How to Talk to your Doctor about IBD Symptoms
Knowing how to ‘talk' to your doctor sounds simple, but can be difficult when:
1. you don't feel well
2. you are finally sitting in front of him or her
3. you know they'll most likely only have 15 or 20 minutes to spend with you.
Just the short amount of time a doctor and patient have to spend together is reason enough to make the most of that time - it could mean the difference between an efficient diagnosis of your illness (whether it's a sinus infection, IBD, or fibromyalgia) and a long list of tests and further appointments.
Diagnosing Crohn's disease and ulcerative colitis can be difficult and can be made even more so if a patient is embarrassed to talk openly and honestly about their symptoms, problems, and concerns with their doctor. Talking about our bowel habits, flatulence, bloating, and abdominal cramping is never easy, it's not something you chat about in mixed company and other than with babies nobody really cares to hear about the color or consistency of your poo or your ‘going' habits. Except, that is, for your doctor. This is the one person who should know and wants to know about these things. In order for them to help you with your illness you have to help them understand your symptoms.
I think the helpful first step for me was to keep my ‘poop diary' (see last week's blog about Journaling). When I was in a flare-up and felt awful I couldn't imagine that I would ever forget the things I was feeling - the cramps, the bloating, the low-grade fever, the incessant pooping with blood sometimes, mucus other times - but when I was feeling better, I did forget. Perhaps not the exact symptoms, but it was easy for me to put into the back of my mind just how bad the symptoms were and how truly awful they made me feel, and just where the most severe cramps were located.
But, by writing down how I felt every day (whether a ‘good' day or a ‘bad' day) made it much easier for me to recall how I'd felt over the past weeks or months since I last saw my doctor. And really, it only took me 5 or 10 minutes each day to do write this stuff down - sometimes if I was stuck on the toilet I'd just take my notebook in there with me and use the time to jot down exactly what was happening and how I was feeling. Then, a few days before a doctor's appointment I would make a list of what I wanted to talk about with my GI. I actually got to the point where I would type up a ‘report' that I could leave with him so that if I forgot to mention something or ask him a question it was left with him and his staff in black and white. This ‘report' - which included the medicines I was currently taking, status of my general health, new problems I was experiencing, status of old problems, and any questions I might have - also helped me to come to terms with how I was feeling, what had helped, what hadn't helped or what made things worse, my current concerns or questions, and any adverse reactions I may have had to a prescription medicines he gave me at my last appointment (I do not react well to many Rx medicines, OTC medicines, or natural medicines and it can get hard to keep the reaction straight if I don't write it down).
I've tried this ‘report' or ‘list of questions' method with both my GI and my general practitioner and so far none have balked at it. In fact, I think it is as helpful to them as it is to me because it allows the appointment to be more proactive and useful since I know what I want to say, have a clear idea of my questions, and can clearly discuss my symptoms and how they have improved or worsened.
If you have IBD or even IBS you'll quickly get over any embarrassment you might feel talking about your bowel habits. Poo is, in one way or another, a top-of-mind part of your life now. And remember, if you're seeing a gastroenterologist these are physicians whose job it is to talk about and understand the function of your bowels. You're not going to say anything that could embarrass them, nor are you likely to say anything or tell them about a symptom or problem that they haven't heard before. They aren't going to point or laugh at you, or wrinkle their nose in disgust, this is their job. They are there to help you, but even with the best medical school training and umpteen years of practice under their belts your doctor can help you best if you give them as much information about you, your family history, your symptoms, and your problems as you can.
Your relationship with your doctor (any doctor) is just that, a relationship. It's not unlike the one you have with your girlfriends, or your spouse. First you need to find one with whom you feel you can have a comfortable and trusting relationship. This could mean seeing one, two, or more doctors before you find the right ‘fit' for you and them. You want to feel comfortable with this person because if you aren't able to share your symptoms with them, as well as your fears and hopes for moving forward, you just might be making it harder for your doctor to help you.
You can read about my personal experiences of working with my doctors in my book, Living with IBD & IBS: A Personal Journey of Success - http://www.ibdandibs.com/.