Preparing for Doctor’s Visit

Purpose of Consult a doctor or doctor visit are following  :-

  • To identify and diagnose about the signs and symptoms of your complaints
  • To get a medical treatment of the diagnosis
  • To regular follow up

Papers to Carry  

Medical History Card

Make sure you always bring along a record of your key information, including medical conditions, dates of past surgeries, current medications, doctors’ names and contact information, next of kin and contact information, health insurance and any drug allergies.

Changes to Your Medical Record

If you’ve received any new test results since your last visit, bring them with you, even if you believe your doctor has already seen a report. Having this information on hand at your appointment ensures that you’ll remember to discuss it with your physician. This is particularly important if you are seeing a new doctor or specialist.

Your Prescription Drugs

Before you leave home, gather all your medications and put them in a zip-lock bag. Tell your doctor if you’ve stopped taking any prescribed drugs or haven’t followed dosage instructions. Be honest: If you mislead doctors about prescription compliance, they may assume your medications are not working and prescribe even more.   

Journal of Your Symptoms 

If your visit is related to a new concern, you should be keeping a journal that documents your discomfort and how it has affected your daily life in the days or weeks since it began. If your appointment is focused on a chronic condition, your doctor may have asked you to keep track of your response to new at-home treatments; to record objective measures, like your blood sugar; or to note subjective perceptions, like the intensity of a recurring headache. Whatever the information, bringing the journal to your appointment can help your doctor better understand what has been going on.

List of Questions

List of Questions You should expect your physicians to be responsive to your concerns, but you need to do your part as well. Always come to an appointment with a list of questions prepared in advance. Brainstorm your questions well before your visit, then note down a concise list, arranged in order from most to least urgent. And don’t leave your doctor’s office without asking them.

Notebook and Pen

This may seem obvious, but it’s important to take notes throughout an office visit. If your doctor mentions an unfamiliar term, get him to spell it out. Don’t hesitate to push for clarifications. At the end of every visit, request a verbal summary and write it down. Before you leave the exam room, review what you’ve written about your treatment plan; if there’s anything you don’t fully understand, ask again.

Friend or Family Member 

Having someone with you can provide crucial moral support. But it’s also a valuable means of ensuring that your doctor addresses your most important questions. A friend or relative may not be able to sit in during the physical exam, but he or she should be welcome when you and your doctor discuss diagnosis, testing or treatment. That’s when a companion can remind you of your primary questions and concerns.
 
Your Smartphone 

There is always some downtime during an office visit. It’s also useful to have your phone on hand if it carries your calendar so you can schedule follow-up visits and screenings.

Snacks

Snacks so you can maintain your energy and mood.

Filing tips/ maintaining medical records

The first step in organizing your personal medical record is to collect hard (physical) copies of as much information about your treatments and diagnoses as you can from all your caregivers, including physicians, nurse practitioners, physiotherapists, psychologists, etc. Keep in mind that federal law requires all doctors and medical facilities to allow you access to your medical records.

  • Remember to be polite and patient when asking to access your medical files. Tell them it’s to establish your own personal records. Some doctors and medical facilities might be hesitant to allow you access due to fear of malpractice litigation.
  • Your caregiver may need some time to organize your medical information because it may not all be in a single file. Schedule an appointment to come back if that’s the case.
  • Keep in mind that a personal medical record combines all the medical information collected by each caregiver/medical facility that you’ve been to into a single file that’s easily accessed.
  • While law gives you the right to access most of your Patient Health Information (medical records, imaging, test results, billing records, etc.), some types of information are exempted. For example, you do not have a right to access psychotherapy notes (i.e., notes taken by a mental health professional during a counseling session) or documents compiled for use in a civil or criminal proceeding like medico legal cases.

Copy all the documents in your medical files. Once you’ve notified the caregiver of your intentions and they’ve organized your medical information, it’s time to make copies of it all. Your personal medical record should include copies of all test/lab results, diagnoses, treatment reports, radiology reports, progress notes insurance statements and referrals from each caregiver/medical facility you’ve visited. Don’t expect the actual caregiver to copy your file for you. Likely their support staff will be the ones to do the actual copying.

  • Although you own your medical information, you don’t own the actual paper, files and x-rays that your info is on, so don’t expect to walk out with the originals. You’re only entitled to copies from the originals.
  • Your caregiver/medical facility has the legal right to charge you a copying fee, so ask how much it might cost. They may charge per page or a flat fee for the copying service and it may vary according to the hospitals.
  • You’ll likely need to sign a release form at every facility that you request records from.

To read more on Patient Care, click on the link below.

Patient Care

Content Courtesy : Portea

Understanding Diabetes

Understanding Diabetes by Famhealth

What is Diabetes? 

Diabetes is an endocrine disorder that elevates your blood sugar levels over a prolonged period of time. It is caused by the malfunctioning of the pancreatic cells, which produce insufficient or no Insulin.

