IBD

The Visit IBD: An Interactive Appointment Experience

Get tips from Partha Nandi, MD, to help you prepare for your upcoming Crohn's or colitis appointment. With this interactive video, you decide what you want to learn next.

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Y ou may have booked your doctor’s appointment already, but the work is only just beginning. The steps you take now to prepare for that appointment can help you come out of the doctor’s office with a plan you feel good about.

The average doctor’s visit in the United States is about 20 minutes long, according to a study published in The American Journal of Managed Care — and considering that those 20 minutes can have a major impact on your health for the next few months (if not longer), you’ll want to provide your doctor with all the information he or she needs to recommend the best treatment plan for you.

You are your own best advocate.
— Partha Nandi, MD

The secret to a successful doctor’s visit? “Good communication,” says Partha Nandi, MD, a gastroenterologist, practicing in Detroit. The more information you provide your doctor, the better and more accurate their assessment will be.

For telehealth visits, it’s also important to come prepared. A poor connection problem, spotty Wi-Fi, or technology glitch can interfere with the (already limited) time that you have to spend with your doctor.

Remember, “you are your own best advocate,” says Dr. Nandi.

Meet Dr. Partha Nandi

Partha Nandi, MD, is a fulltime practicing gastroenterologist and internal medicine doctor in Detroit, as well as the chief health editor at WXYZ ABC Detroit and host of the nationally and internationally syndicated medical lifestyle television show Ask Dr. Nandi.

“My hope is that everyone who is living with a chronic disease will one day recognize that they are a true health hero.”

Meet Dr. Partha Nandi

Telemedicine or In-Person: Which Appointment Type to Choose

Telemedicine-or-In-Person-section

T he COVID-19 pandemic brought telehealth to the forefront of healthcare. In 2019, about 43 percent of health centers provided telemedicine to their patients — during the 2020 pandemic, that number shot up to 95 percent, according to a report published in February 2021 in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report.

More people used telehealth, too: According to the CDC's Morbidity and Mortality Weekly Report published October 30, 2020, there was an 154 percent increase in telemedicine visits in March 2020 compared to the same week in March 2019.

Part of the reason for this increase in visits was the introduction of new laws, which made it easier (and more financially feasible) to see a doctor virtually. The Coronavirus Aid, Relief, and Economic Security (CARES) Act expanded patient access to telehealth services and ensured that, under Medicare, they were as affordable as those of in-office visits — which paved the way for many other commercial insurances to do the same.

154 percent increase in telemedicine visits in March 2020 compared to the same week in 2019.
— Centers for Disease Control and Prevention

Now that more people than ever are taking advantage of telehealth, you may be wondering which type of doctor’s appointment you should schedule. The answer, however, can vary depending on what type of care you need.

New patients who may be seeking an IBD diagnosis for their symptoms will likely need to schedule an in-person appointment, as will those who need blood work, computerized tomography (CT) scans, and other tests that can’t be done via telemedicine. People who need routine follow-up care with their regular gastroenterologist or primary care doctor may want to take advantage of telemedicine visits.

Regardless of whether your next appointment is an in-person or virtual one, telemedicine may be here to stay — a good thing for people with IBD. In fact, a study published in March 2020 in the journal Smart Homecare Technology and TeleHealth found that regularly checking in with a physician via telemedicine can help people with Crohn’s disease and ulcerative colitis manage their symptoms and reduce the frequency and severity of flare-ups.

   Poll

Which type of doctor’s appointment do you prefer?

How to Prep for Your Appointment

You’ve likely waited weeks (or months) for this appointment. Now that it’s finally arrived, you don’t want to forget any important information — like, for example, that you’re still having occasional symptoms in the middle of the night, or that you’re interested in trying a new medication. (After all, it’s not uncommon to freeze under the florescent lights in a doctor’s office — or under the backlighting in your bedroom.)

The more information you can give your doctors about your current health and well-being, the better we’ll be able to help you.
— Partha Nandi, MD

To stay organized, Nandi recommends coming to your virtual or in-person appointment fully prepared with a goal in mind (such as remission or better symptom control), and lists of information that can help you and your doctor achieve that goal. Think: lists of medications and symptoms, logs of your food intake and sleep schedule, and anything else that might be relevant to your health.

“The more information you can give your doctors about your current health and well-being, the better we’ll be able to help you,” says Nandi.

In-Person-Tips-spotlight

In-Person Appointment Tips

  • Set a goal. Ask yourself what you’re trying to achieve. To ease your symptoms? Avoid surgery? Get a referral for a specialist? “Once I know your expectations, we can work toward them,” explains Nandi.
  • Make a list. It’s easy to forget even your most vital questions when you’re in the middle of a visit. The solution: “Write down the things you want to discuss and bring the list with you,” says Nandi. “Be specific and put the most important concerns at the top of the list so we get to them first.” If you have a lot to discuss, you may need to schedule a follow-up appointment.
  • Take notes. “I know how hard it can be to remember everything we talked about, and I want you to leave feeling confident, not confused,” says Nandi.
  • Relax and speak freely. “Sometimes people are intimidated to speak to their doctors, especially in person,” says Nandi. “I’m not here to judge you, I’m here to help you.”

Download these tips.

