Friday, September 5, 2008

Reading "YOU: The Smart Patient" as a Migrainuer



If you have ever read any of the YOU books by Michael Roizen, M.D and Mehmet Oz, M.D., you are familiar with their desire to present essential information that is not diluted straight to their readers. Their approach is humorous in a way that helps you remember what you are reading. I am especially fond of YOU: The Owner's Manuel. If I had only had this book in college biology, I think I might've gotten an A.


Another fantastic book by the same authors, YOU: The Smart Patient, is an insightful read particularly because it is written by doctors for patients. While keeping an intellecutal yet humorous manner, they let their hair down and share insights on health care from their perspective. As a Migraineur, I found this book particularly helpful because although it is directed toward the general population, it contained nuggets of information that specifically informed my experience as a Migraineur. YOU: The Smart Patient also educated me on important topics such as alternative treatments and getting a second opinion.

Dr. Roizen and Dr. Oz emphasize the importance of "finding Dr. Right." They have a section on questions to ask a doctor's office when choosing a doctor and examples of answers they judge as "good" or "shaky". The following question they proposed may be helpful for migraineurs to ask of neurologist offices: "Which types of patients does the doctor usually see?" Using the author's example answers in context of Migraine, a "good" answer would be people who have similar health issues to you such as Migraines/headaches. A "shaky" answer would be people who have health issues that are not similar to you such as stroke or degenerative diseases.

Another question they proposed that would be helpful for Migraineurs is "Is the doctor especially qualified to treat patients with your condition?" Their suggestion is that a "good" answer would be affirmative with examples of how s/he is qualified by training or special certification. A shaky answer may be if they do not give any reason why they are qualified. For Migraineurs, it is important to know that the neurologists that we see are indeed specialists in Migraine/headache. For more information on what makes a neurologist a Migraine/headache specialist, check out this article: Migraine and Headache Specialists - What's So Special? by Teri Robert.

In YOU: The Smart Patient, the authors include a checklist on what to bring to an appointment. One item I thought particularly helpful was a tape recorder with a blank tape and fresh batteries. Even when taking notes, I still forget some of what my specialist says. A tape recording of my appointment would enable me to review my Dr.'s reactions to my symptoms & side effects, his
answers to my questions, his prescribing directions, and his reasoning for new medications. Of course they suggest writing down specific questions that you want to discuss ahead of time.

Dr. Roizen and Dr. Oz suggest asking questions every time your Dr. recommends performing a test (i.e. MRI or CT scan) and when s/he prescribes a new prescription. Though their suggested list of questions is long, some, key questions stick out, such as: "What is this for?" "Why do I need it?" "What can go wrong?" "What are common side effects?" and "How should I take this?"
An informed patient is a smart patient.

Making friends with your pharmacist is also recommended because they are a very readily available and knowledgeable source of information regarding prescriptions. And this book, in fact, is very informational about medications in general. Medications are listed with potential interactions. This is essential knowledge for Migraineurs because often we take more than one medication, which could potentially result in unwanted side effects.

On the sometimes delicate topic of getting a second opinion, Dr. Rozien and Dr. Oz say "Never think twice about getting a second opinion." "We can be wrong and we can be wrong a lot." Hearing a doctor admit they can be wrong is refreshing, but also gives more importance to the caution we need to take when thinking about the treatment we are receiving from our specialist. Perhaps it is time to push our doctor about considering other treatment options. Or perhaps it is time to get another opinion on treatment options. Sometimes more heads bring more and better ideas.

However, the authors did warn the reader that scam artists often swarm to and target those who have chronic health conditions, such as Migraine. If something sounds too good to be true, it probably is. They say to watch for "claims supported by unidentified studies or testimonials from people using phrases like 'it saved my life, improved my sexual performance, and buttered my bread, too." They also warn about treatments that boast curing unrelated problems such as dandruff and boosting short term memory. Getting a second, third and fourteenth opinion is sometimes necessary and helpful, but make sure to bring your thinking cap along.

According to these doctor authors, being a smart patient is being a smart detective, and as the anology holds, "no smart detective would hang his whole investigation on a single witenss's story without making sure it checked out." Investigate. Read. Question. Educate. This is how we can further our chances for finding the best Migraine treatment out there.

Another great chapter for Migraineurs to check out is the one on alternative treatments. The importance of sharing with your doctors all alternative treatments you are receiving is highlighted. Additionally, the authors expound on the differences between the alternative treatments in which Americans reportedly spend fifty billion dollars a year. The treatments discussed include the following: chiropractic, acupuncture, naturopathy, homeopathy, massage, hypnosis, supplements, vitamins and herbal remedies.

YOU: The Smart Patient has so much helpful information on these topics and others including surgery, hospitals and hospital stays, patients bill of rights and health insurance. The book is a must-read for all people who are patients (and who isn't?), especially Migraineurs.

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