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Talking to Your Doctor

We were all really pleased with the doctor who took care of my father. He answered all of our questions clearly and helped us to prepare for what lay ahead. He was gentle in his dealings with my father, and at the end of each meeting he shook all of our hands.

You won't always feel good when you leave the doctor's office, but you should feel like all your questions were answered adequately and that you have a firm grasp of what's going on. In a situation where so much pain is caused by things which are not in your control, making sense of medical conditions can give you some measure of confidence in your ability to cope with a difficult reality.
K.M

Tips from a Doctor on Talking to Doctors
Some General Tips
Take Note of Changes in Your Love One's Condition

Excerpts from Peaceful Dying - A Step-by-Step Guide To Preserving Your Dignity, Your Choice, and Your Inner Peace at the End of Life

by Dr. Daniel Tobin

Dr. Tobin piloted the FairCare program for peaceful dying at the V.A. Hospital in Albany, New York. He is also a member of the Board of Directors for Partnership for Caring: America's Voices for the Dying-a national non-profit organization devoted to raising consumer expectations and increasing demand for excellent care at the end of life.

When you talk to your doctor during the information gathering stage, try to stay focused on getting the medical facts as clearly as possible. Most doctors are overworked, and many lack the skills to offer counseling about the emotional aspects of dealing with you illness. What you want to know at this point is the details of your illness.

Gathering information about your loved one's condition can help settle your mind. Understanding specific aspects of the disease and its prognosis can help you plan for both your immediate and your distant future. Ask the doctor what, specifically, the diagnosis is, and if you don't understand, ask for very precise clarification.

  • What are the treatment options?

  • What is the prognosis? How long do you think my loved one has to live? While there is no surefire way for a doctor to predict how long a person will live, you can get a general idea of the life span of most people at that stage of disease.

  • Will the prognosis be significantly different if you don't treat the disease medically?

  • What are the side effects of the treatments you are suggesting?

  • How much time do we have to make up our minds about which treatment to use? If we wait a few weeks to thinking about it, will we cause the effectiveness of the treatment to diminish?

  • Where can we find support groups of people with similar diseases?

  • What treatments exist outside of those offered by traditional Western medicine and where can we research such alternatives? Since doctors often don't know much about alternative treatments, you may have to search a little further to find answers to this last questions. There are excellent books on all forms of such treatments, most of which include information on how to find practitioners. Check your local bookstore or health food store, or library.

  • You may also need to search further for answers to some of your questions. Surfing the Internet can be helpful, as can checking out libraries and talking to friends. It may be useful to get a second and even a third medical opinion. Self-help and other support groups, which offer emotional help, can also proved factual help, since their members have faced similar situations to yours. Take as much time as you feel is necessary to help you decide on a treatment plan that is right for you.

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Take Notes

  • Keep a notebook by the bed so you can take note of changes in your loved one's condition and write them down, noting the dates and times which they occur. This will include: Physical observations, pain, eating and appetite, and emotional changes. Bring your notebook with you when you talk to your doctor. This will help you keep track of medical issues in an organized way.
  • Prepare a list of questions for the doctor. Remember that even the most compassionate doctors may be very difficult to reach by phone. The time you have with them in person is extremely valuable. So come prepared with your questions and a means to jot down what the doctor says.
  • Since all family members can't be present, it might help to bring a small tape recorder (you can buy a small inexpensive one used for dictation). That way, there's no miscommunication among family members in their understanding of the evaluation.

Ask About Performing Tests Before They're Performed

  • Find out why doctors want to perform certain test or initiate certain treatments.
  • Find out if it's painful and whether there are any risks involved.
  • Ask how long it will take to get the results back
  • Ask about the accuracy of the results.
  • Ask what would happen if you don't do the tests or follow a certain course of treatment.

Ask About Medications

  • Ask how long it takes for the drug to begin working and whether there are any side effects (also find out what you should do if you notice side effects).
  • Mention all allergies or food sensitivities.
  • Make sure you understand the purpose of each medication and how it's supposed to help.
  • Be aware of possible drug interactions and what the symptoms might be.
  • Ask if the drug is best taken with or without fluid or food.

Prepare Yourself

  • Find out if your loved one's condition is likely to worsen slowly or rapidly.

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Physical Observations

Pain

  • Stomach pain and/vomiting
  • Headaches, ear aches (change in hearing), nosebleeds, eye pain
  • Painful or limited movement (mention any falls or bruising you're aware of)
  • Tenderness in joints
  • Painful breathing, wheezing or shortness of breath

Eating and appetite

  • Loss of appetite
  • Lack of thirst or extreme thirst
  • Noticeable weight loss
  • Discomfort before or after eating
  • Difficulty chewing or swallowing food
  • Pain in the gums or teeth

Emotional changes

  • Anxiety
  • Aggression
  • Withdrawal
  • Confusion
  • Depression
  • Hallucinations
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