When it comes to describing medical symptoms – from sharp chest pains to sudden mood swings – the patient is 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.
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.
You don’t need to use medical jargon to be understood.
“It’s important for patients to describe things in their own words, not to try to use medical terms or what the doctor is expecting to hear, but to use their own language,” says Barrett Levesque, an assistant professor of clinical medicine at the UC San Diego Health System Inflammatory Bowel Disease Center.
Michael Klinkman, a professor of family medicine at the University of Michigan Health System, agrees that patients shouldn’t try to sound like doctors. “They just need to sound like people. ‘My stomach hurts and it’s really bad and I’m worried about it.’ Now, that’s a place to start from,” Klinkman says.
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,” he 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.”
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The basics of symptoms include how they feel, their location in the body (if physical), severity, how often they occur and how long they’ve been happening. Also consider whether they’re associated with a certain activity, specific injury, time of day, food or drink, or any other triggers or patterns you’ve picked up on.
Levesque says that for many patients, “it could be a recent trip that might have set something off, stressors, medications they’re taking, family history – all are important to learn about, because it puts their symptoms in context.”
Among his patients with inflammatory bowel disease, he wants to know how their lives are affected: “Are they missing days at work? Or they can’t go out at night with their friends on the weekend because it’s always that they need to find a restroom? Or even the simple fact of the troubles they have driving into work, because they have to know where each gas station is.”
Don’t hesitate to mention symptoms even if they seem embarrassing or less than urgent.
“If somebody’s having bleeding in their bowel movements and not talking about [that], it can be difficult to make a diagnosis,” Levesque says. Or “leaving out something like extensive weight loss, for example, that might need additional tests to get to the answer.”
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You can communicate with more confidence by preparing in advance, says Penney Cowan, executive director 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.
“Now they’re prepared,” Cowan says. “You have to be organized because it’s very intimidating in front of your provider.”
By all means, make a list of concerns, but keep it short and focused, Klinkman advises. Too long a list can obscure what’s most significant and drain away precious office visit time.
“That’s another thing that we kind of cringe about as physicians, because it’s been so hard for patients to get their appointment with me," Klinkman says. "[Then] they have a list of 15 or 20 things they want to know about, and they start going down the list.” .
Attention-grabbing phrases include “I’m worried about this” or “This is concerning to me,” he 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.”
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For his part, Levesque has found some people “may minimize their symptoms because that might just be their personality,” but he warns that if patients say they feel better than they really do, it can affect how doctors interpret their test results.
“It’s helpful sometimes for patients for us to give them some language,” he says, by suggesting, for instance, descriptive terms like “watery” or “oatmeal” for bowel movements.
Other patients have no trouble describing their symptoms in full, Levesque notes, including creative use of technology. “Patients have even become comfortable taking pictures of the toilet to give a view of what they’ve been going through,” he says.
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, he says. “But it may be that somebody’s expressing their anxiety or distress through more somatic or body-focused symptoms.”
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Someone with a condition like fibromyalgia or arthritis could go onto the American Chronic Pain Association site to maintain an interactive pain log. While the log includes the standard “rate your pain on a scale from one to 10,” it drills a lot deeper, 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.
When it comes to describing your symptoms, “It’s important to realize that it’s a partnership,” Levesque says. “Doctors will help patients sort out their symptoms and address which ones we can alleviate and which ones there could be solutions [for] outside of medicine, such as dietary changes, rest, exercise, social support – all these things that are part of healthy living – that can be addressed as well.”