Preparing for an Appointment With a Specialist

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Going to a new doctor does not have to be an overwhelming experience. The key is to be prepared ahead of time. Following are some ideas to get ready to see a specialist for the first time.

The Legwork of Getting Ready to Consult a Medical Specialist

The first thing to understand is what the purpose is of being referred to a specialist. What does the general practitioner hope to accomplish by sending the patient for more specialized care? Will it be the patient’s duty to report the findings back, or will the two doctors be in communication over the medical condition?

Ask the general practitioner who he or she recommends as a specialist, but don’t stop there. For instance, if the other doctor will be a neurologist, rheumatologist, high risk ob/gyn, etc, ask friends and family for recommendations as well. Often others' personal experience can be very valuable in making big decisions like this. The internet can also be a valuable recourse for reviews of doctors and medical centers. Do some homework before choosing a doctor.

Check with the insurance company to find out what doctors are covered and what the patient’s financial responsibility will be. Also ask if a written referral is necessary, and obtain one from the general practitioner if required.

Sometimes, if the situation is not urgent, there can be a waiting period of a few weeks or a month before the appointment. Use this time to collect all medical records to bring to the appointment. Also prepare a list of any medications being taken, both prescription and over the counter. Start thinking of questions to ask the doctor, and make a list to bring.

The Day of the Specialist Appointment

It’s a good idea to bring a family member or close friend to the appointment, both for company and to ask any questions that may have been forgotten. Four ears can also listen better than two, and when a patient is nervous, it can be helpful to have someone else there to listen to instructions.

Check the route to the medical center or office ahead of time, especially if unfamiliar with the area. If possible, it’s even a good idea to take a dry run there a day or two before the appointment so as to feel comfortable with the directions.

Plan to arrive at least 20 minutes before the appointment time. This will allow time for filling out paperwork and getting settled and calmed down before the appointment. Fill out all answers honestly and thoroughly, this makes it much easier for the doctor to know what’s going on. If possible, clear the rest of the day of responsibilities, that way if the waiting time is longer than anticipated or the appointment itself is lengthy, there will be less stress.

Seeing a new doctor can be stressful in any situation. Often, if a specialist is getting involved, it may be more so. Being prepared ahead of time and having everything in order on the day of the appointment can make the situation much easier to deal with.

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Participatory Health: A New Paradigm Centered Around the Patient

participatory health

The National Council on Aging reports that one third of all chronically ill people say they leave a doctor's office or hospital feeling confused about what they should do to continue their care; 44 percent of people (aged 44 and older) with chronic conditions want their doctors to spend more time talking with them; and 57 percent report that their healthcare providers have not asked whether they have help to manage their conditions at home.

Most of these concerns arise from the fragmented nature of health care delivery in America and the fact that there's often a gap, a disconnect in the amount of digital health information and the exchange of data among providers, patients and caregivers. How often do patients go in for routine tests but never receive a call about their results, good or bad? Why do some patients wait hours to see a physician, only to spend 15 minutes in the exam room and not have all of their concerns heard or addressed?

The healthcare system today is so taxed that physicians often feel pressure to see as many patients as possible, in the shortest amount of time. Though it's a sad state of affairs, the impact can be minimized through today's increasing reliance by society on mobile devices, which can lead to better patient-provider interactions. mHealth, participatory health and participatory medicine are just a few terms that address this new area of healthcare but what do they all mean?

Understanding mHealth

According to the mHealth Initiative, only one year ago, many people didn’t know the meaning of the term "mHealth." Now more and more individuals are familiar with the term (also written as m-health or sometimes mobile health), a recent moniker for medical and public health practice supported by mobile devices.

With the lofty, ambitious and admirable goal of connecting providers, patients, payers, and others came a complement to this endeavor, the idea of better communication in healthcare through participatory health.

Defining Participatory Health

Most experts define participatory health as a partnership between patients and providers and trusted experts, one in which participation is enabled and enhanced by technology such as the Internet and mobile health platforms.

Participatory health is also sometimes referred to as participatory medicine, a movement in which networked patients shift from being mere passengers to responsible drivers of their own health, and in which providers encourage and value them as full partners, according to the Society for Participatory Medicine.

