You know your own body and mind.
When it comes to describing medical symptoms — from sharp chest pains to sudden mood swings — as the patient, you’re the go-to member for the entire health care team.
Unlike signs picked up on physical exams or laboratory results, symptoms are what you experience firsthand and concern you enough to seek health care in the first place. And now, with the growing presence of telemedicine, your role in conveying symptoms during virtual office visits is more important than ever.
By explaining symptoms clearly, you help your doctor make the right diagnosis and develop the best treatment plan. So when it comes to describing symptoms, don’t be shy — dive right in and go into detail. These tips can make it easier.
Speak in your own words.
You don’t need a medical degree to hold a conversation with a doctor. Skip the jargon and use your own words, speaking in normal language with everyday terms.
Patients needn’t try to sound like physicians, says Dr. Michael Klinkman, a professor of family medicine at the University of Michigan Health System. “They just need to sound like people,” he says. “‘My stomach hurts, and it’s really bad and I’m worried about it.’ Now, that’s a place to start from.”
“Using accurate, concise descriptions of symptoms is likely to help your physician quickly diagnose straightforward problems or determine if tests like bloodwork or imaging are needed to facilitate diagnosis,” say Dr. Lisa Ravindra, an assistant professor in the department of internal medicine and a primary care physician at Rush University Medical Center in Chicago. “In a lot of ways, doctors act as detectives, using clues from a patient’s medical history and current symptoms to help find a cause.”
Be as precise as possible when describing your symptoms, Ravindra suggests. “Avoid using vague terms for timing like ‘for a while’ or stating that a symptom occurs ‘once in a while’ since these mean different things to different people,” she says. “If you aren’t sure exactly when a symptom started, it’s more helpful to speak in terms of ‘years,’ ‘weeks’ or ‘hours.'”
Similarly, don’t say something hurts ‘a little bit.’ Instead, use the pain scale to self-rate your pain, Ravindra advises.
“Patients that are prepared with this information help me form a mental list of possible causes — a differential diagnosis — for the symptom more easily,” she says. “For instance, if I see a patient with a headache, knowing whether the headache has been on and off for years versus present for one day, or if it is a 2 out of 10 on the pain scale versus 10 out of 10 will lead me down different paths regarding further questions and appropriate tests.”
Presenting a symptom with a strong analogy can be a good way to go.
“When patients say something like, ‘I’m having this headache, and it feels like a hammer going off and beating on the one side of my skull,’ I remember that description vividly,” Klinkman says. “In one sentence, it tells me that it’s unilateral — on one side of the head — and it’s a throbbing, pounding headache; it might wind up being a cluster headache, just because of that description.”
Have basic medical tools at home.
Make sure you have a thermometer in your home medicine cabinet. “If a patient has infectious symptoms — sore throat, cough, vomiting, diarrhea and so forth — I will always ask about the presence of a fever, and it’s helpful to know an actual temperature,” Ravindra says.
Bonus points if you own a blood pressure monitor, particularly if you’re being watched or treated for chronic hypertension. That way, you can give health care providers a more complete picture of your blood pressure trends.
Prep for your visit.
You can communicate with more confidence by preparing in advance, says Penney Cowan, CEO of the American Chronic Pain Association. Her organization offers online tools, including a sheet where patients briefly explain why they’re going to the visit, new symptoms they’ve had since their last visit, how things have improved and any questions they have.
Draw attention to key symptoms.
Let your doctor know how much a particular symptom matters to you. For instance, if you’re rapidly losing weight without trying to and anxious about what this could mean, say so.
Attention-grabbing phrases include: “I’m worried about this” or, “This is concerning to me,” Klinkman says. “After you’ve said the two or three things that are really most important, then you might want to ask your doctor something like, ‘Does that make sense to you?’ or get him to engage back with you.”
Talk in terms of function.
Drill down on broad symptoms, like fatigue, whenever you can. Terms like fatigue “can often be challenging for doctors since the list of possible causes can be very long,” Ravindra says. “It’s often helpful for patients to talk more in terms of function.” For example, she says:
— A patient who feels fatigued used to be able to walk around the block, but now gets too winded. That description may lead the doctor to look into an underlying heart or lung issue.
