Know your choices

So, I went to the dentist sometime near the end of my first trimester of pregnancy. It had been a stressful pregnancy. Apparently I’d been grinding my teeth. The dentist said I should get a bite guard. Ugh. Did I ever hate that piece of wax that fit way too firmly on my upper teeth. It hurt, it made it harder to breath and it made me talk funny. The only thing I liked about it was that I could sing songs (i.e “I will Survive”) and laugh at myself in the mirror. But did I mention that the thing hurt? I hardly wore it.

About a year later, when I went for my annual cleaning, I admitted to the doctor that I hardly ever wore my bite guard. What did he say?

  “You know a lot of people like ones that fit on the bottom teeth better.”

“What the hell?!?!?!?!?”
“Yeah give me one of those!” And he did -for free. Guess what? The bottom bite guard does not hurt as bad, it’s not as hard to breath and I don’t sound as stupid when I talk.
So, if a doctor ever gives you a medication or treatment plan that you are not comfortable with, ask about all your options. You might be able to find something that works better for you. (and if not just put in a mouth guard and sing “I will survive” after all, laughter is the best medicine).

-Ava

Give 'em all the info

            I recently read in the Readers Digest (April 2011), that doctors may be missing important information about women’s breast cancer risk. The health brief stated that while medical providers often ask if there is any history of breast cancer in the patient’s mother’s family, they but often neglect to ask if any women from her 
father’s family have had cancer.

           So, ladies when you are at the doc make sure you volunteer any information you have about womanly troubles on your father’s side of the family.
           Gentlemen, you can take this advice and flip it. Be sure to let your doctor know about any diseases the males on your mother’s side of the family have experienced.
           Unless you were adopted, like me, then you can save yourself a few minutes on those long forms you have to fill out in waiting rooms J

Your next appointment will be...never

       When I was in 7th grade,  I went shopping at the mall with a friend. I tried on a shirt I liked, but I wasn't quite sure if I wanted to buy it, so I put in on hold.

        “We’ll keep this until we close at nine,” the saleswoman said to me pleasantly.

        “What happens if I decide I don’t want it?” I asked my friend, Amanda, a little too loudly.

        “Shhhhh, you just don’t come back.”

        You just don’t come back. It’s that easy! If you put something on hold and decide you don’t want it, you just don’t return to the store. A staff member will put it back on the rack where it will wait for somebody else to buy it.

        When I moved away for college, I started doctor shopping. Finding the right health care provider is important. You want to find someone with whom you feel comfortable. You need someone who cares about you, and seems to actually know a thing or two about medicine.

        When I don’t like a doctor, I just cancel my appointment and never re-schedule. I usually feel kind of bad about that though. Am I treating the doctor like that shirt I didn't want to buy.? I always assume that they have so many patients, they will never notice I’m gone. Do they deserve to know why I left though? Or do they just think nothing of it? People change doctors all the time. It’s that simple. Or is it?

        I really want feedback here because I seriously don’t know what’s proper. Is there some type of etiquette  we should follow when leaving a health care provider's practice?

Why Do They Do That?

I found this article on MensHealth.com 

What Your Doctor Tests for During a Physical

By: Maggie Grodon

Blood-pressure check? No mystery there. Same for the trip to the scale—which is way off, of course. But what's with the penlight and little rubber mallet? Here's what your doctor's looking for when he . . . 

1. . . . asks you to say "ahh." 
He's looking for swelling or discoloration in your mouth and throat, which may indicate oral cancer. This test also checks if your palate and uvula—the punching bag at the back of your throat—contract at the same time. If they don't, your glossopharyngeal and vagus nerves may not be working properly. "This can signal problems such as a stroke, brain tumor, or multiple sclerosis," says David Deci, M. D., a professor of family medicine at the University of Wisconsin. 

2. . . . shines a penlight in your eyes. 
Your doc is testing your optic nerves, which transmit visual information to your brain, as well as the oculomotor nerves that control your eye muscles. "If your pupils don't dilate or dilate too much, that could indicate nerve damage," says Dr. Deci. That damage could involve the specific nerves or be centered in your brain, possibly as a result of a stroke or reduced bloodflow. 

3. . . . taps and presses on your abdomen. 
This helps detect an enlarged—and potentially infected—organ. "When I tap over your liver or spleen, the sound is dull. It becomes more resonant as I move off the organ, helping me gauge its size," says David Simel, M. D., chief of medicine at the Durham Veterans Affairs Medical Center. Your doc may also press in as you take a deep breath. This pushes your diaphragm down, shifting your liver and spleen so they're easier to feel. 

