Staying at the Center of my Healthcare
By Kerri Sparling
Doctor’s offices used to intimidate me. (Shhhh, don’t tell!). I don’t know if it was specifically the white coat, or the examination table, or the instruments, but I spent a very long time never feeling comfortable at appointments with my doctor. This isn’t an issue that’s specific to my diabetes care, but one that spans the landscape of my healthcare interactions.
Like my dentist appointments. Sensitive teeth and a long-standing history with type 1 diabetes make for sometimes painful cleanings. I found myself lying my face off when I saw this medical professional, making ridiculous claims like, “I brush seven times a day and I floss while I’m falling asleep.” (I don’t. I only floss during REM sleep.)
Or my endocrinologist appointments, where when asked, “What do you think the cause of these mid-morning highs are?” I was reluctant to respond honestly. I didn’t have the guts sometimes to tell my endo, “I’m high mid-morning because sometimes I grab a fast breakfast and completely wing it on the carb counting.” Excuses like “distracted by a toddler” don’t cut it when she’s looking at my glucose meters in black-and-white, without context or variables carefully outlined.
Regardless of what system is under scrutiny during the course of a medical appointment, one thing remained consistent: I never, ever remembered to ask the questions I intended to ask. I never made the appointment about my actual health concerns.
What made this happen? What is it about a medical professional that, when I was the one under the microscope (or the paper johnny), made my brain go blank and my confidence stumble? Why was it so hard for me to make the most of those fleeting and heavily medically-coded doctor’s appointments? Up until about three years ago, I would smack my forehead while driving home from a doctor’s appointment, saying, “SHOOT! I meant to ask about [insert medical issue here]!!!”
Part of me was caught up in the shuffle of the bodies in the doctor’s office. From checking in with the receptionist to seeing the nurse to the examination with the doctor, there’s a certain rhythm to most medical appointments, and I felt uneasy bucking the system. I often felt silly asking the doctor about a different treatment option, or a potential test to run, because I figured she was the doctor, shouldn’t she be the one asking ME questions? My desire to keep the appointment going smoothly took precedence over what I was actually there to accomplish. I didn’t want to “get in the way” of my own doctor’s appointment, which is ridiculous, since my health is at the very center of that appointment.
Or at least it should be.
Thankfully, three years ago, I was pregnant with my much-loved little daughter. And during my pregnancy, the laser focus I had on my health was only rivaled by my fascination with my growing belly. It was during my pregnancy that I was told, “Hey, pregnancy brain might render your memory a little useless. Make sure you keep a running list of questions you have, and bring that list to your appointments.”
So simple! Writing down what I was concerned about, while it was top-of-mind, made a huge difference in how I handled my medical appointments. I spent months keeping a running list in the notes section of my phone, which was easily retrieved both to add to it and when the doctor needed to hear what was on it. Something as simple as a list of questions prompted me to ask them, and this list served as a reminder of what I was concerned about outside of the doctor’s office. Keeping it on-hand made me feel empowered.
To me, patient empowerment matters most when it’s the least noticed and the least chronicled. It matters most in the doctor’s office, and in the chaos of a patient’s regular life, because that’s where the core of care takes place. At these appointments, I need to share the good, the bad, and the truly ugly about what’s going on, because that kind of honesty is the only way I’ll move forward. I needed the confidence in myself and in my medical team to admit the things I’m truly not doing, or the areas where I’m having trouble being adherent. Diabetes can be a demanding disease, and my health deserved the extra efforts it took to keep me feeling confident.
As a patient living with diabetes, it also means taking care of the day-to-day tasks of diabetes management, but also thinking ahead to what my health goals are. Do I want to lower my A1C? Am I looking to add something interesting to my exercise routine? Do I have questions about new treatment therapies? Does my psychosocial health need nurturing? And sometimes my questions weren’t so high level; sometimes I wanted specifics. A bulleted list including “ask about vitamin D, what about the pain in my Achilles tendon, interested in trying Novolog” can be enough to make the meeting worthwhile, simply because it keeps my individual needs at the forefront of the appointment.
Being engaged with your health can be as simple as just remembering what to ask. Remembering to ask those questions can lead to answers, and those answers can lead to better health. Gone were the days of stumbling through answers to mundane questions– these productive doctor’s appointments were my new future. And gone was that feeling of insecurity, because that list helped me remember that the health in question, and hanging in the balance of that appointment, was mine.
And I had better pay attention to it.