How To Speak "Doctor" (What to say and not say in the exam room)

A discussion of how patients can improve doctor-patient communication from their perspective.
Chapters:
@0:00 introduction
@1:59 Why doctors can seem like bad communicators
@5:42 How to communicate symptoms
@11:11 How to communicate concerns & questions
@13:20 Commonly misunderstood medical jargon
@14:53 Closing thoughts
Related video on "medical gaslighting": • Medical Gaslighting Is...

[@StrongMed]

The thumbnail (preview) is discussed in the second half of the video, but for anyone who didn't get there, the phrase "I have a high pain tolerance" is a surprisingly common phrase that doctors hear, which is often used in the complete opposite way that one might expect - being followed by a request for opiates. This phenomenon biases doctors to assume that all patients who use the phrase will be asking for opiates, or worse, is "drug seeking". It's not ok that such a bias exists, but it's reality. Saying "I have a high pain tolerance" actually makes it less likely the patient will receive appropriate pain control, and I strongly recommend patients avoid it.

[@staciamwalrus]

My take is that so many people say it that it's meaningless. I immediately dismiss it.

[@ZZuluZ]

It essentially means “please don’t see me as weak”… which is something you would only say in this context if you were asking for opiates. Sometimes people also use the sentence to indicate how “tough” they are, and are proud to be in pain and not get treatment. Ultimately just the patient’s way of getting validation from the doctor

[@nineteenfortyeight6762]

Why??????? It makes no sense 😮

[@prettyevil6662000]

@@nineteenfortyeight6762 People who are seeking opiates will say they are in pain. But see they have such a high paint tolerance that if they're in pain, they need super strong drugs. So they don't usually hear "I have a high pain tolerance, so I'll just rotate ibuprofin and tylenol and come back if the pain is too bad for that" they hear "I have a high pain tolerance but this is so awful nothing is touching it so please give me something strong."

[@commonomics]

I always say I have an extremely low pain tolerance and can’t handle shit

[@quasinfinity]

Today I learned: I've been confusing doctors by refusing pain killers with "I have a high pain tolerance, ibuprofen will be fine"

[@billbombshiggy9254]

Me too! I'm a former addict, and I reject any pain med they offer because I am too scared to take narcotics (never know when that monkey will decide to show it's ugly face) and I take kratom, and I'm already beating up my liver and kidneys with that. I had a abscess tooth and went to the ER because man, it fucking hurt. All I wanted was an antibiotic because after a couple of days of clindamyacin, the pain would go. So the ER doc said he'd get me some antibiotics and something for pain. I told him "that one isn't necessary." He looked at me funny and I said, "if you insist, please only make it ketorolac, okay?" Nurse eventually comes back in and theres my antibiotics and a script for lortab (just ten). I finally go to leave and I stopped at the desk and tried to give it back. Apparently that was a first for them, and they said they absolutely could not take it back and I could just not fill it because they'd already charted that it was prescribed and that I had left, etc. I filled it and it sat in the cabinet for a few years "just in case" anyone had a shit ton of pain that ibuprofen or Tylenol didn't help. I think there's still a few left, and this was ten years ago XD

[@prettyevil6662000]

Same. I said it once and asked the dr if it was safe to rotate tylenol and ibuprofin for the oral surgery and he gave me a prescription for vicodin. I was super confused. Didn't need it either.

[@colorbugoriginals4457]

I also refuse the weaker meds, if they would handle the pain then i don't yet need anything for pain.

[@nathanlonghair]

I also confuse doctors, because I have a *low* pain tolerance - but ALSO ask for weaker drugs, because I respond very strongly to them. It is very very rare that 500mg paracetamol (AKA acetaminophen) won’t cover almost everything for me. 1000 in rare cases (where they would have prescribed the codeine, paracetamol and ibuprofen cocktail)

[@runningfromabear8354]

​@@nathanlonghairI have a high pain tolerance but low threshold for opiates. I absolutely HATE that opiates first make me nauseous and then like breathing is hard and then I pass out. Every time I've had surgery I'm told my oxygen levels dropped when they give me opiates. I tell them and they don't listen until after and I wake up feeling like shit. Most embarrassing was in the ER with appendicitis. I was in a lot of pain and I guessed I asked one too many times when my surgery was. They couldn't say. Someone insisted I needed something. I had said no earlier. And then I was still in pain, felt high, hard to breathe and unable to cope so I sitting crying and then passed out. Woke up in a bed in the ER hooked up oxygen and machine tracking my pulse. I don't do well with opiates. I found out with gall stones then from that surgery and then c-section and then orthopedic surgery and then stomach ulcer and then appendicitis etc... I don't know what it is but after they see my heart rate in pain they put me on opiates and it never goes well for me.

