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8 Ways to Help Your Doctor Make the Right Diagnosis |
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Your feeling sick, maybe you are aching all over, tired or even exhausted, coughing, have a fever, some part of your body is not working correctly, what do you do? Maybe you feel that you should see your doctor or maybe you do not have a doctor and you believe you should go to an Urgent Care or even the Emergency Room. If you do, how can you help your doctors not only find out what is wrong with you but also fix what ever your problem rapidly and with the utmost safety to you?
It could be someone you love or really care about is sick, your husband or wife, your partner, a child, your mother or father, a brother or sister and you would like to help them as much as you can to assure that they get the very best care possible and the right diagnoses is made and the right treatment is given.
Certainly you will want to know why you or your loved one is sick. You most likely will also want to know this as soon as possible. Yet, in the past it has not always been easy to get information nor to find a doctor who could make the exact right diagnosis, especially when symptoms are vague or common. Unfortunately, it is possible that in the past doctors have not made the right diagnosis and your health problems have been misdiagnosed.
Studies estimate that the medical error rate for making the exact right diagnosis is between 10% to 15%. One recent study looking at medical malpractice claims performed at the Armed Forces Institute of Pathology in Silver Spring, MD found that the top five conditions most commonly misdiagnosed are heart attacks, breast cancer, appendicitis, lung cancer, and colon cancer. For most people this is quite scary.
At this point you are likely thinking or asking yourself that since you cannot always prevent becoming ill, what is it that you can do to help make sure that your doctor make the right diagnosis and that you ultimately get the best care possible.
Here are eight things you can do to help your doctors make sure that you get the very best care possible. Eight things you can do to help your doctor find the exact right diagnosis, so that he or she can help you to get the very best result possible and the exact right care for your needs:
1. Write Down Your Symptom and What You Are Experiencing
We doctors are too often surprised at how frequently patients come to see us and are not at all sure of what is happening to them. Often the patients may be totally unaware of what their symptoms are, what they are feeling or what is happening to them. It is also not unusual for patients to give you what I call the “short list” that is a few of the more prominent symptoms and not much more. Often patients will call back and later that day or the next day to present a new list of symptoms they “forgot about” when they were in your office. As one patient put it during a phone call the day after his visit, “ Sorry Doc, I forgot to tell you something important ..." Only then did he give me a piece of information that allowed me to make a more correct diagnosis. Unfortunately for him he ended up being sick one more day, purchasing the wrong medication and spending a sleepless night worried why he was not getting better.
Help yourself, spend some time with pen and paper and write down what you are experiencing. Write down how and when your symptoms started and in what order they started and occurred. Write down what you want to talk to your doctor about and what you feel you need to tell him, so that you won’t forget when you are with him. You may have to spend some time and sit down and write several times before you create the most accurate picture of what is happening to you.
One more important thing about making this list; you need to bring it and a pen with you to you doctors appointment. This list will not be helpful if you leave it at home and you do not have it with you when you see your doctor.
It is also helpful to bring along your pen and a note book or a least a blank piece of paper to take notes. It is likely that you probably won't remember most of what your doctor tells you, so it can help greatly to write as much down as you can to help you remember what your doctor wants you to do to get well again.
If your doctor uses electronic medical records, you can even ask for a copy of his notes on your way out of the office.
2. Be As Accurate and Specific About Your Symptoms As Possible
Be as precise as you can about what you're experiencing. Exactly where is the pain? Does it move from one place to another or simply stay in the same place al of the time? Is it a sharp pain, a shooting pain, or a dull aching pain? Does it come and/or go after eating? How long does it last? Does it last for seconds, minutes, hours or days? How long have you had it? A week? A month? A year? Does anything you do make it go away or cause it to come on. Does anything you do increase or decrease the pain? If there is no pain what is it you are experiencing, as exactly as you can describe it.
Make sure that you present objective rather than subjective information. If you feel feverish take your temperature for and record it. If you feel your blood pressure is up take your blood pressure and record everything you monitor, write down all pertinent information.
