Have an appointment with the doctor? Tips show what to ask

Good general info for anyone of any age, no matter what symptoms or disease you may have.

 

by John Beale

Good communication between patients and their health-care practitioners is essential for good care. To help older adults better communicate with their health-care providers, the American Geriatrics Society's Foundation for Health in Aging has released a new, easily understandable tip sheet.

 

The tip sheet, "How to Talk to Your Healthcare Practitioner: Tips on Improving Patient-Practitioner Communication," outlines steps older adults and their caregivers can take before, during and after a visit to a practitioner. These steps help ensure practitioners, older patients and their caregivers get the information they need. The tip sheet is available online at: http://www.healthinaging.org/public_education/communication_tips.php.

 

Before visiting a health-care provider, the tip sheet advises older people to, among other things, make a list of any symptoms or health problems they have, as well as past health problems, any treatments they've undergone and any adverse reactions to treatments they have had.

 

Bring medications

It also encourages older adults to put the medications, supplements and other remedies they're taking in a bag and bring it to their appointment. That way, their practitioner can see what they're taking and at what doses - important information, since medications may interact and some may affect medical test results.

 

The tip sheet also advises older adults who don't speak English as a first language to consider looking for a practitioner who speaks their native tongue, bring along a bilingual buddy to translate or call the office and request a translator ahead of time.

 

The tip sheet encourages older patients and their caregivers to answer all questions frankly, to request explanations when needed and to ask follow-up questions, such as "Are there any risks associated with this treatment?" and "Are there any alternative treatments?"

 

Understanding is vital

It also suggests patients and caregivers repeat back what their providers tell them about their health and treatments to ensure they've understood correctly.

 

After an appointment, the tip sheet advises older patients to contact their practitioner's office if they don't feel better, if they have an adverse reaction to a medication or other treatment or if they realize they've forgotten to mention something important that's relevant to their health.

 

Other easy-to-read health tip sheets for older adults and their caregivers cover such topics as cold and immunizations, falls prevention, emergency planning, and joint replacement surgery for older people.

 

Anyone who does not have online capability may call the Office for the Aging at 845-486-2555 for tip sheet copies.

 

From http://www.poughkeepsiejournal.com/article/20090629/COLUMNISTS06/906290301/1005/LIFE

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How to Talk to Your Healthcare Practitioner: Tips on Improving Patient-Practitioner Communication

The list mentioned in the article from http://www.healthinaging.org/public_education/communication_tips.php

 

Good communication between you and your healthcare practitioners -- the physicians, nurse practitioners, nurses, physician assistants and other healthcare professionals you see -- is essential to good care.

 

It's important that you give your practitioner the information about yourself and your health that he or she needs to provide quality care. And it's important that he or she explain what you need to do to stay as healthy as possible, in a way that you understand.

 

Here's what experts with the American Geriatrics Society's Foundation for Health in Aging (FHA), suggest:

 

Before your appointment

Make a list Visiting a healthcare professional can be stressful -- particularly if you're not feeling well -- and stress can make it harder to remember what you need to tell and ask your practitioner. So make a list and bring it to your appointment. Write down any health problems you have had or do have, and any surgery or other treatments you've undergone. Write down the names of any medications you've taken that have caused unpleasant or dangerous side effects. If you're sick, write down all of your symptoms.

 

And don't forget to write down any questions about your health that you might have. You can find comprehensive lists of questions that older adults should consider asking their healthcare practitioners - organized by subject - on "Aging in the Know" (www.healthinaging.org/agingintheknow/questions_trial.asp), the FHA's free senior health website.

 

Bring your medications, vitamins, and other remedies to your appointment Before leaving for your visit, put all of the prescription drugs, over-the-counter medications, herbs, vitamins, and other supplements you take in a bag. Take them with you and show them to your healthcare practitioner. This way, he or she will know exactly what you're taking, when, and at what doses. This is important because some drugs, herbs and supplements can interact with medications your practitioner might prescribe. They might also affect the results of certain medical tests.

 

Pack paper Bring paper or a notebook to your appointment so you can write down what your healthcare professional tells you. If you have trouble remembering later on, you can look at your notes.

 

Consider asking a buddy along A family member or close friend who goes with you when you see your healthcare professional can offer your practitioner information that you might forget or overlook. He or she can also help you remember what your healthcare practitioner says. If you want to discuss something with your practitioner alone, you can always ask your relative or friend to leave the room while you do so.

 

Call ahead to request a translator if necessary If English is not your first language, you might seek out a healthcare practitioner who speaks your native language. Other options include bringing a bilingual buddy with you to your appointment, or calling your practitioner's office ahead of time and asking if staff can supply a translator.

 

During your appointment

Answer questions honestly It's essential that you answer all of the questions your healthcare practitioner asks you, even if he or she asks about topics that might make you uncomfortable, such as mental health problems, drinking, and sex. There's nothing to be embarrassed about. Your practitioner needs complete information to provide proper care. And everything you tell him or her is confidential.

 

Ask questions If you don't understand what your healthcare professional tells you during your visit, ask him or her to explain it. You need to -- and have a right to -- understand what your practitioner says. It's particularly important that you understand any treatments he or she recommends. You should ask if there are any risks associated with treatments, and if there are any alternatives.

 

Mention any cultural or religious traditions that might affect your care If your healthcare practitioner recommends that you eat foods that your religion prohibits, for example, or if you need to fast at certain time of the year, tell him or her.