[@tonym6920]

You have to be an advocate for your own health, in other words, educate yourself in the available treatments for issues you are facing, procedures (the benefits and risks), medications (side-effects) how the organs function as it relates to you. Knowledge is power. It’s really comforting to talk to a doctor and understand what he or she is talking about and being able to meaningfully contribute to the conversation - and ultimately to your own care. It might be beneficial that such a checklist as you mentioned be provided when an appointment is made as a preparation for your visit.

[@NormalPersonCommenting]

Funny, because I've said "I have a high pain tolerance" but what I was trying to communicate was the lack of a desire for more intense pharmaceuticals Like, yeah, my hip is broken, but I'm not in surgery anymore. Just bring me a chicken sandwich and get out of the way of the TV; Star Trek's on!

[@memorywhole366]

You’re not normal

[@theenglandguy]

Using a number higher than 10 on the 1-10 pain scale is literally indication of unreliability in patients. It can indicate a patient either does not understand the scale, does not want or feel the need to comply to the scale's parameters, or shows the patient minimizes the importance of the questions asked by the provider, among other things - all indications of initial unreliability (which can mean confused/needing more explanation, or can mean malicious intent.) While it does not mean the provider should withhold specific care or dismiss a patient based on such answer, it does indicate unreliability, just like a patient giving unrelated answers to other OPQRST/anamnesis questions.

[@VyewVyew]

I just don’t use the 1-10 pain scale at all, it’s better to target specific limitations (mobility, sleep) etc

[@SatumainenOlento]

@@VyewVyew This is great! As a patient I feel much more comfortable talking about the actual practicalities in life with the pain than try to use a scale which is abstract. I always feel like I need to make the scale correct and relate it to ALL THE PAINS IN MY LIFE. And I have suffered great pains...compared to those my knee pain is only 3-4, but it actually stops me from going for a walk and pains me when I walk to the kitchen....so where should I put it on the scale that I would still get treatment from a doctor? Or perhaps I should say that the root channel operation was 6 as a comparison? 🤔

[@colorbugoriginals4457]

@@VyewVyewi have made a personalized 1-10 that uses these factors. annoying but ignorable, or disruptive to ADLs, etc. I highly recommend it, it will help you better understand your own pain levels.

[@kaemincha]

​@@SatumainenOlentoAs a patient as well, scales are utterly useless for me most of the time. It just doesn't jive with how I understand pain.

[@ramironin2042]

Great video, patient education shouldn't be limited to only their health, but also how doctors perform clinical reasoning and make decisions. For example, in my experience most patients ignore that diagnostic testing and reasoning are statistical in nature, and therefore uncertainty is always present. This contributes to something all of us have seen: a doctor chooses not to perform certain tests because they deem a diagnostic as unlikely, or a treatment as not beneficial, and another doctor might perform them either because (1) they don't think it likely either, but do it nonetheless to satisfy patient demands, or (2) they consider the diagnostic likely and end up being correct. In this scenario de first doctor is thought of as negligent by the patient and the second one as a "hero", even if they didn't even consider the diagnosis in the first place. In the opposite side of the spectrum, a doctor might perform a test, invasive procedure or start a treatment, but a second doctor wouldn't have done it because they considered that the risks outweigh the benefits. If the patient is harmed by said procedure/treatment, then the first doctor is deemed as negligent and the second one as the responsible one. Example: patient with epigastric pain which is non-specific in its clinical characteristics. First doctor chooses a conservative approach and an empiric treatment, second doctor orders an endoscopy and the patient is harmed by a procedure complication and ends up in ICU, and the study wasn't helpful in diagnosis. Similar patient same doctors, but the endoscopy goes well and uncovers a peptic ulcer. The second doctor gets praise while the first is judged, even if the second doctor, as the first one, wasn't sure about the endoscopy but did it regardless and owes his correct diagnosis to luck!!! This situation could be avoided if we as physicians explained to patients how we actually make decisions and what information we use to do so, and how probabilities, based on either published research or clinician gestalt, influence this process. If patients understood that we are never 100% sure that something will be helpful or not (either in diagnosis or treatments), they wouldn't think less of a physician when they are wrong or, if they are unsure about starting a specific treatment or performing a specific test/procedure. In my experience communication gaps and biases between parties are almost always the main culprit of adverse outcomes in patient-care.

[@evercuriousmichelle]

Yes, the doctors that explain their thought process are my favorite!

[@Mr_3raqi]

"Complaining of x" doesn't mean the doctor has heard enough of you or doesn't want to listen to you, it's a medical term meaning the main symptom of this person is x

[@colorbugoriginals4457]

My actual surgeons have told me i have a "high pain tolerance." and they do give me dilaudid, bc everyone is different and some people need different meds. I am not prone to addiction tho and am on it IV schedule around the clock in-patient, last dose right before going home, and quit it cold turkey. I even ask them not to prescribe any oral meds for home. I suppose this will become more common bc of high tolerance of some classes of drugs that come with regular medical mj use. My worst pain was cured by a crazy surgery after 6 yrs. I always wondered why doctors risk leaving someone in pain in order to spite addicts. If someone is addicted, isn't that a serious medical condition that would be quickly sorted out by experts? Aren't you going to be able to interact with them better if they aren't currently in withdrawal? Pain trauma is real, there are some hospitals I would literally die before going back to, instead of living with more of this sort of trauma.