Having this information available to you when you see your doctor you can say, "I've had six headaches in the past month, they were all over my left eye. They weren't relieved by Tylenol or Motrin. They lasted four hours, and I experienced moderate nausea with them." This said you can then give your doctor time to ask questions to help him hone in on what is happening to you.
If you would like a preprinted Blood Pressure Record Form, click here. If you would like a preprinted Body Temperature Recording Form, click here.
3. Know Your Medical History
Long before your next appointment with your doctor spend some time writing out your medical history. List everything you know about yourself childhood illnesses, illnesses , surgeries, treatments, hospitalizations, medications so that you have a complete list of your past medical history. Also, go through your family tree and look at what diseases and conditions run in your family. If you don't know, ask your relatives. Conditions like cancer, heart disease, even depression and anxiety have a genetic component and may be important to your overall diagnosis and treatment. To the best of your ability make sure that all of the information is accurate, that you have accurate dates and dosages of medications. Be sure that you list all allergies to foods, environmental exposures and most important, medications.
It is important that in writing down your medical history that you describe and tell about your symptoms, but that you do not make suppositions, guesses or create false directions. I recently saw a patient who presented at an Urgent Care with a headache. The first thing he told the Urgent Care doctor was, “I must have a brain tumor my head just hurts too to be a simple headache.” This lead to dozens of unnecessary x-rays, an MRI, a CT scan and an EEG. The problem was a sinus infection which was easily treated, BUT because the patients had brought up the possibility of a brain tumor the Urgent Care doctor felt that for medical legal reasons all of these other tests would have to be done. Instead of simply being prescribed an antibiotic and hot compresses and sent home, my patient was kept without food or water, placed on IV’s, and held in the Urgent Care for 16 hours to allow all of the tests the Urgent Care doctor felt he had to perform to absolutely rule out a brain tumor.
If you would like a comprehensive preprinted Medical History Form, click here. If you would like a preprinted Vitamins and Supplements Form, click here.
4. Bring in Your Medications
Here is another situation were people create problems for themselves. They show up to a new doctors visit, the Urgent Care or Emergency Room, with no knowledge of what medications they are taking, the dosages and why they are taking these medications. This undermines the doctors ability to know exactly how to treat you, whether you might have side effects, and whether the medication he is going to prescribe for you will cause adverse reactions or any negative interactions with your current medications. You also will want to make sure that you are currently taking the correct medicine and in the correct dose. The labels on your medicine bottles can provide valuable information for your doctor to help him better diagnose and treat you.
5. Ask Your Doctor What You Should Expect and What You Should Not Expect
When your doctor makes his or her diagnosis, ask what he expects form you. Ask if there are any red flags or warning signs you should continue to look for and what he wants you to report to him, Ask what symptoms or finding you should consider urgent and what can wait until the next visit. For example, if you have an acute viral respiratory infection you should be better in seven days. If you suddenly develop a high fever or develop headache or neck pain, this is an indication that something isn't right. You should make sure that your doctor tells you what you should be looking for to make sure that you do not get sicker. Also, make sure that you have your doctors office and emergency number so that if you have a problem you will know where and who to call.
6. Ask Question, Expect Informational Answers
Don't be afraid to ask your doctor what additional information or tests he or she will need to make the right diagnosis. You can be direct: “What more do you need to know to get to the bottom of this problem?” “What is your differential diagnosis?” The differential diagnosis is the list of possible diagnoses that he or she is looking at. “Will I need to see a specialist, have additional procedures or tests, in order to help you make the right diagnosis?” “When do you want me to see me again and what information can I bring with me to help you make the right diagnosis?” What more do you need from me?”
Once you have a diagnosis, don't be afraid to ask your doctor all of the questions you need answers to. “Are you sure this is what I have?” “What makes you chose this diagnosis over all others?” It always helps to ask all of your questions as if you are seeking information and not judging his or her decisions. When patients ask in a condescending way or questioning the skill or veracity of the doctor they are likely to get less then helpful answers, this is merely human nature. Maximize your information by asking real meaningful and honest questions to obtain real and helpful information.
