Whether it's a crash, overuse injury, or non-triathlon illness, most triathletes are going to end up seeking medical help for some reason. As an experienced patient, I can tell you this: Be a Proactive Patient.

By Proactive Patient, I don't mean that I want you to be someone who eats all your vegetables and takes a 30 minute walk 4 days a week (although these are all good things). I mean that once you become a patient, you need to be a confident, organized, out spoken, well-read, and demanding patient.

For example, you're out for a morning run, step on the curb the wrong way, and hear a loud crack as you roll your ankle. "Damnit, I've broken it" you think. So, you hobble your crippled leg into the orthopedists office, sit in a room for 30 minutes with no pants on, then finally see the doctor.

No pants allowed while you wait for the doctor

He tells you there's no need for an X-ray, it's just a simple sprain, and that you should rest for 4-6weeks. That'll be $150, thanks.

As a proactive patient, you don't take that shit. You tell him you want an X-ray, you tell him if he refuses, you aren't paying for the office visit, and then you go and get yourself a second opinion anyway. And you put your damn pants on unless he specifically needs to look underneath them.

Here's some specific steps for becoming a Proactive Patient:

1. Get Second Opinions

Always get a second opinion, no excuses. Here's a little story to illustrate their importance... I have been dealing with a pain in the medial area of my left knee for a while now. I decided to get it checked out by a sports chiropractor. He quickly diagnoses Plica Syndrome, an irritation around the knee usually caused by muscle imbalances. He can help me out by massage treatment and muscular physical therapy. Since I've had trouble with clots, I decide to see a vascular surgeon about the pain. He quickly diagnoses the same pain as Post Thrombotic Syndrome, a painful condition caused by scarring inside the veins. I go to the Orthopedic Surgeon for a third opinion. He gets an MRI and diagnoses a torn meniscus (although this doesn't show on the MRI). He recommends a cortisone shot, and exploratory surgery.

Three doctors, three different diagnoses. And, interestingly, each diagnoses corresponded perfectly to a treatment in that doctor's respective field.

What did I do? Nothing, and the knee feels great.

The moral is, get a second opinion. If I had ONLY gone to the orthopedic surgeon, and had I blindly followed his advice, I'd be recovering my meniscus reconstruction surgery right now. Instead, I am busy being awesome.

2. Ask what you can do

Assuming you get a definitive diagnosis, make sure you find out what exercise you can do to stay active, and even gain some fitness while you are out with your illness/injury. Say you've developed an overuse problem with your shoulder. Most likely you'll get set to a therapist who'll prescribe a series of shoulder rehab exercises. But you've also got two good legs, plenty of good core musculature, one good arm that can all use a good training effect. The proactive patient finds out what movements and exercises won't interfere with her recovery.

3. Leave a doctor you don't like/respect/trust

I hear people say things similar to this so often it makes me want to stick packing peanuts in my earholes, "Yeah, I went into the doctor, and he made me wait for an hour! Then, when he came in, he just refilled my prescriptions and didn't even listen to my concerns about the headaches. He just said I should relax."

Leave your doctor! Find a new one! Just because there's a lot of crappy doc's out there doesn't mean there aren't some really awesome ones, too. Dr. House, for example, can diagnose just about any disease.

I once had an endocrinologist at Johns Hopkins University prescribe me an incorrect dosage for a medicine... 7 times the recommended dosage, just because she was not familiar with the prescription protocol. Good and bad Docs are everywhere... if yours sucks, go find a new one!

4. Pursue all of your concerns

Get any problem checked out, even if it seems insignificant. A small cough could be a sign of lung cancer, or a leg pain could indicate Deep Vein Thrombosis. In most cases, unless you are actively and obviously dying, doctors aren't going to go out of their way to treat a condition of yours.

Worried that your malaise could indicate hypothyroidism? Feeling occasionally lightheaded and worried that your have some anemia? Stop worrying about it, stop searching the internet trying to diagnose yourself. Get yourself to a doctor and find out for sure! (Then go get a second opinion!)

Closing Thoughts

I don't want to put a bad spin on the medical industry, for there are definitely some unbelievable people working there. However, just like any job, there are those health care professionals who are just there to punch the clock. It's up to you to clearly, confidently, and aggressively advocate for yourself. If you aren't satisfied with your care, go find a new doctor, go get a second opinion, and put some pants on!


NursAdrn said... @ September 14, 2010 at 12:55 AM

Great tips. I would add that most of us have a pretty good idea of what is going on before we go in to the doctor (when it is an injury). If you have time, research it before seeing the doctor. They hate this; but it never pays to be uninformed.

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