[@SatumainenOlento]

I caused changes on bones of my fingers by working through pain during 5 years. So I worked pretty hard to get them to that stage in such a short time. The changes are clearly seen in ultrasound. I conclude that I might have a little higher pain tolerance than average. I will be silent like a mouse about this fact when a doctor is around.

[@jws3925]

Yes, we have learned in this video to be very careful what you say to your doctor.

[@SatumainenOlento]

GREAT SUBJECT!!! Thank you so much Hank and Dr. Strong!!!

[@pragyasingh2297]

This is an excellent topic! I'm so glad that we're having these kinds of conversations. Thank you!

[@liliherndz5792]

Well Informed patient is KEY on all possible options in the decision making process and creating a plan of action for restoring health with medical professional Great guiding insight 👨🏼‍⚕️

[@jws3925]

This topic is very interesting and, in some aspect, enlightening. I have had physicians who actually want to dialog with me and, whether true or not, appear to actually want to be a medical "detective." Lately I moved to Florida and have found an epidemic of physicians who come into the exam room obviously hurried and frazzled. At first I thought I just got an overloaded doctor who, for whatever reason, did not have time for much dialog, if any. Mostly I will describe them as test reactive only doctors. No actual "art" of medicine required. They either have test results or order tests and then just prescribe a medication based upon these tests. If one makes another appointment (weeks wait time) and tell the doctor the symptoms are not better they either up the dosage of said medication or prescribe another similar one. This observation has been experienced from my general practitioner (which is a NP because no one sees a doctor as a GP here), urologist, orthopedist and cardiologist. Health care stinks in my opinion in Florida. It is interesting that the "blame" in many cases for a communication difficulties seems to lie with the patient according to this video. Don't say this or that or your doctor may think you have a narcotic drug problem! I have actually said to my previous Orthopedic surgeon in MI that I had a high pain tolerance to try and convey; "listen I don't go to the doctor for every ache and pain so when I do come in I have a serious issue." Instead he may be thinking all I want are narcotics??! I am sick (no pun intended) of receiving poor, sometimes rude care from my south Florida physicians. I though switching docs would solve the issue so I got a new GP------same. I dropped my first urologist and waited months to get into to see one highly recommended------same. In fact this new urologist was sent all my records from not only from my previous Florida urologist but also my Mi urologist. These records included bladder cancer, kidney stones and prostate issues. He walks into the room and says; " why are you here today?" I proceed to tell him I have some urological issues that need monitoring and recently moved to the area from MI. He asks: "like what?" I said that I dropped off my records that outlined it all. His response: " why don't you just tell me, I don't have time to read all that." Is it any wonder we go to the internet to try and diagnose ourselves and plot what an effective treatment might be based on that information? The doctors don't seem all that interested. I get the impression all they want to know is what medication to you want and, if it is not a narcotic, they will write or call in the order and bingo, they can go to the next room.

[@davidstanford4885]

I have been in 10 major auto accidents. Several back surgeries plus elbow rebuild in 80s and metal in left shoulder. I've heard all the excuses used to keep from prescribing pain meds,even when I wasn't looking for it

[@prettyevil6662000]

TLDR: I'm just vending you can ignore this. I apparently mostly understand dr speak. I answer as succinctly as possible for almost anything as I simply don't want to be there anymore than the dr does. I also come in with a list of how often the pain or symptom was interfering with my life and in what way so I can give an accurate account without relying on memory or 'it feels like it's a lot but is it really?' But I'm constantly begging my dad, who I'm a caretaker for and keep similar daily notes on his care and how he says he's feeling every day, to stop telling stories to the dr. Dr will ask when the pain started and my dad will launch into a story about how when he was a kid... that has nothing to do with current pain but is about how he felt similar pain once as a kid that went away. A 15 min story for the dr to nod and smile to and then repeat so when did the current pain start? (Or worse, the dr didn't get that the pain back then ended and treats it like a lifelong condition and I have to correct it.) And yes, he runs out of time in appointments all the time and I can't get through the things I'm actually worried about because he takes up the whole time telling stories. This is also not a problem of old age. He has done this ever since I was born. He used to give my medical history in he same way until I was old enough to see a dr alone.

[@HatoriCrazy]

You just answered a question that has kept me from seeing a doctor for years. I've had menstrual cramps that (now that I've given birth unmedicated twice) I know are as bad as labor pains for the past seventeen years. I've learned to live with them and become very good at dealing with pain. I've avoided hospitals because doctors always just pushed drugs at me and never took my concerns seriously, all because I said I have a high pain tolerance... I can't say that this makes me trust doctors, but it'll help with my next ER visit.