You do not have to be afraid to ask for a second opinion. Doctors are not perfect and sometimes if they are unsure asking for another opinion is the exact right thing to do. Good doctors are not threatened by requests for second opinions. If a second opinion is not necessary your doctor should be able to intelligently tell you why and set goals and parameters that can help you be clear that he or she is correct and has made the right diagnosis and now only time is needed for healing.
7. Plan Your Appointment With The Specialists
If your doctor feels that you need to see a specialist then it is smart to prepare for the visit with the specialist. Since it is likely that the specialist you are going to see will not know you nor why you have been sent, ask your doctor to send a copy of your medical records, diagnostic testing and lab via fax or email to the specialist. Therefore when you see him he will already have a copy of your pertinent records in his possession. If your doctor cannot do this, or it is you that is choosing the specialist, ask your doctor to give you copies of all of your pertinent medical records so you can take them with you. Have your doctor make copies for you before you leave your last visit or stop at your doctors office, lab, radiology or other doctors and get copies so that you can bring them with you when you see the specialist. It is a smart idea to make two sets of copies of all medical records, one copy for you personally and one copy to give to or leave with the specialist.
Make sure that you have copies of all record, diagnostic testing and lab tests that have already been done related to your current problem: X-rays, MRIs, blood work, etc. By law you're entitled to copies of all of your medical records. To obtain copies of your medical records all you should have to do is call or go into all of the health care providers you have already seen and ask them to send to or give you their authorization form, a Release of Medical Records form. Since the laws relating to release of medical records often differ from state to state check with your primary doctor what will be necessary to get records from all of your providers. Please remember most facilities are allowed to charge a reasonable fee for copying and sending records. Remember to bring these records with you to the specialist, if you leave them at home they will not be of value at the time you see the specialist.
For a preprinted Request for Medical Records Form, click here.
8. Follow Through
Now that you have seen your doctor, possibly even a specialist or two, it is important for you to remember that medical care is only as good as your ability and desire to follow through and make appointments, take medication and have diagnostic testing which has been requested. If you simply have an exam and do little or nothing more, your condition may get better on its own, but is it is also possible that it will get worse and your life or well-being may be threatened. Do the work needed to heal yourself and you will be back to normal sooner than latter.
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By Dr. Noato Hashimoto, DC
Massage is the general term for pressing, rubbing and manipulating your skin, muscles, tendons and ligaments. There are a wide variety of techniques and styles of massage, finding the right fit for you is the most important. Some people like a massage where they are positioned in stretched out postures while the therapist works out tight areas. Other people simply want a relaxing experience one where they just lie on the table and gently get worked on. The two most common types of massage are: Swedish and Deep tissue.
- Swedish massage is a gentle technique, where the therapist uses long strokes with circular motion and vibration to create a very relaxing experience.
- Deep-tissue encompasses slower and more forceful strokes which target deeper layers. It is commonly used for to reduce or relieve muscle damage from injuries.
One question which is commonly asked is whether one type of massage better than another? The simple answer is different styles of massage are either enjoyed or work better for different conditions as well as for the needs of the recipient. Finding the right style for you and your body is the most important. In order to obtain the best results one should decide why the massage is being done and what benefit is desired. Of, course, one of the best reasons for getting a massage is simply to enjoy the experience. If a resolving health problem is the goal below are a few of the more common reasons massages can be helpful and even therapeutic.
