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Kestner

With every patient that comes to see me I sit down and review their medical history and try to learn a little bit about their life as well.  

Some people are very good at telling me pertinent things about their health, and some are more obtuse.  I jokingly tell patients that I can often get a better health history from an 8 year old than from an adult.  The child typically answers my questions straightforwardly and doesn’t find it necessary to describe the past 10 years of experiences that led up to the current situation.  

In some cases, though, instead of giving me too much information, adults provide too little.

A few years ago, an elderly lady came to see me with a complaint of lower back pain. A lot of people have low back pain, and although it might seem like that should be a fairly simple thing to diagnose, in reality, there are dozens of conditions that might be responsible for that pain. You might have the same complaint your neighbor had three weeks ago, and there might be a drastically different cause for the symptom.

So, back to the lady in my office. She told me that she had been having the pain for about a week and that it was getting worse. I asked her about any falls, injuries, fevers, illnesses surgeries or any other clues that would lead me to understand the problem. She denied any other problems and just kept insisting that her only complaint was her left lower back. I sent her to the examination room.

When I opened the back of her examination gown, I was taken aback to immediately see what appeared to be a fresh surgical scar that started in her left flank area and coursed around her side to the front of her abdomen. Although the scar was healing, it was pink and slightly puffy around the stitch marks.  

I asked her what the scar was from. She replied that she had had a kidney removed two weeks earlier. I asked her why she had not told me about the surgery. She replied candidly, “Well I figured you didn’t need to know about any of that, I’m coming to see you to fix my back!”

I closed her gown, instructed her to get dressed, and explained that I wanted her to go back to the doctor that had referred her for the surgery. I wanted that doctor to see her first since the pain could be related to her surgery or the condition that required the surgery.

I further explained to the lady that in the future, it would be a good idea to tell any doctor that she sees about all of her recent healthcare issues, so that the doctor can decide whether those conditions matter or not.

What should you share with your doctors? Should you simply answer their questions, or should you be more informative and volunteer information? On the one hand, it is important that any relevant information be provided but sharing every moment since birth is definitely “too much information”.

My suggestion is that you take a few minutes before any doctor visit to jot down all the complaints, symptoms or concerns that you think might possibly be relevant. Then put a star by the ones that have the highest priority. When you visit the doctor’s office, tell the person taking your history about the reason that you set up the appointment. Secondly, give them the list so that they can ask about any of the other items that may be relevant for that visit.

Working with any healthcare provider is a partnership. How well you communicate contributes to the effectiveness of the visit.

Dr. Mark Kestner is a licensed chiropractic physician in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com

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