[@franzpattison]

I recently went through an operation where they tried to give me 2 mg of hydromorphone and I kept saying that extremely resistant to pain medication such that it usually takes me at least 3x-4x the normal amount to have an effect, and even then it doesn't really reduce the pain, merely assists me to refocus my attention so it's not unbearable. (This is true, not drug-seeking BS; hydromorphone is actually a very unpleasant drug to me because of how confused it makes me, which I even told them.) Eventually I was able to convince the nurses, thank God. I understand that sometimes people are disingenuous in order to "score" but it makes it much harder for people such as myself who sincerely are resistant to painkillers.

[@StrongMed]

I'm not at all doubting your experience, but I think you have made a mistake in the units or dose on your hydromorphone. Even assuming the less potent oral route of administration, 2000mg of oral hydromorphone is ~1000x the typical starting dose. Maybe you mean micrograms (ug)?

[@franzpattison]

@@StrongMed hahahaha yeah I meant 2mg LOL. Gonna fix that

[@suemilkbone4868]

Wow, i didn't realize how stacked the cards are against patients until I saw this video. Because of doctor-patient biases, patients become angry and frustrated leading doctors to document in the patient's EMR that they are "difficult and noncompliant" thus leading to future biases. It is a neverending cycle stacked against the patient.

[@elinordrake9716]

One of my favorite of your videos Dr. Strong! I really the bit about explaining the level of interference your symptoms cause in your daily life. The only place I've heard symptoms talked of in this way, was at my Occupational & Physical therapy appointments. Both the therapists I saw asked things like, how does the problem affect cleaning house, running errands, showering, etc. Prior to that, I'd thought of my symptoms in a sort of vaguely miserable way, I'd literally never thought of how my symptoms caused a smaller life. I got the impression from the P.T & O.T folks that their way of looking at it, which seems down to earth & common sense, are more a P.T/O.T thing. And I don't think it had yet occurred to me that I can TAKE that way of describing things back to the rest of my medical care. Thanks!

[@NYPD99STARR]

When i was alot younger i had a surgical proceedure and because i didnt like needles and percocet made me sick. I spent a week in hospital on no painkillers. The doctor just shook his head.

[@legallyredone5561]

I have been hoping to find such a translation guide to speak to my doctors!

[@warbler1984]

I liked this video...very balanced as I've met fellow doctors who were amazing communicators others who were just burnt out and then those who were just inherently bad at it

[@mistylee717]

If there is one thing I would change about how many or likely most physicians communicate, it would be explaining the fallibility of initial diagnoses. Example: hubby had pain with urination and slightly discolored urine. I accompanied him to his doc appmt. They did a urinalysis and the doc said, “you have a UTI”. Prescribed antibiotics and left. I told hubby that the doctor does not know if it’s a uti or not. A basic urinalysis showed presence of WBC. But if he had blood in his urine (which I suspected) that would explain the presence of WBC. He did, in fact have a large kidney stone. What his doctor should have said? “It appears you have a UTI. I’m going to prescribe some antibiotics. If it doesn’t improve in _____, call my office.” Very often physicians and nurses ask me where in the medical field I work. Because I do have a greater than average understanding of medical jargon. I just say, “I’m a professional patient”. I have had multiple health problems my entire life. I have a heck of a lot of experience with physicians. I even almost married an internist. I’ve often thought I should write a book about the serious communication problems between doctors and their patients.

[@mistylee717]

Also I often say I have a high pain tolerance but not in the setting you mentioned. I say it because physicians and nurses have told me so. In fact after performing a very painful procedure on me a physician said: “don’t ever let anyone tell you you’re not tough. Because you are one tough woman!” This is actually an important thing for a diagnostician to know. Don’t you think?

[@mistylee717]

I don’t engage in Doctor-bashing. I love my doctors. Some of the best people I know are MDs. But even the good ones may have habits or beliefs that are not good for a patient. For example. My very good doctor believed my pain was “in my head”. He was careful to explain that it doesn’t mean the pain isn’t real or that he isn’t going to try to help me with it. However I did not believe it was originating in the brain. I lived with some pretty awful pain for almost a couple of decades. I saw several doctors and had several tests. Orthopedist believed it was radiating from my spine as I have evidence of disease processes there. I said, “There is something wrong with the rib. It isn’t coming from my spine. I don’t know how to explain that I know this. But I KNOW it.” Finally based on my own research I found a condition that I was convinced was the cause. Long story short, my diagnosis was proved correct via surgery. On one side all the false ribs had detached from the sternum. The cartilage was completely fractured. A week and half after that surgery I was in the hospital to diagnose a horribly distended stomach. A gastric emptying study confirmed Gastroperesis. (More about that later). While there I told the physicians and nurses treating me about the ribs. They had never herd of the condition. But one said he asked a thoracic surgeon about it and he said he had heard of it but it was rare. Here’s the problem, how possibly could he or anyone know go rare it is when it is extremely difficult to diagnose and few primary care doctors even consider it? Regarding the Gastroperesis- this is another condition I had for decades before getting properly diagnosed. Again I was told it was “rare”. Again. How can we know if it takes decades to get diagnosed. Even good doctors have tendencies to not believe certain patients.