Some of the potential benefits of massage are:
- Increases circulation of blood - brings vital nutrients to the tissues
- Increases circulation of lymph – beneficial for the immune system
- Relaxes and softens tight muscles
- Reduces muscle spasms and cramping
- Increases flexibility
- Decreases stress levels
- Reduces pain levels which can lead to a decrease in use of pain medications
The old adage, an ounce of prevention is worth a pound of cure is true here. There are a wide variety of potential benefits from massage and the risk is very low. The most common side effect is muscle soreness, much like you get from vigorous exercise. If you have special health conditions such as: deep vein thrombosis, open wounds or severe osteoporosis the therapist can modify their technique to avoid any potential issues. Also, notify the therapist if you have any skin sensitivities to certain lotions.
Preparing for a massage is easy: show up well hydrated and ready to relax! If you are uncomfortable removing your clothing, you have the option of having the massage performed in a special chair with your clothes on (much like you will see in the mall). Most people prefer the traditional massage utilizing skin on skin contact, but this is a decision you can easily make with your massage therapist. Even if you do take some or all of your clothing off, you will be completely covered up underneath a sheet on a massage table and only the areas being worked on will be exposed as necessary. To make you more comfortable, you may also request either a female or a male therapist.
The therapist will generally use some kind of a lubricant (oil or lotion) on your skin. I generally recommend using lotion because it creates less of a mess on your clothing after the massage. The therapist will likely ask a few general medical questions in order to find out if there are any health concerns before you start with your session.
Once you get started, all you need to do is relax and breathe. If the therapist finds some tight muscles, you may experience a little tenderness during the massage. This is quite normal. If, at anytime, it starts to become uncomfortable or painful, communicate with the therapist so that they will lighten up. Communication is very important. When you communicate you will get the most out of your massage session. If you are not sure how you will respond to massage, ask the therapist to go a little lighter on your first massage and add more pressure on subsequent visits.
If you’ve never had a massage I would strongly encourage you to get one.
Remember, after having your massage be sure that you drink plenty of water and enjoy the benefits!
Dr. Noato Hashimoto, DC is a practicing Doctor of Chiropractic and author who operates a natural health clinic that offers massage at Washington St and 48th Ave behind Walgreens. Call 760-777-8377 to schedule a one hour massage for only $29 (introductory rate).
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Herb-Prescription Medication Drug Interaction |
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If you choose to use herbal treatments of any medical condition there are a few rules that are essential. These rules are meant to help the individual one three levels.
1. Use herb correctly to protect individuals overall safety 2. Use the right herb for the right job 3. Do not over dose
The Basic Rules:
1. Do not self medicate 2. Do not medicate on the basis of a clerk at a health food store 3. See a well-trained, certified herbalist to be treated correctly with the right herb used at the right dosage 4. Be sure that if you are using any prescription medications there are no negative herb-drug interactions.
Using this philosophy will keep you from having problems, under or over medicating and prevent complication, side effects or problems with being treated correctly and obtaining optimal results.
Herb-Drug Interactions
Herb-drug interactions are generally very common. Some herbal medications will cancel the effect of certain prescription medications. Others can reduce or even eliminate the positive value of certain prescription medications. Other may even exaggerate positive effects, sometimes helping, and sometimes creating a negative situation. Individuals taking medication for HIV or medications for associated symptoms or disorders, may be particularly vulnerable and should make sure any herbal medications used are approved by their HIV physician.
General Principles
If you are generally health and using or deliberating the use of herbal medication consider the information below:
Dong Quai: Dong Quai is commonly used to treat menopausal symptom control. Dong Quai can negatively interact with warfarin (a anticoagulant), St John's Wort and also with some antibiotics such as sulfonamides, quinolones.
Echinacea: Echinacea is often used as an immune booster to prevent cold’s and the flu. You should not take Echinacea if you are using some heart medications, antifungal medications, HIV medications and anti-anxiety medications. Talk with your doctor before using Echinacea.
Ephedra: Ephedra is a powerful decongestant. It contains ephedrine and ephedrine can dilate bronchial air tubes within the lungs. Ephedra is currently very controversial because it's also a very powerful stimulant and can cause high blood pressure and insomnia. Ephedra should never be used by individuals who are also taking prescription heart medications or who are being treated for high blood pressure, glaucoma or thyroid problems.
