With middle age comes a mid-life crisis for some.  For others it means stepping into the wide world of decline when health problems start to raise their ugly little heads.  Some people may be blessed with a great genetic make-up, but for most of us who spent our younger years flying by the seat of our pants and teetering on the edge, we find ourselves the products of those years of bad choices, risky lifestyles and life's glorious excesses.  So what do we do?  So do we freak-out and quietly fall apart?  Or do we do the unthinkable and explore a new world of using pharmaceuticals for actual medicinal reasons?  Do we start taking our doctor’s advice as our medical charts start to grow thicker with lab results, surgical reports and progress notes? Those carefree days of recreational use and abuse have now ceased and we stand humbled as our doctor writes each Rx.  We stand wondering what side effects might follow hoping that the cost of our healthcare will result in lower cholesterol, lower blood pressure, a peaceful sense of well-being and ultimately a longer life.

In the past few years I’ve learned a lot about the healthcare system as a whole. Most of the following things may be commonsense things that will prompt a quick response of “I knew that”, but often times we get in a doctor’s office and go blank. Consider this a refresher course or just a gentle nudge in the right direction.

Life is full of choices. Remember that when selecting a doctor! Word of mouth referrals are probably the most helpful in weeding through all the doctors from Dr, Jekyll to Dr. House to Dr. Welby to Dr. Doolittle. Ask your friends, relatives and co-workers who they use. Doctors develop reputations that follow them wherever they go. Your doctor isn’t supposed to be the enemy, so if he or she acts like the enemy it’s time to find someone new. Nothing says you have to feel entirely uncomfortable for those few minutes while you’re prodded and probed, so why pay for someone who makes you feel like a pin cushion and like just another chart number to be filed away and forgotten about as soon as you leave the building? If you don’t feel good about the person with whom you’ve entrusted your life then it’s time for a change. And keep changing it until you find someone you like, respect and trust.  This person might have to assist you in making some life and death decisions along the way, so it might benefit you to get a doctor who not only knows your name, but knows your person.

After you find the right doctor, my first suggestion is to start making a list of things you want to discuss during each appointment. You spend your hard-earned money to pay for your office visits, so get your money’s worth while you’re there. I’ve found that doing a little homework about my health problems makes it easier to talk to my doctor.  The internet is great resource for medical information. Arm yourself with facts and don’t be afraid to ask your doctor questions about new procedures and new medicines.  A good doctor will take note of the interest you show as being a signal that you might be more apt to be compliant in any prescribed course of action.  Often times I forget that my doctor isn’t a mind reader and can’t properly diagnose and treat me unless I’m completely candid about my symptoms.  Even small details might be crucial in an accurate diagnosis because many illnesses mimic each other in their early stages, so don’t dismiss anything as being insignificant if it consistently bothers you. Let the doctor be the judge of a symptom’s significance.

Next, definitely learn about the drugs that you may have to take for the rest of your life. Find out what the long term effects may be and if periodic lab work will be required to make sure you remain within normal ranges. For instance, those people taking lithium to treat bipolar disorder need to be closely monitored because the difference between an accepted therapeutic level and a toxic level is a very small range. Also, ask your doctor about new drugs that may come available in the near future.  Trust me; your doctors are constantly courted by many drug reps wanting them to write prescriptions for their drugs. A good doctor knows which drugs work best and will recommend them without hesitation.

Tune in next time for the commonsense approach to health insurance. For now, this is Nurse Ratched signing off to get some much needed beauty sleep.