Anyone who has done yarn work knows how challenging it can sometimes be to find the starting point in a skein of yarn.  You think you have pulled on an outside end only to find out that it is pulling from the inside and creating a great, tangled, ball of mess.

Now imagine a person with a complex, chronic illness.

You can’t just grab the first “end” that you see and pull.  The situation may become more complex instead of helping you and the patient peel back the layers to find what is driving the illness.

When working with people with complex chronic illness, an illness that involves multiple (all) body systems, where do I start to help them get better?

I start with History.  A good, comprehensive, interactive, history. 

My new patient intake form gives me a rough outline and an idea of what this person is dealing with. 

The new patient visit is 2 hours.  Whatever was in the intake form is the starting point for the conversation, but there is always much more information that I find by actually asking questions and listening to the person.  

Why a 2 hour initial visit?

1.  Most of my patients have a complex history with multiple medical events and evaluations. 

2.  There are often very important clues related to their current illness that they may not even realize needed to be said.  A medical history is more than a list of surgeries and tests. 

3.  This is sometimes the first opportunity that the person feels that are being heard and their concerns validated.  Sometimes being heard is the first step on their healing journey. 

4.  Family medical history can contribute significantly to the medical history. 

5.  Environmental exposures are an important part of the history.  Where has that person lived?  What chemical challenges are we looking at?

6.  During this visit the initial lab testing is decided on.  This is not a One-Size-Fits-All clinic and not everyone gets the same testing. 

7.  There will likely be some teaching time.  Actually, this is part of just about every visit.  I have found that most of my  patients want to learn all they can about their illness.  I use Clinic/Telemedicine time to explain why particular lab findings are important and what the lab findings together are telling us.  I also explain how different nutrients, and even medications, are working to improve symptoms and health.  

What happens after the visit that is still actually part of the visit?

• Orders and charting. 
• Lab orders are written and sent to the patient in their secure portal. 
• Lab that involves kit testing will be ordered. 
• Prescriptions will be written and sent to the pharmacy.  
• Specific supplements are selected and this information goes into the medical chart. 
• Charting is documentation for the official medical record and is also a document for the patient.  The chart note covers what we discussed and the lab findings.  The treatment plan outlines our next steps in the treatment plan and lists current medications and supplements.  It details the plan for follow-up testing and visits. 

Patients can contact me with questions through their secure portal.  Many simple questions can be answered through the portal.  More complex questions may need a phone or Telemed visit. 

Helping a person with their medical/health/healing journey is my job but also my calling.  I have maintained an independent practice so that I could continue to create my vision of the optimal healing environment.

NOTE:  The information presented in this post  (and all of my posts) is for informational use only.  This information is not intended to diagnose or treat any condition and should not be taken as medical advice.  If you have medical concerns, please discuss these with your healthcare provider.