Feverfew: Feverfew is generally used to treat severe migraine headaches. When you use feverfew do not use any other migraine medications, as the combination may cause a rise in heart rate and/or blood pressure. Feverfew also can react with warfarin anti-coagulants and increase its effect in thinning the blood.
Ginkgo: Ginkgo increases blood flow and circulation throughout the body. This can help improve memory. However, it may interact with anti-coagulant medications such as Aspirin, warfarin (Coumadin), or heparin and cause the blood to become too thin. This could provoke a serious bleeding disorder. A report in the New England Journal of Medicine describes a man who was using low dose Aspirin to prevent a heart attack and had spontaneous bleeding into his eye within a week of starting a daily dose of ginkgo. Ginkgo, should not be taken along with HIV medications.
Garlic: Garlic is often used to lower cholesterol and to prevent the formation of blood clots which could lead to heart attacks. Garlic capsules may increase blood thinning. If you are already on anti- coagulants you should not take garlic as a medication. It can however, still be used in cooking in regular amounts. Do not take medicinal dosages of garlic along with diabetes medication as it can cause a decrease in blood sugars. If you do use garlic appropriately lower blood sugar meds under your doctor’s supervision. Garlic should always be use with caution with HIV medications.
Ginseng: Ginseng is used to help reduce stress, boost energy and improve stamina. It may also help lower cholesterol. Ginseng can induce nervousness and excitation, and with overuse it can lead to headaches, insomnia and heart palpitations. Ginseng can also increase blood pressure. It should not be used if you are taking prescription medications for high blood pressure or if you are using warfarin (Coumadin).
Hawthorn: Hawthorn is sued by some people to reduce attacks of angina. It also can lower blood pressure as well as cholesterol levels. Hawthorn should not be taken When using the heart medication, digoxin and the combination can lower heart rate, and sometimes too much.
Kava: Kava is used to treat anxiety. It's also used to relieve insomnia and nervousness. Kava should not be used if you have a history of liver problems. Kava also should not be taken along with antidepressants, sedatives, and it should never be mixed with alcohol.
Licorice: Licorice is used to treat coughs, colds and peptic ulcers. High doses of licorice can lead to increased blood pressure, water retention and potassium loss. Do not use licorice when you are taking diuretics or digoxin as it can lead to loss of potassium which is essential for normal heart function.
St. John's wort: St. John's wort is a natural anti-depressant often used to treat mild to moderate depression. St. John's wort should not be taken along with other anti-depressants, HIV medications, oral contraceptives, some heart/blood thinning medications and Tamoxifen (anti-estrogen, a cancer drug).
Valerian: Valerian acts as a mild sedative which has secondary hypnotic effects. It is commonly used to promote sleep. Valerian should not be used along with alcohol or Valium.
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PreventiveMedicinePS.Com offers information to the general public regarding medical conditions and both Standard Western and Alternative, Holistic approaches to treating these conditions.
Dr. Allen Lawrence, M.D. is the Editor and Chief
Dr. Neal Rouzier, M.D. is Senior Medical Consultant
To learn more About Prevention, click here.
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Neal Rouzier, M.D. in the Director of the prestigious Preventive Medicine Clinics of the Desert, in Palm Springs, CA. Dr. Rouzier performed residencies at U.C.L.A. in Family Practice and as a Specialist in Emergency Medicine. He is a leader in Preventive and Holistic Medicine.
Preventive Medicine Clinics of the Desert's The practice has been in the same location at 2825 Tahquitz Canyon Way in Palm Springs for the past 20 years.
Dr. Rouzier came to the practice through his work as an emergency room physician.
“I saw patients who where sick and begged for someone to do something for them. I knew in my heart that help should have started many years earlier,” says Dr. Rouzier, “I know that to be a good doctor, all you had to do was treat these long-standing illnesses and get good results; but I believe to be a great doctor, I have to prevent my patients from getting sick in the first place.”
