One of my quirks is seeing most of life’s experiences as somehow analogous to healthcare.  In keeping with my usual way of looking at things, here’s a story that draws out the similarities between car repairs and healthcare.

 

My son’s VW jetta was having issues.    He talked to me about it and said he was going to take it to the dealership.  Because I haven’t had such great experiences with dealerships, I shared my apprehension with him.

Going to the dealership reminds me of going to the ER when you’re sick.  Not my first choice unless it’s absolutely necessary. 

He decided to take it to his local mechanic who didn’t have the right diagnostic equipment for his VW.

I had the idea to check out Yelp to see if I could find him another mechanic.  After asking his permission, I went on yelp and called a couple mechanics that had excellent reviews.  I asked them if they had VW diagnostic equipment and they did.  Yeah!

Digressing again, I was terrified of looking on yelp for a mechanic.  What if I found someone who was incompetent or a crook?

In my mind, looking on yelp for a mechanic was akin to looking on yelp for a healthcare provider.  We both knew that his car was having a serious problem.  This car has been part of his life for 10 years and has 98,000 miles on it.

Somehow, my brain had aligned looking for a healthcare provider on yelp with looking for a mechanic.   It was like I was recommending a doctor for someone with an important and potentially serious health issue.  In this case, I was recommending someone I’d never seen or met to my son, who I obviously adore.  I didn’t want to be responsible for the results if things went south.

Returning to our story. . .

My son goes to see both mechanics and they agree he needed to go to the dealer.  So, off he goes to the dealer with some trepidation because his gut told him this was going to be a serious and expensive repair.

Digressing again, my anxiety mounted as I could see there was no choice but to take the car to the dealer.  Though the car is an inanimate object, a serious issue with it brought up all my stuff around loss in general.  (Ugh – don’t even get me started there!!!)

In the meantime, my son objectively handles the situation taking the car to the dealer and gets the bad news that the transmission needs to be replaced which would cost more than the blue book value of the car.

Now what?  Well, it’s taken a few days for the news to settle.  Of course, I want to help in any way I can.  But, the truth of it is, he doesn’t want or need my help.  It’s important that I step back and let my son handle this and make the decision that is right for him.

I’m only a supporting player in his life. . . not the one in charge.

So, why am I sharing this long story?  How does this apply to healthcare and dealing with health issues?

  • We aren’t responsible for how things turn out:  Often friends or family ask us for a recommendation for a healthcare provider and when things work out, it’s a blessing.  And when things don’t work out, we can feel like we steered them wrong.  And, it’s not up to us how things work out – we just do our best.  The results are not up to us.
  • When you’re the patient, you’re in charge:  Since my son owns the car, he’s the one who makes the decisions.  I know that seems very obvious.  However, when someone we care about is having a health issue, likewise, they are in charge.  We can give them input and offer our opinions.  What I’ve found though, in working with clients as well as in personal matters, is that it is empowering for others to take charge of their lives.  They need to hear themselves think through the options much more than they need my opinion.
  • Solutions are everywhere:  There are many options for dealing with this car.  He can sell it for parts, fix it, or get a rebuilt transmission.  I’m sure there are more.  Likewise, when you’re dealing with healthcare issues, there are many providers and options available.  Usually, there are more than the first two or three options that come to mind.
  • Be informed:  My son’s decision was to continue to research his options and pay for an additional month of car insurance so he can take his time figuring out what to do.  If you’re struggling with your health, the first thing to do is download my free Appointment Preparation Worksheet.  Fill it out before your appointment.  If you need help describing what’s going on that you want help with, contact me and we’ll talk about it.  You can also check out Patient Power which will help you be sure you and your provider are clearly communicating so you can get your needs met.

Doing the best we can with whatever we’re dealing with, looking for lots of options and making informed choices based on good solid information is so important to getting the healthcare you deserve.  If you’re struggling with your physical or mental health and want objective compassionate support so you can feel better, feel free to contact me to set up a time to chat about your situation.

 

 

 

 

“Once you see a pattern, you can’t un-see it.  Trust me.  I’ve tried.  But when the same truth keeps repeating itself, it’s hard to pretend that it’s just a coincidence.”

– Brene Brown from The Gifts of Imperfection

All my life, I have been ashamed to admit I have a very low pain tolerance.  I’ve tried muscling through, denying it, resisiting it, making fun of myself, letting others make fun of me and laughing with them – nothing works.

I still get queasy at the sight of blood and have been known to faint over what others label “something small.”

Last week,  I cut my finger while cooking.  It wasn’t a big cut but it was deep and I couldn’t get it to stop bleeding so I went to an urgent care facility to have it evaluated.

