Here’s a news flash from the Prepared Patient forum of the Center For Advancing Health: your doctor is not a mind reader. And how you describe your symptoms can be just as important as what you describe. Physicians – and experienced heart patients – say you must be as detailed and descriptive as possible. For example:
- Adjectives are important. Don’t just call it pain. Use descriptive words like dull, throbbing, intense, burning, tingling, heavy or piercing. Sometimes ranking pain on a scale from one to 10 (with 10 the highest for example) can be a good way to track changes and severity of your discomfort.
- Describe how symptoms change your daily life and ability to function. Instead of just saying you feel “tired,” talk about specific changes in your day-to-day life. One heart patient, for example, explained that she had became too weak to use a blow-dryer and needed two hands to lift a glass of water. Rather than just telling your doctor “I can’t do things like I used to,” be very specific. Give context and explain any measurable differences in how you carry out daily activities.
- Be sure to give a location for your symptoms, and don’t be afraid to point if necessary.
- Writing down your symptoms can help you remember everything you’re experiencing and make your time with the doctor more efficient. Some patients keep a symptoms diary to track a chronic illness like heart disease. Then you can tell the doctor specifics like: ‘I feel worse at night or whenever I walk up our steep driveway.”
- Be insistent about your symptoms if it feels like your physician isn’t clear on what you’re experiencing. Your doctor may have the technical knowledge, but only you can accurately describe the impact your symptoms have on your life. A recent report in the New England Journal of Medicine found several studies showing that doctors often downgrade the severity of patients’ self-reported symptoms, particularly when it comes to medication side effects. Keep a written record of the frequency and severity of your symptoms, so you can talk about them with certainty.
- You might be embarrassed in describing your symptoms – for example, if you fear you may be judged or criticized (when you’re a smoker, are obese, have allowed serious symptoms to go on for a long time, or are used to having your symptoms dismissed and are reluctant to keep on “making a fuss”). You could start the conversation with your doctor by saying something like:
“This is difficult for me to share with you but I need your help.”
But if you can’t trust your doctor with this kind of information, it may be time to find another doctor.
Prepared Patients also reminds us of the importance of understanding two-way communication with your physician. For example, Dr. Davis Liu, a family physician in Sacramento, California, advises:
“Doctors want to hear how you feel, not what you think your diagnosis is.
“Doctors are very specific with terminology, and what you mean could be completely different than what a doctor understands the term to mean.”
I would argue that the exception to this advice is when you are experiencing symptoms that feel like heart attack. In this case, call 911 and say loud and clear to anybody who will listen:
“I THINK I’M HAVING A HEART ATTACK!”
Read the rest of the Prepared Patients essay called Talking About Symptoms With Your Health Care Team. Or for six detailed pointers on good communication at your next doctor’s visit (e.g. “Don’t Leave Until You Understand What To Do Next”) check the University of Minnesota’s Center for Spirituality & Healing.
- When Doctors Can’t Say: “I Don’t Know”
- Cardiac gender bias: we need less TALK and more WALK
- Six rules for navigating your next doctor’s appointment
- The ’18 Second Rule’: why your doctor missed your heart disease