Don’t Be Shy: 4 Tips for Talking to Your Doctor

Special Report: How Resilience Can Get Us Through the Pandemic

Don’t Be Shy: 4 Tips for Talking to Your Doctor | Johns Hopkins Medicine

I t was supposed to be the happiest time of my life: I had moved from New York City to Washington, DC, to enroll in a graduate program in international relations at Johns Hopkins University in Baltimore.

My career was on track. My health was good. And oh, yes: I was engaged to a kind, brilliant, charming, and honest man, a Navy doc who was opening hospitals for pediatric cancer patients in Iraq and Afghanistan.

Life was rocking — except for my gnawing suspicion that the sweet, noble doctor might not be as sweet (or noble) as he’d purported to be.

Was he really a former Navy SEAL? Could he really have rescued his ex-wife when she was held hostage in Iran? I questioned almost every utterance that came his mouth; he, in turn, attacked me for having “trust issues.

” I began second-guessing everything about myself, my beliefs, and my perceptions; not only could I not trust him, but I could no longer trust myself.

Twelve months into the relationship, I left. I couldn’t live in that liminal space between fact and fiction and not know which was which. I then promptly beat myself up for being such a horrible, mistrusting commitment-phobe. Why did I have to be so suspicious? Why couldn’t I have a normal relationship other people?

Besides the emotional despair, there were logistical issues. The future I’d anticipated was suddenly derailed. I’d given up my place in Manhattan, I had no money, and nowhere to go. Plus, I still had classes and work to deal with. Now what was I supposed to do?

Come up with a plan. Figure it out.

So I did. I wrangled a magazine assignment about Washington hotels, which I clearly had to test out in person. I commuted to DC once a week by bus and continued my studies at Hopkins.

I sold my engagement ring (which, for the record, I tried to return to my ex but he told me to keep) and even began dating again. In short, I turned lemons into lemon meringue pie.

It wasn’t fun, it wasn’t pleasant, but I refused to let some guy bring me down, even if he was a war hero.

A year and a half after I left him, he was arrested for writing fraudulent prescriptions for narcotics. Not only had he forged the names of his colleagues at the Pentagon (where he actually did work), but also those of his deceased relatives, his former father-in-law, a smattering of fictional counterparts — and me.

He had not been a SEAL nor any kind of special operative; he met his ex-wife in medical school. After the shock wore off, elation set in. I’d been right to dump him; the dude was bad! (The woman he was engaged to — while he was engaged to me — agreed.

) He spent the next two years in prison, and I ended up writing a book about deception, based largely on that experience.

What I went through was traumatic and, clearly, psychologically damaging. But I did learn a few things from it, most notably how resourceful I am. Rather than flee the country in humiliation and despair, I figured a way a hole. I didn’t give up on my goals; I just rejiggered them.

In a strange way, it was very similar to what is going on today with the coronavirus: Nobody really knows what the real story is, or who is giving us the straight facts, or how everything is going to play out.

Our heads are all spinning. On the other hand, no one died in my story. And I didn’t have to self-isolate (though I wanted to). My small world was spinning control, yes. But it didn’t feel the end of the world.

The word for this is “resilience,” derived from the Latin word resilire, meaning to rebound. And it’s a skill — yes, skill — we need to develop.

Source: https://www.everydayhealth.com/wellness/state-of-resilience/

25 Scientific Tips For Raising Happy (& Healthy) Kids

Don’t Be Shy: 4 Tips for Talking to Your Doctor | Johns Hopkins Medicine
A father and son bond over kite-flying. (Image credit: Sergej Khakimullin, Shutterstock)

There are many ways to raise happy, well-adjusted kids, but science has a few tips for making sure they turn out okay. From keeping it fun to letting them leave the nest, here are 10 research-based tips for good parenting.

Don't be fooled by their height

(Image credit: Dreamstime)

No matter how tall they get or how grown-up they look, your kids are still just that … kids. And parents of older children especially need to remember this fact, according to Sara Johnson, an assistant professor at the Johns Hopkins Bloomberg School of Public Health.