What follows are some details of this story along with some mistakes, and the lessons I  learned afterwards. I’m hoping that if you struggle with this sort of thing, the lessons I learned  may be helpful to you if you ever find yourself in a similar position.

I drove myself to the urgent care, calling my kids and two close friends while en route to let them know what happened and left messages for them, asking them to send my finger good vibes.

Mistake:  Do not drive yourself to the urgent care.  Take someone with you.

Lesson Learned:  Do your best to get a hold of someone you trust when you need urgent care, rather than driving yourself.

By the time I got to the urgent care, my finger wasn’t throbbing as much though it was still bleeding heavily.  So, I asked myself “What would you do if this was one of the kids?” which is my own standard of care that I apply to myself when I have concerns.  Just by asking myself this question, I knew that having it looked at was the only thing that made sense, so I gently escorted myself inside.

Lesson Learned:   It’s a good practice to apply the same standard to yourself that you would apply to someone you love when deciding whether you need urgent care.  Ask yourself, “What would you do if this happened to someone you love?” when deciding if you need medical attention.

The doctor looked at it and said that because it was so deep, I’d need a couple stitches.  He explained that he’d give me a shot in my finger to numb it, that it may burn a little bit, and then he’d stitch it.  “No big deal” – he said.

I then said to him:  “I have a very low pain tolerance and I’m the worst patient in the world!”

Mistake:  Do not kid about being the worst patient in the world.

Lesson Learned:  Let the doctor know you  have a low pain tolerance in a direct straight forward manner and that you want the maximum amount of pain medication to make the procedure tolerable.

We then proceeded to joke about my low pain tolerance and share some laughs together, along with some chit chat about a recent trip he took to Taiwan to see his family.

Mistake:  Chit chatting and laughing with a healthcare provider in a self deprecating way is inappropriate  when you’re scared of a procedure.

Lesson Learned:  Be honest about your needs for pain management.  Let the doctor know that if the pain gets to be too much, you are going to tell him to stop the procedure and give you more pain medication before he begins the procedure. (Thanks to my friend Linda, a professional caregiver, for telling me this was an option as I never knew I could do this.)

The result of my series of errors was a horrendous but life changing experience.  This was one of the most painful procedures I’ve ever had and I later learned from the nurse that there are more nerves in the tip of your finger than anywhere else in your body.  Ohhhhh, how I wish I knew that ahead of time as perhaps I would have been more assertive about my needs for pain management.

I share this with you, dear reader, because I know I’m not the only one who has a low pain tolerance.  I’m also not the only one who has tried to hide that fact or been ashamed of it.

What I have learned is that having a low pain tolerance is nothing to be ashamed of nor is it a character flaw.

After all, what is a low pain tolerance anyway?  It’s comparing how you deal with pain with how “they” (and who are the “they’s” of the world by the way?) deal with pain.  Comparisons never work when we’re talking about human behavior in my opinion as we’re all so very different.

Brene Brown also says, “Owning our story and loving ourselves through that process is the bravest thing that we will ever do.”

If you have a low pain tolerance, I invite you to lovingly  acknowledge this without shame or guilt  first to yourself.  If you’re anything like me, that step in and of itself may be very healing for you.   Should you find yourself in need of medical attention, it will be easier for you to communicate your needs clearly without apologizing or joking about it.  That way, it is more likely that the professionals involved will support you in getting your healthcare needs met with less pain.

Last night while I was making dinner and my son saw my cat Sabby lying in the kitchen, I discovered once again the parallels between dealing with veterinarians and dealing with our own health.

But, this is not a story about me and my cat.

This is a story about all of us who deal with chronic pain, depression and anxiety.  There are so many similarities  I found between my own experience and what’s common for those of us dealing with these invisible illnesses.

“Mom, look at Sabby, ” he said, ” His belly is huge.  Feel this.   He looks awful!”

It was 7:30PM, I was hungry and in the midst of making a late supper for us.   What I was looking forward to was eating (I was long overdue already!) and cleaning up the kitchen, turning in for the evening early.

I so didn’t want to hear that.

The truth is I had noticed over the last couple days that Sabby was acting funny.  He was hanging out in my room by the heater a lot and had had an accident.  I thought to myself, “Oh, it’s just this one time.  Don’t make a deal out of it, this happens.  Just clean it up and move on.”

Pausing here – stepping outside of this example – and noticing how many times I’ve noticed that I don’t feel well, and just passed over it rather than give myself a little TLC in the moment.  How many times has this happened for you?

Anyway, I’d noticed Sabby didn’t seem up to par and I didn’t really want to deal with it.  Not because I don’t care – but because I didn’t have the energy to find out what’s going on.

So, I said to Aaron, “The vet is open on Saturday and I’ll call in the morning.”

