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How to get the most out of your consultation

How to get the most out of your consultation

Written by Dr. Haroon Thowfeek

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Before your consultation on oDoc, it is best to be well prepared. A well-organized patient not only makes efficient use of the doctor’s time but is also likely to get better medical care, as they are helping the doctor a great deal in making an accurate diagnosis. Here are the steps you can take:

  • Create a list of issues or queries you want to discuss
  • Makes sure you have all your medical records with you. You may even bring a note book to jot down all the important information the doctor tells you.
  • Remember to inform your doctor about all your symptoms. List them in a chronological order, starting from the time when you first noted that something was not right
  • Make a list of all the medications you are taking or let your doctor know what remedies you have tried earlier, and whether they have helped you or not. Alternatively, you can collect all your medicines and show them to your doctor.
  • If you have consulted a doctor earlier or have undergone relevant tests, please share this information with your present doctor. This information will help your doctor plan your treatment better.

Once you’ve spoken about the above with your doctor, you can ask him what he thinks your condition could be. If you do not agree with the doctor’s diagnosis, make sure to ask them more questions and understand why the doctor has come to this diagnosis. If you do not agree with it, you are unlikely to follow his advice and treatment, so it is always best to get your concerns sorted.

When the doctor presents you with a diagnosis, you can ask the following questions:

  • What is the diagnosis? Find out the complete medical name – and what it means in plain Sinhala/Tamil/English!
  • What is my prognosis (outlook for the future)?
  • What changes, if any, will I need to make in my daily life?
  • Is there a chance that someone else in my family might get the same condition?

If you cannot understand your doctor’s explanations, here are a few questions you can ask:

  • Could you explain in simple Sinhala/Tamil/English?
  • Can you write it down for me?
  • Can you draw what you are describing?
  • Where can I find more information about this subject?

What happens if you and your doctor differ about a treatment option? Let me point out that there’s a right way of approaching your doctor and a wrong way. It’s simply a matter of mutual respect; you wouldn’t want your doctor to assume the worst about you, so, don’t assume the worst about him! Often, if you can put across your feelings and apprehensions in the right way, you can get your doctor to help you. Explain your needs to the physician in a polite way, without any belligerence or hostility. Remember that you are both on the same side – yours!

In order to best support your doctor and them you, make sure to do the following:

  • Get ready for your appointment on time or if you are unable to make the appointment, cancel ahead of time  
  • Do your best to explain exactly what is bothering you. i.e. You can express your anxieties and apprehensions clearly.
  • Answer the doctor’s questions honestly.
  • Volunteer any important information that the doctor may not specifically ask about, including family history.
  • Let the doctor know if you cannot follow his directions and specify the reasons why.
  • Take medications as directed, strictly adhering to the dose schedule. Do not stop taking your medication once you feel better. Make sure to stick to the timelines your doctor has provided you with.
  • If you disagree with your doctor, express your  dissatisfaction in a courteous manner

While your doctor can provide guidance on your sicknesses or any medical conditions, you will be doing most of the legwork in getting your mind and body to its healthiest state.  So take an active interest in your medical care. After all, this is the only body you have! Patients who know how to make the most of their doctor get better medical care. Therefore, it’s very important that you learn how to do so!

How to get the most out of your consultation - Dr. Haroon Thowfeek

Dr. Haroon Thowfeek, MD

Family Physician on oDoc

SLMC Number 35006

Sri Jayewardenepura General Hospital

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All you need to know about Gestational Diabetes

All you need to know about Gestational Diabetes

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Did you know that gestational diabetes mellitus, also known as GMD, is one of the most common medical complications of pregnancy?

What is GMD? Why does it happen? Can you prevent it? Keep scrolling for answers.

So, let’s start with the basics. What is gestational diabetes?

Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth. Many hormones are involved in maintaining the blood sugar level. As the hormone levels fluctuate during pregnancy, they prevent the body from using insulin effectively, leading to insulin resistance. This causes  glucose  build-up in the blood instead of being absorbed by the cells. Typically, the pancreas can make additional insulin to overcome insulin resistance, but when insulin production is not enough to overcome the effect of the placental hormones, gestational diabetes results.

A study conducted by Kai Wei Lee et., found the prevalence of GDM in Asia was 11.5%. GMD can happen at any stage of pregnancy but is more common in the second or third trimester.

But why is that?

