Wednesday, January 25, 2012

Beta Blockers and POTS/dysautonomia and HISTORY/SYMPTOMS

Continuing questions abound on the use of Beta-blockers and the diagnosis of dysautonomia or Postural Orthostatic Tachycardia Syndrome (POTS).

No one can give advice on this question via the internet :-). The issue is too complicated and the doctor who prescribed the B-blocker has to be involved. There are many questions to be asked before a decision can be made.

First of all, the doctor needs perspective. This information is gained from the Medical History. How old are you? Are you female or male? What is your Ethnicity? These are just the first 3 basic questions.

After that, there is a slew of questions about just one Complaint. What medical problems do you have? When did they start/how long have you had them? What makes symptoms better or worse? Do you have 'associated symptoms'?

Doctors start with the same format, so that we all can talk to one another in 'doctor talk'.

More Questions on the Review of Systems (condensed and not-inclusive list):
Ear, Nose and Throat/ Head and Neck/ Cardiac/ Pulmonary/ Gastrointestinal/ Private Parts/ Neurology/ Extremeties/ Skin/ Overall

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From here, the Vital Signs are taken into consideration. Blood Pressure (BP)/Heart Rate (HR)/ Respiratory Rate/ Temperature/ .... Orthostatics: BP/HR while laying down; BP/HR when sitting; BP/HR while standing (all in that order).
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Then the doctor is ready to examine you. If the doctor does not touch your body, then (s)he can not bill for your medical visit.

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The PHYSICAL EXAM is next.
Then, laboratory studies or tests.
Then, the ASSESSMENT.
Then, the PLAN.

Hope this helps!

2 comments:

  1. Este blog é uma representação exata de competências. Eu gosto da sua recomendação. Um grande conceito que reflete os pensamentos do escritor. Consultoria RH

    ReplyDelete
  2. Translation from Portuguese to English, using translate.google.com:

    "This blog is an exact representation of skills. I like your recommendation. A great concept that reflects the thoughts of the writer."

    ~ These are the clinical skills from the mind of the physician. Many factors go into the clinical assessment, and each patient is different. Thank you for your comment.

    ReplyDelete

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