In the meantime, Aaron said, “Mom, he looks really bad to me and I have a bad feeling about this.”

Oh, how I hate when Aaron has a bad feeling about something.  I just hate it!!!

“Oh, @$%^#, ” I thought, “Now, I have to deal with it.”  I sooooo didn’t want to.  I can’t tell you how much I didn’t want to deal with this.

Fortunately for me, my vet has an emergency service which she almost always responds to.  She called me back and met me at the office.

After examining him, she said, “It’s not urinary blockage so what we need to do is blah blah blah!”  It’s not that what she was was unimportant –  it’s that I couldn’t understand it.  Nor did I want to understand her.

All I wanted to know is that he was going to be okay.  I wanted reassurance and a plan of action to take care of him.  I didn’t want details.

She continued sharing the details and my ears perked up when she said, “We need to rule out heartworm and feline leukemia.  That could have potentially devastating consequences not only for Sabby but for your other cats at home.”

OMG!!!  OMG!!!  OMG!!!!  My system was on full alert.  I might be dealing with an epidemic rather than one sick cat. As I tried to hold it together for my son who was with me, I could feel my heart sink into the pit of my stomach as tears streamed uncontrollably down my face.

My worst fears were coming true.  This was somehow all my fault.

Here’s what I learned.  As I share this with you, think about your own situation or perhaps that of someone you love who is dealing with chronic pain, depression or anxiety:

This is a No Blame Zone: It’s so common to blame ourselves when we suffer from chronic pain, depression and anxiety.  The truth is it’s not your fault. (Just like it’s not my fault that I have these things.)  It happens, life happens, and it’s up to us to find ways that work for us to deal with it.  That’s the reason I chose to teach Your Health Your Way (which will be starting again – stay tuned for more details soon)

This is Also a No Blame Zone for Loved Ones: When we love someone who is sick, it is likewise not our fault.   (Just like it isn’t my fault that the cat is sick.)  People struggle with depression, chonic pain and anxiety and we didn’t cause it.

Not wanting to deal with health issues is natural and human: No one wants to deal with health issues that get in our way.  I keep learning this over and over again despite the fact that I often ask myself, “Why didn’t you get help for this before?”  The facts are that illnesses disrupt our already busy lives and we have other things we’d rather deal with .  That’s the way it is – it’s not an indictment of our character.

So, if you’ve got health issues going on that you don’t feel like dealing with, I get it.  Permission to deal with them when you’re ready to or when things get acute enough that you feel forced to deal with them – or not.  It’s up to you.

Help – and any number of choices –  will be available whenever you decide you’re ready for it.   And with some experimentation, you’ll find things that work well for your lifestyle.  I believe that with all my heart.

Healthcare Providers may be thinking out loud:  When healthcare providers start talking in what appears to be gobbldy gook, in my opinion, it is okay to tune out of whatever they are saying that you don’t understand. Think about what is most relevant for you to get your needs met.  In my case, what I needed was to be reassured that my cat would be okay and also to know the other cats weren’t potentially in jeopardy.  I also recognized that my veterinarian needed to process things out loud in order to draw her own conclusions

Healthcare Providers often cannot offer us exactly what we are needing:  My veterinarian could actually not offer me the reassurance that I wanted. How do I know this?  Because I asked her directly, “Will he be okay?” and she said, “Char, the prognosis for your cat is not good.”  That’s not what I wanted to hear.  On the other hand, I said, “Does it look like it’s heartworm or feline leukemia which would jeopardize my other cats?” and she said, “At this point, it doesn’t look like that’s the case and I’ve ruled it out pretty much.”  Again, this is not the absolute reassurance I wanted but it helped me.

So, if you’re dealing with chronic pain, anxiety or depression – the good news is there is hope and help available for you when you’re ready for it. And when you’re not ready, there’s still that same hope and help that is available whenever you choose to attend to it.

And physicians and others who speak gobbledy-goop?  There’s ways of dealing with that to get the information that is most useful to you.

Figure out what your needs are from your healthcare provider and ask for them.  For example, you can say, “Can you reassure me that I’ll be okay?”  If that’s what you need, ask directly for it.   Even if they can’t reassure you, that knowledge is better than wondering about it in my opinion.

I offer you tools that I personally have found helpful as I’ve navigated my way through chronic pain, depression and anxiety – and found I was really ready to partner with my providers to take care of myself.  I wanted information that I could understand.  I wanted to help myself find things that really worked for me on my own .  I developed some strategies were truly helpful.

I now offer you these same tools that you can adapt and custom fit to your own ever changing health situations.  To use them in ways that feel truly supportive, loving and give you the information you need to make the choices that are right for you.