4. . . . hits your knee with a small mallet. 
This classic reflex test exposes nerve or metabolism problems. If you have lower-back pain, for example, and your leg barely budges when your doctor taps your knee, then some of your spinal nerves may be damaged, says Dr. Simel. An x-ray may be the next step. A karate kick could indicate an overactive thyroid. In that case, flooding hormones can make your reflexes more forceful.

Read more: http://www.menshealth.com/mhlists/medical_exam/index.php#ixzz1Lgu3CZ5x

Pain Management for Vaccinations

Did you know that you can numb your child’s skin before he gets a vaccine? My pediatrician prescribed me Lidocaine and Prilocaine cream. About a half hour before my daughter, Vayda’s, doctor visit, I rub a little on her legs. She stills feels the pressure of serum in her muscle, but she doesn’t feel the needle so it’s less painful. I’m happy that I can spare her at least a little pain. The last time she got a shot she didn’t even cry!

            

          If you are interested in learning more about how to help your little ones get through their vaccines check out these articles:

http://www.whattoexpect.com/child-vaccinations/minimizing-pain-for-infants.aspx

http://tnpedfoundation.org/PDF/ReducingChildrensVaccinationPain.pdf

-Ava

Separation of Church and Hospital?

                 After leaving my midwife’s office one day, my husband said, “She does not practice secular medicine.” He’s right. My midwife, Lillian, has mentioned God at least once during most of my visits. While I was in the depth of my postpartum depression, she said she would pray for me. That was nice. Here’s what wasn’t nice:

                While in labor, (a natural labor I might add) I kept saying “oh God, oh God” during powerful contractions. Then I would correct myself “Godddd, I mean gosh. Oh God, I mean gosh.”

                “It’s OK to say God,” Lillian told me.

                “Yeah, because he did this!” I screamed.

                “No, no, Eve ate the apple.”

                Excuse me? I’m not even sure if I believe in Adam and Eve, but I know I don’t believe that the pain of labor is a woman’s punishment for a biblical person eating a piece of fruit.

I was very concerned that I had offended Lillian though, so I apologized a few times. Looking back, that seems wrong. Didn’t I have enough to worry about without apologizing for something I said while enduring an excruciating contraction?

                I tend to describe my postpartum depression as “living in Hell.” I would never say that to Lillian though, I’m afraid it would offend her. I sometimes wonder what she would do if someone did say something that offended her. Would she tell the patient that she is not comfortable being her midwife?

              

           I want your opinion. Should health care providers talk about their religious beliefs with their patents? What about the other way around?

­-Ava

Hello, my name is Dr. X. You need to trust me.

       Doctors don’t always like me. Why? I ask questions. I try to learn about the reasons behind the decisions being made about my health and explore all my options. I feel like I have a right to know why these decisions are being made about my body.

        This makes some doctors nervous; they think I don’t trust them. It doesn’t matter if I met them five minutes ago; they expect me to put blind trust into their choices. One example of this is a psychiatrist I saw in the psychiatric hospital. He wanted to change all my medications, taking me off of four of the drugs I was on and adding two new ones. I told him I was uncomfortable with that because it’s hard on my body to switch medicines and I knew that once I left the hospital my psychiatrist on “the outside” would want to change everything around again. The doctor said to me, “While you are in this hospital you have to trust me." The truth was, it didn’t matter whether I trusted him or not, I had no choice but to accept his decisions. They wouldn’t just let me leave the hospital and the nurses were in charge of administrating my medications, there was no way for me to take the medications I wanted to. With defeat and tears in my eyes, I said “okay.” I would take whatever he wanted to give me. After he wrote out all of my prescriptions he asked if I was okay with the changes. I shrugged and responded “I don’t think I have a choice.” He didn’t reply.

                   

          Sure enough, once I was on the outside, my psychiatrist wanted to make a few changes as he was unhappy with the choices that the hospital doctor made.

         “I would like to increase your Lamictal”

         “Can we wait a few weeks?” I asked because things had been going better for me at this point.              

        That simple question caused the doctor to go one a huge rant about how I should probably find a different psychiatrist because I didn’t trust him. There was that word again – trust. Did I trust him? Heck no! He made a lot of contradictory statements and did not show me the respect I felt I deserved. Wanting him to end the lecture, I agreed to do whatever he wanted, this time with tears and snot running down my face.

                   

       When I was getting ready to leave his office, we scheduled another appointment for two weeks. I did not keep that appointment. I once again started a search for a psychiatrist that I felt like I could trust.

                   

       In conclusion: a patient should be able to trust their doctor. But not just because the doctor tells them they have to, because the doctor shows them respect. Doctors know more about the diseases and medicines but patients know more about themselves. The two need to work together to create harmony and balance.

                   

       All right, now I want feedback. What does a doctor need to do to make you feel like you can trust them?

       And for you health care professionals reading this – how does it feel when you don’t think a patient trusts you and what do you do about it?

-Ava