Diabetes for Canadians for Dummies
by Alan L. Rubin, M.D. and Ian Blumer, M.D., F.R.C.P. (C). Copyright © 2004 by John Wiley & Sons Canada. Ltd.
Excerpted with permission of the publisher John Wiley & Sons, Inc. This book is available at all bookstores, online booksellers and from the Wiley website at www.wiley.ca, or call 1-800-567-4797.
NOTE: Excerpts are provided on dLife.com for informational purposes only. The information contained within will not be updated by dLife and may be outdated. Please consult your doctor before acting on anything described here.
Chapter 21 – Top Ten Tips for Getting the Best Possible Health Care
In medical school you learn lots about anatomy and physiology. You learn lots about pathology and statistics. And you learn lots about diseases and how to treat them. But one thing that you don't learn is how to help your patients get the most out of their visits to their health care providers and from the health care system in general. In this chapter we share with you some key tips that we have learned over the years – tips that will help you when you see your health care team, save you time and aggravation, and help you stay healthy.
Prepare for Your Visit
If you were going to be traveling to the Caribbean for a holiday, you would make sure you packed the right things and dressed appropriately for your destination. Well, when you are going to be seeing a member of your health care team it is a good time to make sure everything is ready. Let's say, for example, you were going to see your diabetes specialist. Here's what you'd be wise to do:
Make sure your glucose logbook is ready (and don't leave it behind on the kitchen counter!). If you don't usually write down your readings – and, by the way, we think you should – transcribe them from your meter's memory into your book. If your doctor has readings to review it will be a lot easier for him or her to give you advice regarding your glucose control.
Take your medicine with you. Put all your medicines in bag and take them with you to your appointment. Your doctor will likely want to review then with you. If you prefer to carry a list, it is essential that it be up-to-date and include, for each drug, the name, the dose, and how often you take it. If you are taking alternative or complementary therapies (see Chapter 13) take those with you too.
Check to see if you will be needing any prescription renewals. Some doctors will renew prescriptions only while the patient is with them in their office. If that is true of your doctor, save yourself the hassle of a return visit just to get a prescription: ask your doctor for one while you are there.
Dress for the occasion. It is much easier to be a diabetes specialist in Canada in mid-July than in mid-January. In summer, shirts having replaced sweaters and sandals having replaced boots, it is a piece of cake to check a blood pressure or examine a foot or assess some others part of anatomy. But alas, in Canada summer lasts about 2 weeks (okay, maybe longer in Victoria and, perhaps, even Vancouver). Still, there is no reason for you to not get the physical examination you require just because it is -300 C outside. When you are getting dressed, make sure that you wear clothes that will allow:
- Your neck to be readily exposed so that your thyroid can be examined.
- Your arm to be easily accessed to allow for a blood pressure measurement. Avoid wearing sleeves that cannot be rolled up easily.
- Your feet to be exposed readily so that they will get checked. Pantyhose, for example, may help keep you want, but also they prevent your feet from being examined. (A simple yet highly effective way to make sure that your feet get examined is to remove your shoes and socks while you are waiting for your doctor to come in the examining room.)
Think ahead about what questions you want to ask. If there are certain things that you have been waiting to ask your doctor, write them down and bring the paper with you. Otherwise, you may forget your questions, only to remember them after you have left the office. And that can be very frustrating!
Plan to bring two sets of ears. If you feel that you want the support of a friend or family member, or, equally important, the benefit of two memories, then plan on bringing someone with you to your doctor's appointment.
TIP: If you are going to bring someone with you to your appointment, make sure you ask your doctor if it is okay to have them join you before your companion walks, unannounced, into the examining room. Otherwise, you may severely regret bringing your teenage daughter with you when your doctor asks you whether you are experiencing erectile dysfunction. (Reversing generations – and perhaps more disconcerting to you – your teenage daughter with diabetes may be far less likely to talk to her doctor about her need for birth control if you are sitting there.)
If you will be seeing your dietitian and if you are not the person in charge of food preparation in your house, it is essential that you and your partner both go. Oh, by the way, do not announce to the dietitian that you do not have to know the information because you do not do the cooking. It is unlikely that you will be eating 100 percent of your meals at home, and besides, the food will be going in your mouth – don't you want to know why?
Plan for Your Next Visit
Your diabetes specialist and ophthalmologist likely have heir appointment schedule drawn up many months in advance. Indeed, some specialists are fully booked for well over 6 months. So if you realize on April 1st that, say, you haven't seen your eye doctor for a year and you want an appointment for the next day, the receptionist will likely tell you that you sure are in the spirit of April Fool's Day and wasn't that a good joke you just made.
A much better idea is to book your next appointment before you leave the present one, even if the next appointment won't be for another year. If you are told that you should call to book an appointment because they do not know what the doctor's office hours will be that far in advance, ask when you should call and then mark the date in your calendar so that you don't forget.
TIP: Tired of waiting an hour or more in your doctor's waiting room? Try booking your next visit for the first appointment of the day.
A Requisition for Success
If you have diabetes, you and your forearm are no stranger tot he local laboratory. Typically, your doctor will give you a requisition as you leave his or her office, ask you to go to the lab, and tell you that you will be contacted if there is a problem. Well, we can tell you we immediately see a problem! The problem is that you will have missed out on a golden opportunity to review your test results face-to-face with your doctor. And if you won't be seeing your doctor again for 6 months, that's a long time to be in the dark.
A much better system is to get a requisition as you are leaving your doctor's office not for tests that you need then, but for the tests you will need later (that is, at the time of your next appointment). Go for the tests 2 weeks or so before your next visit and that way, when you arrive for your appointment, your doctor will already have the results and you can review them together.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...