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Thread: Appt with new doctor - Daniel Wallace

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    Default Appt with new doctor - Daniel Wallace

    I was diagnosed with lupus about 8 months ago and since then have been on plaquenil and I'm currently down to 5mg of prednisone daily. I still have aches and pains that are manageable, raynauds, occasionally swelling of my ankles and legs, and minor hair loss.

    The doctor I'm currently seeing seems very smart and knowledgable but is ALWAYS rushed. Our appointments never last more than 5 minutes and I rarely have time to ask questions. (I have alot of questions) So I figured a second opinion on my prognosis and seeing another doctor might a good idea. I just read "The Lupus Book" by Daniel Wallace (great book!) and called his office to set up an appointment. I live in Hawaii and am flying to LA for the appointment... this is NOT going to be cheap! but I'm hoping its worth it.

    I'm making a list of all my questions, concerns, and am planning to send my charts to his office, but is there any other way I should prepare for this appointment? Like I said its not cheap and I want to get the most I can out of this. Have any of you seen Dr. Wallace before? I'm a bit nervous about the whole thing really. Any information would be greatly appreciated!

    Aloha!

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    How to Prepare for a Doctor’s Appointment

    In today's managed care environment the time you spend face-to-face with your physician is limited. To get the most from your health care providers (HCPs) you'll need to meet them halfway, and preparation is the key. If you come prepared with the details and history of your problem, anticipate questions, know your medications, and bring medical records you increase the likelihood of an accurate diagnosis. And if you are anxious about doctor appointments, good preparation will go a long way to alleviate that anxiety. The following tips can help you make the most of your appointment.
    Organize your history
    What is the process of diagnosis? The majority is buried in the history -- a description of the problem. What "Star Trek" and "ER" fail to show is the process of sifting through that description to locate the nuggets of pertinent information. While it's true that additional information is gleaned from the physical exam, laboratory and imaging tests, it is the history that provides direction for the investigation. The more organized your presentation, the easier it will be for your HCP to arrive at a diagnosis. Keeping a journal of your symptoms may be helpful. If you feel it might be necessary, enlist a relative or friend to help you prepare and/or accompany you to the appointment. Physicians appreciate an accurate history whether it comes from the patient or someone who clearly knows the problem. (If someone does accompany you, be sure there's unified agreement to the story. Bickering in the exam room is counterproductive.)
    In describing your problem, be specific. Telling the doctor you "feel ill" is not as helpful as, "I feel warm, ache all over, especially in my back, and I'm coughing up yellow stuff." Give as much information as you can. If you have more than one problem, talk first about the one that worries you the most. Prepare a separate history for each problem and strive to make it clear and complete. Present them one at a time so you don't confuse your HCP.
    Anticipate what the doctor needs to know
    Let's say that, for example, you have pain. (If you have more than one type of pain you may need to describe each pain separately.) You should be prepared to answer the following questions:

    • Where is the pain most severe?
    • When did it start?
    • Does anything trigger it?
    • Is there anything you could do to bring it on, make it better, make it worse?
    • Is it present every day, or do you have pain free days?
    • Is it worst in the morning, as the day goes on, or constant?
    • On a scale of 1-10, how severe is the pain?
    • Is it constant or off and on?
    • Do you have any other symptoms with it, such as chest pain, shortness of breath?
    • Does the pain stay in one area or spread to other areas?
    • Does it interfere with your daily routine?
    • What has been its course? (Is it stable, or getting worse?)
    • Is this a new symptom or a recurrence of a previous problem?

    These questions apply to most problems or symptoms. If you've thought about how you would answer them ahead of time you'll be prepared, your response time will be shortened and this may leave more time to discuss your concerns before the end of the appointment.
    Know your medications
    Another aspect of preparation is knowing what medications you take. Although you may recognize your pill as "the little blue one," there are probably hundreds of pills that are little and blue. The likelihood of your doctor being able to identify your blue pill is slim. Put ALL your medications -- prescription, non-prescription, vitamins, herbs, minerals, each in its original container -- in a bag and take them with you to your appointment. This way the doctor will know the medication, dosage, frequency and your need for refills. If you take medications chronically, keep an updated card in your wallet or purse with the names of the drugs, dosage and frequency. This is important if drug interactions are to be avoided. It's not uncommon for patients to be seen by several specialists each of whom prescribes different medications. Each doctor needs to know what drugs you are taking, including those prescribed by other physicians. They assume you will be able to list all medications you currently take. If you can't tell them, you may put yourself at risk.
    Medical Records
    If you have any copies of medical records from other physicians bring them with you. Also bring X-rays or MRIs with you if appropriate. If you are being referred by another physician, try to expedite the exchange of medical records. Very often, you'll need to consent to your records being released to the new physician. Not every doctor's office will anticipate this or contact you beforehand to arrange for the transfer of records. To make the most of the appointment, call ahead and ask how these arrangements should be made. A transfer of your records may help you avoid repeat diagnostic tests which carry their own risk and expense. Also, if you’re H.M.O. (health maintenance organization) allows a consultation with a specialist, your first visit may be your only one with that doctor, so it helps to be as prepared as possible.
    Request a verbal summary
    In the stressed and compressed time of a doctor's appointment it's very common for communication to be impaired. A recent survey of how much patients recalled following a general exam revealed that most could not remember more than of the medical problems their doctor diagnosed! Would you consult your banker, tax preparer or clergyman and leave the meeting without making sure you understood what was discussed? While many HCPs are aware of the need to restate treatment plans or medication adjustments, others may not do so. Sometimes time restrictions decrease the amount of verbal reinforcement the doctor can offer. Ask for a brief summary to make sure all points are covered and necessary prescriptions filled out. Ask what kind of follow-up is needed. Be prepared to take notes.
    Questions you should ask during a visit with your HCP

    • What is this problem likely to be, among the possibilities?
    • Is further diagnostic evaluation necessary?
    • What can I expect from the natural course of this problem?
    • Is there treatment available to modify the course?
    • How long before I should see the effects of the medication?
    • Under what circumstances should I notify the doctor?

    If your expectation is that all you have to do is show up for an appointment and the doctor will do the rest, your visit is likely to be a frustrating one, and you may put yourself at risk for misdiagnosis. Remember, unlike "Bones," your doctors don't have scanners they can pull out of their pockets to miraculously diagnose your problem. They need your help. The doctor's appointment is your opportunity to discuss medical problems and concerns. By preparing for the appointment you will be less likely to waste the opportunity, and more likely to gain a degree of satisfaction from the visit.


    info obtained from lupus.org


    Stay on topic...and relax..breathe. Don't be nervous.


    Wishing you wellness,
    Love,
    Oluwa




    I have Lupus. So *^#@! what.

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    welcome to our family....you will always find open arms here at whl.

    wow, an appointment with dr. wallace....how wonderful. Please come back and let us know how everything goes...it will be so interesting to hear what he has to say.

    In addition to the outstanding advice that Oluwa provided, I would also ask about the expectations of the new drugs being released this year. There are a couple of treatment medications that might come out this year....i would really interested to know what his expectations are for these.

    again, welcome....and please keep us posted.
    Phyllis

    share a smile today

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    As always, Oluwa has provided you with wonderfully informative information for your first visit with Dr. Wallace. How lucky are you to be seen by one of the nation's foremost authorities on Lupus! Please tell us how the visit goes!

    Peace and Blessings
    Namaste
    Saysusie
    Look For The Good and Praise It!

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