The developmental period known as adolescence lasts about 10 years — from ages 11 to 19 — and it's regarded as a critical time for brain development. So it's important to keep in mind that, even as kids grow into young adults, “they are still in a developmental period that will affect the rest of their life,” Johnson told Live Science in March 2016.

Support the shy ones

(Image credit: altanaka/Shutterstock.

com)

A little bashfulness is one thing, but kids with behavioral inhibition — a trait that refers to shyness and also extreme caution in the face of new situations — may be at higher risk of developing anxiety disorders, according to researchers. And parents who shelter kids demonstrating behavioral inhibition (in effect, encouraging this inhibition) may actually make the situation worse.

So how do you support shy kids? The key is to get them their comfort zones without trying to change their nature, said Sandee McClowry, a psychologist at New York University.

Why not just break them of their shy habbits? Research has shown that shyness is a part of some children's character and a very difficult trait to change.

In other words, it's better to work with shyness than against it.

“That acceptance of the child is a huge, huge thing,” McClowry told Live Science in September 2016.

Live in the moment

(Image credit: szefei/Shutterstock.com)

Adults tend to constantly think about the future, but kids — especially preschool-age kids (ages 2 to 5) — live in the here and now, scientists say. To get on a kid's level, parents need to learn how to live in the moment, too, said Tovah Klein, director of the Barnard College Center for Toddler Development in New York City.

This is especially true when it comes to communicating verbally with a young child, said Klein, who is also the author of “How Toddlers Thrive” (Touchstone, 2014).

Instead of telling a 3 year old that it's time to get ready for some future action, going to school, parents should give their child a set of instructions, Klein told Live Science in August 2016. Replace ambiguous statements “it's almost time for school” with clear, simple explanations and directions, such as, “We need to leave for school. It's time to get your coat.”

Tell them how they feel

(Image credit: Alena Ozerova/Shutterstock.com)

While older kids are widely regarded as the kings and queens of self-expression, young children often lack the vocabulary to properly label their own emotions, according to researchers who study child development.

Kids ages 2 to 5 are just starting to understand emotions fear, frustration or disappointment, according to Klein.

You can help your kid express herself by calling out such emotions when you see them. For example, a parent might say, “It's disappointing that it's raining outside, and you can't go out to play,” Klein said. 

Slow down

(Image credit: Soloviova Liudmyla/Shutterstock.com)

The hectic schedule of adulthood doesn't always vibe with the relaxed pace of childhood, according to Klein.

“Children move at a slower rate,” and parents should try to match that pace, Klein said. By scheduling extra time for the little things, a bedtime routine or a trip to the grocery store, parents can turn hectic chores into more meaningful time with their children, she said.

Limit distractions

(Image credit: NotarYES/Shutterstock.com)

Do you check emails or scroll through your social media feeds while spending quality time with your kids? Because you shouldn't, Klein said.

It's hard to be really engaged with your kids if you're distracted by a bunch of other things. And this distracted presence can take a toll on children, who might feel you're not really there for them when you're attention is divided, Klein said

“Children don't need their parents’ attention 24/7 and 100 percent of the time,” she said. But when your kids do need your full attention, you should give it to them without any caveats.

Be polite

(Image credit: Oshvintsev Alexander/Shutterstock.com)

Want to raise polite children? Try adding the words “please” and “thank you” to your own vocabulary.

Kids learn how to interact with others mainly by observing how grown-ups do it and then modeling that behavior themselves, according to Klein.

So if you treat everyone — from cashiers and bus drivers to teachers and family members — with respect and politeness, chances are your kids will, as well.

Remember, teenage tantrums are real

(Image credit: Sabphoto/Shutterstock.com)

Just when the tantrums of your child's toddler years seem ancient history, you can expect such emotional outbursts to make another appearance.