[@KellykellzGarrett]

I don't have a high tolerance for pain. I hate pain.

[@KellykellzGarrett]

*Wasn't officially diagnosed.

[@nerida3347]

I had noro and a flare up of my chronic functional dyspepsia at the same time last year. I was carrying around a bucket to puke in at the ER, begging for painkillers. I got anti-vomiting meds. I hate how asking for painkillers makes you a drug seeker, like yeah i am, because I'm in the worst pain I've ever been in 😑 My boyfriend got noro too the next day of course, and we begged the hospital to take us because there was no close family and we could do *nothing* for eachother or ourselves. Doctors have consistently failed me when i communicate my needs.

[@satrianirocks]

I have a high pain tolerance = I only need tylenol

[@bookaufman9643]

I was diagnosed with KSS about a year ago and I was wondering if you've ever done videos about mitochondrial myopathy? There's very little information on KZbin and the guy that diagnosed me set my appointment for a year later.

[@CandyGirl44]

I had a stash of Tramadol and other drugs in that line, all left over from various operations and procedures, broken leg etc, I think I have a fairly high pain tolerance. I thought I would keep them for a time when we might not have medical aid or money. I also gave out some to our cleaner for her son's broken arm, the hospital had sent him home with Disprin. We had a petsitter in when we went to my Mom's funeral, our usual one wasn't available, this one was however recommended. She went through my bathroom cupboards and stole the lot. Apparently, she used some and sold the rest for thousands. Another case of someone with bad pain from back injuries and cancer, where the state hospital either didn't have meds or just gave out Disprin.

[@juliefraser8136]

I like the idea of having a note to myself but I have heard that one must NEVER bring a list or any form of note to your doctor. I have never heard an explanation.

[@bookaufman9643]

About 20 years ago I was having back problems and my doctors in the pain clinic insisted that I could take all the oxycontin in the world because it wasn't addictive. A year later they called me an addict because I went through withdrawals when they cut me off. How did that communication cycle go? I have a fatal mitochondrial myopathy so I see doctors a lot now but I never fully trust them and it seems like doctors never fully trust their patients.

[@CoJau911]

When i ask "when did your symptoms start" please, pleeeaase do not answer "since my cousin's wedding" (i have no idea when it was!) or "a while" (that can range for a few hours to 10 years!). I can not tell you how many patients fail to give an informative answer to this question

[@markwilliams2620]

Phrase the question correctly. "How many hours ago did your symptoms start?".

[@armin8306]

"uhh it's been a minute mhmmm" (means a month or 6 apparently)

[@mistylee717]

I rarely know the answer. I have had so many health problems that I tend to ignore symptoms until they get really bad. I know that sounds foolhardy but it has been a necessity. At best I can discuss 3 symptoms per visit. But it can take multiple visits with trial and error to address one issue. I simply must prioritize symptoms.

[@suserakabrotherbruceinchri4053]

