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Making the Most of Your Doctor Visit #1
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DUKE MEDICINE
Joe T Minchew, MD posted:
Due to the complexity of the problem, the difficulty in determining a definitive diagnosis, and the invasive nature of many of the treatments, patients with back pain often seek evaluation by several physicians or providers. These evaluations and second opinions can be very helpful and worthwhile. However, if you are poorly prepared for these visits, they can end up being of very limited value. The following are some suggestions for maximizing the benefit from your next evaluation:
1. Pay close attention to your symptoms prior to your visit so that you can communicate them well to provider. In particular, pay attention to the pain that is the most problematic for you. Is the major problem your back or pain in one or both legs? Pretend (and it may not be completely pretending) that the pain in the back and leg(s) are separate problems. If you could get rid of one but not the other, which pain would you pick. If you have pain in both the back and leg(s), how would attribute a percentage to the pain? For example, is the pain 80% in your lower back and 20% in your leg or legs. Pain attention to where the pain radiates or travels and be prepared to describe that radiation to the provider. Sometimes the pain is so severe that it seems everything is involved but try to pay attention to whether the pain radiates primarily down the front, side or back of the leg. Does it regularly go below the knee? If so, where.
2. Pay attention to associated symptoms like numbness, tingling, prickling or weakness. Try to be able to describe or draw out with a finger where you experience these symptoms. Try to determine which joint or joints is/are affected by weakness in the legs. Is it primarily your hip, knee or ankle/foot. Try to separate limitations of the use of the leg due to pain from times when you had weakness with minimal pain. Definitely pay attention to any changes in your bladder or bowel function or habits but also pay attention to any prior history you have had with these problems related to medication usage, stress, coughing, etc.
3. Make sure that the visit with the provider is authorized by your insurer or other provider prior to the visit. In particular, if the problem is due to a work related injury make sure that the visit is authorized. Many times patients want to get an ?independent? evaluation outside of the worker?s compensation system. This can be appropriate and can be authorized. However, you can not be seen under your health care insurance for a problem that is related to a work injury. This is an exclusion in every health care policy. The provider may have to refuse to see you that day if the visit is not authorized.
4. Go to the visit prepared to have a thorough evaluation. Arrive at least 15-30 minutes prior to the scheduled visit time to complete necessary registration paperwork. Also allot enough time for the provider to review your prior records and imaging studies (x-rays, MRIs, etc.). This also includes dressing so that you can be comfortable with an examination even if it includes being asked to disrobe and wear a hospital gown. A thorough examination of the lumbar spine often requires the patient be in a hospital gown and if you are self conscious about this during the examination if may limit the providers ability to assess you.

To Be Continued....
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marilynk2 responded:
I don't want to be negative a say it was not helpful because I have been around the block too many times. However, I think Dr. Joe has done an incredible job with this and I can just see myself in the doc's office as I read down his points. It is so VERY important to know the exact route of the pain because it helps your doc pinpoint which disc is invollved or whatever. Just the difference of the pain radiating down the side of the leg as oppossed to the front tells a lot. I have even made marks on me when it is the day to go with pen or permanent marker. It really makes a difference when yoou have protruding nerve roots, herniated discs, S-I jjoint dysfunction. Helps make a plan of action quicker, which means less pain quicker.
 
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Petesaddle responded:
Hi Doc,

I found your first pointer to be the most useful. Communication is the key to successful treatment in most cases. There are so many patients that communicate emotionally as opposed to communicating effectively.

People suffering from pain usually tell their troubles in such a way as to take some burden off their mind while it might not necessarily communicate what is wrong with you.

A doctor needs concrete information from a patient to assess the situation to the best of his knowledge. Patients should try to be very specific with the information they provide and be as helpful as possible.
 
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alliej0225 responded:
And where do you practice? The doctors in my area rush you thru so quick, I feel like a hog going thru the slaughter. They don't take the time to explain and if I ask them questions, they look at me as if to say I don't have the time. You will need to talk to my nurse. And that's even IF you get to see a doctor. Here you see the nurse practioner first. Now I don't have anything against a nurse practioner but when I pay to see a doctor, I want to see the doctor. And that's how I have been treated lately by my primary care doctor and the neurosurgeon's office. So any questions that I have had I posted on the WEBMD site to see if I could get any answers. Thanks for listening.
 
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bj1208 replied to alliej0225's response:
hi allie - when u first log onto this site on the right hand side is a spot that says: featuring experts from - and then there is the bio from Mr. Minchew - it outlines where he is at, etc.,

if he is not in your area the best thing to do is research the facility on the internet - just google the name and it will bring up info relating to them -

or you can ask around - you'd be surprised once you mention back/neck problems how many people there are - you may also speak with a pharmacy and see if someone there goes to a particular pm doc -

hope this helps - take care - Joy


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Making the Most of Your Doctor Visit #2Expert
Here are the rest of the suggestions (had to break into to two parts due to the character limits) 5. Make sure that all records ... More
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