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Appointment checkup

A handful of tips can help you get the most from your next doctor’s visit.

by Elise Oberliesen

People with multiple sclerosis know that doctors’ visits can seem few and far between. Maybe it’s been six months since your last checkup and tons of questions are swimming through your head. And with just 15 or 20 minutes per visit, you’re probably trying to make every minute count—and so is your doctor. That’s why it’s important to have a strategy.

Hannah Webb, 27, says that what she does between visits is what’s most helpful in maximizing time with her neurologist. Diagnosed with MS in 2006, the Fort Collins, Colorado, resident uses a notebook to record details about any issues she experiences. Then, a few days before her next appointment, she prepares by jotting down questions she wants to ask. That way, she won’t have to improvise during the visit.

For example, Webb experiences bouts of fatigue and occasional cognitive issues, as well as pain. She tracks the patterns of each symptom so she can give her doctor a “complete picture” of her symptoms.

Webb says she asks herself questions like: “When am I getting fatigued? How often? What type of pain am I experiencing, and when I am experiencing it? How much are my daily activities affected?” Then she records the answers in her notebook.

Kathy Costello, an MS-certified nurse and clinical care specialist at the National MS Society, suggests keeping—and bringing—a few other types of records:

  • An up-to-date list of any drug allergies, current prescriptions and over-the-counter medications and supplements you take
  • A list with the names and contact info of other healthcare providers you see
  • A list of any new medical diagnoses or treatments

No doubt this kind of preparation is time-consuming, but if you know what you need to do to get ready, you can allot the time for it. “Just as you would put a doctor’s appointment on your calendar, you could also write ‘prepare for doctor’s appointment’ on it,” Costello advises.

Prioritizing topics
Physicians want you to offer information and ask questions about your health, says Dr. Richard Grant, a researcher for Kaiser Permanente in Oakland, California. But, he adds, your doctor also has an agenda and questions for you. “You have this short window of opportunity; it’s like two actors who have to deliver their lines,” he says.

Dr. Grant is leading a study to understand the best way to do that, thanks to a $1.3 million award from the Patient-Centered Outcomes Research Institute (PCORI), a Washington, D.C.–based nonprofit aimed at maximizing patients’ involvement in decisions about their health.

For now, experts recommend that you prioritize your biggest questions. “Given the time constraints, you may not be able to present a list of 10 things to discuss,” says Costello. Instead, she suggests focusing on your top three issues, “to make sure your priorities get the attention needed to develop a management plan.”

Costello also suggests going a step further and bringing a family member or friend to the appointment. “A lot of information will be exchanged in a short period of time. If you have someone else there, it’s another set of ears to listen,” she says. That person can also help you formulate questions during the appointment, and stay on track with the doctor’s recommendations after the visit.

It can also be helpful to use a small voice recorder—or even your phone—so you can process information later. Just be sure to let your physician know you’re recording the conversation before you begin, says Rosalind Kalb, PhD, a clinical care specialist at the Society.

Even with the best listening and time management, you might still run out of time during your visit and have unanswered questions about a specific issue. Some doctors, like Webb’s, may take follow-up questions by email. Even if they don’t, it’s important to know, Dr. Kalb says, that you always have the option to schedule a follow-up appointment.

Tough conversations
If you haven’t yet developed a strong or trusting relationship with a provider, you may feel squeamish about bringing up certain MS-related topics. Sexual changes, bladder and bowel issues, and cognitive changes are some of the most difficult topics to discuss, says Dr. Kalb. While it’s normal to feel uncomfortable at first, you may realize that you’re not the only one who is having difficulty with a topic.

“If you pick up that your doctor doesn’t seem to be so comfortable talking about some of these topics, it’s time to find another doctor; you need to be able to talk with your MS care provider about whatever problems or symptoms you need help with,” Dr. Kalb says.

Alternatively, people with MS may downplay their symptoms because they don’t want to be labeled as “complainers” or “problem patients.” This can happen when people worry they will somehow “disappoint” their doctor, says Dr. Kalb. “Some people fall into the trap of wanting to be the good patient,” she adds. “They want the doctor to like them and don’t want the doctor to see them as difficult or as not doing enough for their MS.”

But the truth is that most providers understand your symptoms and want to help you, Dr. Kalb says. “Don’t deprive yourself of the opportunity to get help with something just because it’s not the most comfortable thing you’ve ever done.”

Elise Oberliesen is a Denver-based freelance writer.
Summer 2015
To learn more about building a relationship with your healthcare provider, register for the Society’s telelearning program, Preparing for MS Doctor Visits, beginning Sept. 15, at nationalMSsociety.org/telelearning.
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