Agreed however I covered for my dr and said my symptoms were only for 3 days when they had been for: months since I became extremely ill in 2019 and sirs organs failing at only 40, didn’t take antibiotics until it was probably too late bc of my history of cdiff 3x.. long story short I had 3 previous cardiac ablations on the right side of my heart in my early 20’s I was a gymnast and an athlete but I couldn’t ever breathe and they thought I had asthma and gave me an inhaler but it didn’t work a caring cardiologist suspected pulmonary hypertension but it was difficult to diagnose, my insurance changed and I was seen by an electrophysiologist who dealt just with that not considering anything else but I fully believed in him and he’s an excellent surgeon despite his horrific communication skills and I actually talked 4 people out of suing him.. long story short I don’t go to the dr unless it’s serious and I’ve only been to the ER 2 times in 15 years. I kept telling him something was VERY WRONG with my heart and he totally dismissed me and said nothing was wrong. I later learned he even lied to me about my echo a year earlier and said it was perfectly normal when I had cardiomyopathy. I kept telling him that something was very wrong but he wouldn’t listen. I showed him my ct scan (2 months before I was extremely ill with a 104 fever and sirs and enlarged heart etc he still said nothing) showing pulmonary edema and he again dismissed it. I ended up in the ER code critical called twice 2 weeks later. I started having symptoms the last two months but severe symptoms for a week before I went to the ER and I would have gone immediately had he been honest. I have permanent heart damage now and severe heart failure symptoms and everything moved to the left side of my heart and I went into atrial fibrillation 265 bpm fast ventricular response and all kinds of arrhythmias and 2:1 block. Nothing was working I was in the hospital almost a week and I still defended him when my nurse friends said I must be transferred to either UCSF or Stanford. She noticed my heart failure symptoms long before. Even my Kaiser dr did ten years prior when I had Kaiser. I’m in shock that he lied. He waited six months to even give me my records. I’d never sue but I want answers. I’m afraid to say anything to anyone here bc he has so much power here. He put in my pacemaker two months after my a fib ablation bc my heart stopped but I had sick sinus syndrome for a decade and it wasn’t treated. I still looked up to him and trusted him. He didn’t even show up for me I when I went into severe acute heart failure lactic acidosis of 4 bnp 1400 and I almost didn’t go to the ER bc I am a very stoic patient and have had 25 surgeries and always tried to perceive to be strong in front of doctors. I’ve had awesome drs and drs majorly mess up causing permanent disability and I have never ever considered suing (despite my working with attorneys as a senior analyst at an insurance company in the asbestos and hazardous waste department let’s just say I saw horrible cases and I was on my way to becoming an attorney myself but I became totally disabled and bedridden needing constant care from my amazing husband) let alone complaining bc I think so highly of drs and what they do but I’ve lost SO MUCH trust and I switched to a regular cardiologist but she’s under him still and I haven’t seen her in a year and need to ask why my pacemaker reports are saying I’m being paced 75% of the time and it keeps going up when it started I was only being paced 11-15% of the time. I need answers for Medicare as well. They paid my $300k bill and I paid 20% though I believe it was totally preventable but again I’ll never say anything. I really want to be seen outside of town but every time I’ve tried to I can’t get into ucsf etc when I used to be able to get the best care and seen there before for my congenital ptosis amblyopia palsy etc surgeries. The only time I’ve seen a Dr lately is when I thought my pacemaker was infected but they had me do a mammogram and it was Birads 4 and biopsy ptl totally normal :) but since all of this I don’t want to see anyone in town and lost so much faith in drs after being lied to and mistreated (another story when he put my pacemaker in if he had my records he would have known that I’m supposed to have Mac anesthesia with an anesthesiologist present bc I’ve been traumatized by being awake and nothing going into my veins bc ivs easily slip out of my veins from so much scar tissue and he started the procedure and I said no and I was in a fib and almost broke the male nurses hand when thankfully he said stop and do an angiogram and make sure the I’ve is in her arm and they did and it wasn’t in my arm so thankfully put it in my other arm and then I was given versed and was fine but I still have nightmare of having surgeries awake and again could have been prevented. My therapist (who’s actually a psychiatrist but I chose him bc he doesn’t hand out drugs and I’ve been seeing him for 20 years to cope with my disability and job loss etc) saw him too when he was in the hospital for 2 days had a temporary bout of a fib and he said he was never even visited by him. Everyone dr and nurse has bad things to say about him/ this dr but I’ve defended him for 24 years but now I just stay silent. I guess I just needed to say that outloud knowing that no one knows me or him bc I have never been lied to like this and lost all trust yet need to see someone. I did everything right on my end lost 40lbs though I was only 15lbs overweight and I swim every day in my swimspa in my garage but I’m getting worse not better. ER dr put NSTEMI on initial records I believe I had a heart attack but wasn’t seen / had my trophy in levels checked until a week later bc again week before that electrophysiologist said I was fine so I thought I was and didn’t go until I couldn’t see.. severe left arm pain chest pain and massive confusion Oh and when you lose vision and are extremely Ill that’s not a good time to record pertinent info even if the patient looks fine bc I’m really good at looking totally normal when I’m not at all. Thank you drs for everything you do! Even the not perfect ones not acceptable but we learn by it and find ways to forgive and move on knowing that no one is perfect. I’d still love to see someone else (my last echo EF wasn’t reduced but high; ecgs say LV overload and ischemia my Apple Watch that I rarely check still shows a lot of tachy Brady and I’m out of breath just standing up and get bad pain in between my upper back doing any exertion and I still have swollen ankles and no exercise tolerance though I try SO HARD I was a previous athlete but I could only do short spurts and I tore my acl in same knee twice and had 8 knee surgeons by excellent doctors but it was unfortunately messed up during my 2nd open acl recon surgeon accidentally blew up shrapnel metal all inside my knee and it created major problems severe arthrofibrosis at the time and now I live with a permanently bent leg that’s very atrophied despite me doing pt for 10 years 5x week again before I was a gymnast even after my first acl recon (open) that went perfectly and I have broken my pelvis when I was competing with my horse I was completely crushed in’89 and unconscious and fully recovered and I’ve been in serious car accidents but never let it stop me I was working full time since I was 16 and got my degree in economics in 2 1/2 years and accepted into a joint MBA and JD program still invited but I can’t bc my health anyway I want to be a better patient and not give my life story and this doesn’t even scratch the surface as I have 30-40 conditions but I’ll stop for everyone’s sake.. I haven’t been the same since 2019 mentally (not as quick and memory isn’t good) oh and I also have to get iron infusions every few months another story but I’m incredibly grateful for my hematologist only dr I see lately) or physically and very sob though I’ve been swimming hard daily for 18 months now every single day) and I still have irregular heart rates even with my pacemaker and I don’t know why it went from pacing me to 11-15% in 2019 then slowly more and more and last report 50-75% 50% overall when I’m doing everything I can and not on any heart meds bc for some reason after 2019 I can’t take calcium channel blockers bc they put me into a very irregular rate (?) and beta blockers never worked so I haven’t taken those in years I would love to see another cardiologist and electrophysiologist and build trust (I’ve always been told I’m a very pleasant positive patient) but after all of this…I don’t even know where to start. Forgive my lengthy comment. Have a wonderful day & thank you again!