Scientists have not been able to identify the exact hormone that causes GDM in pregnant women. But, many scientific theories suggest that as the placenta grows, more and more hormones are released, which increases risk of  insulin resistance. Thus, symptoms of GMD are seen more often in the 2nd and 3rd trimesters. 

What are the symptoms of GMD?

Many women who have GMD do not show symptoms, but the most common ones are: 

  • Increased thirst
  • Urgency to pee more often
  • Dry mouth
  • Tiredness
Gestational Diabetes Causes

These symptoms are relatively common during pregnancy and not necessarily a sign of GMD. If you are pregnant and have noticed these symptoms, you should speak to a VOG doctor or a general physician, via oDoc who will provide a prescription for a lab test. You can carry out the lab tests from the comfort of you home via oLabs too. 

Who is at risk?

GMD can affect any woman, but a list of risk factors identified by scientists increases the chances of developing GMD. 

The risk factors include

  • Being overweight before pregnancy
  • Having a family  history of diabetes 
  • Being Prediabetic (if you have a blood glucose level higher than normal but not high enough to be classed as diabetic.
  • Having PCOS 
  • Being older than 25 as they are at a greater risk for developing gestational diabetes than younger women
  • Having high blood pressure, high cholesterol, heart disease, or other medical complications
  • Having  given birth to a large baby (weighing more than 9 pounds)
  • Having had a miscarriage

How does GMD affect the mother and the baby?

More often than not, women who have GMD go on to have normal pregnancies and deliver healthy babies. However, in other circumstances, GMD can lead to:

  • Macrosomia. This is where the baby grows very large as they absorb the excess glucose in the mother’s blood and convert it into fat and are deposited. This leads to difficulties during labour, causing doctors to opt for induced labour and c-section. 
  • Too much amniotic fluid (the fluid that surrounds the baby) in the womb can cause premature labour or problems at delivery, known as polyhydramnios.
  • Premature birth
  • Low blood sugar (hypoglycemia) in the baby after delivery. This happens because the mum’s high blood sugar level also causes the baby to have a high blood sugar level, and after birth, it no longer has the high level of sugar from its mother, resulting in the newborn’s blood sugar level becoming very low.
  • Obesity and type 2 diabetes later in life for babies. Babies of mothers with gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
  • Stillbirth. Untreated, gestational diabetes can result in a baby’s death before or shortly after birth.
  • Future diabetes for the mother. If you have gestational diabetes, you’re more likely to get it again during a future pregnancy. You also have a higher risk of type 2 diabetes as you get older.

What are the treatment options?

The American Diabetes Association recommends screening for undiagnosed type 2 diabetes at the first prenatal visit in women with diabetes risk factors. In pregnant women not known to have diabetes, GDM testing should be performed at 24 to 28 weeks of gestation. 

If you are found to have GMD, don’t worry, as it can be treated, and complications can be reduced. The doctor may ask you to monitor your blood sugar level often, exercise often, eat healthily and maybe give insulin injections if necessary. 

How is it prevented?

There are no guarantees for preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better.

So don’t forget to 

  • Eat healthy – Choose foods high in fibre and low in fat and calories.
  • Exercise often – Exercising before and safely during pregnancy can help protect you from developing gestational diabetes.
  • Start pregnancy at a healthy weight. If you’re planning to get pregnant, losing extra weight beforehand may help you have a healthier pregnancy.
Preventing Gestational Diabetes

If you are pregnant and experiencing any of the symptoms mentioned above or have any questions, you can speak to one of the Obstetricians, Gynaecologists or GPs on the oDoc app. Click here to download the app.

Sources 

  1. Alfadhli, E., 2015. Gestational diabetes mellitus. Saudi Medical Journal, 36(4), pp.399-406.
  2. Gestational Diabetes Mellitus (GDM). (n.d.). Johns Hopkins Medicine. Retrieved April 6, 2022, from 
  3. Gestational diabetes – Symptoms and causes. (2020, August 26). Mayo Clinic. 
  4. NHS website. (2021, November 29). Gestational diabetes. Nhs.Uk. 
  5. Lee, K.W., Ching, S.M., Ramachandran, V. et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 18, 494 (2018).
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Endometriosis

Endometriosis

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No woman looks forward to “that time of the month.” Dealing with nausea, stomach cramps, mood swings, back pains and fatigue, all whilst facing that undeniable social pressure of pretending to be ‘normal’ and going about your daily activities. Because periods are a natural bodily function… right? It’s not like a cold where you would be rightfully exempted from resuming your daily tasks.

