Saturday, August 9, 2008

Health History 101

Over the last few years I've seen many specialists. Some immediate concerns combined with general feelings of "blah" had led me on a search for answers. I am still working on finding the source(s) of "blah."

When you've visited a slew of doctors and they've all given their 2 cents, ordered tests, and written prescriptions, it's important to keep it all straight. Creating a Health History is a step in that direction.

Case in Point #1 - Records
I've seen three dermatologists in one year because I intuitively felt my primary had become overly aggressive, taking an average of 5 biopsies at every 6 month appointment and scheduling follow-ups to dig out more. My second opinion conducted two biopsies just weeks after my first doctor had last seen me (who naturally had just made several biopsies of his own but apparently wasn't too thorough). Maybe moles are like apples or oranges, depending on which doctor you ask. Doctor #3 has been conservative with his slicings - he records and watches. In fact, he has yet to "gut" me (I'm a little dramatic with my terminology). This makes me curious. Is he too conservative? I feel like I've got a goldilocks and the three dermatologists situation going on. Record keeping is especially important when you're looking for the skin docta who is "just right!"

Another recent experience involved my gastroenterologist, GI Jackie (seriously, this is what I called her). She had ordered a cat scan two years ago in an effort to identify the cause of my symptoms. When I didn't hear back about the results, I followed up to see what was going on. "Everything looks fine." I had a gut feeling (no pun intended) that it wasn't but I wanted to believe everything was ok. Fast forward two years later. In the interest of creating a health history and having all my records from every doctor I had seen, I ordered a copy of my cat scan results. I was alarmed to find the radiologist's note on my kidneys.

I called the GI office, wondering why this result had not been mentioned two years earlier. "We specialize in the digestive system," she said. "We don't work with the kidneys." She recommended that any concern with the kidneys be addressed with a urologist. I thanked her for that advice and stated that having that recommendation two years ago would have been helpful.

Note to self - Trust your instincts and find doctors who are thorough. As a back-up I now request all copies of results - for piece of mind and for 2nd opinions.

Case in Point #2 - Medications
When keeping records of current and previous medications for my doctors, I now include any natural supplements. I either experienced a freak reaction at the dentist's office or a horribly strange coincidence. About a week prior to my dentist appointment I had been reading a new book on supplements and foods that allegedly, among other things, contribute to better skin. I also started taking a small supplement for heart health and continued taking fish oil at night.

My dentist didn't ask if I was taking any new "medication" and I probably wouldn't have considered to include the fish oil or heart health pill in that answer. About an hour after the anesthetic wore off I felt a lump in my neck. Another hour later there was a second bump. Over the next few days my neck was inflamed with bumps and hives.

The dentist was quick to establish that her anesthetic had nothing to do with the reaction. At the time I only cared about knowing what was happening and why. I wanted to determine the cause of the reaction, not establish blame.

After researching further I discovered a possible answer - the anesthetic prilocaine may react negatively with blood thinners. I wasn't on prescription blood thinners BUT a lot of the natural supplements I had been taking had the added benefit of...thinning blood. I ended up seeing an allergist when the symptoms got worse. The symptoms eventually ceased but neither the allergist nor dentist established the cause, which might prove helpful the next time I need dental work. My reaction may have been coincidental or may have been related to the anesthesia. I may never find out. Sometimes doctors are more interested in treatment than underlying causes. And sometimes there can be no explanation.

Note to Self - Keep only those doctors that will listen to your concerns and answer all questions you have without making you feel like you are a hypochondriac or gathering information only with the intent to sue them. I now carry a list of current medications to notify any health practicioner during a visit.

Recording a Health History
Hoping to prevent further health concerns, I started to record all medications, diagnoses, history of family illnesses, previous and current health providers and procedures. I also recorded vacations I took (especially if vaccinations were recommended but not taken), my typical daily diet, sleep patterns and exercise. It's been a handy tool for me and my very proactive primary doctor.

Other Helpful Tools
I keep a binder that includes the Health History, labwork, doctor's notes/records, and a notebook. The notebook comes in handy to write any questions or concerns I have prior to each doctor's visit (so as not to forget anything) and take notes regarding necessary follow-up.

Eventually I hope to pinpoint what's going on. The symptoms could apply to a bunch of different things. While it feels a bit chaotic at times, good records-keeping plays a crucial role while providing the added benefit of reassurance that I'm doing everything I can to keep my ducks in a row.