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Tuesday, February 2, 2016

Share Your New Year’s Goals with Your Doctor



Losing weight, quitting smoking, exercising more—these are great New Year's resolutions to share with your doctor, especially if your doctor encourages and motivates you and holds you accountable. But, there are other goals, seemingly unrelated to health, that are also worth sharing with your physician.

When I know my patients' other goals, I can tailor their treatments for their particular situation, which results in more personalized care. Here are some examples from my movement disorders practice.

Goal: "I want to walk my daughter down the aisle for her wedding this summer."

One of my patients with Parkinson's disease told me one January that he wanted to walk his daughter down the aisle at her June wedding and share a father-daughter dance with her.

My Approach: As the date neared, we explored some new medications for improving a tremor (a symptom that didn't usually bother him, but something he didn't want to distract from the wedding) and planned physical therapy just prior to the wedding to make sure his walking (and dancing!) was optimized.

Goal: "I want to do well on my exams this semester."

I had a patient with dystonia last year who was enrolled in college. When she learned that one of the possible side effects of trihexyphenidyl (Artane), a common medication for dystonia, was mental slowing, she was concerned that it might affect her academic performance.

My Approach: We discussed the pros and cons of starting the medication in the context of her semester goals. She decided that she would not start treatment until after she completed college, since trihexyphenidyl is not meant to be started and stopped.

Goal: "I'd like to retire this year."

People with Parkinson's disease are often diagnosed in their early 60s (on average), a time when they are weighing the pros and cons of continuing to work or retire. A diagnosis can affect their retirement plans and force decisions regarding disability.

My Approach: When one of my patients wants to work as long as possible, we discuss medications that target symptoms that affect employment. For example, we might use levodopa to prevent slow and less accurate typing. For those planning to retire or apply for disability, I connect them with our social worker to make sure they and their families have planned appropriately and have the forms and medical coverage they need.

What goals will you share with your doctor at your next visit? Don't hesitate to discuss them with your neurologist.

Armstrong_Melissa (1).JPGDr. Armstrong is a movement disorders specialist at the University of Florida Health Center for Movement Disorders and Neurorestoration in Gainesville. She is also involved in the American Academy of Neurology's evidence-based guideline program.