Adolescent kids (ages 11 to 19) deal with a lot of social, emotional and mental stress that they don't yet have the ability to process or cope with, according to Johns Hopkins' Sara Johnson. This can result in some serious tantrums, which might surprise the unwary parent.

In such situations, parents should stay calm and listen to their children, said Sheryl Feinstein, author of “Inside the Teenage Brain: Parenting a Work in Progress” (Rowman and Littlefield, 2009.) Modeling levelheaded behavior is a good way to teach your teen the proper way to deal with all that stress.

The golden rule

Using harsh words with teens may actually lead to worse behavior, a new study finds.

(Image credit: Dad and teen photo via Shutterstock)

We'll keep this one short and simple: Thou shalt not yell at your teenager. Seriously, just don't do it.

The more you yell at a teen, the worse they're ly to behave, according to a study published in 2013 in the journal Child Development.

Stick to the basics

(Image credit: Vasilyev Alexandr/Shutterstock.com)

“There are a lot of different ways to raise kids, and there's not one formula that works for every kid,” said Amy Bohnert, a psychologist who researches child development at Loyola University Chicago. But surely there's some kind of recipe for success when it comes to parenting, right?

Kind of: Bonhert said the first basic rule of being a good parent is fostering a secure and warm attachment with your kids.

That way they know their needs will be met and that they'll have a place to go when they need comfort.

And as they get older, kids need freedom to explore their own identities and make mistakes, but in a safe and age-appropriate way, Bonhert told Live Science in 2011.

Source: https://www.livescience.com/17894-10-scientific-parenting-tips.html

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An important part of good health care is a good relationship between you and your doctor. You must be able to communicate well with each other so your needs are met. Cancer treatment often means that you will have more than one doctor. Sometimes other health specialists are involved, too. You may get facts from many sources. However, it is a good idea to choose one doctor to be your main source of information. You can turn to this doctor with your concerns. This doctor may or may not be the one you see most often. Only you can make that choice, and this information can help.  You should feel at ease with your doctor, a good relationship with your doctor is worth the effort needed to create it. If you and your doctor have similar viewpoints about sharing facts, making choices, or joining self-help groups, you are ly to have a good relationship.For you, what is the first step in creating good communication with your doctor?
Ask Yourself, “How Much Do You Want to Know?” :
You may want a lot of details. Some people feel much better when they know all the facts about what is happening to them. If you are this, you should ask the doctor for exact details and information. Or, you may want only the overview. It disturbs some people to be told too many details. They may want simple directions-what pill to take or what their treatment will be and when it will be done. They would rather leave most decisions to the doctor. Don’t be afraid to tell your doctor how much, or how little, information you want.
Sharing Information :
We each have our own ways to communicate. That is why the perfect doctor for one person may not be a good match for another. You may want your doctor to be business-. Some people prefer doctors who are direct and to the point. They don’t need a warm relationship-just a sharing of needed facts.  Or you might prefer a doctor with a more friendly style. This is often the case when your illness requires long-term treatment.  After you know what you want as a patient, the next step is looking at how you talk with your doctor.
Understanding Your Doctor :
Remember it’s hard to listen well and understand when you are anxious or afraid. Even if the doctor is very thorough, you may not hear or remember what is being said. Take notes to help recall what your doctor says. Or ask if you can tape record your talk for later review. You may also want to have a family member or friend there with you. They can remind you of questions you want to ask and help you remember what the doctor said. Having someone there also helps your family know what is happening. You may want their help in making decisions.  Some doctors try to share information with patients but use terms you may not know, if you don’t understand something, ask your doctor to explain it to you.
Asking Questions :
Here are some questions your doctor can usually answer for you:
  • What’s wrong with me?
  • What treatment do you recommend?
  • What are the benefits of these treatments?
  • What are the risks?
  • What medicines are you giving me? What are they for?
  • How should I expect to feel during treatment?
  • What side effects, if any, can I expect to have?

