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I am Dr. Todd Brandt. I am a urologist. 

These are words I couldn't have imagined myself saying as I was growing up thinking about medicine as a career. 

And I have been asked many, many times why I went into urology as a medical specialty. In this podcast I attempt to explain how I got here. Why did I choose urology as a specialty? Why do I like it? Why, if you are someone with a urinary tract, should you care? Get it? Why Urology.

This podcast is a personal experiment in medical audio content. I make the obvious disclaimer that this is not medical advice. You should be going to your own physician for that.

These episodes are meant to educate, entertain, inspire or inform you in some way with urology as the launching point for each episode. Each episode is varied in format and length as I have experimented with content. 

Listen, follow, share, rate, review, know what to do.

If you have kidney stones, or prostate cancer, or another urologic health concern this podcast may help you.

If you have a loved one with any urologic health concern this podcast may help you. 

If you are someone who has asked, "How does my bladder do it's thing?", this podcast may help you.

If you make urine, or even if you don't, this podcast may help you.

Thank you for listening to this podcast. I do appreciated any feedback I get so please reach out to me at the link provided on this website. 

Be well,

Dr. Todd Brandt

Aug 31, 2021

Six things to ask yourself before you see your doctor

In the previous episode of this podcast, I reviewed five things you need to do before seeing your doctor for your next appointment. 

In that episode I said that the very first thing you need to do before even making an appointment is to sit down with a piece of paper or a notebook and to write down why you are going to be seeing the doctor in the first place.

In this episode we are going to talk about  six questions to ask yourself about your elbow pain prior to seeing your doctor.

These six questions are the same questions that your doctor is likely to ask you in one form or another, or at least are the things that your physician will use to frame the discussion about your elbow.

And I would encourage you not only to ask yourself these questions but to write down the answers.

Why should we write things down?

If we don’t write it down it is quite possible we will forget to tell the doctor during the visit about the details of the problem, or the doctor may not be on his or her game or make assumptions. 

Small details matter. Don’t trust yourself to remember all the details at the time of the appointment. Write them down ahead of time and go ahead and show the doctor what you have written down and let the doctor read those notes. It’s faster and probably more accurately describes what you are going through. It’s one of the reasons you get all of that paperwork to fill out prior to coming to your appointment or are encouraged to go online ahead of time and fill out the forms. Also, you will have more time thinking about the character of your elbow pain, where exactly in the elbow it hurts, how it came about, how long you have had it, how severe is it and what makes it better or worse.

Writing it down will help you get the details right. And it will help you get the problem fixed. 

Here are the six questions you need to ask yourself about any complaint that requires you to see a physician.  I have already given them to you. If you missed it, here they are again

After naming the problem, in this case elbow pain we need to ask ourselves six questions. What is the location? How long have you had this problem? What is the character of the problem? What happened when it started? How severe is it? What makes it better or worse?

Location. Duration. Character. Onset. Severity. Aggravating or relieving factors.

One. Location. Where is the problem?How specific can you be? What part of your groin or stomach hurts. Where exactly in the elbow?

Two. Duration.  How long has this been going on? 4 days or  2 Month or 9 Years? Or maybe the issue is better now. How long did the problem last after you got it before it went away? 

Three. Character. What is the characteristicas of the problem? When describing your own problem try to describe the character of the problem in your own words. Is it like a pressure? A sharp pain? Does it come and go? Try to describe what you feel.

Four. Onset. What was going on when the problem started? This is quite simply a questiona about what you were doing when it started. When did you first notice it? Was it a normal day or were there special circumstances surrounding the onset.

Five. Severity. How severe is the problem? Usually, we try to use a scale on this, maybe a 1 to 10, with 1 being a not severe problem vs a 10 very severe. The problem may be more of a nuisance that is tolerable and not limiting other activities

Six. Relieving or aggravating factors. This is self-explanatory by now. What make the problem worse and what makes the problem better?

Location. Duration. Character. Onset. Severity. And relieving or aggravating factors.

Let me take a moment to say that for those things that don’t necessarily give you symptoms these questions can be a little tricky to answer. We see this in urology, in cases where blood is found microscopically in the urine during a routine general yearly physical. There are no symptoms.  In that case the character of the blood in the urine is microscopic and not visible blood, the location is urine, the duration is since the time of the urinalysis, the onset was routine physical exam. The severity will be defined by the amount of blood seen under the microscope and there will be no identifiable relieving or aggravating factors known since it is not symptomatic. If you work hard enough you can find an answer for each question, but I think to make it easier you should just try in that case to answer as many as you can.

Here is what to do when you make a doctor’s appointment. First, write down the list of problems you want to discuss with your physician. Then, for each problem, try to answer the questions about its location, duration, character, onset, severity, and relieving or aggravating factors.

Doing those two things shouldn’t take very long to do and will really help you get the most out of your clinic visit with your physician.