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Preparing for your appointment
By Mayo Clinic staffYou're likely to start by seeing your primary care physician. However, you may then be referred to a doctor who specializes in disorders of the nerves (neurologist). In addition, depending on the part of your body that's affected by autonomic neuropathy, you may need to see other specialists, such as a cardiologist for problems with your blood pressure or heart rate, or a gastroenterologist for digestive difficulties.
Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to arrive well prepared. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet for certain tests.
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Make a list of all medications, as well as any vitamins or supplements, that you're taking.
- Ask a family member or friend to come with you, if possible. Sometimes it can be difficult to remember all of the information provided to you during an appointment. Someone who accompanies you may remember details that you missed or forgot. Additionally, family members may need education about your illness. For example, if you don't know when your blood sugar levels are dropping rapidly (hypoglycemia unawareness), you may pass out from low blood sugar levels. Your family members will need to know what action to take.
- Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For autonomic neuropathy, some basic questions to ask your doctor include:
- Why did I develop autonomic neuropathy?
- Are there any other possible causes for my symptoms?
- What kinds of tests do I need? Do these tests require any special preparation?
- Is autonomic neuropathy temporary or long lasting?
- What treatments are available, and which do you recommend?
- What types of side effects can I expect from treatment?
- Are there any alternatives to the primary approach that you're suggesting?
- Is there anything I can do on my own that will help?
- I have other health conditions. How can I best manage these conditions together?
- Are there any activity or diet restrictions that I need to follow?
- Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- Does anything seem to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
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- Stevens MJ. Diabetic autonomic neuropathy. http://www.uptodate.com/home/index.html. Accessed Jan. 29, 2010.
- Autonomic neuropathy. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/neuropathy/autonomic-neuropathy.html. Accessed Feb. 22, 2010.
- Masharani U, et al. Pancreatic hormones and diabetes mellitus. In: Gardner DG, et al. Greenspan's Basic and Clinical Endocrinology. 8th ed. New York, N.Y.: McGraw-Hill Medical; 2007. http://www.accessmedicine.com/content.aspx?aID=2633151. Accessed Feb. 22, 2010.
- Diabetic neuropathies: The nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/DM/pubs/neuropathies/. Accessed Feb. 21, 2010.
- Boulton AJM, et al. Diabetic neuropathies: A statement from the American Diabetes Association. Diabetes Care. 2005;28:956.
- Disorders of the autonomic nervous system. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2906166. Accessed Feb. 22, 2010.
- Vink AI. Diabetic autonomic neuropathy. Diabetes Care. 2003;26:1553.
- Autonomic nervous system. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec16/ch208/ch208a.html. Accessed Feb. 22, 2010.
- Ma J, et al. Diabetic gastroparesis: Diagnosis and management. Drugs. 2009;69:971.
- Bethanechol (prescribing information). Minneapolis, Minn.: Upsher-Smith Laboratories, Inc.; 2005. http://www.upsher-smith.com/PDFs/bethanechol.pdf. Accessed Feb. 22, 2010.
- Robinul and Robinul Forte (prescribing information). Atlanta, Ga.: Sciele Pharma, Inc.; 2006. http://www.shionogipharma.com/PI/Robinul%20PI.pdf. Accessed Feb. 22, 2010.
- Bansal V, et al. Diabetic neuropathy. Post Graduate Medical Journal. 2006;82:95.
- Sandroni P (expert opinion). Mayo Clinic, Rochester, Minn. March 1, 2010.
- Detrol (prescribing information). New York, N.Y.: Pharmacia and Upjohn; 2009. http://www.pfizer.com/files/products/uspi_detrol_la.pdf. Accessed March 8, 2010.
- Ditrol (prescribing information). Raritan, N.J.: Ortho McNeil Pharmaceuticals; 2008. http://www.ortho-mcneilpharmaceutical.com/sites/default/files/shared/pi/Lg%20Ditropan%20PI.pdf#zoom=100. Accessed March 8, 2010.
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