A Healthier You: A 5-step guide to better doctor visits

0:04This is Ted Health, a podcast from the Ted Audio Collective. I'm your host, Dr. Shoshana Ungerleiter. For the next few weeks, we're bringing you a special series called A Healthier You. We'll tackle topics like heart health, exercise, mental health, and something that we heard listeners liked, gut health. I'll talk to experts, dive deeper into these ideas, and share my insights with you. Today, I want to talk about something that we all need to learn and get better at, and that's how to advocate for ourselves at the doctor. But before we dive in, let's hear from our sponsors.

0:45Have you ever been at the doctor's office and felt like you're playing charades? You're trying to describe that weird pain or feeling, but somehow the words just don't come out right. It's frustrating. Trust me, I've been there. I'm a doctor, but I'm also a patient. I still go for my own appointments, and being on the patient side is a real eye-opener. So today I want to dive into what it means to truly advocate for yourself when it comes to your health. And I'm sharing this from both perspectives, physician and patient. Even doctors need a plan when it comes to their own health care. The turning point for me was when I decided to have my ovaries and fallopian tubes taken out after discovering I carried a BRCA mutation.

1:33A mutation in one of your BRCA genes, also called BRCA, increases the likelihood of developing cancer because this mutation can keep your body from being able to repair damaged DNA, which can then lead to cancer. And specifically, it raises the lifetime risk of ovarian, breast, pancreatic, and prostate cancers, as well as melanoma. Discovering a BRCA mutation early can save your life. But the decision to undergo preventative surgery can be really intense for people. It's a very personal choice. For me, I felt like it was necessary given the risks. That journey was a lot to handle. But more than anything, it taught me the importance of advocating for myself.

2:23now drawing from that experience i want to share the top five things i've learned about how to advocate for yourself at the doctor's office and it starts with the power of preparation let's be real how many times have you walked out of an appointment and thought oh i forgot to ask that it happens to all of us before i spoke to my doctor about the surgical options related to my BRCA mutation, I wrote down questions like I was prepping for an exam. And when I thought of more questions in the days leading up to an appointment, I added them to the list. I had so many concerns, and there was no way I could rely on my own memory just to get through it all.

3:08Think of it like preparing for a meeting. You wouldn't go in without an agenda, right? The same goes for your health. Sadly, doctor's appointments often feel rushed. And in those cases, I prioritized the top two or three concerns, but I made sure those questions were answered thoroughly. And if I felt like the doctor was still moving too fast, I'd slow things down with something as simple as, hey, I'd like to make sure we cover a few key things before we wrap up. So that's pro tip number one. Go in prepared. Write down your symptoms and questions ahead of time and then prioritize them. It helps you feel more in control of your appointment and your health.

3:53After my ovaries and fallopian tubes were surgically removed, I was slammed into menopause at age 42. The ovaries produce estrogen, and so with them gone, I was menopausal about 10 years or so before I would have naturally gone through that change. Let me tell you, the hot flashes were brutal. But at first, I didn't fully communicate just how bad it was. Part of me thought, well, maybe this is just normal? Sound familiar? How often do we downplay our symptoms because we don't want to be seen as dramatic? But here's the thing. If you don't speak up, your doctor won't have the full picture. eventually i realized that i had to be honest about the hot flashes the insomnia and just how much this was affecting my daily life and once i laid it all out my doctor and i could actually start talking about solutions so here's pro tip number two be real with your doctor even if it feels awkward tell them exactly how pain or illnesses or medical procedures affect your day-to-day life.

5:07They can't help you if they don't know what's really going on. After my surgery, I was considering hormone therapy. My hot flashes were really intense. I wasn't sleeping well, and I also knew that a lack of estrogen, which is a type of hormone, at my age might lead to bone loss and other issues. But I was told by my doctors that I shouldn't even consider hormones because of my BRCA mutation, as they believed it could increase my risk of breast cancer. Based on my own research, that didn't sit well with me, especially after I had already had a mastectomy to reduce my breast cancer risk. I wanted evidence-based options to improve my quality of life, and I wasn't satisfied with that first answer I got, so I dug deeper.

6:00I reached out to the experts, even the ones who had written the guidelines for hormone therapy for menopause. And also, given that surgical menopause, which for me came about 10 years before my body would have naturally gone through a reduction in estrogen, can lead to osteoporosis or bone loss, heart disease, cognitive issues, and other problems, I felt compelled to ask for more information. guess what the advice was all over the place but by asking questions and pushing for clarity i was able to find a path that worked for me

6:42we're going to take a quick break we'll be right back with the last three pro tips

7:01I eventually found a provider who specialized in premature menopause. And together, using expert guidelines, we created a plan that I felt comfortable with. It included hormone therapy, along with close monitoring of my bone and heart health. And I'm happy to share that I'm now completely symptom-free. It took some time and persistence to find the right path. but I'm feeling great. So pro tip number three, don't be afraid to ask questions or even get a second or a third opinion. Clarifying things isn't just okay, it's necessary. I get it though, this can be hard to do. There were moments when I was so overwhelmed that I couldn't keep track of all the information being thrown at me.

7:49Sometimes I'd bring my husband along to the appointments and he'd take notes or ask questions I hadn't even thought of. Having that extra set of ears made a world of difference. So that takes us to pro tip number four. Bring a trusted person to your appointments if you can. Take detailed notes that you can review later. It's easy to forget things in the moment. It also helps to go back later and process everything, especially if you're juggling multiple treatment options. And last but not least, don't be afraid to follow up. After I started hormone therapy, I had more questions about dosage and any potential side effects.

8:31So I went back. I pushed for answers and eventually I found that specialist who helped me fine-tune my treatment plan. That persistence paid off. Here's the truth. You're never a burden for asking questions or pushing for better care. This is your health we're talking about. If you're involved and informed, that leads to better outcomes. So pro tip number five, if something doesn't feel right, follow up until you get the answers and the care that you deserve. The bottom line is this, we've got to normalize advocating for ourselves in healthcare. It's okay to ask questions, push for clarity, and again, even get a second or a third opinion.

9:19Your health is worth it. So here are those five takeaways again. Number one, prepare for the appointments. Write down your questions and prioritize your concerns. Two, be honest with your doctor. Tell them the whole story. Three, don't hesitate to ask questions or to seek a second opinion. Four, take notes or try to bring a support person. And five, follow up and be persistent.

9:55I'll leave you with a final thought, a loving challenge for you. What's one step that you can take today to be a better advocate for your own health? Maybe it's scheduling that appointment that you've been putting off or writing down a few questions for your next checkup. It might seem small, but trust me, it makes a difference. And if you have questions about how to advocate for yourself in the healthcare system, I would love to hear them. Send me a DM at ShoshanaMD on Instagram, and I'll do my best to address them.

10:33and that's it for today ted health is part of the ted audio collective this episode was produced by me shoshana ungerleiter and costanza gallardo edited by alejandra salazar and fact checked by vanessa garcia woodworth special thanks to maria lagis farah de grunge tally emlin daniela Balarezzo and Roxanne High Lash. If you enjoyed today's episode, rate and review the show on your favorite platform. It helps other people find us. And I'd really love to hear your feedback. Send me a DM at ShoshanaMD on Instagram. I'm Dr. Shoshana Ungerleiter, and thanks for listening.