Jennifer talks to DrB about her Top Tips for practitioners
Jennifer is a work-at-home mother of two. One with eczema, allergies, and asthma. One with mild eczema. She blogs @ It's an Itchy Little World. She is the founder of The Eczema Company and is also one of the founding members of www.AtopicSkinDisease.com. She lives in Quebec, Canada.
DrB: Hi Jennifer. We have been talking with a Dermatologist, Bill Gould in Palo Alto, USA and a Family Practitioner, Val Doc in London, UK. Bill shared some thoughts on the importance of a practitioner understanding the point of view of a parent or a patient. Both Wall Street Journal and Harvard Medical School have Tips for patients. From your point of view as a parent, what is your first Top Tip for practitioners?
JR: Support is really important! Eczema is stressful for everyone. As mothers, we are often at our wits' end trying to do everything in our power to help relieve our child's suffering. We are many times on the verge of tears when we see our children in pain. Just know that we could loose our cool at any point during an appointment. If we do, it would be nice to hear some reassuring words and to have a tissue. We also look for comfort from others going through the same situation. It would be great to be connected to other parents who have children with eczema, so please at least be able to recommend a support group in the area or online.
DrB: To be supported is certainly something we all benefit from when we become distressed. How can the the practitioner show support right from the the beginning of a consultation?
JR: Listen! We may come to an appointment with a very long list of items, either in our heads or on paper, that we want to discuss. Please listen and address each item as concisely as possible. Long roundabout answers will probably go in one ear and out the other, not doing very much good at all. Please give us your undivided attention and time. We respect you, and expect to feel the same in return.
DrB: Mutual respect will always allow the practitioner-patient relationship to remain positive. What other tips do you have to make things go well?
JR: I would say be open. Sometimes both prescription and over-the-counter treatments work, and sometimes they don't. We hear a lot about unconventional natural treatments that have worked for many eczema sufferers. If we want to try one, please keep an open mind and don't disregard our idea because it's not something you learned in medical school. If it's truly dangerous, we want to know. Otherwise, please be supportive about our choices. Sometimes conventional and natural medicine work really well together and it's worth exploring.
DrB: And to have an open mind is a necessity if new effective treatments are to be discovered. Which of the possible causes of childhood eczema do you think need better attention?
JR: Food Triggers. Yes, research shows that a very small percentage of children's eczema is triggered by food allergies. Perhaps this is because food allergy tests, both skin and blood, aren't always reliable and display negative results when obvious allergic reactions to said foods have occurred for the child in the past. Regardless, food can be a trigger and an easy one to rule out. Many children can see vast improvements in their skin by simply removing some top foods allergies, such as gluten, from the diet. So, please don't say that food isn't usually a trigger before ruling it out the right way, with a supervised elimination diet.
DrB: Do you have a Top Tip for the practitioner who wants to start a new treatment?
JR: Certainly! Always remember to explain. Whenever you prescribe a treatment, tell us why you think it will work. Why we should try it. And always clearly discuss the side effects and any possible areas of concern, even if you think they are unwarranted. We will do our research when we get home and if there are side effects that aren't mentioned in the appointment, we may not follow the treatment programme you recommended until we are able to speak to you again, to clarify our findings. These are our children that you are treating, whom we love with all our hearts. We respect and trust you, but we must also listen to our mother's intuition when things don't match up as we expect.
DrB: To finish with, how can the practitioner ensure an explanation is optimal?
JR: I have two tips for this: the first is to document. Because too much information can be so overwhelming, it would benefit us greatly if you wrote everything down. Everything. Diagrams, charts, etc., all are good and will help us understand and be able to follow your prescriptions and recommendations for treatment.
And my last tip is demonstrate. Don't just tell us or write it down for us, show us too. We need real, live demonstrations on how to apply creams, where and how often. Which one goes first? For how long? How many times a day?
DrB: Thank you Jennifer!
Jennifer's Top Tips for Practitioners include understanding the importance of being supportive, the need to listen with respect, the value of keeping an open mind about causes of eczema and the value of ensuring treatment is explained and understood.