These visits are scheduled for 90 minutes.

At any follow up visit we will review the results of new labs that may have been ordered and the  progress of our initial plan. 

We review these questions every time:

1. What is better?
2. What, if anything, is unchanged or worse?
3. What information do we have now that we didn’t before (ie lab results, etc.)?
4. Do we need to make any changes to our action plan to work towards our goals?
5. What is a reasonable timeline to expect improvement and when should we re-evaluate?

Follow up visits are scheduled for 30 minutes.

Subsequent follow-up visits are scheduled on an individualized basis depending on the needs of each patient. Typical intervals vary between 3-12 weeks depending on how many different goals we are trying to accomplish. Often we need to address one goal at a time so more frequent visits may be necessary for a while until everything has been covered.

I wasn’t joking when I said a large part of the initial visit is reviewing your homework. Prior to your first appointment you will be asked to gather a lot of information and do some extensive documentation on yourself. This includes:

1. an in-depth family health history including parents, grandparents, and siblings
2. a detailed account of events and the environment of your childhood
3. a lifelong health history including reflecting on when you felt healthy and when you felt sick
4. Significant emotional, physical, and social events in your life (trauma, losses, accidents, illnesses, etc)
5. A current assessment of your social life- your stressors, your joys, your support network, your hobbies and activities. 
6. A current assessment of your symptoms- to what degree have certain symptoms impacted you over the last 2 weeks, 2 months, 12 months? 
7. A list of what has been done so far in terms of treatments or trials to address your current symptoms: medications, including when tried and side effects; herbs or supplements; surgeries or other procedures; alternative treatment modalities 
8. A 3-day journal of your current lifestyle habits- this is a 3 day snapshot of what you ate and drank, how you slept, how you felt, and any physical or social activities you engaged in. 

In addition to this packet I will ask you to gather any health records from other doctors or health providers in the last 2 years, including labs and imaging as well as any other older notes or studies that you feel may still be relevant to how you are currently feeling. I will also ask you to gather and bring in all of the medication, herb and supplement bottles you are currently or recently using so we can make sure everyone is on the same page. 

While I understand this may seem daunting and burdensome to most of you, I promise it will be well worth your time investment.  Doing this inventory is often an eye opening experience for everyone.