Skip to content

Understanding your history leads to better health

To coincide with the launch of Google Health, I thought I would encourage you to take stock of your medical conditions, drugs and risks. This will improve you ability to have a good relationship with your doctor, and better outcomes for yourself.

How should I take stock?

This is the easiest thing in the world, but it will involve a little time. Take a paper and pencil, your favourite word-processor or one of the more technological solutions suggested below, and make three lists.

  1. List all your present and past medical conditions
  2. This includes anything you were treated for as a kid (you can leave out colds and flu’s unless they caused a hospital admission), anything you have been in hospital for, or taken long term medication for. Take a highlighter and mark those conditions that you think are still important to your health. For example, if you had a hip replacement 6 years ago, it may not cause you problems now, but you know that it might break down at some point in the future, so you still need to be aware of it.

  3. List all the medications you now take
  4. Try to work out for each medication when you are meant to take it, how many you should take and how strong the tablets/injections are. If you can, write out what the medication is for, and what other names it has. Finally, try to make a guess of how regularly you actually take the medication correctly. Remember, you are the only one that is reading this.

  5. List all the doctors and health professionals who look after you
  6. Make sure you have their contact details and write down which conditions each of them thinks they help you look after. Write down the next appointments you have with any of them. For each write down when you should make a new appointment. For example; “Make an earlier appointment with Charlie the Physio if I have worse back pain.”

Let these lists bounce around in your head for a little while to make sure they are complete and you haven’t forgotten anything. Now take a good look at your lists.

There are probably some conditions that you are not sure about, and don’t understand. Maybe there are medications you don’t know what they are for, or are forgetting to take. For those medications that you are worst at taking, make sure you know what they are meant to be treating. Check your final list to make sure all the doctors and clinics you see are listed, and you are not due for a new appointment with any of them.

What is Google Health?

Google Health is a new service offered by the omnipotent Google. Basically the idea is you enter all of your health information into one secure account. It keeps a track of all your conditions and medications, and all of the information that was previously on index cards (or in your head) is kept secure.

But there’s more. With your account, you can access interesting information about your conditions, search for US doctors and navigate to their websites, keep track of doctor contact information and even share the information you have entered with other people. This works in a secure way, and could be used to give your health information to a doctor, or your next of kin in case of an emergency.

This is not the only product in this market. HealthVault and Revolution Health offer similar products.

How does reviewing your health information help? What should I do now?

Once you have your health information in one place, save it and review it regularly. It is to your advantage to know what is going on with your health. If you have a printable or paper version, tuck it in the corner of your purse and keep it with you. This improves the care that you get - both in preventative medicine and any emergencies that occur.

I have seen this system in use and it works wonderfully. It wasn’t initiated by me, but my obstetrician when I was pregnant with my children. At the end of each office consultation, she would print out a summary of all the tests results, philosophical discussions and medications that were relevant. When I arrived for my deliveries in a state of panic and disarray, I handed the most recent print out to her, and she knew everything she needed to. It would have been the same if we ended up in a strange hospital or if her computer battery failed. It was the perfect solution to reduce my stress, and make her job easier.

Try your health audit today. Make sure there are no chinks in your knowledge and you will reap the health rewards.

How to find an after-hours doctor

Doctors work around the clock, but it seems the ones that work after hours hide in the shadows a bit. Finding a doctor in public after 6pm needs more than a little luck. And if you manage to catch one, you have often dealt with a long wait and a higher than usual fee. When your medical problem is a roaring emergency, the answer is easy - simply call an ambulance or high-tail to the emergency department (where a little inside information will help shorten your wait). But when your problem is simpler, accessing a doctor seems a lot more complicated.

You can imagine the situation. It’s 7pm and you are just making dinner when you slice your hand with a knife. “Ow! Swear word! Ow!” you exclaim, as you compress the cut with a clean cotton dishtowel (rendered relatively sterile by the iron). The cut is not huge, and you are pretty sure it is not too deep, but it won’t stop bleeding and you think you might need stitches. You are faced with the major modern medical dilemma - how do you find a doctor in the evening outside your local emergency department?

This situation can be stressful and it is often combined with other considerations. Maybe you have to look after your kids. Maybe you have an early start in the morning and can’t be up after midnight just to get your hand chacked. There are a number of ways to make it easier, and less stressful.

Get to know a doctor personally

This is one of the best ways to get to see a doctor when you need them - rely on familial obligation. Be careful with this tactic, though, as it can backfire. If the doctor is a member of your family, you will have to respect them a little bit, as you would if they were a “real” doc. If they are a friend, you really only can do this once or twice before they stop answering your calls. So pick your health emergency with care.

Finally, make sure the doctor you choose to befriend is appropriately qualified. When I was deciding what specialty to choose, my Dad strongly argued against paediatrics, purely because he could see that he would never get his “money’s worth.” For the record, he favoured general practice, surgery or psychiatry.

Get to know Doctor’s staff personally

Most doctors are pretty malleable and are particularly at the mercy of their staff. As in all industries, good staff are hard to find, and you want to do favours for them, if you can. If you can marry a medical receptionist, or carpool with a practice nurse, you will have a reasonable chance to manipulate an after hours appointment in an emergency.

For this to work, you really need to have a real emergency or extenuating circumstances to persuade your friend to pull in a favour from their boss. They must also be a treasured member of staff, so make sure your friend is not a nuff-nuff. The doctor will only go out of their way to coddle a member of staff they want to keep on their payroll.

