What I write down before every appointment

Dear You,

My appointments are twelve minutes. I’ve timed them. Twelve minutes, from the knock to the hand on the door, and for the first year I spent the first four remembering what I’d meant to say and the last two realizing what I’d forgotten.

So I started bringing a page. One sheet, handwritten or printed, folded once, in the pocket of whatever I’m wearing. It has changed those twelve minutes more than anything else I’ve done, and it took me an embarrassingly long time to think of it, given that I’ve walked into a thousand work meetings with a pre-read.

Here’s the page. Steal it, change it, make it yours. None of this is medical advice; it’s a way to get more out of the person whose advice you’re actually there for.

What changed since last time

Four or five lines, dated. Not a diary. A changelog.

• Started a new job, lunch moved to 1:30.
• Travelled two weeks, meals irregular.
• Sleeping better since the end of September.
• Clothes fitting the same.

The point is context. A prescriber looking at a number without the story behind it is guessing. A prescriber with the changelog can say “that tracks” or “that doesn’t,” and the second one is where the useful conversation lives.

Side effects, two lines each

Each thing I noticed gets exactly two lines: what it was, and when and how often. Not a paragraph. Not “sometimes I feel weird.”

• Nausea: mornings after the injection, days one and two, mild, gone by lunch.
• Constipation: most of week three, resolved after I changed what I was eating and drinking.
• Fatigue: afternoons, 3 to 4 pm, most days, worse in the travel weeks.

Two lines forces precision, and precision is what lets your care team tell a pattern from a coincidence. If I just say “I’ve been tired,” they have to interview me to get what two lines would have handed them.

The three questions

Three, in order of importance, written as actual questions. Not topics. Questions.

I used to walk in with “ask about the tiredness” and walk out having discussed the tiredness in a general way without getting an answer. “Is afternoon fatigue something you’d expect at this point, and is there anything about timing or food that tends to help?” gets an answer.

Three is the limit because twelve minutes is the limit. If I have six, I put the three most important on the front and the other three on the back, and I ask the back ones only if there’s time. There usually isn’t. The back ones go on next time’s page.

The medication list

Everything I take, with the dose as written on the bottle, including the stuff that feels too small to mention: the supplement, the allergy pill, the thing I take for sleep twice a month. Prescribers ask this every visit for a reason, and “um, a vitamin?” is not a helpful answer.

I also note the date of my last fill and whether I had any trouble getting it. Refill problems are easier to head off when the person who can write the authorization knows about them before the pharmacy calls.

Why the page works

Twelve minutes is enough time. It just isn’t enough time to think and talk at the same time. The page does the thinking in advance, at my kitchen table, the night before, with a cup of tea and no one watching the clock.

It also does something I didn’t expect: it makes me a better patient to have. My prescriber once said, scanning the page, “This is great, most people can’t remember what week they started feeling off.” I don’t think I’m a better person than most people. I just brought a page.

A few practical notes:

1. Write it the night before, not in the waiting room. Waiting rooms are where thoughts go to hide.
2. Bring a pen. Write the answers on the page, next to the questions. You will not remember them by the parking garage.
3. Keep the old pages. Six months of them in a folder is a history no portal gives you.
4. If an appointment is by video, email the page ahead, or read from it. The screen doesn’t make the twelve minutes longer.

The appointments are still twelve minutes. They just hold more now.

Want to tell me something? Reply to any Low Volume email, or write to me here. I read everything.

Getting Quiet shares lived experience, general education, and practical tools. For medical decisions and individual treatment questions, talk with your qualified care team.