When you’re ready, there’s hope and there’s help available for you no matter what you’re struggling with.  And when you’re not ready, and just want support and understanding for whatever you’re experiencing, I hope that you find that too.

Whether you choose to read my blog or contact me personally, I believe that there is hope and help available for you – always – in ways that may be surprisingly simple and do-able.

As for my cat, it’s a waiting game at the moment.  I’m waiting for test results and while I do, I’m doing the little things that help me feel better like doing yoga, staying in touch with my kids, and walking my dogs.  Why?  Because taking care of myself is ultimately taking care of those I love.

I invite you to do the same – is there one thing that comes to your mind right now that would be helpful to you to feeling better?  Share it with us here on the blog – your ideas give others ideas too.  I’d love your good wishes for Sabby too!

If you’re anything like me, I hate filling out forms.

I particularly hate having to remember the dates of past surgeries, illnesses, etc – things I’d frankly rather forget about.That is the reason that I designed the Medical History and Summary form which is part of Patient  Power.

What I didn’t realize at the time that I designed this was that the healthcare reform act would be passed. My understanding is that for healthcare providers who are accepting Medicare, the databases are being updated and all old data will be destroyed.

That is why medical providers are now requiring you to completely redo your medical history.

The other thing to remember is that no one knows your medical history better than you do. Also, no one cares more about your health that you do.

Since you are the only one who knows and cares about your health, it really is important for you to have it written down in a place that you can find it and make it as complete as possible.

Though healthcare providers do the best they can, mistakes happen. It’s no one’s fault. However, when you are the one who was keeping track of your medical history you are much less likely to make a mistake.

Picture this. Fill out your Medical History and Summary one time. Think through the dates of all of your procedures, surgeries, allergies, etc.  it’s easier than you think – pinky swear.

Update it as your situation changes.  You’ll never have to think it through again.

Take it to your provider’s office and give it to them and they will have all the information they need.  You can go to your doctor’s appointments well prepared, taking a copy of your form with you.

Instead of feeling irritated by the inefficiency of the system, you can feel organized and on top of your game.

Let me know how this works for you.

I know how hard it can be to get that FIRST opinion when you’re not feeling well. Perhaps you’re finally willing to accept that something is wrong and you need help. Or, maybe you’re so sick that you feel forced to ask for help as you simply can’t go on feeling that way. Or somewhere in between.

In any event, I know when I am willing to ask for help I really I want someone to get it right, explain it to me in a way I can understand it and fix it the FIRST time (or at least give me some hope that it can be fixed if I do some things to help myself).

We’re taught to listen to the doctor, to not question what they say, to trust their expertise. To be a good girl. To not rock the boat. To do what we’re told. It’s so easy to silence that little voice inside us – that gut feel, intuition, knowing – that says that something isn’t working for you when you want help so badly.

I know – I’ve done it more times than I can count. I’m ashamed to say I still do it – though I catch myself quicker these days. But not always.

When I had the willingness to keep my appointment for a second opinion after last week’s adventure with the hand surgeon, the benefits couldn’t be measured til afterwards. Why? Because I couldn’t know what a good fit the second doctor would be for me til – obviously – after I had met with him.

I learned so much, not only about my own health situation, but also about what helps me know I have the right healthcare provider. This healthcare provider:

Gathers Specific Information: She asks specific questions like this: “I hear you have numbness in both hands. When you have numbness in your hands, where is it? Does it wake you up at night? On the average, how many times?” She listens to my answers and asks detailed follow up questions.

  • Explains Recommendations Thoroughly: She explains EVERY test that she is requesting and answers all my questions. She doesn’t order tests without telling me why.
  • Makes Referrals to Competent Providers: She works with other providers who are also responsive to my needs, schedule things promptly and ask pointed, specific questions while listen carefully to my responses.
  • Gives Detailed Follow Up Instructions: She asks to be contacted as soon as the follow up tests are scheduled to get me back in the office to go over them.
  • Has a Support Staff That Makes Things Happen Quickly: Her staff goes the extra mile by getting me in on a cancellation as I requested and also making sure the doctor has the test results before I arrive at my follow up appointment.

NONE of these things happened with the first surgeon. And I had that gut feel that things weren’t right – though I didn’t want to admit it to myself because, understandably, I really wanted the first hand surgeon to offer me what I wanted.

I didn’t know the difference between a responsive hand surgeon and one who wasn’t until I had something to compare it to. And, I had to be willing to trust my gut that something was off. Thank God I was willing to do that.

Having said all this, people vary. What’s the right provider for me may not be what’s right for you. And your opinion is the only one that counts when it comes to getting your healthcare needs met.

