How to plan for a remote consultation.
The Covid 19 pandemic has forced changes to the way we interact, not only with family and friends but also with our GP.
Many people have responded to the Government request to Save the NHS by staying away from their GP. But GP services have continued to operate throughout the pandemic and are still there, for you, when needed.
As a result of Public Health England guidance, most consultations are presently being conducted remotely by telephone or video. While this can seem strange, with good preparation it can be a positive and productive experience without the inconvenience of travel or parking.
If you want to talk about menopause, there are some things you might like to consider.
What to think about in advance
Like all things in life, preparation is key. Think about:
- Your environment
- What you want to say
- What you want to happen as a result of your consultation
The psychological symptoms associated with the menopause can make us anxious, lacking in confidence and prone to panic. Sleep disturbance and tiredness resulting from night sweats can impair our concentration. Think about the time of day when you feel at your best and if possible, book an appointment for this time.
Ask if the practice has a GP with an interest in menopause and if possible, book a double appointment. Make sure that the practice has your correct contact details. At the time of the appointment think practicalities. Go to the toilet beforehand, have a drink to hand, make sure you are comfortable, and ensure your mobile is charged and not on silent.
During your consultation you will be discussing personal and private matters so choose a location where you are unlikely to be overheard or disturbed. Forewarn any other household members that you need a quiet environment during the consultation. Delegate someone to walk the dog.
Most remote consultations will be conducted by telephone and occasionally by video. If it’s on video, you will have been given instructions how to access the video and which platform will be used.
If you are unsure about this, call the practice and ask for clarity. Better to be sure than to miss your appointment. In advance of your appointment check your camera and audio are enabled and that your backdrop is free of clutter. Even doctors can get distracted by family photos, children’s art etc
What you want to say
This is your chance to tell your story. Your GP appointment is likely to be for 10 minutes which may not seem long but used wisely a lot can be achieved in those precious minutes. The lack of oestrogen associated with the menopause can cause a complex mix of physical and psychological symptoms so it’s useful to focus on what’s important to you. It might help to download a Menopause Symptom Checker.
You will be given time to tell your story. Use your symptom checker as an aide memoir to retain your focus.
Be prepared to answer questions such as:
- When was your last menstrual period?
- If your last period was more than 12 months ago, have you had any vaginal bleeding since then?
- Have you had any bleeding between periods or after intercourse?
- Do you have any abnormal vaginal discharge?
- Which symptoms are you most concerned about?
- Do you feel that your symptoms are related to the menopause?
- What interventions have you already tried?
- Are you taking any regular medications either prescribed or over the counter?
- Have you had any serious illnesses or operations in the past?
- Do any serious illnesses, particularly breast cancer, run in your family?
- Will you require contraception?
- Do you have any vaginal dryness or pain with intercourse?
- When was your last cervical smear?
- When was your last mammogram?
- Do you smoke?
- How many units of alcohol do you drink per week?
- What is your height and weight?
- Do you have a recent record of your blood pressure?
- Are you hoping to be prescribed HRT?
- What do you already know about HRT?
- What do you understand about the benefits/risks of HRT?
- Are there any benefits/risks that you would like to discuss further?
While this can look daunting, advance preparation will allow these questions to be dealt with quickly, leaving more time to talk about treatment options.
What you want to happen as a result of your consultation
This is key to a successful consultation. “What do you hope to achieve as a result of today’s consultation?” is a question that I ask all my patients. Your GP will be pleased to hear you clearly express what you would like to happen, we are here to help. You may want to:
- Be signposted to a reliable, evidence-based source of information to facilitate further reading
- Discuss lifestyle changes to help you cope with your symptoms
- Explore non hormonal ways to manage your symptoms
- Have HRT prescribed. HRT is recommended by NICE for the relief of menopausal symptoms. It also has long-term health benefits particularly if started within 10 years of the menopause or below the age of 60
At the end of your consultation your GP will summarise what has been discussed, explain any treatment that has been prescribed and advise you what to do if you experience side effects. A follow-up plan will be agreed and the consultation will end.
“Don’t wait” were the wise words of a lovely patient when I asked her what one piece of advice she would give to menopausal women. So, if you are troubled by symptoms that are negatively impacting your quality of life, your relationships or your ability to cope at work, don’t delay seeking help.