Why is Insulin so vital ?

Insulin is the hormone that is responsible for the process that converts carbohydrates into sugar; which is then stored it in the body for future use. Insufficient or no secretion of insulin from our pancreas leads to an imbalance in the body, causing liver cells to convert glycogen to glucose and accumulate in the blood stream.

Indications of Diabetes

Some of the most common symptoms suggesting the onset of diabetes are frequent urination, frequent thirst, frequent hunger (even after full meals), unexplained burning, itching or rash in the body, specially the foot, bruising easily, slow healing of wounds or clotting of blood when the skin is broken/cut, tingling or numbness sensation in the extremities of the feet and hands as also extremely low energy levels. However, often these symptoms could go unnoticed leading to undetected diabetes. Hence, it is always a good idea to get yourself regularly checked by a doctor for preventive healthcare.

Why did I get Diabetes?

Leading Endocrinologist Dr Sanjay Kalra from Bharti Hospital, Karnal shares his perspective on why diabetes is spreading like an epidemic. Nearly 70 million Indians are living with diabetes today. This is not a small number. Our genetic make-up is tuned such as to store fat reserves in the body in order to survive severe weather conditons such as famine. In ancient times, these stored food reserves or lipids were converted into energy in the bodies of our ancestors, so that they could survive the harsh living conditions. Cut to the present generations, lifestyle, stress levels, sedentary life, lack of physical activity, unhealthy diets, all contribute to surplus reserves for the body. As a result, the pancreas gets overworked and starts malfunctioning.

Am I at Risk?

There are several factors which may cause diabetes but medical science is yet to ascertain the main cause responsible for a specific person. However research indicates that the following conditions make people twice more likely to get diabetes than those without these conditions.

It could be genetic, family history has a strong role. Other factors such as obesity, high blood pressure high triglyceride levels, presence of diabetes autoantibodies, substance abuse, or excessive consumption of alcohol and tobacco.

Diabetes Ranges

Age 20 and above 
amounts shown as 
mg/dL
FastingLess than 100
Before Meal70-130
After Meal (1–2 hrs)Less than 180
Before ExerciseIf taking insulin at least, 100
Bed time100-140
HbA1cLess than or around 7.0 %

SOURCES: American Diabetes Association. “Standards of Medical Care in Diabetes—2014,” Diabetes Care, January 2014.

Shown above are blood glucose ranges defined by American Diabetes Association. You’re kindly advised to refer to a doctor as the values may differ slightly with different age & gender.

What is Prediabetes?

When the blood glucose levels are borderline or higher than what they should be. But not as high as people with diabetes is known as Prediabetes. This condition is a “whistle blower” and indicates that you may proceed towards diabetes type 2, if you do not make the necessary changes in your lifestyle.

What are the Types of Diabetes?

You may have already undergone tests and your doctor may have already explained if you have Diabetes, and if so, the specific type you are living with. As a general understanding, the following classifications should give a sense of various types of diabetes:

  • Type 1 Diabetes:
    • Type 1 diabetes is when there is insufficient or no production of insulin in the pancreas. This condition requires external insulin to help your body convert sugars to energy.
  • Type 2 Diabetes:
    • Type 2 diabetes is when the pancreatic cells, become insulin resistant due to a defective response in the receptor cells in the body. This is the most commonly found type worldwide.
  • Gestational Diabetes:
    • Gestational diabetes is when blood sugar levels are raised during the time of pregnancy. This is most likely a temporary condition, in which blood sugar levels are often likely to come back to normal after the delivery.
  • Latent autoimmune diabetes in adults:
    • LADA is when autosomal alterations can lead to defective BETA cell function, resulting in Type 1 diabetes. LADA is often misdiagnosed as Type 2 diabetes in India.

Complications

Diabetes is called as a silent killer because many people remain undetected till such time as the consistently high blood glucose levels start affecting other organs such as the heart, the kidney and the liver – referred to as Macro-vascular complications and the nervous system resulting in foot, gum or vision problems called Micro-vascular complications.

Check for other important co-morbid conditions:

  • Diabetic Retinopathy
  • Kidney Disorders
  • Diabetic Neuropathy
  • Chronic Vascular Disease
  • Liver Disorders
  • Erectile Dysfunction
  • Polycystic Ovarian Disease

What else do I need to know ?

Often many people remain undetected till such time that consistently high blood glucose levels have already started affecting other organs such as your heart, kidney, liver – referred to as Macro-vascular complications, and your nervous system resulting in foot, gum or vision problems called Micro-vascular complications.
If you are “suffering” from any other life style conditions, “co-morbid conditons” consult your endocrinologist/ diabetologist. Your doctor will prescribe specific medications and solutions to manage this or any other complication.

To read more on Diabetes, click on the link below.

Diabetes food

Diabetes excercise