基本原則：要真實(shí)，不隱瞞。

    當(dāng)你向醫(yī)生描述自己的癥狀時(shí)，不需要用專業(yè)術(shù)語，但是如果可以的話，這可以讓這個(gè)問診過程更加方便。

    無論是說你胸部的刺痛感還是情緒的大幅波動(dòng)，在醫(yī)生那里，他們都會(huì)把這些信息與某些病癥相聯(lián)系。

    這不像是在體檢或是實(shí)驗(yàn)過程中提取信息，癥狀自查需要你對(duì)自己的身體狀況足夠關(guān)心，足夠了解。

    如果你能清楚地向醫(yī)生描述自己的癥狀，那么醫(yī)生就能夠做出準(zhǔn)確的診斷，制定最佳治療方案。所以當(dāng)你描述自己的狀況是，不要遮遮掩掩，并盡量具體，不要遺漏過多的細(xì)節(jié)。

    上文已經(jīng)提及過，這個(gè)過程并不需要我們對(duì)醫(yī)學(xué)術(shù)語非常了解。

    “病人用自己的話病癥非常重要，不要想著怎樣使用專業(yè)術(shù)語，也不要臆斷醫(yī)生想要聽到你提供哪些信息，盡可能用自己的話把癥狀說清楚就行了?！?加州大學(xué)疾病監(jiān)控中心的臨床醫(yī)學(xué)助理教授Barrett Levesque如是說。

    Michael Klinkman是密歇根大學(xué)健康系統(tǒng)的家庭醫(yī)學(xué)教授，他也非常贊同這一觀點(diǎn)。他舉了個(gè)例子，當(dāng)你描述的時(shí)候，你可以說：“我覺得肚子很痛，很不舒服。”其實(shí)這樣簡(jiǎn)單明了的描述就可以了。

    當(dāng)然如果你可以打一些比方來更生動(dòng)地描述你的感覺就更好了。

    比方說，你可以這樣描述：“我覺得頭很痛，感覺像錘子在不停的敲打頭的一側(cè)一樣。”從這樣的話當(dāng)中，醫(yī)生就可以得出這樣的信息：這是單方面的一側(cè)頭痛，這是一種劇烈的陣痛感，那么根據(jù)他的描述，醫(yī)生就可能會(huì)得出叢集性頭痛的結(jié)論。

    描述癥狀的時(shí)候，應(yīng)該要包含這些內(nèi)容：你的感覺，如果是生理上的病痛，那么它在身體的什么部位，發(fā)生的頻率大概是怎樣，這些癥狀是從什么時(shí)候開始的等等，如果可以的話，也可以說說這是不是跟你的某一活動(dòng)有聯(lián)系，比方說天氣，時(shí)間，食物或者飲料，或者任何你認(rèn)為與病情相關(guān)的事情。

    Levesque說，這有助于幫助我們?nèi)ヅ袛嗖∪说陌Y狀是不是因?yàn)閴毫^大而產(chǎn)生或者是不是與某種藥物或家庭病史有關(guān)。

    不要對(duì)病情遮遮掩掩，即使有的時(shí)候這些癥狀很難啟齒，也不要忽略哪些你認(rèn)為不重要的細(xì)節(jié)

    “有些人大便的時(shí)候會(huì)出血，如果病人不告訴我們，那這將會(huì)給整個(gè)診斷過程帶來很大的麻煩，因?yàn)槿绻麑?duì)這些事情遮遮掩掩，那可能就需要更多的測(cè)試才能幫助我們知道他的身體狀況?！?

    美國疾病協(xié)會(huì)的組織曾經(jīng)發(fā)明過一個(gè)網(wǎng)上醫(yī)療工具，，那么病人就可以直接在它提供的表格上填寫自己就診的原因，自上次治療后出現(xiàn)的新癥狀，身體上是否有新的改善，以及他們要向醫(yī)生提出的新問題。這樣的事情，春雨醫(yī)生也一直在做。

    因?yàn)樵谔顚懕砀竦倪^程中，病人自己就會(huì)知道自己到底想要問什么，自己的身體到底有什么不適。那么在問診的時(shí)候，大家也要注意不要描述過長(zhǎng)，因?yàn)檫@樣的話可能就讓醫(yī)生抓不住你問診的重點(diǎn)。

    而另一件事情就是，因?yàn)椴∪艘獑柕膯栴}太多，而要約到醫(yī)生的時(shí)間和機(jī)會(huì)卻少得可憐，在這種情況下，移動(dòng)醫(yī)療就給這一訴求帶來了光明，病人可以在突破空間和時(shí)間的限制，得到更加細(xì)致更加專業(yè)的醫(yī)療幫助。

    當(dāng)你為醫(yī)生提供了相對(duì)準(zhǔn)確清晰的描述之后，他們就可以更好的把你的癥狀與病征相匹配，那么就可以更準(zhǔn)確的來為你做一個(gè)治療方案了。

    “我覺得腹部隱隱有疼痛感，每當(dāng)心情緊張的時(shí)候，這樣的癥狀就會(huì)加劇?！北确秸f這樣的描述就很好，很容易讓醫(yī)生理解。

    在春雨醫(yī)生的網(wǎng)站上，患者可以進(jìn)行病情的自查，并可以隨時(shí)向醫(yī)生詢問自己的病情，這會(huì)讓我們對(duì)自己的身體狀況有更清晰地了解，這樣就可以為我們的身體健康提供保障了。

    最后，提醒大家，在描述自己的癥狀時(shí)，要意識(shí)到，這是一個(gè)與醫(yī)生合作的過程，因?yàn)獒t(yī)生可以通過你的描述來整理患者的癥狀，告訴我們有哪些藥物或者治療能夠幫助我們緩解病痛，再比如，他們對(duì)我們?cè)陲嬍?，休息，運(yùn)動(dòng)等方面的建議也會(huì)讓我們的生活更加健康。

編譯自

How to Describe Medical Symptoms to Your Doctors

Use your own words, don't hold back and don't be shy.