Dr. Rouzier continues, “I chose to study and learn how to prevent illness, help people get well and to also help them to stay well.”
Dr. Rouzier is a graduate of UCLA Medical Center where he not only served his internship, but also residencies in family practice and emergency medicine. After completing these residency programs, Dr. Rouzier attended the University of San Francisco where he performed additional residency training in occupational and environmental medicine. He is board certified in emergency medicine.
Dr. Rouzier continues practicing his specialty at Queen of the Valley Hospital in West Covina where he was medical director of prehospital care and assistant director of the emergency department, as well as maintaining his faculty appointment to the UCLA Medical Center.
Today, in addition to being Preventive Medicine Clinics of the Desert's medical director, Dr. Rouzier is a world-renown expert in Bio-Identical Hormone Replacement Therapy. Dr. Rouzier is nationally sought after as a speaker and trainer on the important role appropriate hormone replacement plays in health, metabolism and well-being. He also maintains an active and essential role specializing in preventive medicine, natural hormone replacement therapy and family medicine. His expertise has earned him international recognition and he is highly sought as a specialist of preventive medicine and natural hormone replacement therapy. Dr. Rouzier regularly teaches one of the most comprehensive medical seminars for health care practitioners and physicians from around the world on how to prescribe and monitor hormones for their patients. His seminar, “Practicing Natural Hormone Replacement Therapy: The Effects of Hormonal Therapies on Quality of Life Issues,” is widely attended and considered a "must" for physicians who prescribe hormone therapy for their patients.
Dr. Rouzier book "Natural Hormone Replacement for Men and Women: How to Achieve Healthy Aging and How to Achieve Healthy Aging" (now in its second edition) has made him a world-renowned author. He regularly lectures to such esteemed groups as The American College for Advancement in Medicine, the American Academy for Anti-Aging Medicine, the American Academy of Environmental Medicine, the American Society for Bariatric Physicians, the American Academy of Cosmetic Surgeons.
“The Preventive Medicine Clinics of the Desert is a unique medical practice,” says Dr. Rouzier, “We have three goals — find the right diagnosis, give the right treatment and help people to get what they want and need.”
This practice is different from every other practice in the Coachella Valley. Dr. Rouzier and his associate, Dr. Allen Lawrence, not only work with standard Western medical modalities, but also with integrative medical treatments such as nutritional counseling, IV vitamin-mineral infusions, chelation and IV hydrogen peroxide treatments.
Dr. Rouzier says that he long ago realized that if people are not in optimal hormonal balance, they not only have physical and emotional symptoms as well as medical problems from their imbalances, but their immune system and their ability to defend themselves from illness is compromised, and they get sick.
“If these imbalances are not recognized and set right, no matter how much medication they take, they stay sick,” says Dr. Rouzier. “Our goal is to return our patients to optimal hormonal, nutritional and physical balance. When we do this, people get better and their life becomes so much better, and they become so much more healthy and happy.”
When asked what types of people are most commonly seen at the Preventive Medicine Clinics of the Desert, Dr, Rouzier responded, “We have two types of patients we see regularly. Most often, we see those people who are looking for or are already using alternative or integrative medical care and are looking for a practitioner who understands what they want and need. We literally have hundreds of people who want to have control over their lives and either do not want to take medications or want to do this using more natural methods.
“The second group,” he says, “are those people who have medical problems and are either not getting better using allopathic (standard Western medical treatments) or they simply want to add integrative methods to the traditional medical treatments they are already using. Both are welcome, and we never try to convert people to do it one way or the other. We simply help them the way they feel is best for them.”
Most important of all, Dr. Rouzier has many years of experience in treating thousands of patients with natural hormones.
Preventive Medicine Clinics of the Desert 2825 Tahquitz Canyon Way, Ste. B200 Palm Springs, CA 92262
For evaluation or an appointment call: 760-320-4292
To go to Dr. Rouzier's web site HormoneDoc.Com, click here.
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