Being your own health care advocate: talking about your symptoms

In our previous “being your own health care advocate” blog, we explained the importance of being actively involved in the relationship that you have with your physician, and the process of asking questions during each visit. Part of many physician visits include a discussion about symptoms you are experiencing; quite likely the reason for at least one of those visits. This discussion is in fact very important to the diagnostic process, and is when your physician or other healthcare provider actually learns a good bit about you. Describing how you feel, and your concerns about how your symptoms affect your day-to-day life is not always easy. Following are some suggestions to help make this discussion easier for you, while enabling your physician in diagnosing and treating your symptoms:

• Provide a very basic explanation of your problem, for example, “I’m having a pain in my back.”
• Describe when the symptom began, and perhaps what was happening when it began, for example, “It started one week ago after lifting a piece of furniture.”
• When describing pain, use adjectives to describe intensity and, since providers often use a scale of 1-10 to evaluate the severity of it, it’s helpful that you do as well and also indicate how long the pain lasts (e.g., “The pain is a gnawing sensation, about a 3 on a scale of 1-10. It has been pretty constant since it began, but gets worse when I’m walking…about a 6.”)
• Explain if you’ve ever experienced this symptom in the past and perhaps what you’ve done to get relief (e.g., “I had this kind of pain two years ago after shoveling snow, but it went away after a few days. This time, it’s not getting any better even after using Icy Hot crème and aspirin a few times a day.”
• Describe how your symptoms are affecting your daily life. Instead of saying, “I used to be able to do everything.” Say, “I’m not able to walk more than one block without having pain and I’m having difficulty sitting for more than a few minutes without changing my position, and I need to sit at my computer to work.”

While the symptoms above concern pain, the suggestions provided can be applied to other symptoms as well. Whether you’re experiencing nausea, difficulty breathing, unexplained weight loss or gain, or other problems, describe how you’re feeling as descriptively as possible, and how it’s impacting your life. Remember, that doctors want to hear how you’re feeling and not what you think your diagnosis is. So, instead of saying that you think you have asthma, let the doctor know that you’re “out of breath” or “wheezing”. And because people experience conditions in different ways, you may have to try to explain just how you are feeling several times in order for your doctor to have a real understanding of what’s bothering you.

Sometimes the symptoms you have may make you feel embarrassed, or result in a more uncomfortable conversation. Try to keep in mind that there is really nothing that your doctor hasn’t heard before. In these situations, you might start by saying words like, “This is difficult for me, but I need your help with something.” An open, honest conversation will allow your physician to begin the process of getting you feeling better sooner.

Catherine M. Mullahy, RN, BS. CRRN, CCM, is the president of Mullahy & Associates, LLC and the author of The Case Manager’s Handbook, Fifth Edition. Since 2009, Mullahy & Associates has been a provider of educational and training programs for case managers serving within Veterans Health Administration facilities nationwide. Mullahy & Associates’ “Best in Class Case Management – Veteran’s Health Administration Edition” is the recipient of the Case In Point 2014 Platinum Award.