1. What drugs do you recommend I take for my fibromyalgia? Why? Please explain how these drugs work.
Depending on your symptoms, their severity, and other medical conditions, your doctor can choose from various medications. Use this question to open a dialogue with your doctor about the best treatment combination for you.
The best answer to the “why?” question will be a full explanation that gives you the sense that your doctor has put thought into your personal case and isn’t just giving you the same drugs she routinely prescribes for other fibromyalgia patients — or worse, because she doesn’t believe in or understand fibromyalgia. You need to trust your doctor, but the savviest patients remain slightly skeptical. No one profits when you eat your vegetables or go to the gym, but both drug companies and some doctors earn money with prescriptions.
2. What percentage of improvement can I reasonably expect from this drug?
As you weigh the potential risks and benefits of taking any drug, hearing about the positive effects as a percentage may help clarify the facts. Ask your doctor to talk in specific terms, such as the average percentage of improvement for reducing sleep problems, pain, or fatigue.
No doctor can predict with absolute certainty how well a medication will help you, but this discussion establishes realistic expectations. Another big variable is your willingness to adopt healthier eating and exercise habits. Be sure your doctor explains your personal case and not just national averages.
3. How will you know if this drug is working well?
It’s equally important to understand the details of how your doctor plans to assess and monitor a proposed drug’s effectiveness over time, especially since fibromyalgia is a chronic disease without a cure.
Also ask, “How often will I need to make follow-up visits to the doctor’s office or for laboratory tests?” and “How long will I have to take this drug for it to be effective?”
4. What short-term side effects are possible? Long-term side effects?
Are there any side effects that may not go away? Get the specifics on both short-term and long-term side effects. Be sure your doctor addresses this question for your specific case and not just with data from clinical trials or general studies.
Don’t let your doctor gloss over his answer to this question. Double-check his response by searching the Internet for this medication by its generic and brand names. And don’t forget to ask about potential permanent side effects and toxicity — a great question that few people think to ask.
5. How will you (the doctor) help me to manage any side effects?
This question will help you to learn more about side effects and if there are ways to lessen their impact on your health and wellbeing. For example, if you experience stomach upset, which is common with some medications, there may be simple over-the-counter remedies or another prescription to help control this problem.
6. What can I do to minimize the side effects and stay healthy?
Asking this question will help you feel like you are more in control of your own health. This question also implies that you and your doctor are a team, with both of you actively involved.
Sleep expert Dr. Charles R. Cantor at the University of Pennsylvania gives an example: “Some medications, including antidepressants, can improve sleep, but others cause insomnia. If your doctor doesn’t know that your sleep quality is poor, he may not connect the dots between sleep problems and your antidepressant.”
7. What, if any, restrictions will there be on my normal activities while I’m taking this drug?
Be sure you understand if there are any prohibitions on foods, other drugs, alcohol use, or any additional considerations you should know in advance. This is especially true if you still live a normal and active lifestyle, including travel, work, sex, sports, and outdoor activities.
8. What should I do if I miss a dose of my medicine?
Use your doctor’s answer to solve any mysteries about whether or not you should double up or not in order to compensate for missed dosages.
9. What changes in my symptoms are serious enough for me to call you?
Find out the specifics about increased pain or disabling side effects.
Many people (especially women) hesitate to call their doctors for fear of “bothering” them or overreacting to new symptoms. Let your doctor’s response guide you to a better-informed decision. If you aren’t pleased with your doctor’s response to this question, consider finding another one.
10. What is my overall treatment plan?
In addition to discussing specific drugs, you’ll be smart to find out the big picture for your long-term care, treatment, and wellbeing. An overall treatment plan may include more tests, experiments with alternative therapies, lifestyle adjustments, and staying on top of breaking news about medical advances in fibromyalgia management.
Ask if the proposed treatment options will interfere with your other medications or will include lifestyle improvements (more exercise, better diet, etc.). Also clarify if you must take medications for the rest of your life and about your long-range chances for disability.