If you’re struggling with something that is overwhelming and hard for you, it’s understandable if you’re frustrated, sad, angry, numb, shocked or anything in between. Permission granted to feel whatever you’re feeling . . . . and also there’s help.

There’s more than one way to deal with what’s hurting; in fact, there’s so many that that can be overwhelming in and of itself especially when you’re not feeling well.

If you choose to see a healthcare provider, go to your appointment prepared and trust your gut feeling on whether you’ve got someone who can really help you.

Here’s the most important take away for you today:

Remember . . . . though you may be in the role of a “patient”, you’re not damaged goods. You have some issues that you need help with. You’re a healthcare consumer and making a purchase for your most important client – yourse
lf.

Get more than one opinion if you have any doubt about the first one. And keep looking for help until you find the healthcare provider that’s right for you. For every provider that is inattentive, I believe there is another provider who practices with integrity and professionalism.

I’ve heard it said that you should never go to a surgeon’s office by yourself; you need a second set of ears to make sure you get the story straight.

Though I believe that’s true, what is also true is that I didn’t have someone with me today while I was at the surgeon’s office.

And you know what?   Even though I was in pain and scared and overwhelmed by the whole situation, I felt grounded and focused.

Why?  Because I had prepared for my appointment ahead of time by using my Appointment Preparation Worksheet.  It took two minutes to fill it out.  I also kept track of my medications, symptoms and medical history using Patient Power so I had all the information I needed right at my fingertips.

At a time when I felt so vulnerable, I had the tools I needed to stay on track and remember what hurts, what makes it better, and what aggravates my symptoms.

And you can have these simple tools too, and walk into your healthcare provider’s office feeling clearheaded and secure.

Here’s what happened to me:

I arrived early, filled out the necessary paperwork and was greeted promptly by a very helpful nurse who performed some initial tests.  So far so good.  However, I was thrown off track because, after explaining my symptoms and how the computer aggravated them, the surgeon said:  “You have bilateral carpel tunnel and it’s a myth that working on the computer causes carpel tunnel.”

I felt angry when he said that and I said to him, “What I’m saying to you is that my symptoms are worse when I’m on the computer, and I know that for a fact.”

He simply retorted: “And what I’m telling you is that the computer is not causing your symptoms.  The computer has nothing to do with your symptoms.”  He then went on to quote a prominent study to support his statement.

To tell you the truth, I wasn’t interested in science.  I wanted help understanding why my hands hurt, what my diagnosis is and what my treatment options are.

Telling me that my symptoms, which are most intense when I’m on the computer, are not caused by the computer felt invalidating and unsupportive.

Though he may be correct and I’m sure he’s up on the latest scientific studies, this kind of information did not give me the feeling that he understood how much I use my hands for work and how this adversely affects my daily life.

This is just the kind of thing that happens to me (and lots of other people) all the time.

When I’m uptight and uncomfortable and a healthcare provider appears to be challenging me on the legitimacy of my symptoms, it’s easy to forget why I’m asking for his expertise.

(In fairness to this surgeon, I’m sure what he was trying to do was to dispel a myth about carpel tunnel and give me some data in support of his statement.  It just wasn’t a match for my needs for empathy and understanding.  And it caused me to momentarily  lose my focus about what I really wanted information on.)

Here’s what’s important for you to remember:

If you tend to get overwhelmed when you’re dealing with your healthcare provider, by writing things down you can stay on top of your game. Just the act of writing things down helps you remember them even if you forget to look at them as you’re talking.

Why?  Because writing things down gives your brain a break from remembering things. And everyone’s brain deserves a break in this very hurried world we live in.

If you are forgetful – as I am –  writing things down helps as well.

And, if you know you’re forgetful, you can train yourself to look at what you’ve written down OR go back to the office (as I did) when you forget to ask something important.

Next, when a healthcare provider is talking so quickly that you can’t take it all in, you can verify your understanding by using my materials. It’s easy to make sure you’ve understood what they’ve said correctly and a good provider will want you to understand their recommendations clearly.

Give your good brain the rest it deserves especially when you’re not feeling well.

Prepare ahead of time for your appointments, make sure you got the story straight, and then you’ll have what you need to use the healthcare system in a way that works for you.

As a Jewish Mother, let’s just say I fit the stereotype of overprotective quite nicely.   Though I know there are some things that are better left unsaid, the frustrated lawyer in me sometimes gets pretty indignant about things when I feel life has dealt my kids something they didn’t deserve. I do a fairly good job of keeping myself in check so they can learn the lessons that are available for them when things don’t go as planned . . . . . but what happened to my oldest son the other day has really got me steamed up. With his permission, I’ll share this little rant.

He has had some serious bad bike karma.  Two times now his bike has been stolen.  The first time happened while he was in college.  The second time, he loaned his bike to his roommate who went out and “forgot” to lock it up in Washington, DC.