[@HaemDream]

@@markwilliams2620 right, and then then patient starts trying to multiply 24 by 9. Asking how long is a perfectly reasonable question

[@twistedtea7046]

Now we need one on hospital staff communication lol. Seems like a decent sized chunk of hospital staff can barely manage to procure a meaningful string of words these days.

[@oz_jones]

Tell nothing to the police and tell everything to your lawyers and doctors is my motto and hasn't steered me wrong thus far.

[@CNP-rn3gd]

My experience with physicians in the last 5 years is that they are too busy to deal with you and you should only mention one symptom and then keep quiet so they can fill in the EMR. Don't offer any opinions or they get mad (after you have taken time off, driven to the office, found parking and then waited in the office and the exam room). In short, it's not worth the effort to go visit a doctor anymore.

[@KellykellzGarrett]

Excedrin works dor me, because ibuprofen has torn my stomach up. It gets better if i leave it alone. But ibuprofen too long consecutively is not good

[@d.awdreygore]

I'm not in the USA, I've been lucky to be able to choose doctors who are good communicators. Whenever I've encountered a medic I don't feel confidence in, I simply find another one. But I know plenty of people who this would never occur to, even though they can afford to. Edit - also, whenever I have to see a new doctor, I email them all the relevant history I can think of in advance.

[@robertkeyes258]

My physician is Dr. Gregory House, what do I need to know?

[@Crow0567]

godspeed soldier

[@jyetie]

I wish I had House as a doctor. Sure, he's a dick, but I bet he could figure out what's wrong with me and effectively treat it. Idc if you have the best bedside manner if you're misdiagnosing me.

[@JustAnotherBuckyLover]

Ha. Seems I just have shit doctors then because no matter how I explain my level of function associated with my symptoms, I still have to fight with them on the regular about pain management, and they still won't provide me with the one non-pain-related medication that actually manages my health issues. Seems like being literally bedbound and unable to even sit upright for more than a minute or so without fainting or puking or both isn't "enough" of a reason to justify the corticosteroids that dramatically limit my symptoms.

[@KellykellzGarrett]

How about i anticipate

[@wingleuing9211]

👍

[@999Patriots]

"I want that 'D' drug for pain. Um, what's it called? Starts with a 'D'." Oh! you want ducolax! We can give you all the ducolax that you want!

[@somethingsomething404]

I have a high pain tolerance means I don’t need pain meds..?

[@somethingsomething404]

Opioid tolerance isn’t the same thing as pain tolerance. Pain tolerance is people saying they handle pain well.

[@damdamfino]

I saw a doctor once say that if a patient says they only had 1 drink, they assume they had 3. If doctors think patients are ALWAYS lying, this just seem like it will give nothing but awful results. When there’s a bomb threat, we always treat it as if it were real, despite how many were fake before. When someone threatens suicide, it’s better to treat them as if they mean it, than to think they’re just lying. IMHO, if someone is lying for opiates, then that’s on THEM. It was their actions that made the doctor think they needed it. Why do the doctors have to be judge jury and executioner on who they think is lying or not?

[@elizabethbrauer1118]

I'm not worried about younger MDs. It's the older docs who can't communicate. Then again, I'm a KP patient, so my expectations are low.

[@kitefan1]

Just so you know, it's almost impossible to get a new doctor around here, Northeast US, in less than 8 months.

[@Vio45lin]

In Quebec it's more like 8-10 years.

[@KellykellzGarrett]

Wont tell me anything until i. Person visit. And all the opther appointments are telehealth.

[@MkE1121]

So, can you say "I have a high pain tolerance and I despise opiates. I know my kidney function is questionable but ibuprofen or steroids will fix this ... last time I told them that - ibuprofen decidedly did not fix it. My appendix ruptured ...

[@KellykellzGarrett]

I would rather they make a caring effort to help figure out whats wrong, than constantly be told the its probably just...... Speech and then throw a prescription at it and not even giving it a second look .

