I am a two-time survivor of cancer. Chemotherapy did significant damage to my heart and lungs.* Because of this I have spent a lot of time in the health care system. I have an ology problem. I have more ologists in my life than I know what to do with. I have a Cardiologist, Neurologist, Urologist, Anesthesiologist, Hematologist, Oncologist, Pulmonologist, Rheumatologist and a Nephrologist. My brain is not able to keep up with just one of these. If you have any chronic illness then you understand the dilemma that I have. How does a person keep up with all of this? The simple answer is by keeping a medical journal. It does not matter if you have one doctor in your life or like me a dozen, keeping a medical journal will not only help you manage your health care but it will improve the quality of the care you get as well.



There are four sections that I keep in my medical journal. There is a section for notes I take at the doctor's office, a section for questions I have for the doctors, a section for research and a section for the drugs I take. Each one of the sections has a purpose and each can help insure improve the quality of care you receive.

The first section is I have in my journal is for notes I take at the doctors office. This is important for two reasons. It is hard to remember the things you talk to your doctor about when you get home, much less to remember it a month later when you are seeing a different doctor. Create a separate page or section for each doctor you see. When you have a chronic illness you have different doctors from different specialties that you see. This helps you keep up with what you have talked about with each. Always take notes while you are at your appointment with the doctor. It is important to get the information down when it is fresh in your mind. It is ok to be brief with your notes while you are in the room with the doctor because you can sit down before you leave the medical office and finish them. Remember to date your entries for the doctor visit section of your journal. If for any reason you need to go to court then these notes are admissible.

The second section is your research section. As you look over your notes from your doctor visit if there is anything you do not understand you can research it. This research can be on the Internet, asking friends and family or talking with others in a support group for your condition. Personally I use all three. While in the doctor's office, if we talk about something I do not understand, I put it in my notes. Sometimes I even ask the doctor to spell the term. You are the one who has power in making your medical decisions. These decisions are best made with as much understanding as possible. When you get home from an appointment go over your notes and see if there is anything you need to have more information about. Then write this in question form in your research section. Say your doctor says that your hematocrit in your CBC is off. First of all you ask your doctor what that means. If after his explanation you feel you would like to have more information you can look it up. For example he tells you that your hematocrit showed that your white blood cell count was elevated you can lookup to see what that means.

The third is a very important section. In fact if you only have one section this is the one to have. It is the questions you want to ask your doctor. All of us have been to the doctor some time and after we left we remember that we forgot to ask the doctor something. This helps prevent that from happening. This should include questions from your self and from your medical support team. First if there are any questions you have after looking over your notes from a doctor visit write it down. If while doing any research a question comes up you write it down. If a question comes up while talking with friends and family, someone in your medical support team or condition related support group you write it down. Before you go to a doctor visit you go over these questions and write down all that are relevant to discuss with this doctor. This way when you go to the appointment all the questions I want to ask are right there in front of you.

The last section is for drugs. This section lists all the drugs you are on. Every time you see a new doctor they want to know what drugs you are taking. It also should list all the drugs you have been on before. It is important when you stop taking a drug to write down why you stopped taking them. If the doctor takes you off of a drug because it is not working you should write that down. It is really important to write down any drugs your doctor takes you off of because of side effects. You should have a page in this section that lists drugs you can not take and the reason you cannot take them. I have been taken off so many drugs because of side effects that I cannot remember them all. When a new doctor recommends a drug to me I look to make sure it is not one I have stopped taking for a specific reason.

After a while this notebook may get large. You do not have to carry it to every appointment. Usually I take a spiral notebook that includes the questions I want to ask and room for me to take notes on. When I see a new doctor or I am seeing several doctors about the same condition I take the whole notebook with me.

If you keep up with your medical journal I am sure you will find that the quality of your health care will improve.

* For those of you considering Chemo this is a rare occurrence of two of the specific chemo drugs I was taking.

* For more information about a medical support team look up my article "How to make the most of your health care with a medical support team.?