Call your regular doctor

All primary care doctors have an ethical obligation to provide after hours care. Sometimes they have a roster of doctors on call, or they may employ a locum service. Some prefer you to attend the local after hours clinic. The best way to find out what your doctor would want you to do is to phone their main number and listen to the recorded message.

If you are lucky, you will find out that your doctor has extended their hours since you last checked, or may be willing to stay a little bit longer to fit you in.

Visit a 24 hour clinic or “Super Clinic”

Super Clinics are usually open all hours, often with more staff available after hours. The quality of staff varies, although all are qualified to a minimum standard. These clinics are a good solution for any after hours primary care emergencies, like cuts and grazes, sprains, colds and flus, and childhood illnesses. The system varies, but usually you attend and simply wait until it is your turn. Usually the wait will be longer than an appointment with your regular doctor, but shorter than attending a hospital ED.

These are not good places to go if you have a condition that could deteriorate rapidly, like chest pain, or asthma. It is better to have these things assessed by hospital staff.

These are also not good clinics to attend for regular appointments, as you can’t usually get repeat appointments with the same doctor.

Call a locum service

Locum services provide primary care doctors that make house calls after hours. This is usually a paid service (as are most after hours services). Again, you will have to wait an unpredictable amount of time, as it depends on what other patients have called in. However, you get to wait in your own home for the doctor to visit you. This is particularly valuable if you feel rotten, or you are minding children who are asleep.

Locum services will communicate with your regular doctor so they know what has occurred. If you are not sure how ill you are, locums are generally a good option. You can cancel the call if you decide you feel better. And if your condition deteriorates, you can call an ambulance.

What to do now

When it is 2am and your partner is having an episode of abdominal pain, it is really hard to figure out what to do, and often they are not helpful (she speaks from experience). It is important to figure out your plan in advance. Search your telephone guide right now and find where your local after hours clinics, and the number of your town locum service. Next time you visit your doctor, ask the staff what to do for after hours care.

Being prepared, and in the know, will help you find the “doctor of the night”.

Technorati Tags:
, , , , ,

How to know when your child is really sick

When your child is sick, everything seems to crowd in and collapse on you. It is difficult to cope, let alone sort out what to do.

Recently, my ten month old son pulled a bowl of boiling porridge onto himself. Our lovely family breakfast was shattered by his screams, which cut straight to our hearts. Almost immediately, his sister became distressed, more able to express herself than we were. After a morning in the emergency room, and ten days in silver dressings, the burns to his arm have healed well. At that time, it was a disaster, but we were lucky: we knew that he was sick as soon as it happened. We knew to strip his shirt off and pour water on him. And we knew to seek medical care immediately.

When I was working in the emergency department, we had a patient arrive in the middle of the night by ambulance. He was a two year old boy, and he had a cold. He was unhappy, but not particularly sick. His mother had been investigated by child services in the past and was keen to “prove” that she cared enough. He wasn’t that unwell, but we all understood how she got herself in that situation. I think the junior docs were a lot more understanding than the paramedics, though.

So how do you know when your child is really sick?

Kids can get better very fast, but they can also get very sick very quickly. Unlike adults, they can sometimes seem a lot more settled when they are really sick. This can sometimes trick people into missing the signs, so how do you really know?

Beware of the cuddly child

Children who have accidents or get colds and flus are normally cranky and irritable. They normally have insufficient sleep, and it shows. They often want lots of cuddles, but they are usually pretty unsettled at the same time.

However, when kids get really sick, they can become very flat. “Flat” is a word medical staff use that looks exactly what it sounds like: an infant or child with little facial expression, cuddling their parent, but not really distressed when they are put down. They tend to have no energy, and don’t really react to what is going on around them. Sometimes, it can seem like a sick child has “settled.” But if your child gets sleepy and drowsy, and stops really noticing what goes on around them - call an ambulance. They might be really sick.

Check their nappy or potty

Do you notice when your child goes to the potty? When children are sick they dehydrate rapidly. A lack of wet nappies or wees in the potty is one of the early signs that they are not doing well. If you pick it up early, you can prevent disaster. A common example of this is gastro. Gastro isn’t usually life-threatening and usually only needs hospitalization if the child gets dehydrated. If you think your child might be dehydrated, give them water or diluted juice, or anything they like and can keep down. If you can’t fix it, see a doctor immediately.

Believe your child

My two year old is currently learning how to manipulate her parents. She often tells us she “has a sore tummy,” but if we ask further questions, she explains that she “needs choc to fix it.” Last Thursday, she spent the day telling me she had a sore tummy and needed cuddles to fix it, so I gave her lots of cuddles and reassurance. When I got to the end of the day, I realised she had emptied her bowels four times over the course of the day. In retrospect, she probably was having cramps and was feeling pretty rotten.

Sometimes it is easy to take our kids verbal skills for granted. Often they can tell us when things are wrong and they feel awful: they are not always trying it on. While we deal with their manipulations, it is important to realize they might be telling the truth.

Believe yourself

The truth is, almost all parents know when their child is really sick. Unfortunately, we feel so much pressure to do the right thing and be good parents that we fail to believe our own judgement. It is ok to get it wrong. It is ok to feel stupid. If you think your child is sick, then call an ambulance, beat down doors and wring necks until you can get someone to pay attention to you. You might be wrong, but there is an excellent chance you are right, and that is the only important thing.

Technorati Tags:
, , , ,