When you get instructions from your doctor, write them down. Make sure you understand them before you leave the office. Then follow them exactly. Keep written notes and bring them with you, if needed.Here are some more questions you may want to discuss with your doctor:

  • Who else gets information about me? Should anyone else-a spouse, a friend, or another doctor, also get information? Think about the choices and tell your doctor what you want.
  • What issues are important to me? For example, will the disease or the treatment keep me from working or caring for my family? Will I have any physical limitations? Again, ask your doctor if you want more information about your treatment. Ask if there is written information you can take with you.
  • If you have persistent low or hopeless feelings, mention this to your doctor; you may have a clinical depression, a diagnosable and treatable illness that may occur along with cancer.
  • What is the best time to call you if I have a question? Some doctors have a special time for call backs. Expect your doctor to return your calls, but remember that a quick response may not be possible if another patient is having a crisis.

Above all, your doctor should take your questions seriously. He or she should be interested in your concerns and not make you feel rushed. If your doctor does not respond this way, bring it up at your next visit. If you don’t, communication will be blocked and your relationship may suffer.

The Doctor-Patient Relationship :
Here’s how to maintain a good doctor-patient relationship.

  • Try to state as clearly as you can any changes in body functions, from sleep and bowel habits to other changes such as headaches. Make notes so you can report these to your doctor.
  • Talk over your concerns with your doctor. Mention lifestyle habits, even if it’s something you’re not proud of such as smoking. Never keep back information. Something you think is minor could affect your treatment. Or, something you think is serious might be easily relieved.
  • Make a list of all your questions. Take it with you to your doctor visits. Don’t be ashamed or shy about asking these questions. There is no such thing as a “dumb” question. Refer to the list of questions above for some ideas, and then add your own.
If You Have a Problem Talking to Your Doctor :
If you have a problem talking with your doctor, there are ways to improve the situation.For example, if you need more details after your doctor answers a question, let him or her know. Generally it is even helpful to ask the question again in a different way. It will seem as you understand unless you tell your doctor that you do not. If you want to take an active role in your cancer treatment, ask your doctor to suggest some reading materials. If you still have concerns, ask for a special visit to discuss the problem. Go to the meeting with as much knowledge as possible. You can call the American Cancer Society at (800) ACS-2345 for information about cancer. The National Cancer Institute also has information. You can call the Cancer Information Service at (800) 4-CANCER to get this information. Tell your doctor where you got your information and then ask for his or her opinion. Being angry or hostile doesn’t help improve communication. Don’t use questions or statements as an attack. It’s normal for people-including doctors-to withdraw or become defensive. Do make it clear that you need answers to your questions.  What should you do if you feel you have done your part but the situation has not improved? Perhaps you could talk to a third party. The head nurse or your family doctor might be willing to discuss the matter with the doctor. Sometimes this is less stressful than facing the doctor directly. It could be a positive turning point. If not, it may be time to find a new doctor. Don’t stay with a doctor only to protect his or her feelings. Just because you were referred to the doctor does not mean you can’t decide to change on your own. It’s your body and you have the right to find the best doctor for you.
Changes in the Relationship :
If you are in the hospital, your relationship with your doctor could change. Many people will be involved in your care. Hospitals have rules and policies. Your doctor has to follow these, too. Sometimes all this activity and the need to follow hospital routines can cause stress. There may be times when your doctor can help you solve problems that might come up about hospital rules or practices. If you have a problem with your doctor while you are in the hospital, there are others there who may be able to help, Speak to someone a nurse or a social worker. Or ask if the hospital has a patient service representative on staff. They can provide support and help you organize your thoughts before talking with your doctor. With your permission, they might even speak directly with your doctor.  People who have cancer are ly to want to build a good relationship with their doctors. Over the long term, it is helpful to identify one doctor to be your main source of information. Ask the person if that will be OK. Building this relationship doesn’t just happen. It takes care and effort on both sides.

