10 Questions You Need to Ask Your Doctor
Next time you have a physical, arm yourself with this checklist of questions.
Have you ever left your doctor’s office and then realized you forgot to ask about something that’s been worrying you?
Do you wonder what the latest studies recommend you do to take preventive action against things such as osteoporosis and breast cancer? We consulted the experts to compile this list of 10 key things to ask your doctor.
1. Am I getting the best cancer screening possible?
When it comes to breast cancer screening, mammograms are the best option for women who are at average risk and aged 50 to 69, says Heather Chappell, senior manager, cancer control policy of the Canadian Cancer Society. But ultrasound and MRI testing may be a good adjunct to mammograms for women who are at a higher risk, such as those with a family history of the disease.
“Ultrasounds and MRI are not necessarily more reliable than mammograms unless they’re used in conjunction with a mammogram,” says Dr. Jan Christilaw, senior medical advisor for provincial women’s health programs at the BC Women’s Hospital & Health Centre. Mammograms can detect tiny calcifications that may indicate early breast cancer, ultrasounds may offer more follow-up clarity for women with dense breasts, and MRIs may be useful for women at high risk.
If you do have a family history of breast cancer, testing for BRCA1 and/or BRCA2 genes can help your doctor develop a customized prevention plan for you. For cervical cancer testing, while Pap smears often first detect the disease, human papillomavirus (HPV) tests are increasingly used as an adjunct. The technology is still in limited distribution, however.
2. Am I clinically obese?
Some 5.5 million Canadians are obese, with a body mass index (BMI) of 30 or higher. And even though obesity opens the door to type 2 diabetes, heart disease and cancer, only about 40 percent of those affected get advice from their doctor. “For many physicians, once you’ve finished an appointment, there is very limited time left to talk about weight,” says Pedersen, an endocrinologist at the University of Calgary. Ask the doctor to measure your waist: 31 inches (80 centimetres) or higher could spell trouble. Then ask for his or her advice on treatment options because if you are clinically obese, even a five to 10 percent weight loss will benefit your health.
3. Could my back or joint pain indicate a chronic illness?
Ovarian and pancreatic cancers and even kidney stones can show symptoms through back pain. In a Tokyo Women’s Medical University study, 30 percent of patients who had pancreatic cancer suffered from abdominal or back pain. And diseases such as lupus often reveal themselves through joint pain.
4. Should I worry about hypertension before I’m 50?
Yes, if you had a hypertensive pregnancy or have a family history of high blood pressure. “We know that within 10 years of that pregnancy, women have an increased risk of significant hypertension, and their cardiac risk goes up 10 years earlier than the general population,” says Christilaw. What we do to our arteries in our 30s and 40s is critical: “Eat a reasonable diet low in cholesterol, maintain a normal weight, and exercise,” suggests Christilaw.
5. Should I get a bone density screening even though I’m young?
If you are under 50 and have a family history of bone deterioration, ask your doctor if you should get screened, says Tanya Long of Osteoporosis Canada. If you’re over 50, you should be assessed, and if you have one or more major, or two or more minor, risk factors, a bone mineral density test is recommended. (Anyone over 65 should have this test.) Doing weight-bearing and resistance exercises three times a week reduces risk. And women over 50 should get 1,500 milligrams of calcium and at least 800 International Units (IU) of vitamin D daily. For those under 50, it’s 1,000 milligrams of calcium and at least 400 IU of vitamin D daily.
6. Why won’t this severe headache go away?
“Severe” means a headache with excruciating pain levels that you’ve never experienced before: Whether it’s a single headache or a recurring pain, dial your doctor. And if it’s accompanied by nausea, vomiting, seizures, or other neurological symptoms, get to an ER. It may only be a migraine, but it could also be a ruptured aneurysm — a potentially fatal bursting of a widened or bulging blood vessel in the brain. If it’s caught in time, you can recover.
7. Why won’t my flu symptoms go away?
The flu usually lasts three to four days, with fever, chills, dry cough, aches and pains. But if it continues past four days, you may have a secondary infection — pneumonia, mononucleosis, strep throat, a staph infection or even early-stage lung cancer. “Especially if there’s a chronic cough or if you’re coughing up coloured sputum, you need to be seen,” says Christilaw.
8. Should sexually transmitted infections worry me?
If you have a new sexual partner, regardless of your age, there’s a risk of STIs. HIV-positive cases have increased in the past five years for those over 30, due in part to more active sex lives among older adults and poor HIV awareness. Not using a condom during sex is a concern because your chances of developing an infection increase as you age. “Post-menopausal women have thinner vaginal tissues and are more at risk of chafing, and those are risk factors for developing HIV,” says Christilaw. Chlamydia, gonorrhea and HPV are also on the rise. “If you’re post-menopausal and you get gonorrhea, you may not have the heavy discharge a younger woman does. So you can get sicker before you know you have an infection.”
9. Why am I experiencing abdominal discomfort?
Feeling bloated, gassy or achy may indicate something more serious than a bad meal. Chronic discomfort can point to conditions such as appendicitis, ovarian cysts, diverticulitis and pelvic inflammatory disease. To be sure, your physician may, along with pressing on your abdomen, order an X-ray. “If you’re in severe pain, if it gets worse within 24 to 48 hours, if you have a fever or if your bowel patterns have changed over time, you should be seen,” says Christilaw.
10. Why do I have heartburn and shortness of breath?
The signs of heart trouble in women may be more subtle and long-lasting than the chest pain and arm numbness you’ve heard about for men. “Women having heart attacks might feel short of breath or sick,” says Christilaw. “Heartburn is the number one thing it’s confused with.” Chronic heartburn could also indicate GERD — gastroesophageal reflux disease, in which stomach acid comes up into your esophagus. If these symptoms arise suddenly, or persist, get a formal diagnosis.