The Need for Participatory Health

In a September 2009 report prepared for the California Healthcare Foundation, "Participatory Health: Online and Mobile Tools Help Chronically Ill Manage Their Care," Jane Sarasohn-Kahn, M.A., M.H.S.A, Think-Health, includes the following quote that speaks volumes about the state of healthcare today and the need for participatory health:

"In our country, patients are the most under-utilized resource, and they have the most at stake. They want to be involved and they can be involved. Their participation will lead to better medical outcomes at lower costs with dramatically higher patient/customer satisfaction." - Charles Safran, M.D., President, American Medical Informatics Association in testimony before the Subcommittee on Health of the House Committee On Ways and Means, June 17, 2004

To this end, companies like Healthetreatment strive to enable individuals to share health and wellness knowledge so that others diagnosed with the same or similar conditions can learn from their experiences. Simply put, the site is creating a catalog of health conditions, symptoms and treatments compiled by real people.

According to Mike Bennett, the founder of Healthetreatment, user-generated health information is more robust and more current than existing medical resources. The key to being current and comprehensive, in his view, is to keep people coming to the website to provide the latest information on their condition.

Achieving the Best Potential Health Outcomes

By linking the patient back to his or her physician or healthcare provider, the m-health and participatory medicine movements will go a long way toward ensuring that patients receive the best possible care and that they play a critical, central role in their own health and well-being. As the e-patient movement gains momentum, the power of the online crowd will grow, allowing for improved medical outcomes and quality of life through better healthcare communication.

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Scoliosis – One of Several Disorders of the Spinal Column

scoliosis

Scoliosis is a condition where the curve of the spine, or backbone, is not aligned correctly. In a person with scoliosis, the spine curves from side to side instead of in a straight line. On an x-ray, the shape of the spine may look like the shape of the letter S or the letter C.
According to the National Scoliosis Foundation in its “Information and Support” section, scoliosis affects two to three percent of the population. An estimated six million people in the United States has some type of scoliosis.

Classifications of Scoliosis

There are five main classifications or types of scoliosis which relate to the possible cause. The most common class is called idiopathic, which means the cause is unknown. This class is further broken down into subclasses which describe the age of onset. Idiopathic scoliosis is sub-classified as infantile, juvenile, adolescent or adult.


The second class is called congenital scoliosis. In this class, the abnormality of the spine existed at birth or the cause was due to vertebral abnormalities that were present at birth.

The third class of scoliosis is called neuromuscular. Neuromuscular scoliosis develops as a result of a secondary problem of another medical condition. Conditions such as spina bifida, spinal muscular atrophy, marfan’s disease, cerebral palsy or some kind of physical trauma can impact the formation of the spine as well as the curvature of the spine.

The fourth type is called functional scoliosis. An abnormal curvature of the spine develops because of a problem in another part of the body. One leg being shorter than the other, frequent back spasms or pain in the hips and knees can, over time, impact the normality of the curve of the spine.

The fifth class or type is called degenerative scoliosis. This type is more often seen in adults and is caused by changes in the spine due to age. Some conditions that lead to curvature of the spine due to age include arthritis, weakening of ligaments, muscles, and soft tissue and development of bone spurs.

Signs and Symptoms of Scoliosis

Most cases of scoliosis are mild with slight noticeable changes in the body. Most cases do not cause pain. A person with scoliosis may notice that his clothes do not fit as they did before. Or, he may notice that one pant leg is longer than the other.

Other signs of scoliosis may include uneven muscle formation on one side of the spine, a more prominent shoulder blade or rib prominence. The lengths of the hips or the shoulders may be uneven. A female may notice that one breast size or location is slightly different from the other.
In severe cases, scoliosis can cause more severe symptoms. A person may experience slower nerve action or aches and pain, especially in the back. Due to the asymmetry of the chest, a person with scoliosis may find it more difficult to take a deep breath or may have periods of shortness of breath.