Apparently, bike thievery is rampant there and you’re asking for it if you don’t lock your bike up in at least two places.  After collecting the money from his roommate, my son proudly purchased a new bike complete with two bike locks from Revolution Cycles in Washington, DC.   His bike is his primary mode of transportation and he made his selection carefully, being especially mindful about bike security – hence the kryptonite lock plus the cable lock recommended by the store.

Three days later, while out to dinner with his friends, he comes out of the restaurant to find his wheels and seat which were locked up with the cable lock missing. Immediately he contacted the store and shortly thereafter took everything in.

The store was completely unsympathetic, wouldn’t stand behind the cable lock that they sold him and the cost to replace the wheels and seat were almost as much as a brand new bike. When I heard this story, I went bezerk.  How could they not be sympathetic to his situation?  The bike was three days old.

The fact that this store sold him the cable lock expressly to protect his wheels and seat, and still were  unwilling to stand behind its product- which is the reason he bought it in the first place – was appalling.

My son is self sufficient financially and did everything he could to protect his property, and some idiot decided he needed his wheels and seat for reasons I’ll never understand

He said it’s a bought lesson – his next bike will be a cheap used one. I guess, given his bike history, that makes sense.

Though I agree with his conclusion, I have a big problem with Revolution Cycles and the way they handled this situation. They are out of integrity when they didn’t offer some reasonable ways to handle this unfortunate situation.  Had they offered him a discount, a refund on the lock, some used parts, or some other accommodations given the way this happened – I’d feel differently.  Their unsympathetic uncaring attitude is deplorable.

There are bigger problems in the world than a stolen bike I realize.

And since my passion is helping you make informed choices about your healthcare, I would like you to consider your relationship with your provider, and a health situation that you’re in the process of addressing. Like the bike shop I mentioned, your healthcare provider is advising you on what you need to do to take care of yourself.  I want to be sure that your needs are being met – and that you’re not being offered solutions that won’t work, much like this cable lock that turned out to be worthless.

Perhaps you’re frustrated that your provider doesn’t fully understand your situation as you’d like her to.  Maybe you’ve used my Appointment Preparation Worksheet, been as clear as you know how to be about what’s going on with you and your provider still isn’t getting it despite numerous office visits.

Just like my son who used two locks on his bike to keep it secure, you’ve done all you can to be sure your healthcare provider understands what your needs are.  Maybe you keep shelling out money and time – and you’re getting nowhere.

Or perhaps your frustration is with some of the staff who aren’t getting your messages straight, not returning phone calls or not getting your prescriptions correct.

If you’re frustrated, I get it. I’ve lived my own version of all these scenarios and I know how exasperating it can be to be doing everything possible to be pro-active about my health and still not get the attention I need costing me time, heartache and unnecessary expenses.

But, here’s where it gets interesting.

Instead of deciding that that’s just the way it is, here are a couple options:

  • Speak up: Tell your healthcare provider exactly what isn’t working for you and what you want in one sentence.  Ask them if they can help you with it?  Clarify that you understand their answer and then make a plan together complete with follow up instructions.
  • Send a Letter:  If it’s a staffing issue, send a letter factually describing the problem to the provider and suggest that they read your letter in a staff meeting.   If you want a response to your problem, let them know that.  If you just want to make them aware of it as the situation has been resolved already, you can let them know that as well.  If your healthcare provider doesn’t know how their staff is interacting with their patients they can’t correct any future problems.
  • Find Another Provider: This one is often easier said than done especially in these days where primary care providers are harder to find.   If you’ve been with your provider for a while, it’s important to weigh whether the benefits truly outweigh the burdens and whether it makes more sense to speak up or send a letter.
  • File a Complaint: This is a legitimate option where the provider’s conduct has been unconscionable and not one to undertake lightly at all.  At the same time, there’s a reason we have licensing boards, ethics boards and similar administrative agencies:  they are there so that all patients are protected from behavior that is unprofessional.  If you choose to use this option, I strongly encourage you to let your provider know that that is what you are doing and give them a chance to resolve the situation first.

I felt sad when my son decided it was time to get a cheap used bike as he couldn’t afford to keep the bike of his choice safe in the streets of DC. I want him to be able to have a nice bike and enjoy it – and this is out of my control.  He has to make the choices that are right for him and no amount of Jewish mothering will insure that his bike won’t be stolen again in the future.  I think he’s smart to cut his losses and get a cheap bike actually – though I hate to admit it.

I also feel sad whenever I hear of patient’s whose healthcare needs aren’t being met.

