When you have been sick long enough, you’ve been through the medical system. You probably spent weeks, if not months, waiting for an appointment on the doctor’s schedule. The day finally arrives and you spend an hour filling out paperwork (does anyone ever look at that?). Another hour is spent in an uncomfortable chair in the waiting room and then, if you are lucky, you get 15 minutes with the doctor.
As a Naturopathic Doctor I am lucky enough to spend 50 minutes with patients and I still feel rushed at times! I want to hear every patient’s story and follow every lead, however it isn’t practical and who really wants to spend all day at the doctor’s?
The best way to get the most out of your visit with your doctor is to get organized and arrive prepared!
1. Be Specific
Be as specific as possible when describing your symptoms. Pretend you are planning a party! Who are all the symptoms that come? What are they like? Sharp? Dull? Stabbing? Where do they occur in your body? When and how often do they come? Why do they show up or have you noticed any patterns. Gas and bloating all the time may be indicative of a bacterial dysbiosis where gas and bloating right after meals may point to poor digestive function or yeast overgrowth. Do you have pain? Can you point to the pain and describe the sensation? Do you have constant symptoms or do they come and go throughout the day? Week? Month? Do your best to avoid repeating diagnosis from other doctors. Saying you have IBS is not helpful for a doctor because that can mean a lot of different things. The more specific you can be the more your doctor will learn from your description.
Describe your poop! Don’t worry. We are doctors. We’ve heard it all and if we haven’t heard it, we will pretend you didn’t shock us. We are trained for that. If you are going to blush and leave stuff out then leave your new girlfriend or boyfriend at home. (I hate to be the one to tell you, but someday, if they are worth keeping around, they will learn you poop.) Again, be specific. Who shows up to the party? Diarrhea? What is diarrhea wearing? Blood? Mucous? Water? When? How often? Undigested food? Floating? Sinking? Color?
2. Create A Timeline
Believe it or not, your gut health started before you came out of the womb! Your mother’s health status while she was pregnant has a huge impact on your health. Were you born through vaginal delivery or C-section? Were you breast-fed? Colicy as a child? Were you intolerant to foods growing up? How did your gut develop in your early years? If you have access to this information, collect it.
When did your gut symptoms begin? As a doctor, when you were diagnosed is less important to me than when your symptoms first began. Many people are suffering long before their diagnosis and there are many clues to the cause of your health concern that can be found in the earliest stages of dis-ease.
With gut symptoms, I always want to know how many times you have taken antibiotics both recently and throughout life. Antibiotics can be life saving when we need them to help defend against serious bugs however they can also be a gut killer! It is important to avoid them unless absolutely necessary to stop an infection.
Bring copies of all of your labs and imaging reports to every doctor’s appointment. I recommend organizing it by date with the most recent labs on top. This helps you avoid costly unnecessary retesting and makes time with your doctor more efficient. Some doctors are willing to look at your test results ahead of your visit. If a doctor ever offers to do this, take advantage! This is like a free visit!!! A doctor who has had the opportunity to become familiar with your case before they have seen you will be prepared to make the most of your visit.
No body can heal without proper nutrients. Too much or too little nutrients can each cause disease. We need a healthy balance of proper nutrients in order for all of our organs to function properly. Those with gut conditions suffer twice! Even when you choose to eat a great diet, a dysfunctional gut cannot always digest, absorb or eliminate nutrients.
Many of my patients have tried FODMAPS, GAPS, Paleo, Gluten Free, Whole 30, Dairy Free or other diets. Let your doctor know if you have restricted your diet in any way and what the experience was like for you. If it helped this can give us important clues.
Are you currently taking any vitamins or supplements? If you suffer with diarrhea, magnesium and vitamin C can loosen bowels. Iron supplements can cause or exacerbate constipation. The juice or gel form of Aloe vera is soothing and healing while the latex form is a cathartic laxative. Herbs and supplements have the potential to make all the difference in your gut health when used properly.
Exposures to dirty food and water increase your risk of having a parasite join you on your healing journey. Camping and overseas travel history, particularly if you experienced gut symptoms while traveling are important to tell your doctor about even if it doesn’t seem related. Any persistent gut infection will influence your ability to heal. Stool tests are notorious for false negatives or coming back with clear results when in reality there is a parasite in your gut. Let your doctor know if you have had any stool testing or imaging done and bring the results! Keep in mind, a new doctor may want to repeat tests and/or suggest new ones.
Your gut starts at your lips. Don’t forget that exposures in your mouth can influence the rest of your digestive tract. Dental health including a history of cavities, amalgams, root canals and gum disease all play a role in your digestive health. Let your doctor know whether or not you have had loads of dental work done or haven’t seen the dentist in years.
5. Family History
Does your gut issue run in your family? Does everyone have gut issues? Is there a strong history of colitis or cancer running through your family? Do all of your siblings get stomach upset with stress? Some autoimmune diseases show up as digestive complaints. Has anyone in your family been diagnosed with an autoimmune disease?
6. Treatments Tried
What have you tried? What worked? What didn’t? How long did you try it? Did something work for a little while then stop working?
Some of the most revealing clinical information I get is from therapeutic trials. With some therapies I expect quick results. When that is the case, I may recommend a patient go home with one single new treatment and try it for 7-14 days. If there is significant improvement in gut symptoms then not only do we get some relief, (Yay!) we also get more information about the dis-ease that will inform next steps in the treatment plan.
7. Trust Your Gut
What do you think caused your health issues? What else was happening in your life when your gut issues started? Seemingly unrelated events can influence your health in complex ways. If you have a hunch or a gut feeling about how this all started, that is valuable. Share it with your doctor!
8. Be Patient, Stay Open
As a doctor, maybe your doctor, I want you to feel better yesterday. Actually getting better is a process that takes time. There may be phases of treatment and new things that come up in the process of getting towards your great gut goal. Stay the course. Your body is made to heal.
No doctor is the right match for every patient. No doctor knows everything. You may have the right doctor for today who won’t be the right healer for you a year from now. You may graduate onto a better doctor for the phase of healing you are in. This is progress!
I am grateful to my gastroenterology colleagues who I can refer to for imaging procedures and a second opinion. I don’t always agree with their suggestions because I have a different perspective, however I value their insights and expertise. Gathering advise from a team that might include a shaman, a neurologist, an acupuncturist and even an integrative doc like me will lead you to many unique insights and most certainly in the direction of One Great Gut!