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Preparing for your appointment
By Mayo Clinic staffIf you suspect you have toxic hepatitis, you're likely to start by first seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a liver specialist (hepatologist).
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. 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.
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of all medications, as well as any vitamins or supplements, that you're taking.
- Take a family member or friend along, if possible. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
- Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For toxic hepatitis, some basic questions to ask your doctor include:
- What is likely causing my symptoms or condition?
- Other than the most likely cause, what are other possible causes for my symptoms or condition?
- What kinds of tests do I need?
- Is my condition likely temporary or chronic?
- What is the best course of action?
- What are the alternatives to the primary approach that you're suggesting?
- I have these other health conditions. How can I best manage them together?
- Are there any restrictions that I need to follow?
- Should I see a specialist? What will that cost, and will my insurance cover it?
- Is there a generic alternative to the medicine you're prescribing me?
- Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?
- What will determine whether I should plan for a follow-up visit?
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 allow more time to cover points you want to address. Your doctor may ask:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous, or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- What prescription and over-the-counter medications are you taking and have you started any new medications recently?
- Do you take herbal or nutritional supplements?
- How often and how much alcohol do you drink?
What you can do in the meantime
Toxic hepatitis is a serious condition. If you suspect exposure to a particular chemical or other toxin is causing your symptoms, eliminate the toxin from your environment. In a work situation, this may mean being reassigned to an area without exposure to the chemical.
- Dienstag JL. Toxic and drug-induced hepatitis. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill; 2008. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Nov. 14, 2008.
- Lewis JH. Liver disease caused by anesthetics, toxins, and herbal preparations. In: Feldman M, et al. Sleisenger & Fordtran's Gastroinstestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/111481204-2/0/1389/0.html. Accessed Nov. 11, 2008.
- Friedman LS. Liver, biliary tract, & pancreas disorders. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment 2009. 48th ed. New York, N.Y.: McGraw-Hill; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed Nov. 11, 2008.
- Brown JA. Haz-Map: Information on hazardous chemicals and occupational disease. National Institutes of Health. http://hazmap.nlm.nih.gov. Accessed Nov. 12, 2008.
- Fountain FF. Isoniazid hepatotoxicity associated with treatment of latent tuberculosis infection: A 7-year evaluation from a public health tuberculosis clinic. Chest. 2005;128:116.
- Fontana RJ. Acute liver failure including acetaminophen overdose. Medical Clinics of North America. 2008;92:761.
- Fontana RJ. Acute liver failure due to drugs. Seminars in Liver Disease. 2008;28:175.
- Watkins PB. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily. Journal of the American Medical Association. 2006;296:87.
- NCI drug dictionary. National Cancer Institute. http://www.cancer.gov/drugdictionary. Accessed Nov. 14, 2008.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Oct. 28, 2008.