Telemedicine-Tips-spotlight

Telemedicine Tips

  • Do some prep work. Just as you would for an in-person visit, make a list of topics you want to cover prior to the appointment.
  • Test the technology. Most healthcare providers will send a checklist prior to your appointment that includes checking your Wi-Fi connection, battery life, lighting, and that you’re in a private area.
  • Bring props or visuals. “If you recently had a symptom like a rash or mouth sore, take a picture and bring that to the appointment,” says Nandi. Or, he says, “if you have questions about how to administer a medication or how to use a medical device,” bring those, too; your doctor can show you what to do. (You can also email your doctor the images or questions in advance.)
  • Bring your data. If you’re tracking your sleep, food intake, symptoms, and more, bring it to the appointment for reference. 

Download these tips.

What to Tell Your Doctor: Your IBD Cheat Sheets

Now is your moment. You’re at the appointment and you have one-on-one time with your doctor — but remember that the clock is ticking.

Working together with your physician can make you more satisfied with your care and more likely to stick to your treatment plan.
— American Journal of Surgery

Rather than being a passive participant in the conversation, you’ll want to take a more proactive approach to make sure that you cover everything you want to talk about it. (Hint: You definitely don’t have to wait for the doctor to start talking first.)

According to a study published in July 2018 in the American Journal of Surgery, working together with your physician can make you more satisfied with your care and more likely to stick to your treatment plan.

“Speak up about anything that is impacting your well-being,” says Nandi. “How well are you doing on your medication? Are you having any symptoms? Even issues that may seem unrelated to IBD should be mentioned.”

What-to-Tell-Your-Doctor-spotlight

What to Tell Your Doctor About Your IBD

Here’s what your doctor needs to hear in order to truly help you manage IBD.

Select the topics that best apply to you, then prioritize them from most important to least important before your next appointment:

1. Day-to-day, I feel…

2. My perspective about how well my IBD is managed is…

3. My short-term and long-term goals for IBD treatment are…

4. I have an upcoming occasion, such as a vacation, wedding, family gathering, or big presentation at work, and I need an IBD plan for it. I’m concerned about…

5. My concerns about my current treatment plan are…

6. Some challenges that I’ve had since my last appointment are…

7. I’ve experienced new or worsening symptoms, including the following:

  • Gastro symptoms include…
  • Other symptoms include…

8. My sleep has been…

9. My energy levels are generally…

10. IBD interferes with my daily life in these ways…

  • I have to cancel plans…
  • I can’t do activities such as…
  • My issues at work are…
  • I have relationship issues that are related to IBD…

11. IBD affects me emotionally and mentally in these ways:

  • I have anxiety about…
  • I have feelings of depression that include…
  • I feel alone because…
  • I’ve taken steps to manage my emotional health, such as…
  • My support system includes…

12. My typical diet looks like this:

  • I eat…
  • I don’t eat…
  • My feelings toward food are…

Download this IBD cheat sheet.

What-to-Tell-Your-Doctor-Treatment spotlight

What to Tell Your Doctor About Your IBD Treatment

Your treatment plan might sound good on paper, but it needs to work for you in the real world, too. This appointment is your chance to tell your doctor everything about your current treatment plan.

Select the topics that apply to you and prioritize them before your next appointment:

1. My short-term and long-term goals for IBD treatment are...

2. I’ve been on this treatment plan for … (days/months/years), and what I’ve seen as far as improvement in my symptoms is...

3. The treatment isn’t controlling my condition as well as I expected because…

4. The treatment doesn’t seem to be working as well as it used to because…

5. I’m experiencing side effects that may be related to the treatment, including…

6. I have a few questions about how to take the medication (such as how to do a self-injection, what time of day to take the medication, what to do if I miss a dose), including…

7. I’ve missed or skipped doses because…

8. I’m concerned about affording this medication because…

9. Other medications and supplements that I take are…

10. Alternative therapies that I’ve tried or am considering are…

11. Of the other medications and treatments I’ve tried in the past:

  • Treatments that worked are…
  • Treatments that did not are…

12. I’m interested to learn more about (e.g., a treatment option or clinical trial)…

Download this IBD treatment cheat sheet. 

After Your IBD Appointment

What happens after your doctor’s visit is just as important as the appointment itself. When you leave the office, you’re truly in the driver’s seat of how to turn your successful appointment into an action plan that helps you reach or maintain remission.

But that doesn’t mean you have to go it alone until your next appointment; your doctor is still your primary care partner. With the advent of telehealth and patient portals, it’s easy to stay in touch with your healthcare team, ask them questions, and schedule follow-up appointments. According to research published in September 2017 in the journal The Lancet, IBD patients who utilize patient portals to help monitor and manage their symptoms had fewer outpatient visits and hospital admissions.

Use these tips to feel empowered with your IBD care plan:

  • Schedule your next visit now, per your physician’s recommendation.
  • Find out how to access your healthcare provider’s patient portal so you can connect to your doctor.
  • Ask for a summary of your visit as well as a list of tips that can help you manage your condition.
  • Ask for a list of medications and dosages.
  • Fill your prescription right away and take your medications as prescribed.
  • Review the notes you took during your appointment.
  • Create an action plan that incorporates your doctor’s instructions into your routine.
  • Start your symptom tracker and food diary so you’re prepared for your next appointment.
  • If you have questions or can’t remember something, reach out.
   Poll

Do you plan to schedule a telemedicine appointment sometime in the next year?