(This is a follow-up to the Snowball Appointments post)

The orthopedist was terrific – once we got through the layers of bureaucracy to actually see him.  He looked at the written history I provided, asked us questions, said that he thought that whatever is going on is outside his area of expertise, examined my daughter, and agreed with me that there is something very wrong.  But it’s outside his area of expertise.

He thinks my child needs a rheumatologist.  Even though we’ve already seen a rheumatologist and had a workup, he thinks that’s what we need.  He will fax all our information to the medical school tomorrow and ask their pediatric rheumatology department to take a look.  They will look everything over and decide whether or not they think they can help us.

It’s nice that we don’t have to go in for yet another appointment unless they think there’s something they can do.  It is not nice to have my daughter feel like a ping-pong ball.

In addition to the tentative referral for a pediatric rheumatologist, we have a definite referral for physical therapy.  The kid hates obtaining medical care, and is supposed to go to PT twice a week for the next six weeks.


Appointment Prep

A trip to the see the doctor – even for a “simple” follow-up appointment – is much more than quickly checking in at the front desk, then popping into the exam room for twenty minutes.

  • In my house, preparation begins in advance:
    • For new physicians, I have the office mail me the paperwork so that I can complete it accurately in a relaxed atmosphere.  I hate being told to check in half an hour early so that I can balance a clipboard on my lap to fill out paperwork.  It’s so much easier to take my time in the comfort of my own home.
    • For referrals, copies of x-rays, lab reports, etc. are needed.  I make a list of pertinent results and if it’s for something I don’t already have a copy of, phone the testing facility.  A disk with x-rays or MRI results is $30 for my personal records, but free if I’m taking the disk to a doctor.
    • I keep a running list of questions between appointments so that I’m able to sort through all of them and type out anything I need to ask the doctor. 
    • One doctor has me track a week’s worth of symptoms prior to every follow-up appointment.  That requires paying attention to symptoms for a week.  Answering, “It takes a while; I don’t know how long,” to a question that I know will be asked, would not be helpful to my doctor.  Instead of just enduring swollen hands in the morning, I have to watch the clock to know how long it takes for the swelling to go down enough that I can close my fist.  Instead of keeping off my feet as much as possible, dealing with the pain when I can’t, and avoiding trips up and down the stairs, I have to keep track of how long it takes until I can move around reasonably well.

  • The day before my appointment:
    • verify that I’ve completed the doctor’s paperwork
    • see how many refills I have left on my prescriptions (it says on the bottles)
    • type up my “why I’m here” half-sheet
    • arrange coverage (check schedules/assign work) for everyone while I’m away
    • find clothing for the appointment
    • write a check to cover my co-payment & put it with the paperwork
    • put MRI/x-ray disks and other pertinent test results with paperwork, if appropriate
    • sort through my running list of questions, and type out the ones that I want to ask the doctor at this appointment
    • put all paperwork into car, ready to leave in the morning
    • bake bread/cookies/cake for the office staff (except my FP’s office would prefer a vegetable tray)


  • The day of the appointment:
    • finalize coverage so that things run smoothly in my absence
    • allow adequate travel time (I try to be 15 minutes early, just in case traffic is slow)
    • take notes during the appointment so I don’t forget details later
    • review all notes at the end of the day; clarify anything that’s cryptic so I can I look back at a later date and know what it means

As for clothes selection, the doctor probably doesn’t care what I wear, but I try to anticipate what will be needed.  If my shoulders will be examined, then I wear an open blouse over a tank top; it’s easy to slip the blouse off so that my shoulders are available without having to change into a gown.  If my feet/ankles/knees will be examined, I need to wear socks instead of hose.  Since blood is almost always drawn, it’s important to select a top that allows access to my veins; tight cuffs and sleeves that won’t loosely roll above the elbow are definitely off-limits.  If x-rays will be ordered, it’s easiest to wear a sports bra under my top, and elastic waist on skirt/slacks so that there’s no metal anywhere; buttons interfere with chest x-rays, so blouses with buttons are out, too (unless the blouse is being worn as an easily removable jacket).  Of course one can always undress in the little changing room and wander around the hospital in those flimsy gowns, but it’s much easier to plan ahead and find an outfit that meets all these criteria.

Sometimes the doctor orders fasting blood work, so I try to schedule my appointments early in the day and wait to grab breakfast until after I’ve seen the doctor.  I get hungry, but this is much easier than having to make a separate trip on another day.  This also presents a small problem, since I take meds at every meal and try to eat/take pills at the same time every day.  Figuring it’s not the end of the world, I pack my day’s medications along with me so that I can take them as soon as my blood is drawn and I get some food into my stomach.

It’s time-consuming, but worth doing.  I feel like I’m prepared.  My doctors listen to me and address everything that needs to be dealt with.  They answer my questions.  My appointments go well.  At least they go well for me; I hope that my attention to detail in preparing for appointments doesn’t annoy my doctors.

There’s a post here giving a doctor’s perspective on getting the most from your appointments