Tip:
Highlight text to annotate it
X
Dr. Jerry Blaivas>>> Wow, that is a great question. No one has ever asked me that question
before but I think it is really important because one of the biggest problems in medicine
is communications between doctors and patients, and it is not that the doctors are not listening
and it is not that the patients are not talking, but they are not often on a same way of length.
So the best way to communicate what your symptoms is to your doctor or to start with, by paying
attention. So pay attention to your own symptoms and try to anticipate what kinds of questions
the doctor is going to answer.
The best way to pay attention to your own bladder symptoms is to keep a bladder diary
and you can do that without having seen a doctor. There is places you can find diaries
online or you could just make up your own and the most important thing in this diary
is just for one 24-hour period is to record the time and the amount of each urination
and any symptoms that happen either during the urination like pain or before the urination
like difficulty starting or incontinence or between urinations such as incontinence when
you cough or sneeze so, and whenever your symptom is, pay attention to when it happens.
So, for example, if your symptom is, you wake up in the morning, you have to rush to the
bathroom and then you have to rush all morning and then later on the day you are pretty okay,
look at what you are doing in the morning, the usually culprit for that is coffee or
the caffeine containing beverages.
Pay attention to that. Write it down and then after you have completed your diary and paid
attention to your own symptoms, then you can write them down beforehand, you can either
give a piece of paper to the doctor with that information on it or you can just read it
off and say my most bothersome symptom is rushing to the bathroom or my most bothersome
symptom is I have difficulty starting or I wake up to urinate at night.
Now when the doctor sees you, of course he is going to want to examine you and when he
examines you, if the problem is, for example, incontinence, he is going to want to examine
with you a full bladder.
A lot of patients, when they get to the doctor’s office, the first thing they do is urinate
so if your bladder is not full so you complain of this stress incontinence, which means that
you leak when you cough or sneeze and he examines you and he does not see the incontinence then
he might think “well, you do not have incontinence” but you need to tell him, my bladder really
is not very full, it is much worse than this and then he can formulate his judgement based
on not only his exam or her exam but what you have told him.
Similarly for people that complain of a weak stream or difficulty starting urination, the
doctor is going to probably want to get a flow test, at least an urologist. He is going
to want to get a flow test, he is going to ask you to urinate into a machine and he is
going to measure how forcefully the urine comes out and then he is want to check whether
you empty your bladder or not with an ultrasound. Well, again if you have just urinated before
you got there then you are not going to be able to give a very good stream and he may
think that you are a lot worse than you really are.
So the doctor needs to understand and you need impress the doctor sometimes, that day
that you are seeing, it is just one snap shot in your life and that might be a good day
or a bad day, you need to communicate that to him and then finally the last way I think
you need to communicate with the doctor is when he is finished talking and you think
you are finished talking, you should ask any questions that have been unanswered and the
best way to know about those questions is to have written them down even before you
came to the office.
So if you done your homework on yourself, you will understand what the symptoms are.
If you then write down the symptoms and then you write down any questions, you half about
the symptoms even on that first visit you are to be able to ask the doctor any questions
that he has not addressed during his or her examination and if you do that I think you
will get the best possible care.