Preparing for a Visit to the Doctor

What to Expect When Seeing a Pulmonologist

Have you finally decided to see a doctor because of concerns about some symptoms you are having, such as fatigue and shortness of breath with minor activities? Congratulations! You are doing the right thing. Maybe you have been blaming your symptoms on getting older, or on being a couch potato, but your doctor would much rather see you for minor symptoms than have you wait until you are having a serious problem. Let’s think a bit about what you can do to take full advantage of that appointment you have finally made.

The first time you go into the doctor’s office, be sure to bring along your Medicare and insurance information. If you have any old records of a work up done by another physician, like a pulmonary function test, a chest x-ray, blood work, an echocardiogram, or a sleep study, bring those records with you also. They may be useful and might save time or unnecessary repetition of tests.

Write down a list of all the medications you take. Note the dose of each, and the time of day you take them. This includes over the counter medications (OTC), vitamins and eye drops. If that is too hard, dump the bottles into a paper bag (or suitcase) and cart them along.

Be prepared to fill out an extensive questionnaire about your medical history and that of your immediate family. You might be asked for dates about things like surgeries or major illnesses, along with your smoking history and whether you’ve had recent weight gain or weight loss. Include the dates of your last booster shots for pneumonia and flu, along with vaccinations for measles, tetanus, or shingles if you have them. Don’t worry if you don’t have all this information, just do the best that you can. If you do have any of these records, they are worth keeping in your own files.

The staff will measure your height and weight, check your blood pressure and temperature and also check your oxygen levels using an oximeter (a probe placed on your finger). They will ask why you have come to the doctor’s office before calling in the physician.

One of the mistakes people often make is to minimize symptoms or even ignore them. No one likes to be thought of as being a complainer or, heaven forbid, a hypochondriac! It is hard to admit to a problem, but that is why you are now in the office. Have you ever answered, “I’m fine,” when asked how you were feeling? If you were “fine,” you wouldn’t be in the office, would you? If you called the plumber to fix a leak, you would try to be specific about where the problem was, wouldn’t you? Don’t be uncomfortable when you also try to give information to your physician. A pet peeve of the poor doctor is when the patient chats about minor things for 15 minutes and then, getting up to leave, says something like, “Oh, by the way. I have been coughing up blood.” Try to start your visit by bringing up your most serious concern first, not last, and then limiting yourself to two or three problems.

If you are seeing the doctor, a pulmonologist if possible, because you have episodes of shortness of breath (SOB) or unusual fatigue with activity, try to tell the doctor about specific symptoms you are experiencing. You may be asked, “How far can you usually walk before getting short of breath?” Think about it. It helps to be able to give an example such as, “I used to be able to walk four blocks without any problem, but now I can hardly walk one block.” Or maybe, “I get too tired to walk very far.”

Besides your shortness of breath, a pulmonologist in particular, will be interested in any history of coughing and sputum production, such as:

  • Do you often cough and is it sometimes so bad that you can’t catch your breath?
  • Does your coughing make you wheeze?
  • Do you ever wake up coughing or short of breath at night, or first thing in the morning?
  • Does your cough produce sputum? If so, is it a teaspoon, tablespoon or cup every day? How thick or thin is your sputum? What color? White, creamy, yellow, green or blood tinged?
  • Has there been a recent increase in your sputum or change in the color or consistency?
  • Do you belch a lot or have gastric reflux?
  • Do you sometimes wake up with a headache?

If you are still smoking, that may be the elephant in the room you have been trying to avoid talking about. Your physician knows how addictive cigarettes are and understands how difficult it is to quit, so don’t be afraid to discuss this. Remember there is help available!

Your physician will also consider other possible causes for your shortness of breath and fatigue, besides pulmonary problems. Usually, these would come up in later visits if indicated after reviewing your test results.

Will the doctor discuss all of the above? No, of course not. You live with yourself 24 hours a day while your doctor will see you for less than 15 or 20 minutes. The more information you are able to provide, the better. Become a partner in the management of your health, and work with your physician on the problems that bother you the most.

If you are afraid that you might forget something important, write it down. If you are nervous about going alone or forgetting what is said to you, bring someone with you. Request a copy of all of the tests you might have done. Will you remember everything mentioned above? Of course not! If you remember just 2 or 3 problems on this first visit, then you should be proud of yourself.

Congratulations on following through with your appointment, good luck, and most important, bring along something to read; sometimes it can be a long wait in that office!

Mary Burns, RN, BS
PERF Executive Vice President