Gary McClain, PhD, is a therapist who specializes in helping clients deal with the emotional impact of chronic and life-threatening illnesses.
Terry came away from his doctor’s appointment with a couple of new prescriptions. His physician had recommended that he begin these medications after Terry talked with him about some recent symptoms he had experienced. Terry is already taking two other medications for his chronic condition, so he wasn’t excited about adding two more. On the other hand, symptoms are symptoms.
But are they?
Terry hadn’t been feeling well for a couple of weeks before his appointment. He couldn’t quite put his finger on what was going on, but that was the doctor’s job anyway, right? At least that’s what Terry told himself.
When his doctor asked him to describe how he was feeling, to put words around his symptoms, it wasn’t so easy. His doctor tried to help him, asking him questions like, “Is it like ___ or is it more like ___ ?” “Estimate it on a scale of one to ten.” “What does it remind you of?”
The questions helped. Enough that Terry was hopefully able to help his doctor come to the right diagnosis, so that he could send Terry on his way with prescriptions for medications to alleviate his symptoms. But still … two more medications?
Words can be unreliable. Clarification can reduce nagging doubts.
That evening, Terry was talking to his wife, Dara, about how the appointment had gone.
“You seem uncomfortable about something,” Dara said. “What’s bothering you?”
“Well,” Terry answered, “you know how with some conditions, the doctor does a test or two, gets the results, and then confirms the diagnosis? That’s the easy route to getting the help you need.
“But when you have to try to describe how you feel, it’s not so easy. I wanted her to understand that I wasn’t feeling like I should be feeling. So I went through every possible symptom, like she asked me to.”
“Sounds like you gave her the information she needed. So what’s the problem?”
“I don’t really trust myself to be completely accurate,” Terry answered. “I don’t think I was exaggerating on any of them, but I wanted her to know I wasn’t feeling like myself. I just hope I was accurate. And there were a couple of symptoms I didn’t even know how to describe. So here I am with two new medications and I’m not totally confident we had clear communication. I wonder if there is a gap between what I feel like and what she thinks is going on. If that’s a big gap, then I could be on a medication I don’t need, or the wrong one.”
What about you?
Have you ever left your doctor’s office concerned about whether you were able to accurately describe how you were feeling? Not exaggerating or underestimating? Not accidently implying a symptom was present that wasn’t? And have you ever left with the nagging feeling that you and your doctor might not have been totally on the same page?
Here are some ideas to help the next time you worry that something got lost in translation:
Make it clear to your doctor that you are unsure of your description of your symptoms. Letting your doctor know that you aren’t totally comfortable with your description of how you are feeling, and the symptoms you are experiencing, can help in a couple of ways. First, it may prompt your doctor to help you to get more specific through the questions he or she asks. And, being transparent about your discomfort will help you feel more comfortable with this discussion, and less pressured to say the “right” thing. Don’t hesitate to be upfront about any qualms you have about how you are describing your symptoms.
Clarify to your doctor that you aren’t necessarily expecting any additional medication. In this day and age of the empowered patient, physicians often tell me that they feel pressured to give their patients a prescription in answer to a complaint. If you are concerned that your physician may over-interpret your description of your symptoms, make it clear that you are only seeking his or her objective opinion—their guidance in what you should do, if anything. Depending on how bad you are feeling, you might also mention that you are open to watchful waiting. Be clear about what you are expecting and not expecting from your doctor.
If your doctor does prescribe a medication, be clear with him or her on what you said that led to this decision. Doing this will provide you with additional reassurance that you and your doctor are in sync on the path forward. If your doctor seems to be responding to a symptom that you mentioned but that is not that significant, you will have another opportunity to clarify what’s causing you the most discomfort. You may find that your doctor is overreacting to something you said, that one of your symptoms pushed an alarm button with your doctor that didn’t need to be pushed, or that what’s bothering you the most was not communicated or acknowledged.
As always, keep your doctor abreast of how you’re doing. The treatment your doctor prescribes may indeed help you to feel better. If so, sounds like the two of you figured this one out. But if you don’t feel the relief he or she said you should feel, if you feel worse, or if you experience uncomfortable side effects, then make sure you get in touch with your doctor right away. It’s never too early in the process to consider a course correction.
You and your doctor. While medicine is based on science, the language we use to talk about symptoms is not so scientific. Help your doctor to help you by doing what you can to communicate with clarity and honesty.
Have you ever had a hard time getting your doctor to understand your symptoms? What helped? Share your advice by commenting below.