I do believe that “the squeaky wheel gets the oil” (pardon the terrible pun) and if you aren’t getting your healthcare needs met in a way that works for you, you owe it to yourself to go back to the drawing board.  Look at your options. See if you can address the situation with your healthcare provider first.  Or, if you’d rather be done with that particular provider, figure out exactly what was missing in that relationship, get referrals from people you trust, and interview new providers before allowing them to treat you.

Are your healthcare needs being met in a way that’s working for you? If so, that makes me happy.  If not, you’re welcome to contact me privately or leave a comment and we can brainstorm on how to get your healthcare needs met in a way that’s a match for your needs.

Can We Talk??

August 25th, 2010

Have you ever been out to lunch with someone and they ask you a question when your mouth is full?  What do you do?  If you’re like most people, you probably never thought about this – and I wouldn’t think about it either – if it hadn’t been for this story someone shared to me about a recent dental visit.  But, I’ll get to that later.

Coming back to our original story here.   How do you answer a question when you’ve got a mouth full of food?

Ann Landers would say that the polite person notices your mouth is full of food and waits to ask you a question.  Or maybe she would say that you hold your hand up before responding, finish chewing and then respond.

And in this hurry up world of ours, I often find myself answering questions with my mouth full. I know – not a pretty site.  Since I love food, I tend to rush while I’m eating anyway.    If I’m answering as I’m in the midst of a mouthful, chances are good that I’ll answer the question quicker or less thoughtfully than if my mouth was empty.

Which brings me to this story about the dentist.  Have you ever noticed that the dentist asks you questions with his hands in your mouth?  Talk about having your mouth full!

I can understand when a dentist is probing for sensitive areas and has to get feedback as he’s poking around.  It makes sense that he would say something like:  “Does it hurt when I touch here?”   It’s easy to give yes or no feedback – even a grunt will do the job.

But, when they ask things like, “When did you first notice this pain in your gums?”  it’s almost impossible to fill them in on the whole story. If you’re anything like me, I struggle to give a complete response so I give them less information than I would otherwise.

The other thing that has surprised me is though I know what I am saying, it comes out pretty unintelligibly and yet they seem to get what I’m saying.  How do they do that anyway?

And when they don’t have all the information they need, it makes it harder for them to do their job.

Once I heard this little vignette, I tuned into my own dentist’s modus operandi.  I’ve been with her a long time.  I also have to say that I’m a dental nut.  My beloved Uncle was my dentist and he instilled in me the importance of good oral hygiene while I was in utero.  I interviewed my dentist extensively before deciding she was a good fit for me and my family.

Anyway, here’s what she does every time I see her.  She reviews the notes from her assistant which are on the computer, she comes and stands in front of me, asks me whatever her questions are and THEN probes around checking for sensitivity and other issues.

If she asks me something I can’t answer fully, I stick up my hand and let her know.  Why?  Because I want to get the best care possible and I know she needs all the facts to do this.

When she’s done examining me, she tells me what she’s found without her hands in my mouth.  I make sure I understand her instructions and then we usually share a quick laugh about something to do with our kids.  I have always appreciated her – but I never knew why – until I heard this little story about dentists talking to patients with their hands in their mouth.

The world moves quickly as we all know. It’s up to us to stay connected enough with our own experiences to let our provider’s know when what they’re doing is interfering with our ability to either give information or understand what they are saying.

Here’s the important part.  If your dentist is asking you questions and you can’t respond fully as their hands are in your mouth, stick your hand up or find another way to let them know you’ve got more to say.  If a doctor is probing around and telling you about treatment options, findings, or anything else – and you’re feeling distracted by what they’re doing to you and trying to listen at the same time – say something.

You may think they don’t have time to listen or that this is no big deal – and that may in fact be true some of the time.  But, tune in to when it’s not true and when you’re censoring yourself because you’re really not in a spot to talk about what’s going on with you or you can’t listen fully.  By gently noticing this, you can trust that you’ll know when it’s time to find another way to get your healthcare needs met without “talking with your mouth full”.

I was at the dentist today getting my teeth cleaned and the hygienist and I were chatting about our kids.  We were talking about how, at a certain point, it does no good to strategize for them – especially when they aren’t interested in our point of view.

She then was describing how her daughter, who has an hour commute, calls on the way to work most every day to talk about “this, that and the other thing”. I laughed remembering how I used to do the same thing with my Mom when I was in my 20’s and how my two boys answer most questions pretty straightforwardly – there is NO “this, that and the other thing” with them.

Which also made me laugh because “this, that and the other thing” is a pretty common way of describing what’s going on with us  a lot of times.

But, the problem with describing things generally like this or in a rambling way is twofold:

  • We may not know what we really want or need
  • Someone else may not know what we want them to do or say to them

Here’s an example.

