1. "Here Are Some Things You Should Read!"The last thing many doctors want to see is a patient who walks into the examining room carrying a stack of paper -- news articles, journal references, Internet printouts -- to share during the appointment. Some doctors actively make fun of this -- calling patients the petits papiers ("little papers" in French) people. Others are quite obviously intimidated and threatened by -- even hostile toward -- knowledgeable and informed thyroid patients. Some are genuinely willing to read and explore things you want to share...but they simply don't have the time to do so in a quick appointment, while still providing provide you with a thorough office visit.
Solution: Pick a few of the most important items you want to share, and send them to the doctor at least a week or more ahead of your appointment, along with a note explaining which aspect of the material you would like to discuss, and indicating the date and time of your upcoming appointment. And if your doctor is threatened, it's time to find a new doctor.
2. "I'm Tired / I'm Fat / I Can't Lose Weight / I Just Don't Feel Well"It's great to have a friendly rapport with your physician, but remember: your doctor 's appointment is not a gripe session with a friend. While it's totally appropriate to whine over coffee to a friend that "I don't eat a thing and I'm a blob!" or "I feel like I could sleep 15 hours a night, and I am still exhausted" this is not an effective way to communicate with your physician. When you describe your symptoms in an emotional way, there may be a tendency for the physician to view those symptoms as emotional in origin, or, in doctor-speak, as a somataform disorder. And you might end up with a prescription for an antidepressant, or advice to "exercise more," instead of careful evaluation of your thyroid.
Solution: Quantify, quantify, quantify. And do it calmly. If you can take a rational, unemotional, scientific approach to describing your symptoms, you may find that the doctor takes your concerns more seriously. For example: "Doctor, I've been sleeping 8 ½ hours every night, and yet I still need a nap when I get home, and before I make dinner." "I've kept track, and I'm eating 1500 calories a day on a low-fat, carb-controlled diet, and I walk at least 2 miles on the treadmill five times a week, and yet I'm gaining about 1 to 2 pounds per week."
3. I'm Sure I Have _____Even if you suspect that you may have particular condition, it's not a good idea to declare in an appointment, "I'm sure that I have ____." For some doctors, this is the key symptom of "cyberchondria" and can make your doctor immediately skeptical about your self-diagnosis -- or even outright resistant to your theory, even if you may be right! Some less than enlightened doctors have even referred to patients derogatorily as Googlers.
Solution: Reframe the way that you present your suspicions. "Doctor, I have symptom a, b, and c, and I've heard that these may be signs of disease x. Is that something we might explore?"
4. I Read About This on the InternetWhen you want to explore a new idea or treatment approach with your doctor, it's often not a good idea to mention that you read about it on the Internet. While there are many legitimate sources of information on the Internet, a surprising number of practitioners -- especially those who are not especially Internet-savvy (and yes, they do exist!)-- have a negative view of the Internet. Even though the National Library of Medicine and the world's major medical journals are all online, you'll still hear doctors say "The only thing on the Internet is snake oil" or "you can't believe any medical information on the Internet."
Solution: Provide a citation, whenever possible. As in, "There is a doctor in New York who is treating patients with .... " or "there was an article in the Times that talked about..." Or "I saw a summary of this study from the New England Journal." Even if the Internet was the first place you learned of the information, when you bring it up with the doctor, do your best to share the origin of the information, rather than "I read on the Internet that..."
5. I'm Not Taking Anything...Frequently, I hear from patients who say "I'm not taking anything else" when their physician asks: "What other medications or supplements are you taking?" But they are misleading the doctor, because they are sometimes taking medications prescribed by other physicians, or even self-medicating with prescription medications they buy from abroad without a prescription. And frequently, patients are taking vitamins, herbs, minerals, and other supplements -- again, often self-prescribed, or on the recommendation of holistic practitioners, or even clerks at health food stores. The problem here is that certain prescription drugs and supplements can interact with your thyroid medications , making them less effective, or even have the ability to worsen your thyroid condition.
Solution: Make a list of all your prescription medications and supplements, and share them with all of your physicians and practitioners. And if you don't have the kind of relationship with your doctor that allows for this sort of crucial exchange of information, then that's a clear sign that it's time to get a new thyroid doctor.