When the written word isn’t enough

DEAR DR. GOTT: I notice that a number of your responses say: “I don’t have enough information. What are your other health issues? What other meds are you taking?”, etc. By not including the above, you often state that you can’t give a complete answer. Wouldn’t it be BETTER to insist on this information BEFORE accepting a person’s letter? Give us an outline of what you need to give readers a full and complete answer.

I’m not alone on this – other people I know who read your column say the same thing. Just a little friendly advice. Hope this gets to you but it probably won’t.

DEAR READER: The short answer: If I only answered questions with adequate information or those that only ask general questions, such as “What is alopecia?”, I would end up writing about the same topics each week and that would get very boring very quickly.

The long answer is somewhat more complex. Most individuals don’t including past health history but many others don’t realize that even something minor or seemingly unrelated can make the difference in getting an accurate diagnosis or treatment recommendation. This not only holds true in my column, but in real life as well.

All too often patients request help for a problem they are having but leave out other things that may be going on, either because they are embarrassed or don’t believe they are related. A physician isn’t a mind reader and if a patient isn’t totally honest or forthcoming with symptoms, signs, concerns, questions, etc., providing that help can be somewhat difficult.

I have said many times in the past, that it is important that a physician, even a primary care physician who you’ve seen since you were 14, be aware of all your health concerns, medications, over-the-counter herbs and supplements, and lifestyle habits. This is especially true if you see multiple physicians. Each must be aware of what the others are prescribing or recommending so that the risk of cross-interactions, side effects and other unwanted reactions are kept to a minimum. For example, if you drink three glasses of grapefruit juice a day, but didn’t tell you’re cardiologist who prescribed a statin drug, you are at risk of developing toxic levels of that drug because the enzyme that aids digestion and absorption of both cannot handle both substances at once.

All that being said, you do have a point, so I (not, I personally, of course because I am still a technophobe and prefer putting pen to paper) will have my staff make some changes to the contact page on my website and will include some suggestions on how to get the best answer, should the question be chosen for publication. These changes should appear before this article is even posted to my site. Thank you for writing.