In this episode I talk through how to getting the most out of the limited time slot you get with your family doctor.
PART I - PREPARING THE HISTORY
Preparation is key when it comes to seeing your doctor. Take a moment in the waiting room to think about your problem. You might want to think about how it started, is it getting better or worse, are there any triggers, is there anything associated with it. Take a think about any solutions that you may have tried. All too often, nothing is done by patients, but sometimes trying a solution such as an anti-inflammatory medication for knee pain, can help the doctor to work out the diagnosis. If you’re forgetful it might be worthwhile bringing in a list of symptoms for your problem. It may be that you have more than one problem, if this is the case, inform your doctor at the start of the consult to work out which is the priority problem and which can be reviewed at a later time if time does not permit.
PART II - PREPARING FOR EXAMINATION
Now that you have succinctly and coherently put across your problem, your doctor may then interact with you through a number of ways. They may ask you questions whilst you are talking to help keep the conversation on track and to obtain any important salient details about your problem, aiding them with their thought process. Your doctor may then wish to perform an examination. Sometimes this is not always necessary, however if you suspect an examination may be required it’s important to consider this during your preparation. For example, if you have knee pain, your doctor may need to examine your knee, so think about how easy it will be to access your knee with your attire. It might be that you are coming in for an intimate examination, and for this you may need to prepare appropriately with washing or attire.
Once your doctor has performed an examination they may request some further tests, this could take the form of blood tests or radiology to name a few. In these situations, results can take around 2-3 days and you may be required to return at a later date. In some situations like this, the doctor may be unable to give you a diagnosis straight away and so your patience is appreciated. You could use the opportunity of having to return as a time to reflect on your problem and think about whether you have missed anything or want to clarify something with the doctor. Following on from this, be sure to check your understanding at the end of every consultation. Sometimes doctors use medical language or jargon, that is hard to understand. As a habit, I always go through reports or results with picture aids to ensure patient understanding. Generally, if you ask your doctor for clarification on something, they will be happy to help.
Finally, know that the doctor has your back. Remember the doctor has taken a hippocratic oath to do you no harm and to provide you with the best form of treatment that is suitable for your condition. You should generally seek advice from your primary medical practitioner as they know your history well. However, if you feel uncertain about something the doctor has said or you want a second opinion, it is ok to do this. Most of the time, the management will be the same as your usual doctor, which helps to reinforce and reassure the patient-doctor relationship. However, on very rare occasions, I, as a second opinion doctor have found there to be outliers, where I have changed the management to save lives. This goes back to preparation, very often when you see the second opinion doctor, you may have a better understanding of your problem and so when you portray your symptoms for a second time, it may lead the doctor in a different direction.
With 4 confirmed cases of the novel virus at present in Australia, measures are being taken to help stop the propagation of the virus.
In today’s episode of Dr Nora I talk to you about my battle of finding protective measures to protect myself and my patients.
It is thought that the virus may be transmitted through airborne droplets from sneezing or coughing and it is felt that the P2/N95 mask may offer some protection. As a health care practitioner seeing around 50 patients a day it is my utmost priority to look after my patients and ensure that they are safe. After work I rushed over to my local hardware store and enquired about the mask. Unfortunately, they and all of their other franchises had run out and the only ones left were darth-Vader-esq masks.
After much deliberation I got over the aesthetics and remembered the purpose and brought one. As I drove away I thought I would call local pharmacies to check their stocks. After calling 20 different pharmacies over a span of 60km I was met with the same response ‘sorry we’re out of stock’.
Rather fortunately I drove past the hospital and thought perhaps I could ask my colleagues there and explain the situation. After speaking with the staff in ED they kindly gave me a mask for myself and my staff.
WHAT IS WUHAN CORONAVIRUS?
Wuhan is a city in China where the virus originated from. It is not fully understood how the virus is transmitted but it is believe that it originated in a live seafood market and has so far affected over 1000 people in China with around 40 people dying. It is believed that this who have died from the virus have had underlying medical conditions.
Australia has received its first confirmed case this weekend and to date there are 4 cases in two states, NSW and QLD.
WHAT ARE THE SYMPTOMS?
The virus causes symptoms pneumonia, including, fever, cough, shortness of breath and feeling unwell and tired. It is believed that there is an incubation period of around 14 days which means that someone may not know they have the virus immediately.
WHO IS AT RISK?
Those who have travelled to Wuhan or those who have close contacts with someone who has recently travelled or has a confirmed case.
HOW DO I PROTECT MYSELF?
Usual hygiene measures are crucial such as regular hand washing. It has currently not been recommended for the general public to use a mask outside of the health care setting.
If you have a suspicion you may be affected as perhaps you’ve recently travelled from there or know a close contact. You should maintain isolation and seek medical help. It is imperative that before you go to a doctor or the ED you must call ahead so that protective measures may be taken. You will need to be in isolation to protect others around you and hence stop the propagation of this virus.
Tests can be performed to confirm the virus and treatment may be initiated. The virus is new and not much information has been released. Scientists are working on a vaccination though this can take time.
Together with your help we can stop the propagation of the virus.
In this video we listen to the heart of a patient who has a diagnosis of diastolic dysfunction and a heart murmur.
WHAT IS DIASTOLIC DYSFUNCTION?
Diastolic dysfunction occurs when the left ventricle gets stiffer and is not able to accept blood return in a normal fashion. It can lead to high blood pressure and even heart failure thus requiring regular monitoring and management.
This lovely patient also has a heart murmur that you can clearly hear with the stethoscope. We take a listen to her heart at rest and during exercise.
Always consult your physician before beginning any exercise program. If you experience any symptoms of weakness, unsteadiness, light-headedness or dizziness, chest pain or pressure, nausea, or shortness of breath, stop exercising and seek immediate help.
As I travelled back from Sydney this weekend I lost count of how many coughs, sneezes and sniffles I heard.
Respiratory viral infections are spread by aerosol transmission - coughing, sneezing or even talking. They will mostly get better alone with good old fashioned TLC. If you are unwell consider staying home so that the virus doesn’t spread to others and no doubt your workmates will also be happy that they won’t get sick too.
Strict hygiene is important if you are sick, sneezing into a tissue, throwing away used tissues and washing hands regularly are a must.
If you’re symptoms aren’t settling, have any concerns or if you even need a sick note pop down and see me in clinic.
Let’s all do our part to prevent transmission of the common cold.💪 Take care and stay healthy 😘