Dear Doctors: My new doctor always starts talking before I’m finished, and after that it’s hard to get another chance to speak. Sometimes my symptoms get brushed aside like they’re not important. After the appointment, I often still have questions. What can I do?

Dear Reader: Your letter echoes concerns we have heard from other readers. And numerous patient surveys show that your experience of being interrupted, and feeling that your concerns are not addressed, is not an isolated one. The data from these surveys also show this happens more often to older adults and female patients.

In our experience, the relationship between patient and doctor works best when it’s treated as a partnership. If this dynamic isn’t one that comes naturally to your own health care provider, there are steps you can take to guide it in that direction. It requires planning ahead and being willing to be more assertive during your appointment.

Before you arrive, organize your needs for the appointment into a concise mission statement. This will be useful for your doctor and for you. Begin by letting your doctor know you want a moment to state your goal for the appointment, as well as your questions and concerns. Your mission statement will let your doctor mentally prepare for how best to structure the rest of your appointment. Studies have shown that when a patient prepares and speaks uninterrupted, it takes less than two minutes to present their information.

If you have a specific medical issue, present it in a concise and fact-filled narrative. Your doctor needs to know when your symptoms began, whether they have changed or grown worse, the specifics of where they are occurring, and exactly what they feel like. Many patients find it helpful to take notes as their doctor answers and to keep track of follow-up questions. At the end of the appointment, summarize the information to make sure you understood everything correctly. And don’t forget that the nurses and physician’s assistants in the practice can also help with additional questions, clarification and guidance.

If a medical visit veers off track and you feel you are not being heard, be prepared with a few short but pointed phrases. They can be as simple as “I appreciate your expertise, but I know my body and something isn’t right,” or “This isn’t normal for me.” Then follow up by asking the doctor to give the issue more thought. Some people don’t feel comfortable being assertive in this way. In those cases, it can be helpful to bring an advocate to your appointment. This can be useful in virtual appointments as well as in-person visits.

If a doctor just isn’t a good fit, consider switching to someone new. Make sure the new doctor has good credentials, is on your insurance plan, is accepting new patients and has no red flags in their online reviews. It takes time and effort, but the payoff is worth it. A strong doctor-patient relationship builds trust, and the data show it results in better health care.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: Can a doctor rule out walking pneumonia just by listening to your chest? My daughter and husband both have pneumonia, and I have been feeling weird. There’s no cough or fever, and my oxygen is at 99% saturation, so the doctor said I’m fine. But it’s days later and my chest still hurts, and I still feel tired and breathless. What can I do to be taken seriously?

Dear Reader: Your letter contains two important questions -- one about health and one about health care. We’ll begin with your first question about pneumonia. This is an infection that can occur in one or both of the lungs. It affects the millions of tiny and fragile air sacs, known as alveoli, that deliver oxygen to the bloodstream. The source of the infection is often bacterial, but can also be viral, fungal or environmental.

When someone has pneumonia, the alveoli fill with fluid or pus. This causes symptoms such as a cough that can produce mucus, fever, chills, shortness of breath, chest discomfort and exhaustion. It’s also possible for a mild case of pneumonia to be asymptomatic. That means that although the infection is present, the visible or measurable signs of the disease are not. The medical term for this is atypical pneumonia, commonly called walking pneumonia.

Because the symptoms of walking pneumonia can be subtle, it can be difficult to diagnose. The classic wheezing and crackling breath sounds associated with a more severe case of the illness are not always present. So to answer your question, no, walking pneumonia can’t be definitively ruled out based only on the absence of breath sounds. Additional diagnostic clues that doctors often look for include shortness of breath, fatigue and a sensation of tightness or heaviness in the chest.

Diagnosis of atypical pneumonia may include X-rays to check for fluid buildup and lab tests to try to identify the pathogen. If the cause is bacterial, doctors will prescribe antibiotics. People often begin to feel better several days after beginning antibiotics. However, full recovery can take anywhere from several weeks to more than a month. It is important to finish the full course of antibiotics that have been prescribed. Because the inflammation and fluid in the alveoli reduce the oxygen available to the body, it is also important to take it easy during this time.

And now for the health care part of your letter. We’re very sorry you felt your doctor did not take your concerns seriously. This kind of breakdown in communication can leave you confused, frustrated and worried about your health. Worst of all, you can be left with an unresolved medical concern. It’s an important issue and has been a recurring topic in reader letters over the years. We will address it again in an upcoming column and will include strategies that have helped people get the most out of their medical visits.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Hello, dear readers! Welcome to our monthly letters column. With long days, warm nights and plenty of outdoor living, it’s time for our annual summertime reminders. Please protect yourselves from the sun, take precautions against ticks and mosquitoes, always watch children playing in water, and never underestimate the physical threats of a heat wave. And now, on to your letters.

-- We recently wrote about shingles, a painful, blistering rash caused by the same virus that causes chickenpox. This led to a question from a reader in Naples, Florida. “Your column did not include the likelihood of a person who has never had chickenpox possibly getting shingles,” he wrote. “My girlfriend is 64 and has never had chickenpox or the vaccine, and I’m worried about her.” Shingles is a reactivation of the chickenpox virus in someone who has had that illness. That means you cannot get shingles if you’ve never had chickenpox. However, it is possible to have been infected with chickenpox without developing the distinctive rash it causes and not be aware that you had the illness. Without the immunity conferred by either a previous case of chickenpox or the vaccine, your girlfriend is at risk of contracting the illness. This can occur through exposure to someone with chickenpox or contact with fluids from a shingles blister. Shingles itself is not contagious, but the underlying virus that causes it can spread to susceptible individuals during an active flare-up.

-- Several columns have focused on stem cell research to manage or cure Type 1 diabetes. This letter from a reader echoes questions from several parents. “I saved my son’s cord blood and placenta at delivery,” she wrote. “Can these stored tissues be used in a clinical trial for a diabetes cure?” Cord blood and the placenta are indeed a rich source of stem cells. These are "blank slate" cells with the potential to turn into specialized cells. While researchers are exploring how stem cells can be used to trigger insulin production, at this time the studies do not include the use of a participant’s own cord blood or placental tissues. To learn more about current and future research into stem cells and Type 1 diabetes, visit clinicaltrials.gov and search for Type 1 diabetes and stem cells.

-- A column about a possible connection between emotional stress and lower back pain prompted this letter from a reader in Huntley, Illinois. “It seems to me you covered everything but the cure,” he wrote. “All people have to do to rid themselves of lumbar aches and pains is to properly perform the bridge pose and the plank pose for a few minutes every day.” Although the column did include information about medications, heat therapy and physical therapy, you are correct that we did not discuss a role for yoga. We appreciate you sharing your own approach to a challenging form of back pain.

Thank you, as always, for taking the time to write to us. We look forward to hearing from more of you. We will be back soon with a bonus letters column with more of your follow-up questions and comments.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)