more paperwork than usual to complete. Show up early to do that, if you have not already received the forms by mail and completed them.

3. In the days leading up to your appointment, jot down questions that you’ll have for the doc. Many people think about these questions beforehand but forget to ask them once they are in the office. Writing down these questions will help you remember them and ask them efficiently–not at the tail end of the appointment as the doc has his or her hand on the doorknob. When I had back surgery, I kept a notebook where I jotted down information from the doc and documented questions I had in the days leading up to my appointment. I asked these questions throughout the appointment and if the doc seemed as if he was ready to leave, I said, “I have 3 more questions–do you mind if I ask them?” For the most part, he always said yes. One day he was running behind and directed me to ask the surgical nurse and promised that she would answer what she could and take notes so he could get back to me with responses to any questions she couldn’t answer. Turns out there was one question she couldn’t answer–within the day, she was able to consult with him and call me back with my answer.

4. Document a list of symptoms. Share these at the beginning of the appointment. (And don’t assume that the nurse shared this with the doc.)

5. Respect your doc’s expertise but if something doesn’t make sense, say so. For example, when my doc told me I needed back surgery, I asked what made my case severe enough to require a surgical intervention. I had previously done a little online research and knew that only 5% of people with herniated disks required surgery.

6. Consider getting a second opinion. Even if you fully trust the doc, it’s good to hear other perspectives and it will assuage your fears if you get nervous about your treatment.

7. Do your research. Even just browsing through a respected health site like WebMD or MayoClinic.com will help you know what questions to ask. That said, those sites do NOT give you the appropriate knowledge and experience to diagnose and treat yourself. Rely on your medical team for that!

8. Consider bringing a trusted friend or family member with you–ideally someone who is detail specific. If you are dealing with worrisome, complicated treatment (for example, cancer or a frightening medical procedure), it’s important to recognize that you might be distracted, emotional, scared or overwhelmed. Having a trusty, level-headed companion can be of great assistance if you charge them with taking notes and helping you remember the questions or concerns you wanted to address in the appointment.

What other recommendations do you have for people preparing for an important medical appointment?


4 responses to “I don’t think she knows what’s coming…

  1. Will you come with me to my next doctor’s appointment? Please? I think you are more then prepared and I would like to know how much time your doctor schedules for new patient appointments. Hope you get all of your questions answered! Good luck!

  2. Good luck with your appointment tomorrow. It sounds like we are twins! “Bury ’em with data!” Going in prepared is the best way to get things done and I think doctors respect that more – and it gives them a direction to take with you that’s specific to your needs.

    We girls with PCOS have to work 3 times as hard as everyone else just to see a tiny movement on the scale.

    Definitely keep in touch on how your appointment goes. Hopefully your doc is more helpful than mine was and will investigate every angle until she finds what’s going on.

  3. Good luck at your appt today. Great tips for being prepared! Plus I never thought to call the Dr before going to make sure they are on time, great idea!

  4. hope all went well – a good doctor respects a prepared patient and will work with you not blame you.

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