In the severest of cases, pressure on the heart and lungs can cause circulatory and more serious breathing problems. And, finally, severe scoliosis can restrict a person’s physical activity and mobility, according to the article “Scoliosis Symptoms” on the Mayo Clinic website.

Treatment for Scoliosis

The treatment or the management of scoliosis is determined by the type of scoliosis, the severity, the person’s age, likelihood of progression and the symptoms. There are four conventional treatments that include observation, physiotherapy, bracing and surgery.

Observation involves routine evaluations and x-rays by the physician. Treatment of idiopathic scoliosis will be based on the age when it develops. If the spinal curvature is minimal and remains below a certain degree, no other treatment is needed.

If during the observation period, the spinal curvature progresses, a brace may be recommended. Bracing may be more effective in the juvenile idiopathic type of scoliosis because it is this type that has the greatest tendency to progress. The goal of bracing is to prevent the curvature from getting worse until the adolescent has finished growing. When bracing is not meeting this goal, a more aggressive type of treatment may be indicated.

In the neuromuscular scoliosis types, bones of the spine have developed abnormally and it is this type that most often will require surgery to stop the spinal curvature from getting worse. When the progression of the curvature causes lung and heart problems, surgery may be the only effective treatment.

With functional scoliosis, the type where the abnormality is caused from somewhere else in the body, treatment is not directed on the spinal curvature. Treatment in these cases, if treatment is necessary, is focused on relieving the symptoms and correcting the source of the problem.
A person with degenerative scoliosis or a type of scoliosis that is causing pain, especially in the back, will be treated with pain relieving methods. Some treatments that could be recommended here are physical therapy, exercises, chiropractic intervention, bracing and pain relieving medications. If these and other pain relieving measures fail, surgery may be the only solution.

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Techniques Expected to Change Health Care

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Dr. Mache Seibel, a professor at the University of Massachusetts Medical School uses music to promote health education. HealthRock® uses contemporary songs to convey lessons on how people can live healthier lives. They are encouraged to make common sense lifestyle changes. The technique uses a variety of musical genres from gospel to pop, he said.

The musical technique has won recognition for its effectiveness from many publications and organizations. It is available in recordings and live performances at the Centers for Disease Control and Prevention and elementary schools. The technique is available at other locations too, Seibel added.

HealthRock Addresses Chronic Problems

According to the CDC, chronic health problems, such as cardiovascular disease, cancer and diabetes are among the most prevalent, costly and preventable health problems.

“The fundamental problem is that 90 million American adults and most American children are health illiterate. They don’t know how to keep themselves and their family members well,” he said.

To address these problems, he wrote songs that targeted specific health-related illnesses, such as obesity. “Phat Fat Rap,” “Exercise” and “Don’t Be Afraid of a Squash” are meant to encourage exercise and eating habits that fight obesity.

Guided Imagery Reduces Difficulties

Kathryn Farinholt, a Catonsville, Md., resident, developed a four-step technique that teachers, nurses, supervisors and human resource people can use to deal with difficult employees, students and patients.

Farinholt, who holds a doctorate, created the Defusing Difficulties course and began teaching it to her American clients. Now, she is ready to market the technique to health care providers, educators and stress management teams.

“Defusing Difficulties is a stress reduction technique known as guided imagery anyone can master in four simple steps,” said Farinholt. “Some of my clients who have mastered the technique tell me the problem was reduced or went away or like it never happened.”

On Sept. 10-11, 2009, Farinholt presented her technique to the Mid-Atlantic Association of Community Health Centers 2009 Annual Meeting and Conference. The technique was well received. Farinholt plans to teach the course Oct. 15, 2009, at the Howard County Community College in Maryland.

Although Farinholt does not have a health background, she does have an educator background and has had situations dealing with difficult people. She developed the technique to help her cope with those situations without causing additional problems. Those who have mastered the technique have reported their difficult problems disappeared once they applied the technique.

To master the technique, Farinholt said, health care providers must give it three weeks. They are taught to try it three times a day. She also recommends parents and spouses to use the technique in family situations that are usually highly emotionally charged.

These are two techniques that could revolutionize treatment for medical problems or stressful situations.

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