— In contrast, another patient who feels fatigued has been taking naps frequently and has headaches in the morning. That may lead the doctor to look into a sleep disorder, like sleep apnea.
Let your doctor know about circumstances related to your symptoms. “One of the first things we are taught in medical school is how to take a ‘history’ from a patient,” Ravindra says. “This is an interview technique to gain as much knowledge as possible about a specific concern and is important for both primary care physicians and specialists.”
Having knee pain, for example? Here’s basic information to offer:
— Location. Is it the right or left knee? In the front or back of the knee?
— Onset. When did the pain start? Was it constant or intermittent, gradual or sudden? Did it start after exercise or a fall? How long ago?
— Duration. Does the symptom resolve or is it ongoing? If it does resolve, how long does the symptom last before resolving?
— Character. What’s the pain like? Is it dull, sharp, burning or do you feel other sensations?
— Radiation. Does the pain spread anywhere else, like to your ankle or hip?
— Associations. Is there anything else associated with the pain like swelling or redness?
— Aggravating/alleviating factors. Does anything make it better or worse? Does it get worse with going up or down stairs, for instance? Does ice help?
— Severity. How severe is the pain on a scale of 1 to 10?
Keep a log or journal.
For vague symptoms, such as dizziness or nausea, Ravindra sometimes asks her patients to keep a symptom journal after meeting with them. “This can help keep track of when a particular symptom arises and the surrounding circumstances, which can help patients become more in tune with what is happening with their bodies,” she says. “For example, does nausea always occur after eating a large meal or on Sunday nights before a big work meeting?”
Someone with a condition like fibromyalgia, for example, could go onto the ACPA site to maintain an interactive pain log. While the log includes the standard pain scale, it goes much further, allowing patients to concisely self-assess measures such as stress, exercise, sleep, fear of the pain, mood and isolation. Patients can then share these logs with their health team, which can help shed light on trends and pinpoint triggers.
Fill in your family history.
Cancer, heart disease, mental health conditions and many other diagnoses may have a genetic component that can affect your risk. Fill out the family history item on the office’s intake form but also speak up during the visit discussion.
“Patients sometimes overlook how important relevant facts from the past may be,” Ravindra says. “For example, if a 40-year-old patient sees me for chest pain, I may be more concerned for a heart condition and send them for urgent testing if their mother or father had a heart attack in their 40s.”
Your input is valuable. “With the rapid expansion of telemedicine since the start of the COVID-19 pandemic, we rely even more on patients’ descriptions of symptoms since the ability to examine patients virtually is very limited,” she says.
Help doctors connect the dots.
When you give health care providers a good rundown of your symptoms, it can help them make important connections, Klinkman says.
“When we hear something like ‘I’m having these abdominal pains, and they come on when I’m stressed, and they bother me every day with no specific pattern,’ we can see pretty quickly that it doesn’t sound like the common medical causes for abdominal pain. It doesn’t sound like an ulcer or gallbladder disease,” or other causes, Klinkman says. “But it may be that somebody’s expressing their anxiety or distress through more somatic or body-focused symptoms.”
Also, be aware that your provider will often ask follow up or clarifying questions. Sometimes these may seem personal — such as ‘could you be pregnant?’ or ‘do you use any substances?’ — and seem odd or irrelevant to you. But these questions aren’t meant to be judgmental. Rather, they’re the provider’s way of trying to narrow down what could be causing your symptoms.
Throughout the whole interaction, remember that your symptom description represents crucial data. “As advanced as our testing is now, most diagnoses still occur in the exam room after talking to and examining a patient,” Ravindra says. “Patient’s descriptions often hold the key to accurate diagnosis.”
Tips for describing your medical symptoms
Narrate symptoms clearly and completely to help doctors pinpoint your medical issues:
— Speak in your own words.
— Be precise.
— Use analogies.
— Have basic medical tools at home.
— Prep for your visit.
— Draw attention to key symptoms.
— Talk in terms of function.
— Give context.
— Keep a log or journal.
— Fill in your family history.
— Help doctors connect the dots.
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Update 12/22/21: This slideshow has been updated with new information.