A Guide to Asking Your Doctor Questions to Understand Your Diagnosis
Part 3
by Dr Makini McGuire-Brown
Today I end the “Doctor I Don’t Understand” mini-series with the last 3 questions of our 10-question guide for asking your doctor questions to understand your illness. As always, a recap. As a part of our Patient Tip series we started to talk about the importance of understanding your diagnosis to improve your outcomes. The most important thing to remember is to ask questions! And I’ve started you off with 10 questions to ask. To review the details of questions 1-7, please read article one and 2 of this mini-series. Today I will go through questions 8-10. Here are those questions again:
I suggest 10 questions to gain a preliminary understanding of your diagnosis:
- What is the name of my diagnosis?
- What made you come to this diagnosis?
- How will it affect my body?
- How will it affect my mind?
- How will is affect my job?
- How will it affect my social circumstances (family, friends, relationships, hobbies)
- What is the natural course of the illness?
- How can it be treated?
- How does treatment affect the course of the illness?
- What can I do to help myself?
Question 8 might be the question that comes the easiest to most, people always want to know how to treat their illness. It is very important to note the various methods of treatment. These may include drug therapy, lifestyle changes, psychotherapy, social changes, physiotherapy and other adjuncts, rehabilitation, surgical/procedural therapy or, most times, a combination of several of them. The question of treatment therefore may have a long-winded answer and indeed it should.
You must ensure that you understand how each element of the treatment is important. Recovery from a bone fracture may require casting, surgery or both but it does not stop there! Bone healing requires micromovements. Therefore physiotherapy, rehabilitation, lifestyle change and a positive attitude/psychotherapy to get there would be required for the patient to get up on those crutches and walk! Never underestimate the value of non-drug, non-surgical treatment. They are of equal importance! You can be cured of withdrawal symptoms from drug addiction through medication, but no medication can fix the social circumstances that lead to addiction, and no addict can overcome an addiction without changes to the social circumstances that led to the addiction in the first place. When you ask about treatment ensure that the answer is holistic, covering all the different angles of treatment.
Next, you want to understand how these treatments relate to the course of the illness. Recall from the last article that diseases may vary in their course. Some are easily treated and can be cured; some require long term treatment and can only be controlled. Some diseases have a rapid improvement or rapid deterioration, others are a lot more subtle and gradual. It is important to understand that treatment has a broad definition. Some treatments only slow disease-progression, some treatments only treat the symptoms to improve the patient’s quality of life, some treatments give the body time to fix itself, others help control an illness to prevent damaging effects, but never really cures the illness. Understanding what the treatment is meant to do can help manage your expectations.
Medication for HIV for example serves to improve symptom and control damaging effects thereby improving the patient’s quality of life, but, as of yet, the treatments do not cure HIV infections. A disease like hypertension is also a great example to go through. Medications by themselves will never be sufficient treatment for hypertension, it must be combined with lifestyle changes as we learnt in our Parley Blog “Exercise: The Cure” series. Even in combination, these two usually only prevent disease-progression and tend to require lifelong treatment. One should not expect to be “cured” of hypertension but instead most commonly, commit to lifelong lifestyle change and protective medication.
For more emphasis, let’s explore an example of misplaced expectations. Autoimmune disorders are characteristically chronic with flare patterns. If someone with Lupus believes that one course of medication has cured their Lupus they are likely to face severe consequences. Treatments for lupus and other chronic autoimmune disorders help only to prevent damaging effects, reduce flares and control symptoms. These should be used in combination with lifestyle changes to avoid triggers that precipitate flares. Believing that one is cured may lead to cessation of lifestyle changes and/or medication which can cause significant relapse and a major flare. Major flares tend to affect larger organs such as the brain or kidneys. Significant damage to the brain or kidneys can be permanent even after the flare has subsided. Understanding how treatment can affect the course of your illness therefore is extremely important.
Finally, we must wind up this series in the right way, by addressing your autonomy! As a patient there are many things that you can do to help yourself! Never feel helpless! It is important though to understand what is and is not in your control, to again, manage your expectations. Always look for the small wins. You cannot directly cure your cancer, but you can make it through your first round of chemotherapy. That is an achievement! It took effort, positivity, bravery, and perseverance to do that! It is within your power to muster that strength. You can’t change your genes but you can make lifestyle changes that will prevent, reduce the chances of or prevent severe outcomes for autoimmune diseases. It is important therefore to find out from your doctor the things that you have more control of than others. This will allow you to focus your energy most effectively. Question 10 should not be taken as the least important but instead, we do it last to ensure that we end by highlighting why we first began! Knowledge about your illness can encourage you to make better decisions that will improve the outcomes of your illness.
This brings us to the end of the Doctor I Don’t Understand mini-series. I hope that you enjoyed it! We will continue with our Patient Tips series next time by starting a new topic! “Why should I do a Checkup? I’m fine”
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