I don’t think my doctor is taking my symptoms seriously enough. What can I do?

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PreparedPatient (Organization (Verified) ) - 08 / 01 / 2011

Be clear and persistent! A recent report in the New England Journal of Medicine found numerous studies showing that doctors often downgrade the severity of patients' self-reported symptoms, particularly when it comes to medication side effects. This is case when keeping a symptom diary can come in handy—specific data can help both you and your health care team.

For more advice about talking to your providers about symptoms, see our full-length feature article:http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue8.cfm

AZBodyMindCounseling (Professional Therapist (Verified) ) - 07 / 29 / 2011

There are a couople of things I might add to this, having been a nurse.

1. Ask yourself how you will know when the doctor IS taking your symptoms seriously. What will you see or experience when that happens? Are you concerned you aren't getting proper treatment or enough treatment, or are you wishing for some compassion and emotional support from your doctor? Expect that you may not get 100% relief from all of your symptoms all of the time, but don't suffer in silence because you fear your doctor's wrath if you tell him about that pain or nausea again.

2. Doctors and nurses have a hard time quantifying how much a symptom is affecting a patient. That's why there is a scale for pain, for example, that runs from 0 to 10. Health Care professionals use this to try to create a level playing ground on which to communicate. Be as descriptive of the symptoms as you can be and let the health care professional know how the symptom is impacting you. "The pain is so bad I can't cook dinner for my family." "I'm so dizzy I can't walk down the hall when I need to urinate." These sorts of descriptions will let the professional know that it isn't just an annoyance, it's impairing your ability to function.

3. Not every symptom is related to what the health care professional may be treating you for. Sadly, our medical system is structured into silos; oncology, family medicine, internal medicine, gastro-intestinal, proctology... you get the idea. Specializations are great from the standpoint of getting expert care, but they don't help when patients have symptoms that might be outside a treating specialist's area. In cases like this you may need to ask, "Do you think this is related to what you are treating me for, or do I need to see a different sort of doctor?"

4. When people become anxious (which many people experiencing cancer diagnosis and treatment often times can), they may become hypersenstitive to what the body and mind tell them is going on. This is a natural effect of the fight/flight response that can be triggered by an accumulation of stress. Not to say that you don't experience the symptoms, but they may not be an indicator to the doctor of an urgent problem that needs to be treated. It might also be that treating a particular symptom might interfere with other treatment that is more urgent. Tell the doctor about your symptoms and then tell him what you just understood his response to be. Then ask if together you should alter the care you are receiving.

"Doctor, I feel pressure and pain at about an 8, especially when lifting. It's making it difficult to pick something up and move it."

"Well, I don't think that's anything to be concerned about. You should be resting. I'll see you next week."

"Doctor, I understand that you don't feel it's anything to be concerned about, but I brought it up because I AM concerned. Now, do you think there is some way we can decrease the pain without interfering with my treatment? I'd really like to be able to do as much as I can around the house. It helps me to feel normal."

5. Doctors, like any other experts, sometimes forget that their patients don't have the same level of knowledge about their conditions and need to be clued in to what they can expect and what may be "normal" symptoms/side-effects that are experienced during treatment. Keep asking and consider approaching other health professionals until you get an answer that puts your mind at ease. But be careful you don't end up doctor shopping until someone gives you a prescription. "Too many cooks spoils the broth." All your health care providers need to be aware of your medications and other treating physicians so that they don't end up over medicating you or prescribing treatment that is contra-indicated for another health problem.
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Tambre (Complementary Care Expert (not verified)) - 07 / 29 / 2011

Sorry to hear you feel you're not being heard about symptoms you are experiencing. There are several actions you can take to resolve this:
1. Write up a list ahead of time of each symptom including how often you're experiencing it, how it is impacting your life and then scale it on a scale of one to ten with ten being the most severe, how severely are you experiencing this. For example, if you have itching (my late husband went through months of his skin itching non-stop as a side effect of his treatment) on a scale of one to ten how severe is it? A five? A seven? A nine? This helps to create a point of reference -and as you experiment with possible solutions you can scale how well it is working - for example if you try a medication and the itching reduces to about a four from a nine this helps both you and the doctor understand the degree to which your symptom is responding in your experience of it.

2. If you feel applying communication tools isn't going to help with your doctor, talk to an oncology nurse or the clinical director at your treatment facility. Outline your symptoms and ask them to recommend who you should speak to about them. If they refer you back to your doctor, then let them know you've discussed them before but don't feel they've been addresses and ask for some coaching on how to clearly communicate to your doctor about them.

3. You can also look into hiring a patient advocate or having a loved one or friend come with you to help ensure you get what you need. When I was caregiving for my late husband, I served as his advocate. I had more freedom to be more vocal about helping him get his needs met. Sometimes some patients feel fear around rocking the boat with their oncologist or doctor because they are relying on this person to heal them.

Fsechzer (other) - 07 / 31 / 2011

What is causing your feeling?
1.Is it a communication problem? Do you not feel being heard, or not being responded to in the manner you want? If the problem is in communication (not being heard), you can ask the doctor if he understood what you meant when you explained your symptoms.
If you didn't get a response in the manner you wanted, tell your doctor the type of information and the level of detail you would like him/her to communicate to you. Statistically doctors give complete information to about 50% of patients, because of their assumptions as to how patients want to communicate.
2. Is it a problem of inadequate medical care? If you believe that your symptoms warrant intervention your physician is not providing, you can get a second opinion.

In both cases you don't need to add another struggle and stress to your life.Communicate with your doctor openly and honestly and feel the power to do what you feel is the best for your health.
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