Join the debate. Vote Now on the Dear Abby Poll of the week.

by Abigail Van Buren

Mixed Signals Can Muddle Patient's Visit With Doctor

DEAR ABBY: Please share something with medical professionals that will be of immense help to their patients:

When telling patients to perform an action -- "Stand on tiptoe, squat, turn this way or that, cough," etc. -- and it is essential for your diagnosis that they tell you whether it hurts or not -- ASK THEM!

I have more than once been cut off from essential medical treatment because I did not realize that the doctor, dentist, physical therapist, etc. had assumed that an action was pain-free because I didn't say "OUCH!" (I didn't say it because I didn't know I was expected to, and having a fairly stoic personality, I don't complain about every pain I experience.)

A similar lack of communication has been mentioned by several friends who have been asked, "Have you ever had such and such medication before?" They have simply replied, "Yes," without realizing that the care provider assumes that they will mention any bad reaction they had to the medication. Since doctors can't read minds, patients may wind up being re-dosed with something they are allergic to.

Remember, most of your patients have never been to medical or nursing school, so they don't know the reason for your questions unless you tell them. -- ROSEMARIE ESKES, ROCHESTER, N.Y.

DEAR MRS. ESKES: On behalf of all medical professionals and their patients, I thank you. But I would like to add another thought: If a patient has a bad reaction to a prescribed medication, it is the patient's responsibility to notify the doctor immediately so that information can become a part of his or her medical file.

Also, when patients are being treated for a chronic problem, it is a good idea for them to keep a daily diary for the doctor, because often when patients get to the doctor's office, they become nervous or distracted and forget to tell the doctor about symptoms that might be important.

DEAR ABBY: We have a wonderful nanny who looks after our two preschool children 35 hours a week. It took us three months, 24 candidates and $1,200 to get her.

Another preschool mom and I share driving responsibilities. (I'll call her "Mrs. Jones.") Well, when Mrs. Jones picked up our daughter one morning, she asked our nanny if she would be interested in working part-time for a friend of hers. Abby, I am very offended by this. I feel it would have been a common courtesy to ask us before mentioning this to our nanny.

Our nanny is not simply an employee; she is a member of our extended family. We went through a lot of time and expense to find her, and we do not appreciate Mrs. Jones assuming that she is available for a part-time job.

Please tell me what you think of this. -- LONGTIME READER, BLOOMINGTON, MINN.

DEAR LONGTIME READER: I think Mrs. Jones was out of line to have approached your nanny about part-time employment without discussing it with you first.

Abby shares more of her favorite, easy-to-prepare recipes. To order, send a business-size, self-addressed envelope, plus check or money order for $3.95 ($4.50 in Canada) to: Dear Abby, More Favorite Recipes, P.O. Box 447, Mount Morris, Ill. 61054-0447. (Postage is included.)

4520 Main St., Kansas City, Mo. 64111; (816) 932-6600