I was talking on the phone with my friend Janet who was telling me about “this, that and the other thing”.  There wasn’t room for me to get a word in edge-wise other than an uh-huh or a quick question.  Janet wasn’t interested in what I had to say – or so it seemed.  I actually never got around to asking her because she had to go.

I’m not sure if there was anything in particular that Janet wanted me to know about or whether she was asking me to do something.

What I do know is that though I felt engaged with her story and interested in the details, I wished there was some room for me to share what was going on in my world.

The truth is – I never asked her to listen to me so I can’t know what would have happened.   And that’s no one’s fault.

So, what does this have to do with ‘this, that and the other thing”?

Here’s the point.

When we talk about things in a general way to other people when we really want them to know something specific, it’s difficult to get our needs met. In terms of taking care of your health, in my humble opinion, there is no place for “this, that and the other thing”.

There is a huge need for sharing specifics about what’s not working with us and what we want help with.  Here’s a way to do this so your healthcare needs can be met in a way that works for you.

I read this blog post which was a letter from a physician, Dr. Rob, to patients about looking at healthcare from the provider’s perspective.  You can read it here.

This shocked me.  Healthcare providers are often afraid of their patients.

After really acknowledging how hard it is to be a patient in pain as well as the inherent difficulties of explaining it, Dr, Rob goes on to say:

You (speaking of patients here) scare doctors.

No, I am not talking about the fear of disease, pain, or death.  I am not talking about doctors being afraid of the limits of their knowledge.  I am talking about your understanding of a fact that everyone else seems to miss, a fact that many doctors hide from: we are normal, fallible people who happen to doctor for a job.  We are not special.  In fact, many of us are very insecure, wanting to feel the affirmation of people who get better, hearing the praise of those we help.  We want to cure disease, to save lives, to be the helping hand, the right person in the right place at the right time.

Whaaaat?  But they have all this training, they make all this money, surely they’ve been trained in how to deal with this stuff.  And besides – I’m hurting here and I n-e-e-e-d their help. I’d never considered that a healthcare provider could be afraid of me when I’m so absorbed with my own story.

Frankly, this idea that a healthcare provider might be afraid of anything was shocking to me.

So, what are they afraid of?  Dr. Rob does an amazing job of explaining this here:

You don’t get better, and it makes many of us frustrated, and it makes some of us mad at you.  We don’t want to face things we can’t fix because it shows our limits.  We want the miraculous, and you deny us that chance. They (meaning healthcare providers) may feel overwhelmed by the complexity of our symptoms.  They’re (again, speaking of healthcare providers)afraid that no matter what they suggest, there may be nothing that can be done.

And, as I read that, I realized that these are the same things I am afraid of sometimes when I have pain. I’m afraid no one can help me and no matter what they suggest or what I try, it won’t work.  I’m afraid I need a miracle and there just isn’t one.

Interesting that we both may share the same fears.  We touch on their mortality as we are feeling our own when we’re in pain and can’t figure out how to make ourselves feel better.

It opened my eyes to how important it is to be kind, not just to ourselves (which can often be very challenging and is at the heart of my work) but also to our provider’s that are often, frankly, afraid of us.

Of course, it makes sense that regardless of how much training a healthcare provider has had – they are human just like us.  It’s difficult to see others in pain; it often brings up our own pain and vulnerability when we see others hurting.

I really respect healthcare providers who do their best to help us when we’re struggling.  I also know that there are some healthcare providers who, for whatever reason, are unable or unwilling to listen to us and explain things clearly. For every provider who is trying their best, there are just as many who aren’t.  That’s reality.

It’s also true that there are countless horror stories of patient’s whose needs have not been met by their healthcare provider.  There are many cases where patients have felt more harmed than helped which often leads to fatal or long lasting consequences.  When we hear of one of those situations or are personally affected by something like this, there are no words for the aftershocks and I am in no way discounting those situations.  This post does not address those very unfortunate circumstances that I just described and my heart goes out to anyone who has been through something like this.

There are also insurance, financial and practical considerations involved that may limit our choices.

And, despite those limitations, I urge you to find the provider that speaks the same language as you do and work hard to build that relationship – because I truly believe in the goodness of human beings and healthcare providers in particular.  And, where there’s a will there’s a way to find the healthcare provider that is right for you.

I’m not suggesting you treat your healthcare provider with kid gloves.  I am urging you to find the provider who is a good match for your needs and to appreciate their humanness as you share what’s going on with you.

In the best circumstances, we partner with our providers to improve our health.  That requires mutual respect, clear communication and a willingness to be appreciative of each other’s position.

Just as you’re asking them to understand – to get – what it’s like to be you, it’s important that you get that they’re human beings too.

What do you think?