Being an Empowered Patient
There was a time, years ago, when the family physician took the time to treat each and every one of our ailments. Children of previous generations were cared for by a single pediatrician, one who knew them well enough to recite their medical problems without a chart in sight during a leisurely visit in the examining room.
Today, things are different, and medical care is often much more impersonal. If you're in a managed care plan, you may see a different practitioner every time you visit the doctor's office. And you'll rarely spend much more than fifteen minutes with your doctor. So it's important for patients with any type of serious illness, and particularly one like migraines, to find a way to work within the health care system to receive the care they need.
Medical mistakes and prescribed drug interactions are at an all-time high. Medical errors in the United States alone result in between 40,000 and 90,000 deaths annually. While computerized systems are designed to look for drug interactions, it's a good idea to talk to both your doctor and your pharmacist when starting any new drug.
One of the most important aspects to managing chronic illness, and to becoming an empowered migraineur, is acceptance. Migraine, or any other chronic disease, disrupts life. Recognition of this painful but important fact is necessary before it is possible to change your situation.
Along with acceptance, recognize that anxiety, fear, and even anger are appropriate emotional reactions to a chronic diagnosis. Life changing events come with some emotional cost. However, just as you would manage the disease with a treatment plan, emotions can be channeled as well. Often with the help of a trained counselor, you can develop strategies for dealing with these emotions and reestablishing control.
It is important to remember that there is no blame, responsibility, or failure associated with being diagnosed with a chronic illness. Patients may experience these emotions, and they are valid ones. However, with sufficient time to grieve the loss of your past pain-free life, as well as time to acknowledge the role that pain may play in your future life, healing and empowerment can begin.
Each physician comes to the table with his own personal opinion and viewpoint. He may not be aware of research out of his immediate line of expertise, or he may disregard certain therapies as “new and untested,” or “old and irrelevant.” The responsible patient has a duty to inform herself of all the options, and present these to her physician for discussion and evaluation.
One caveat here — remember that your doctor is your partner in health care, so present your questions and comments on migraine therapy in a collaborative, not a combative, way. There is a tidal wave of health information currently available to consumers on the Internet. This has been a double-edged sword for the medical profession. On the one hand, patient education is always a positive thing; a person who takes the time to seek out information on her condition and teach herself is more likely to adhere to a treatment program. But on the other hand, physicians have to spend increasing amounts of time dispelling health hoaxes and migraine myths, sometimes to the disbelief of patients who think that because something was on the Internet (or in the newspaper, for that matter), it has to be right. Always seek out health information from credible sources and communicate your findings with your doctor in the spirit of partnership.
You always have the right to go and seek a second opinion if you don't believe that your physician is listening to or addressing your treatment needs. At the end of the day, you are the one who has to live with the treatment decisions.
Empowered patients must take responsibility for their treatment plan right down to the details of prescription medication. The Internet abounds with online pharmaceutical indexes. With these tools, patients can easily look up the medications they have been prescribed and check to ensure that they do not have negative interactions with one another. Should the pharmacy filling the prescription check for interactions? Of course, but the reality is that mistakes can happen. Taking responsibility for your care helps ensure that these mistakes, if they occur, don't become a health hazard.
It's always a good idea to take notes at your doctor's appointments. But if anxiety or poor penmanship prevent you from taking accurate notes, try using an audio recorder for the question and answer portion of your visit. Be sure to explain your strategy to your doctor at the beginning of the appointment.
Most new physicians begin an examination with a family history. Do you really remember if your cousin twice removed or great-grandmother suffered from migraines? Create a family medical history, put it in writing, and place it in a folder that you bring to doctor's appointments.
No one is at her best while in a doctor's office. Doctors make people nervous, hence the infamous “white coat syndrome” where people who have normal blood pressure tend to get high readings at the doctor's office. Nervous people do not do a great job of listening or paying attention. Bringing a tape recorder to doctor's visits can help make sure that the entire conversation is documented and also gives you something to look back on later, when you have questions about something the doctor might have said.
These days, it is common for migraineurs to see a number of different physicians and health care professionals. If you have other comorbid (or coexisting) medical conditions, the treatment picture gets even more complex. Coordinating the paperwork, records, visit notes, and treatment plans is something that must be done, and who better to do it than the person with the most vested interest in the case?
Remember that collaboration is the best way to ensure success. Make sure that the various doctors on your team communicate with each other, and make sure to sign all the relevant release forms so that they can share records on your care. Get to know the office manager in each practice so you can find the most efficient way to get files, lab results, and other important information where it needs to go. Create a reference list of contact information for all your health care providers to include in your chart at each provider's office. If all players are aware of the treatments and suggestions of the others, mistakes will be significantly reduced and patient care will be improved.