Source: http://abcc.us/?page_id=82

How to Talk to Doctors When They Don’t Listen

Don’t Be Shy: 4 Tips for Talking to Your Doctor | Johns Hopkins Medicine

You’re in the room. That tiny one with the examination table, the sink, the little chair, and the fluorescent light. Your doctor, running late, finally pops through the door. Quick pleasantries are exchanged, and then it’s down to business.

You explain why you’re there. You go over your symptoms. Already, you feel you’re off to the races, and you’re probably right. Research says you get only seconds to talk before the doctor jumps in with a word, question, comment, or redirect.

It all seems so scripted. Does the doctor even hear what you’re saying?

Not all visits are this, of course. But many are. Studies show most complaints about doctors don’t have anything to do with their medical skills. It's mostly about poor communication.

A recent study found that 75% of doctors believed that they communicated satisfactorily with those in their care. Only 21% of the people treated by those doctors said that their talks went well.

Somewhere, there’s a disconnect. That can be devastating.

The more you and your doctor talk with each other — really, really talk — the better the chance you’ll feel better.

“I always tell my patients that we’re a team. It’s you and me, working together for the betterment of your health,” says Ada Stewart, a family doctor with the Eau Claire Cooperative Health Centers in Columbia, SC.

“We gotta work this together,” Stewart says. “You may not agree with all that I say, and if you don’t, then I need to know … But I think the biggest thing is to have that trust. To have that patient-physician relationship. That’s really important.”

But what if that bond isn’t there? What if you don’t feel you’re being heard?

How do you get your doctor to listen? Really, really listen?

Jot down some notes before you go. Have an idea of how you want your time with the doctor to go. Make sure you talk about what you want to talk about. Ask questions. Listen to the answers. Follow up.

Even more, have your health story ready when you get to the office. And tell it, says Leana Wen, MD, a doctor in Baltimore and the author of When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests.

“Doctors end up asking about symptoms rather than the story. And [people] then get conditioned to talk about their symptoms instead of their stories,” Wen says. “Studies have shown that over 80% of diagnoses can be made just by listening.

“By that, they mean listening to the story, the open-ended story of what happened, rather than asking a list of yes-no questions,” she says.

Don’t go into that little office, Wen suggests, simply saying your chest hurts. Tell the story of it. For example:

  • When it started
  • If it’s been painful before
  • What you were doing when your first felt it
  • How it felt
  • How often you feel the pain

That can really help clear things up.

“If a [person] were allowed to tell the story, they might also feel more listened to as well,” Wen says.

Leonard Reeves, MD, a family doctor from Rome, GA, says some old-school listening can really help your doctor.

“The old rule when I was in medical school, back in the old days of stone tablets, was that if you listen to the [person] long enough, they’ll tell you what’s wrong with them,” Reeves says.

Be straightforward and open-ended in asking questions, and be honest if you feel you’re not being heard. Some suggestions:

  • “I’m worried that we aren’t communicating well. Here's why I feel that way.”
  • “I need to talk with you about X. I feel I can’t. Can we talk about this?”
  • “I know you're busy, but I need to talk about X with you. Can we get some time on the calendar?”
  • “Can you help me understand X?”

Consider bringing a friend or family member to your appointment. Someone else may catch things you miss, or ask a question you haven’t thought of.

Be honest and accurate. Some people go to the doctor and don’t tell the whole truth.

“Things that they don’t feel comfortable with, mostly,” Reeves says. “Whether it’s use of illegal drugs or alcohol use. Maybe it’s sexual in origin. But you need to be able to build up that relationship between your physician and yourself that you feel you can tell them whatever you need to tell them.

“These things do impact your health.”

Ask about the best way you can contact the doctor with other questions.

Give feedback about the doctor’s care and your office experience.

Robert Arnold, MD, a doctor who heads the University of Pittsburgh’s Institute for Doctor-Patient Communication, says doctors and those in their care should do what nurses often do — a “teach-back” moment.

“At the end of the visit, [you] say to your doctor, ‘I want to make sure that I have it right. So what you want me to do is this,” Arnold says. “And what the doctor could do is say, at the end of the visit, ‘Just to make sure we’re on the same page, tell me what you’re going to do.’”

