Know your health history
I wonder how often the patients who
depend on me realize how dependent I
am on them?
Physicians use many tools to diagnose
diseases and to learn more about their patients. But none is more important than
the history the patient gives of her present
complaint, past medical problems and
family history. I also need pertinent information about her job, smoking or
drinking habits and general lifestyle. The
best physical exam, lab tests and x-rays
are all of secondary importance.
The human body and mind are incredibly wonderful and complicated. A pain
here or a funny feeling there can be the
symptoms of many different problems.
Medicine is truly an art and not a science
—we deal much more in grays than in
black and white.
Last week a woman came into the office complaining of lower abdominal pain
which had persisted for quite some time.
I asked questions like, "What makes it feel
worse?", "Does it occur at the same time
every day, or every month?", "Does the
"I really like to deal with whole
people, not just sore toes."
pain make you nauseated?". Unable to
answer this type of question, she said, "I
don't know. It just hurts and I want to get
rid of it."
The patient had no abnormal findings
on physical exam, was not acutely ill and
felt she could live with the pain a bit
longer. So I sent her home with instructions to keep a diary of when the pain
on the job
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250 W. 19th Street
tors ask everyone the same types of questions. Knowing what you will be asked and
thinking about your answers before your
appointment really can be helpful.
First, know why you are there. Pinpoint your problem and try to describe
symptoms as specifically as you can.
(Sometimes this is not possible.) If you are
apt to forget something, write it down.
Don't hold something back because you
think it's "dumb" or not relevant. If a
problem concerns you, you should mention it. Often, your doctor will guide you
by asking appropriate questions, but you
can also guide the doctor with your own
Anytime you see a new doctor, you
will be asked for some general information. This includes a past history of medical problems, surgeries and hospitalizations. When did you have your gall bladder
"Medicine is truly an art and not a
came on, how it felt and whether it was
related to meals or menstrual function.
When she returns we can use her observations to try to find out what is wrong.
We lost a week and the office visit was
much less productive than it could have
been. But the alternatives meant giving
her some medication and hoping the pain
would go away, or beginning a series of
expensive, and probably unnecessary, lab
tests and x-rays. It's possible that we may
use some of these tests later, but given an
accurate history, many procedures can be
We each know more about our own
bodies and emotions than anyone else. We
may not know the name of the muscle we
pull, but only we know how it feels, what
makes it hurt more and what eases the
Obtaining medical histories from patients is a structured process; hence doc-
out? Why did you have exploratory abdominal surgery? Was your appendix
removed at that time?
With people moving about more and
seeing many different doctors, it is imperative that patients know what type of procedure or surgery they are having and why
it is necessary. Also, information about
how long you have had high blood pressure, or whether you had rheumatic fever
as a child, is very important.
Family history is also relevant. A breast
lump in a 30-year-old woman may be approached rather conservatively. . .unless
her sister died of breast cancer at age 36.
The review of systems is the next part
of a complete history. This is a general
screen for problems in specific body systems (cardiovascular, gastrointestinal, or
For a woman, gynecological history is
especially important. The date of her last
menstrual period, the regularity of her
periods, the age she began menstruating,
and the type of contraception she has used
are all pertinent to her present state of
As an example, consider the case of a
woman who is having difficulty getting
pregnant. She began menstruating when
she was 15, but her periods were very irregular until she began taking the pill. She
has recently gone off the pill but cannot
get pregnant. Her infertility could be related to a problem she had as a teenager.
It may relate to birth control pill use. Or
it may be something resulting from the
frequent vaginal infections she had in
college. A good history is the single best
way to approach such a difficult problem.
I have to mention another thing about
gynecological histories. I cannot even estimate the number of women I have seen
who have had Caesarian sections but don't
know the reason. Many women have also
had hysterectomies and don't know why
they were performed or which organs
were removed. It is more than your right
to know.. .it is your duty.
This same rule of individual responsibility is true of the medications you take.
You should know exactly what you are
taking, why, how much, and how long
you have been on any medication. Also
know which medicines you cannot take
because of allergy and how the allergy
You may not think that facts about
your personal life are relevant to your sore
foot. But your general pace of life, your
smoking and drinking habits and the pills
you take are all important to your physical health, and they reveal something
about you as a person. This kind of information can also pinpoint possible future
problems which may be prevented. I really
like to deal with wnole people, not ju_i
Evaluated as "Qualified" to serve as Judge
By Judicial Evaluation Committee of the Houston Bar Association — 1975
First, Second or Third Choice for Judge
By Houston Bar Association, Harris County Suburban Lawyers Association and
Houston Lawyers Association — 1972
26 years legal experience — Good reputation
Respected hard working trial and appellate lawyer
Member: American Bar Association, Texas Bar Association, Houston Bar Association, Academy of Criminal Justice Sciences,
Association of Trial Lawyers of America and Houston Trial Lawyers Association.
Served on HBA Judiciary Committee, Bylaws Committee, Bar Candidate Committee and Lawyer Referral Service Committee —
Recent award for exceptional service in 1977.
Outstanding record for community service. Former board member Houston Association of Children with Learning Disabilities
— Greater Houston Chapter, National Society of Autistic Children — Legal advisor and Board Member of Planned Parenthood
of Houston (1971-73) recipient of the Margaret Sanger Certificate of Appreciation, Planned Parenthood Federation of
America in 1972 — Inspector of Elections for Harris County.
56 years old — married — 4 children — active in church work and Scouting.
Navy Fighter Pilot, World War II
Competent, Conscientious, Concerned, Fair, Dedicated.
paid for by Dorthy Curlee on behalf of Louis Moore, 400 Houston Bar Center Bldg., Houston, Tx. 77002,
Bertrand Moser, Campaign Treasurer.
March 1978 HOUSTON BREAKTHROUGH Page 17