Arthritis and Joint Disease Patient Education Information

There are good ways and bad ways to make decisions. Sometimes, people with an illness make decisions about their treatments with less care than they would when choosing a new car or refrigerator. This may be due to lack of knowledge, embarrassment about questioning the doctor, anxiety about being sick, trouble talking with the doctor, or feeling that something must be done right away. This guide suggests questions to ask any time you make decisions about medical and surgical treatments. Other guides review the benefits and drawbacks of individual treatments.

Do you or your doctor think your arthritis is getting worse? If so, you should seriously consider a change, and discuss it with your doctor. You must decide how much discomfort you will accept.

For most situations in arthritis, you have time to think about the pros and cons of a change. Ask your doctor what will happen if you do nothing new for a while longer. Chances are, you have more time for most decisions than you think.

The doctor may suggest one or more treatments based on his or her experience and knowledge of you. At this point, it is useful to find out all your choices, and ask your doctor to discuss them. Sometimes you general health may limit your options. For instance, if you have a liver problem, some drugs may make it worse. It can help to get more information from another doctor (second opinion), books and pamphlets, and other health professionals.

All treatments are not alike. Each has its own benefits and drawbacks, and likelihood of working. If there is more than one possible treatment, your preferences become very important. However, your doctor will not know your preferences unless you speak up. For example, if you have to take medications, do you prefer one that might cause nausea over one that might cause hair loss? Ask what are the chances that each treatment will work and how long it usually takes to work. Ask what kinds of problems you might have, including side effects, costs, and inconveniences.

Even if options are limited, don't be afraid to ask if you can change them to suit you better. You may be able to take a drug less frequently or in smaller amounts than recommended. You may be able to substitute one exercise for another, or do it once a day instead of twice. Even small changes like this can make a treatment more acceptable.

A successful treatment may give you better health and more energy for family, work, and social activities. You may need to rely less on others for help. On the other hand, some treatments may place a burden on your budget, or increase your reliance on others. For instance, you may need transportation to the hospital more often. You might need help from others for a few months after joint replacement surgery.

After consider the options, you will choose one that seems the best. At this point it is good to review for yourself how likely it is to achieve your goals. Also, how likely is it to cause a problem, such as side effects, expense, or inconvenience? If you are not sure if the top choice will work out, you might be able to start it on a trial basis.

Being committed to a decision will help you stick to it. First, make sure you understand from the doctor how to carry out the treatment correctly. How, and how often, do you take or do it? How will you know it is helping? How long should you give it a try? What do you do if it does not seem to work? Second, review the drawbacks to this treatment, and make plans to overcome them. Do you need help paying for a treatment? A reminder system to take all your pills? Transportation, or help from others? Do you need to talk to others to increase your motivation? A realistic look at the challenges of the course you have chosen can do much to help you cope with set-backs when they occur.

You may be right in thinking the treatment is not working. But first, ask a few questions to be sure. Have you given it enough time? Have you carried out instructions faithfully? Do you know what signs of improvement to look for? You should contact your doctor when you think that a treatment is not working. You may have to consider new options (back to the first question). Communicate honestly with your doctor about your experience with this treatment. It will help him or her judge what are your next options. And give your new decision all the care you gave this last one. It's your health, and no treatment is minor.
Improving communication with your doctor: Ask questions.

A good question is specific, direct, timely, well thought out, and gets results.

• Be specific.

  If you ask, "How am I doing?" you may hear, "Not too bad." If you really want to know how serious your condition is, or how long the treatment will last, then ask that.

• Be direct.

  Do not hint. Use words like what, why, and how. You are more likely to get a satisfactory answer if the doctor does not have to guess what you want.

• Be timely and thoughtful.

  Think of your most important questions before your visit. Write them down, and rehearse them if it helps. Tell your doctor at the beginning of your visit that you have some questions you would like answered. Ask when you should bring them up. This gives the doctor a chance to organize his or her time.

• Get an answer.

  A good question gets a clear answer. If the doctor has not answered at all, repeat the question. If the answer is not clear, ask again. Ask for details or simpler words if that is the problem.

Most people, including many physicians, find it difficult to ask questions when they are patients. Here are the most common reasons.

• Forgetfulness.

  This is common, as time is often limited and patients are anxious in a medical visit. Write down your most important questions before the visit, and bring them with you. Ask new questions right when you think of them.

• Embarrassment.

  Many people are embarrassed talking about personal matters with a doctor. Because arthritis affects such things as going to the bathroom, having sex, or feeding yourself, you have good reasons to discuss such concerns with your doctor. Feeling comfortable with your physician may take time. His or her job is to help you live day to day with a chronic disease.

• Medical jargon.

  Many words in medicine are technical. Ask for an explanation of any words you don't understand. Ask if you can repeat something in your own words to be sure that you do understand. Doctors may think that they have explained something, and will not know unless you ask them. Don't be afraid of asking questions. There are no dumb questions.

• Doctor is too busy.

  Doctors get interrupted, and sometimes act rushed. Remember, your time is as important as the next patient's time. If you plan ahead and bring up your main questions at the beginning, the doctor can organize the visit so that you get your answers. Also, you can ask for booklets, a followup appointment, or a chance to talk with another caregiver, such as a nurse, therapist, or social worker.

• Feeling intimidated.

  You have a right to answers to your questions, even if the answer is something like "I don't know until we do more tests." If a doctor doesn't answer your questions, repeat them.

• Fear of the answers.

  It is natural to fear the worst when you have a medical problem. However, the worst is rarely true. Most problems in arthritis are manageable. Don't let your fears get in the way of understanding what you need to do. Taking steps to control a problem is the best way to reduce your fears in the long run.

• Question is not important.

  Anything that is important to you is worth mentioning.