In addition to a lack of time, doctors face other barriers to good communication, including:

  • Jargon that is often misunderstood by those in their care
  • A general lack of, or perhaps a breakdown of, simple communication skills, including picking up nonverbal cues
  • Fear of being sued
  • Avoidance of emotional and social issues
  • Cultural barriers between doctors and who they’re serving
  • Feeling confrontational after resistance or questioning by those in their care

Doctors are trying to do their part to communicate better, following educational models with names AIDET — Acknowledge, Introduce, Duration (allowing an adequate amount of time to talk), Explanation, and Thank You — and RESPECT (Rapport, Empathy, Support, Partnership, Explanations, Cultural Competence, and Trust).

Some experts push the “Four E's” of effective health care communication: Engage (building a rapport), Empathize, Educate, and Enlist (inviting those under their care to actively take part in    health care planning).

many doctors, Reeves remembers when doctors could take the time to truly listen to people’s problems. With all those barriers to good communication, though, with full waiting rooms and the burden of keeping electronic medical records, it’s getting more difficult every day to make that connection.

“We have gotten away from [good communication] because we’re so pushed to see the next [person],” Reeves says.

“If we can ever get it to the point where physicians can actually sit down, listen to the [person] and be involved in their care, rather than feeling you’re making widgets every day and you got to turn out the next one, then I think we, as a society, are going to be healthier and, to be honest with you, happier.”

If there’s a communication problem, though, it’s probably up to you to fix it.

And if you can’t?

“You should always find a doctor that you feel that you can trust and you think is listening to you,” Wen says. “If you don’t think your doctor is listening, how can you trust that he or she is making the correct diagnoses and treatment recommendations for you?

“I would say, though, that it is important to give your doctor another chance, because maybe there’s something that you can do, too,” Wen says.

“But if you feel you’re still not being listened to, maybe it’s time to look for somebody else who you’re more comfortable with.”

SOURCES:

Rhoades, D., Family Medicine, July-August 2001.

Beckman, H., Annals of Internal Medicine, November 1984.

Marvel, M., JAMA: The Journal of the American Medical Association, Jan. 20, 1999.

Tongue, J., The Journal of Bone & Joint Surgery, March 2005.

Fong, J., The Ochsner Journal, Spring 2010.

Sinsky, C., Annals of Internal Medicine, Dec. 6, 2016.

Hayes, E., British Dental Journal, Dec. 15, 2017.

Stewart, M., Canadian Medical Association Journal, May 1, 1995.

American College of Obstetricians and Gynecologists: “Committee Opinion: Effective Patient-Physician Communication.”

The American Academy of Orthopaedic Surgeons: “Academy News: Engage, empathize, educate and enlist to ensure communication.”

Ada Stewart, MD, Eau Claire Cooperative Health Centers, Columbia, SC; member, board of directors, American Academy of Family Physicians.

Johns Hopkins Medicine: “Don’t Be Shy: 4 Tips for Talking to Your Doctor.”

Leana Wen, MD, Baltimore; author, When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests.

American Cancer Society: “The Doctor-Patient Relationship.”

National Institutes of Health: “Talking to Your Doctor.”

Hospital for Special Surgery: “Doctor-Patient Communication: An SLE Workshop Support Group summary.”

Robert Arnold, MD, professor, University of Pittsburgh School of Medicine; director, Institute for Doctor-Patient Communication, University of Pittsburgh; medical director, University of Pittsburgh Palliative and Supportive Institute.

U.S. Department of Health & Human Services, Agency for Healthcare Research & Quality: “Use the Teach-Back Method: Rule #5.”

Leonard Reeves, MD, Faith and Deeds Free Clinic, Rome, GA; associate dean, Northwest Clinical Campus of the Medical College of Georgia; member, board of directors, American Academy of Family Physicians.

© 2018 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/a-to-z-guides/features/be-heard-by-dr