Sadly, sometimes the society we live in doesn’t accurately weigh the impact of periods on our daily functioning. A good example of this is one of the most common gynecological diseases, endometriosis, often going undetected for years because the abdominal pain it causes is dismissed as regular menstrual cramps. Endometriosis is typically a progressive condition. Therefore it’s wise to look out for signs early on and get regular checkups with your VOG to manage any symptoms you have. You can easily channel a VOG in just three taps on oDoc!

What is endometriosis?

The lining of your uterus is made up of tissue called the endometrium. When this tissue grows outside your uterus, it’s known as endometriosis. This disorder causes endometrial-like tissue to grow on your ovaries, fallopian tubes, bowel, and even tissues lining your pelvis.

Unfortunately, this endometrial-like tissue acts as endometrial tissue would — meaning that according to the hormonal changes in each stage of the menstrual cycle, it thickens, breaks down and bleeds. But because it has no way to exit your body, it becomes trapped! This triggers an inflammatory response, and the surrounding tissue becomes irritated, eventually developing scar tissue and adhesions, which are bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other. This leads to pain and other complications discussed below.

Symptoms of endometriosis

Just like all the chocolates we eat on our period are unique in their own way, the endometriosis symptoms experienced by you may differ from that of someone else. Some people experience mild symptoms, but others can have moderate to severe symptoms. The severity of pain you feel doesn’t indicate the stage of the endometriosis you have. You can have a mild degree of endometriosis, but experience agonizing pain or have a severe form of it and have minimal discomfort. That is why it’s important for you to get regular gynecological exams to stay on top of your reproductive and sexual health!

Pelvic pain is the most common symptom of endometriosis. You may also have the following symptoms:

  1. Painful periods – Most women have period cramps, but endometriosis can leave you with debilitating pain. You can get cramps 1 or 2 weeks around menstruation
  2. Heavy menstrual bleeding or bleeding between periods
  1. Painful intercourse – Women might have intense, localized pain during penetration
  2. Infertility – When endometriosis affects the ovaries or fallopian tubes, it may reduce the eggs’ chance of becoming fertilized and implanting into the uterus lining
  1. Painful bowel movements and/or urination
  2. Pain in the abdomen, lower back, or thighs, often lasting throughout the cycle

It’s wise that you get regular gynecological exams, which will allow your VOG to monitor any changes. This is particularly important if you have two or more symptoms.

Endometriosis Treatment

Until endometriosis is better understood, only the symptoms can be treated without the underlying causes. Endometriosis treatment depends on your symptoms and goals.

For example, suppose your goal is to minimize the pain. In that case, you may be prescribed over-the-counter pain medications such as Ibuprofen or hormonal medicines such as the oral contraceptive pill, which can suppress the period and stop mild to moderate endometriosis from progressing. It decreases fertility by preventing the monthly growth and buildup of endometrial-like tissue, reducing the pain.

Other options are available if you wish to conceive, such as undergoing a laparoscopy. In this minimally invasive surgery, your doctor will make small incisions in the abdomen to explore and surgically remove any problematic tissue without damaging your reproductive organs. Even though the name of this surgery sounds scary, most women can go home on the same day as the operation, and it will take roughly five to seven days to recover.

However, if you don’t respond to conservative treatments, your doctor may recommend a total hysterectomy as a last resort. In this operation, your surgeon removes the uterus, fallopian tubes and in some cases, even the ovaries, depending on the severity of the disease.

Life with endometriosis

Living with endometriosis can be difficult as symptoms can significantly impact your quality of life. It may take a toll on your mental health as finding an effective treatment and dealing with the anxiety of symptoms flaring up can be emotionally taxing. It may even cause financial strain depending on the cost of your treatment plan or if your symptoms interfere with your ability to maintain a job. It may also lead to an unfulfilled sex life which may cause a bridge between you and your partner.

To improve your quality of life with endometriosis, it’s good to reduce stress by regularly partaking in leisure activities, exercising and getting adequate sleep. While endometriosis can be isolating, remember that you’re not alone. There are many ways to find support, like joining an online or in-person support group and talking to a mental health professional to work through your feelings. You can easily channel a mental health professional in simply three taps on oDoc!

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