[@aelaan12]

Long story: On August 21st in 2020 I did not feel very well, I could not pin point it, but I felt very tired. My daughter is a nurse and she came home from her night shift and asked how I was feeling. When I said: "I am not sure". She sprung into action. That afternoon I was in the ER, thinking to myself: "I will be home tonight". As we all know it was somewhat in the summer of Covid and I really did not want to stay in the hospital. I went to the washroom with one of those monitor-halters on and when I opened the door there were three nurses waiting for me. ???? What is going on? Please come with us, sit in the wheel chair and we will bring you to a bed. Folks, I felt okay. Once planted in an ER bed they did a lot of tests. That evening a doc came by and I knew him very well... He is a friend of mine, funny thing is that he did not connect the dots and my full Dutch name looks quite different than my Canadian name. He was shocked and pulled up a chair. "Ok, give it to me." I said. He was: "I am going to be very serious with you. You are not going home and we are preparing a room upstairs for you. Our tests have shown that you have an unstable angina." He explained that it was a ticking time bomb. What's the treatment? He explained: "At this moment we do not know, we are scheduling you in for an angiogram in a different hospital". Yeah... that was serious I thought, my daughter came see me before she had to go back into her nightshift and spoke with the doctors. That evening at 10 PM I was wheeled into a room, it was a private room... courtesy of the someone I knew. Long story short: Quad bypass, scared like shit, survived (obviously). The information brochure stated: You can be out of the hospital in a week. That was not the case. I only left the ICU after 7 days, but I felt okay. I never had any pain, honestly I was mostly in a cloud of comfort. The surgeon was so good, what a fabulous person and she got my humour. I bonded with the team and they helped me out of bed to start to walk around a bit more, first with a walker, later with a cane and slowly but surely I made my trek back home. Not all wounds were fully healed but my home nurse was ready to get me going. To sit outside in the late fall sun was so awesome. Two and a half years later I know that my curiosity took some of the nurses aback. They wanted to sugar coat it, but I always insisted in learning the truth. Part of the recovery was a diagnosis of vasovagal syncope, we found that out the hard way on December 29 that year when I went down at home. Of course the worst was feared, but I think I was back within 10 seconds. Of course, in the ER, the same fear of staying put, but I was released at 7 PM that night. The doctor explained what it was, how it happened and that this was something that will happen more as the nerve itself was damaged as a result of the open heart surgery, which is nearly unavoidable. And you know why I can tell all this? Because it was clearly explained, they took time to let me understand it. That takes away so much fear and uncertainty. So far I have fainted a few times, but I have learned to recognize the triggers and take my leave when I feel "off". Work has been great, I love the flexibility and the working from home really helps me put in more work as it is a simple trek to my home office and get going. As a patient I always tell the truth, there is no sense in hiding it if I want to get proper treatment. There is also no sense in any drama, nobody wins. Treat the doctors with respect, if they gaslight me I ask them what I am doing that makes them avoid me. Some are intimidated by my size, you know a 6'4" dude with a deep voice and may I say a large statue. Of course they also do not know me as a person and I appreciate them telling me this. We are all people, doctors have a tough job, no doubt about that.

[@bagniacz3264]

Pain scales aren't particularly useful in my opinion. 8/10 may mean many different experiences for many different people. Also irritated, tired or stressed patients may give spectacularly inacurate answers. Lastly, from what I have seen, patients sometimes unintentionally rate other symptomes along with the pain - I remeber how once a patient with suspected Crohn's disease told me that her pain was like an 8/10, when later it turned out that pain itself was mild, but feelings of being bloated and constant trips to toilet were really affecting her quality of live. It makes much more sense to ask how patient's live is affected by the pain and do they feel need to do something with the pain (for exemple stop working to massage aching spot, or take painkillers - if so how often and how strong). "Usually my pain is tolerable, but once or twice a week it's strong enough that I need to take 1 paracetamol pill and go home earlier, if I can" gives al ot more information than "uhh... like, 6 out of 10?".

[@kinpatu]

How about when staff asks me am I still taking x supplement, and I say no I haven't taken that in years, it actually gets taken off my EMR, so I don't have to get asked again in 6 months and when my bloodwork is slightly out of range, my doctor doesn't go look at the EMR and believe I'm taking supplements? That's just the beginning. Maybe getting asked if I have chest pain 4 times (and always saying no chest pain whatsoever) after being admitted to ER for falling and needing stitches on my forehead; then being subjected to a chest x-ray anyway; then reading the report after getting home and seeing indication for x-ray: chest pain. I could go on and on. When medical staff asks a question, they are just going through a legally defined checklist. I could recite the Declaration of Independence; it wouldn't make any difference. No one is listening.

[@JennWatson]

Imo ignore whether a patient wants opioids or not. Use opioids for pain management ( after surgery or car accident) but limit use to 2 consecutive weeks max at any given time.

[@KellykellzGarrett]

I can't tolerate opiates. I throw up from the smallest dose

[@MultiZirkon]

Empiric? -- What about: "You can't have compartment syndrome, because I have a list here that says compartment syndroms can only occur in the calf!"

[@padensposies6009]

It is equal with white and black women....dare ya to ask me how I know