A doctor's advice for how to get the most out of your virtual health appointment

Tips for how to prepare for your online or over-the-phone visit.

Tips for how to prepare for your online or over-the-phone visit

(Credit: iStock/Getty Images )

Use of virtual health-care platforms within Canada has surged over the past month and understandably so. Not only are people afraid to contract COVID-19 while out and about, but public health authorities have told doctors to limit in-person appointments to patients who need urgent or emergent care. Thankfully, telemedicine has been rapidly adopted in many clinics across the country, making it easier for us to connect to our health-care providers with the tap of a touchscreen — or the buttons on our phone. Here's how to best prepare for a virtual visit with your doctor during this pandemic.

It's all about connection

Take it from me: it's challenging and frustrating for your doctor, not to mention you, to communicate effectively if your Wi-Fi keeps cutting out. You wouldn't dream of multitasking during a face-to-face visit (right?), so apply the same rules to your virtual visit and maximize your bandwidth during your appointment: avoid any downloads or updates, close unnecessary apps or programs, and ask others in your home to avoid using the Wi-Fi network you might be using while you're connected. If you don't have reliable internet, a phone chat is definitely the way to go; plus a good old-fashioned landline is a reliable backup form of connection. For privacy, use a personal device, instead of calling from a public or work phone, and consider wearing earbuds or headphones. And don't forget to recruit a friend or family member to show you the virtual ropes before your appointment if you don't feel savvy when it comes to online technology.

Know how to assess yourself

With physical distancing measures projected to last months or more, now is the perfect time to learn some simple self-assessment skills. Reporting your basic vital signs, like your heart rate and respiratory rate, will give your doctor a wealth of information if they can't see you in person. The easiest place to check your own pulse is on your wrist (radial artery) or neck (carotid artery). Using a timer, count how many beats you can feel in 30 seconds, then double it to calculate your heart rate. Use the same counting technique for your breathing rate: count how many breaths you take in 30 seconds and double that. Also, it may be less than pleasant, but pay attention to the toilet: changes in urinary habits and bowel movements can tell us a lot about your health.

Get the right medical gear

Sometimes solving a health conundrum requires more detailed data than your eyes and fingertips alone can provide. Owning the right medical equipment is especially important for people more vulnerable to illness such as young children, the elderly and those with chronic diseases. Here are some handy tools to consider adding to your arsenal, depending on your needs:

- Flashlight: Because it's hard to see into shadowy spots like your throat without extra illumination.
- Glucometer: Essential for people with diabetes in order to monitor blood sugar levels.
- Peak flow meter: For patients with lung conditions like asthma and chronic obstructive pulmonary disease, blowing into this tube is a cornerstone of home (and office) monitoring.
- Pulse oximeter: Although sales of this portable oxygen-monitoring device have skyrocketed lately, do keep in mind it's most useful for patients with chronic lung diseases.
- Bathroom scale: If you have a condition that can cause excess fluid retention like congestive heart failure or kidney failure, it's important to monitor your weight daily.
- Thermometer: If you don't already have one at home, you should.

Appointment best practices

If you're lucky enough to have a primary-care provider offering telemedicine, resist the urge to log on to a random virtual clinic. Not only does your own doctor know you and your health history best, but research also shows that people who have strong relationships with their health-care providers enjoy the best health outcomes.

Find a private location in your home where you can take part in your virtual appointment. Choose a quiet, well-lit space without distractions. Write down a few important points to remind yourself about what you want to discuss. Make sure you have a list of your medication names and doses on hand, even if you don't need a refill. Also, respect your provider's time and avoid packing several problems into one visit, as chances are other patients are waiting for their virtual visits right after yours. (Now that you can see your doctor from the comfort of your own home, it's even more convenient to schedule another session for less-pressing issues.)

#StayAtHome — unless you're experiencing these symptoms

Lately, emergency rooms across Canada have been seeing far lower volumes of patients with issues not related to COVID-19, as people stay home as much as possible. Unfortunately, what this means is that many patients who do show up tend to be sicker than usual. 

Remember that there are some reasons you should go to the ER immediately, including:

- Severe chest pain, shortness of breath or abdominal pain.
- Severe dehydration not responding to oral fluids.
- Loss of consciousness or seizure.
- Severe headache, especially combined with neck stiffness and a rash.
- New-onset vertigo, vision changes, trouble speaking, one-sided facial droop, limb weakness or numbness.
- Heavy bleeding from a cut or body orifice that won't stop.
- A deformed or open fracture of a major bone.
- Significant burns
- Fever and signs of an infection, such as local redness, swelling and pain.
- Any fever in a child under three months.

Also, if your doctor tells you to proceed to the ER after your virtual appointment, please go — don't try to tough it out.

Last but not least, though widespread use of virtual medicine is keeping us safer for now, many health conditions are ultimately best managed in person. But until we can meet again safely, keep doing your part to flatten the COVID-19 curve by staying close to home and physically distancing — we look forward to seeing you in our offices again one day.

Dr. Melissa Lem is a well-travelled family doctor, on-air medical expert and clinical instructor at the University of British Columbia. Follow her tweets about health, nature and the environment @Melissa_Lem.

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