 

Repeat back After your healthcare professional explains what you should do to stay healthy, or to treat a health problem, repeat this back to him or her using your own words. You might start by saying, "So, you're telling me that I should…." If you've misunderstood his or her advice, your practitioner will realize this, and clarify.

 

Ask for written instructions If your healthcare practitioner puts his or her advice in writing, you can refer to the written instructions at any time.

 

After your appointment

Call your practitioner's office if you don't feel better, have a bad reaction to medications, or realize you forgot to mention something If you don't feel better after your visit, or seem to be having a bad reaction to medication your healthcare professional prescribed, call his or her office immediately. You should also call if you realize, after leaving the office, that you neglected to ask a question or provide information about your health, or didn't understand what your healthcare practitioner said. Ask to speak with your practitioner as soon as he or she is available or ask to speak to another healthcare professional in the office who can help you.

 

Communication between you and your healthcare practitioner is an ongoing process. The simple tips above can help improve communication. Improved communication means better understanding, diagnosis and treatment.

Stanford researchers find molecule that kills kidney cancer cells

From http://www.eurekalert.org/pub_releases/2008-07/sumc-srf070208.php

Public release date: 7-Jul-2008
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Contact: Krista Conger
kristac@stanford.edu
650-725-5371
Stanford University Medical Center

Stanford researchers find molecule that kills kidney cancer cells

STANFORD, Calif. - Kidney cancer patients generally have one option for beating their disease: surgery to remove the organ.

But that could change, thanks to a new molecule found by Stanford University School of Medicine researchers that kills kidney cancer cells. Ideally, the researchers said, a drug created from this molecule would help fight the life-threatening disease while leaving patients' kidneys intact.

"You now have a potential means of going after a disease that's been difficult to treat," said Amato Giaccia, PhD, professor and director of radiation oncology and radiation biology at the medical school. His findings will be published in the journal Cancer Cell on July 8.

Giaccia said his lab focused on renal cell carcinoma, or kidney cancer, because there is no known cure for it short of removing a damaged kidney from a patient's body. "There is no effective chemotherapy to treat renal cell carcinoma," said Giaccia, also a researcher at the Stanford Cancer Center. "Patients still succumb."

Almost 54,400 people in the United States will be diagnosed with kidney cancer this year, and about 13,000 will die from the disease, according to the American Cancer Society. Radiotherapy, a powerful weapon used to fight cancer, has also proven to be ineffective in killing kidney cancer, in contrast to other types of cancer, Giaccia said.

This new research could lead to a treatment to save patients from losing one of their two kidneys. The organs are responsible for filtering blood, controlling blood pressure and preventing anemia, among other tasks.

Giaccia's work focuses on the von Hippel-Lindau tumor suppressor gene, or VHL gene, which normally slows tumor growth in humans but does not work in 75 percent of kidney tumor cells. Giaccia's team searched for a small molecule that would kill cancer cells when this VHL gene is broken. They found their weapon in a molecule called STF-62247.

While STF-62247 is toxic to kidney cancer, it is generally harmless to most other cells in the human body, as they carry a working VHL gene, Giaccia said.

As an added benefit, Giaccia said, patients treated with STF-62247 should not suffer some of chemotherapy's infamous side effects, like nausea and hair loss, because STF-62247 is not toxic to the entire body.

Clinical trials could begin "in the next couple years," Giaccia said.

Stanford co-author and postdoctoral fellow Denise A. Chan, PhD, said she believed the new findings could affect how all types of cancer are treated in the future.

This study is one of the first to identify a trait unique to a certain form of cancer - in this case, kidney cancer's deficient VHL gene - and exploit it to defeat the disease, Chan said. She predicted other scientists soon would follow suit, looking for characteristics in other cancers that also could be manipulated.

Researchers' motivation could be twofold, the study's authors said: to find cures for deadly cancers, and to rein in the debilitating side effects caused by many current cancer treatments.

"These results can be extended far beyond kidney cancer," Chan said.

The findings also speak well for Stanford's High-Throughput BioScience Center, which opened in 2004. The results of this study are some of the first using the center's equipment.

The high-throughput equipment at Stanford can analyze thousands of molecules for their cytotoxicity at the same time, allowing researchers like those in Giaccia's lab to search for hidden genes and molecules that previously would have been quite laborious to find.

Without the center, "This work would not have been possible," said Stanford co-author Patrick Sutphin, MD. The findings have special significance for Sutphin, who worked with the Stanford team before moving on to his internship in medicine at Massachusetts General Hospital in Boston. In 1995, when Sutphin was a sophomore in college, his grandfather was diagnosed with kidney cancer and died three months later, he said.

The experience of losing his grandfather to kidney cancer helped motivate Sutphin to study the disease. His hope, Sutphin said, "is that one day our collective research will result in new drugs that are more effective than traditional drugs, and without the toxic side effects."

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Other co-authors of the study include Stanford researcher and postdoctoral fellow Sandra Turcotte, PhD. The research was funded by a grant from the National Cancer Institute.

Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at http://mednews.stanford.edu.

PRINT MEDIA CONTACT: Krista Conger at (650) 725-5371 (kristac@stanford.edu)

BROADCAST MEDIA CONTACT: M.A. Malone at (650) 723-6912 (mamalone@stanford.edu)