When explaining your symptoms to a doctor, jargon isn't necessary but an analogy can go a long way.

When it comes to describing medical symptoms – from sharp chest pains to sudden mood swings – the patient is the go-to member for the entire health care team.

Unlike signs picked up on physical exams or laboratory results, symptoms are what you experience firsthand and concern you enough to seek health care in the first place.

By explaining symptoms clearly, you help your doctor make the right diagnosis and develop the best treatment plan. So when it comes to describing symptoms, don’t be shy – dive right in and go into detail.

You don’t need to use medical jargon to be understood.

“It’s important for patients to describe things in their own words, not to try to use medical terms or what the doctor is expecting to hear, but to use their own language,” says Barrett Levesque, an assistant professor of clinical medicine at the UC San Diego Health System Inflammatory Bowel Disease Center.

Michael Klinkman, a professor of family medicine at the University of Michigan Health System, agrees that patients shouldn’t try to sound like doctors. “They just need to sound like people. ‘My stomach hurts and it’s really bad and I’m worried about it.’ Now, that’s a place to start from,” Klinkman says.

Presenting a symptom with a strong analogy can be a good way to go.

“When patients say something like, ‘I’m having this headache and it feels like a hammer going off and beating on the one side of my skull,’ I remember that description vividly,” he says. “In one sentence, it tells me that it’s unilateral – on one side of the head – and it’s a throbbing, pounding headache; it might wind up being a cluster headache, just because of that description.”

The basics of symptoms include how they feel, their location in the body (if physical), severity, how often they occur and how long they’ve been happening. Also consider

whether they’re associated with a certain activity, specific injury, time of day, food or drink, or any other triggers or patterns you’ve picked up on.

Levesque says that for many patients, “it could be a recent trip that might have set something off, stressors, medications they’re taking, family history – all are important to learn about, because it puts their symptoms in context.”

Among his patients with inflammatory bowel disease, he wants to know how their lives are affected: “Are they missing days at work? Or they can’t go out at night with their friends on the weekend because it’s always that they need to find a restroom? Or even the simple fact of the troubles they have driving into work, because they have to know where each gas station is.”

Don’t hesitate to mention symptoms even if they seem embarrassing or less than urgent.

“If somebody’s having bleeding in their bowel movements and not talking about [that], it can be difficult to make a diagnosis,” Levesque says. Or “l(fā)eaving out something like extensive weight loss, for example, that might need additional tests to get to the answer.”

You can communicate with more confidence by preparing in advance, says Penney Cowan, executive director of the American Chronic Pain Association. Her organization offers online tools, including a sheet where patients briefly explain why they’re going to the visit, new symptoms they’ve had since their last visit, how things have improved and any questions they have.

“Now they’re prepared,” Cowan says. “You have to be organized because it’s very intimidating in front of your provider.”

By all means, make a list of concerns, but keep it short and focused, Klinkman advises. Too long a list can obscure what’s most significant and drain away precious office visit time.

“That’s another thing that we kind of cringe about as physicians, because it’s been so hard for patients to get their appointment with me," Klinkman says. "[Then] they have a list of 15 or 20 things they want to know about, and they start going down the list.” .

Attention-grabbing phrases include “I’m worried about this” or “This is concerning to me,” he says. “After you’ve said the two or three things that are really most important, then you might want to ask your doctor something like, ‘Does that make sense to you?’ or get him to engage back with you.”

For his part, Levesque has found some people “may minimize their symptoms because that might just be their personality,” but he warns that if patients say they feel better than they really do, it can affect how doctors interpret their test results.

“It’s helpful sometimes for patients for us to give them some language,” he says, by suggesting, for instance, descriptive terms like “watery” or “oatmeal” for bowel movements.

Other patients have no trouble describing their symptoms in full, Levesque notes, including creative use of technology. “Patients have even become comfortable taking pictures of the toilet to give a view of what they’ve been going through,” he says.

When you give health care providers a good rundown of your symptoms, it can help them make important connections, Klinkman says.

“When we hear something like ‘I’m having these abdominal pains and they come on when I’m stressed, and they bother me every day with no specific pattern,’ we can see pretty quickly that it doesn’t sound like the common medical causes for abdominal pain. It doesn’t sound like an ulcer or gallbladder disease,” or other causes, he says. “But it may be that somebody’s expressing their anxiety or distressthrough more somatic or body-focused symptoms.”

Someone with a condition like fibromyalgia or arthritis could go onto the American Chronic Pain Association site to maintain an interactive pain log. While the log includes the standard “rate your pain on a scale from one to 10,” it drills a lot deeper, allowing patients to concisely self-assess measures such as stress, exercise, sleep, fear of the pain, mood and isolation. Patients can then share these logs with their health team.

When it comes to describing your symptoms, “It’s important to realize that it’s a partnership,” Levesque says. “Doctors will help patients sort out their symptoms and address which ones we can alleviate and which ones there could be solutions [for] outside of medicine, such as dietary changes, rest, exercise, social support – all these things that are part of healthy living – that can be addressed as well.”

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