How can you get the best care? Start by telling your neurologist what he really wants to know. We talked with Gary Gronseth, M.D., vice chairman of the department of neurology at the University of Kansas Medical Center. Dr. Gronseth often writes guidelines for neurologists on how best to evaluate and treat neurological problems. Here's what he wants you to discuss:
* YOUR SYMPTOMS: Tell me the story of your symptoms, not what other people have told you about your symptoms, Dr. Gronseth says. Be as specific as possible and concentrate on when the symptoms started and how they progressed.
* OTHER MEDICAL CONDITIONS: It's really important to know the patient's other medical conditions, allergies, and idiosyncratic reactions to medications, he says. That way, if there are several treatment options, the neurologist can pick the one that best fits the patient and will do no harm.
* MEDICATIONS: Don't forget over-the-counter (OTC) drugs, vitamins, supplements, and herbs.
* ILLICIT DRUGS: People are understandably reluctant to talk about this, but you should, because it may be related to your problem. For example, cocaine or amphetamines cause strokes, and some OTC medications-like diphenhydramine (Benadryl)-can cause memory problems and confusion.
* FAMILY HISTORY, INCLUDING GAPS: Some people lose contact with relatives and may not want to admit it. But a gap in family history will be very useful for the neurologist in excluding or continuing to consider the cause of your symptoms.
* WHAT YOU WANT OUT OF TREATMENT: The neurologist needs to understand the patient's values. For example, we often put stroke survivors on blood-thinners. But if the patient has had a bleeding complication in the past and is concerned about it happening again, he should bring it up. Encourage the physician to have a risk-benefit discussion where you can ask Gee, doc, is this really going to be worth it for me?
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