Managing Your Medical Care

Your physician is the person with whom you will address concerns about diagnosis, treatment, and prognosis. If asking a doctor questions is a source of anxiety for you, you may often leave the doctor’s office with unanswered questions. Different people have different relationships with their doctors. Some doctors are willing to form a more collaborative relationship and welcome your input into treatment and medication decisions. Others may become offended if you dare “question” their wisdom. It is important that you choose a physician who fits your preferred style. I recommend that you consider the following information to assist you in getting the most out of your doctor visit.

Choose One Primary-Care physician:

The first step in the management of your medical care is to choose one primary-care provider whom all other doctors report through. He or she must be willing to coordinate your overall care and monitor your medications. It’s easy to get involved with many health-care providers and to begin to lose track of specific details, such as who prescribed which medication and for what purpose. With a head injury, it can be even more difficult to track orders, medications, appointments, and referrals due to your cognitive impairments. Having a primary doctor can make it easier to negotiate the complexities and frustrations involved in your health care. Your doctor can coordinate referrals and medications and maintain the necessary records, which you are always welcome to obtain. Remember, you are the consumer and can negotiate specific components of your care. Don’t hesitate to directly ask your primary-care physician if he or she is willing and able to take on the responsibility of coordinating your overall care. It is essential to your health that your medical treatment be done in an efficient and organized manner.

Prepare for Your Appointments:

When you visit your primary-care physician or any other professional, it’s a good idea to do some preparation beforehand. It often helps to write down your questions and to bring a list of medications and other health-care providers treating you. This should also include a list of your medical team’s addresses and phone numbers. Whenever you see a practitioner for the first time, always obtain a business card and keep these cards organized in a central location. Be prepared to initially answer a large number of questions associated with your health concerns. It’s best to reply as succinctly as possible and to take time to formulate an answer before responding. At all your appointments, write down what the provider says so you can refer to it later. Ask about alternative treatment methods in an effort to understand all your options.

If You Don’t Know, Ask:

Remember, don’t be afraid to ask your doctor questions about your health care and medications. You are the one placing the prescribed medication into your body and the one undergoing the evaluation and treatment processes. You therefore have the right to ask your doctor questions and learn as much as you can about the procedures and medications that are prescribed for you. Before making a medical decision, always ask about all your alternatives. This usually involves doing a little research on your own. The Internet can be a rich resource for this. Participating fully in your care and learning what you can from your physician can help you develop a trusting relationship with him or her. You are hiring your physician as an expert consultant for the care of your personal health and to advise you on all aspects of your medications, from the proper use to any side effects you might experience. Your pharmacist is also a good resource, available for consultation regarding your prescription medications.

Have Your Primary-Care Physician Review Your Medications:

The initial appointment with any health-care provider should always involve a “brown bag session.” This refers to bringing in all of your medications for review. Once you have chosen a primary-care physician that you trust to coordinate all of your care, have that person review your current medications. Make your doctor aware of any medications that you receive from other physicians or that you may be taking over the counter. Also make them aware of any allergies that you might have and what a typical allergic reaction involves. Always ask about any side effects that a new medication may have or any special instructions that you may need to be aware of. If you develop a new symptom after starting a new drug, it’s probably a safe assumption that the drug may be causing the symptom. Report this to your doctor. Ask your physician about alternative medications that might be available, and always try to limit the number of medications that you are taking. However, do not adjust your dosage or discontinue any medications on your own. Consult your physician prior to making any changes in your medication.

If a new drug is added, ask if it can replace an existing drug. Gain an understanding of the typical dose of the medication and let your physician know that you would like to start on the lowest dose possible. It is always better to start low and go slow. With injury to your brain, you are more susceptible to the effects of drugs. As we age, metabolism slows down and we usually need less of a medication to do the intended job. Don’t take a drug any longer than is necessary. Make sure you have a clear understanding of how the medication is to be taken and the proper dose. Finally, get rid of any old drugs that you’re not currently using.

Your pharmacist can also be a good source of information. Take the time to establish a relationship with him or her. Ask questions. Usually an individual will appreciate that you respect their wisdom enough to consult them on an issue. Ask the pharmacist to provide you with any literature that might be available on the medications that you are taking.

Indicators of Need for A Comprehensive Neurological Exam:

  • Memory dysfunction influencing daily functioning
  • Periods of Confusion
  • Getting Lost in Familiar Places
  • Apathy or Loss of Motivation
  • Severe Symptoms of Depression with No Apparent Cause
  • Difficulty with Motor Skills, Tremors, Paralysis
  • Difficulty Speaking or Poor Articulation
  • Comprehension Impairments
  • Difficulty with Reading or Writing
  • Acute Changes in Personality
  • Visual Problems
  • Dizziness

What Might be Included in a Comprehensive Neurological Exam?

  • Neuropsychological testing
  • X-rays
  • Neurological imaging (CT, MRI, SPECT, PET)
  • Electroencephalogram (EEG) to look at the electrical activity of the brain
  • Electromyogram (EMG) to measure activities of muscles
  • Blood work-up (including: thyroid functioning, vitamin levels such as B12, electrolytes, glucose level, liver function test, and heavy metals screening, etc…)
  • A lumbar puncture to check for infections within the CNS
  • A cranial nerve examination
  • A motor system examination
  • A mental status examination, and
  • A sensory examination
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