esl health unit - spring institute esl students [licensed...
TRANSCRIPT
EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee TThhee DDooccttoorr’’ss OOffffiiccee
Intermediate
Concept and initial activities by Heather Musselman
with additional activities and
materials by Marni Baker Stein and Hilary Bonta
Made possible by a generous grant from MetLife Foundation.
Additional support provided by Temple University and San Jose State University.
This unit was developed as part of the SHINE-MetLife Foundation Health Literacy Initiative,
as one component of Project SHINE, Center for Intergenerational Learning. For more
information about this project, go to www.projectshine.org
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Acknowledgments
Thematic units were developed by ESL practitioners teaching ESL Health Literacy classes to
elder immigrants at five senior centers in Philadelphia. Each instructor selected two topics of
greatest interest to their class from a list of health literacy topics, identified by immigrant elders
participating in focus groups in Philadelphia and San Jose. SHINE staff conducted regular
curriculum development meetings at which teachers discussed themes emerging from their
classes and methods for encouraging learners to write about these topics. Many of the lesson
activities within the units are based on learner narratives, in which elder immigrants share their
experiences accessing healthcare in the US.
The project would like to thank the elder immigrants who participated in the ESL Health
Literacy classes and who shared their stories and health concerns with us. Many thanks to the
teachers who taught the classes, participated in the curriculum development process, formulated
the topics upon which the units are based and developed many of the activities in the units. We
would also like to express our gratitude to Gail Weinstein for her work on the Learners’ Lives as
Curriculum framework, which provided the inspiration for this curriculum development process.
Many thanks to Marni Baker Stein, Hilary Bonta, Melissa Halaway and Sharon Nicolary for their
careful work in developing additional activities and instructional materials, ensuring that
activities were at consistent proficiency levels, and standardizing the format of units.
The initial concept and activities for this unit were developed by Heather Musselman,
in collaboration with elder learners at the Golden Slipper Senior Center in
Philadelphia. Additional activities and revision by Marni Baker Stein, author of Talk
it Through: Listening, Speaking and Pronunciation (Houghton Mifflin) and Hilary
Bonta of the English Language Program at the University of Pennsylvania. Patricia
Dillon, RN, PhD, of Temple’s School of Allied Health, provided input on health
content.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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The Doctor’s Office A Thematic Unit for Intermediate Level Learners
Table of contents
Lesson One: Making Appointments 5-22
Reading and Writing Practice
Goals for this Lesson
5-9
5
Before You Read! 6
Reading One: Making a Doctor’s Appointment 7-8
Culture Box: Voicemail Tips 9
Listening and Speaking Practice
Goals for this Lesson
10-19
10
Before You Listen! 11-12
Listening One: Understanding an Automated Voice Message 13-14
Talk About It! 15-19
Real Practice
Goals for this Lesson
20-22
20
Real Practice 21
Checklist for Learning 22
Lesson Two: Describing Pain/ Symptoms 23-46
Reading and Writing Practice
Goals for this Lesson
23-32
23
Before You Read! 24-25
Reading Two: Describing the Symptoms of a Migraine Headache 26-28
Grammar Tip: Using the Simple Past Tense to Tell Stories 29-30
Health Watch: Just Relax! Tips for Handling Headaches 31-32
Listening and Speaking Practice
Goals for this Lesson
33-43
33
Before You Listen! 34-35
Listening Two: Improve Your Communication with Your Doctor 36-39
Talk About It! 40-43
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Real Practice
Goals for this Lesson
44-46
44
Real Practice 45
Checklist for Learning 46
Lesson Three: Knowing Your Health History 47-66
Reading and Writing Practice
Goals for this Lesson
47-54
47
Before You Read! 48-54
Listening and Speaking Practice
Goals for this Lesson
55-62
55
Before You Listen! 56
Listening Three: Know Your Doctor’s Office 57-60
Talk About It! 61-62
Real Practice
Goals for this Lesson
63-66
63
Real Practice 64-65
Checklist for Learning 66 Note to Teachers!
The following websites were used in developing this site. You may find them useful references
to support your instruction.
WebMD “Check Your Symptoms”
http://my.webmd.com/medical_information/check_symptoms/default.htm
Talking With Your Doctor: A Guide for Older People
http://www.niapublications.org/pubs/talking/p5.htm
The Mayo Clinic: Compiling your family medical history: Using the past to prepare for
your future.
http://www.mayoclinic.com/invoke.cfm?objectid=385FC65E-F961-49BA-
99B799A3A0DAF885
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee TThhee DDooccttoorr’’ss OOffffiiccee
LLeessssoonn OOnnee MMaakkiinngg AAppppooiinnttmmeennttss
SS oo uu rr cc ee :: hh tt tt pp :: // // ww ww ww .. cc ss ww uu ss aa .. cc oo mm // ii mm aa gg ee ss // CC ll ii pp aa rr tt // RR ee ss oo uu rr cc ee __ -- __ tt ee ll ee pp hh oo nn ee __ ww hh ii tt ee __ bb kk gg dd .. jj pp gg
RReeaaddiinngg aanndd WWrrii tt iinngg PPrraacctt iiccee
IInntteerrmmeeddiiaattee
Goals for this lesson: Below are some of the goals of this lesson. Which ones are your
goals too? Check (√) them.
� describe your feelings
� develop strategies for listening to automated telephone
messages
� understand common phrases used in automated messages
� describe common reasons you need to call a doctor’s office
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Lesson One – Making Appointments Reading and Writing Practice
Before You Read!
In this lesson, you will read about the frustrating experience one Chinese elder had
when he tried to make an appointment with his doctor. Before you read, discuss
the following questions with your classmates and your teacher.
1. In your home country where you were born, how do you make an
appointment with your doctor? If you call the doctor, who answers the
phone – a person or a machine?
2. Is making an appointment with a doctor in your home country easy or
difficult? Why do you think so?
3. In the United States, how do you make an appointment with your
doctor? When you call the doctor, who answers the phone – a person
or a machine?
4. How does it make you feel when you call somewhere and a machine
answers the telephone?
5. Is making an appointment with a doctor in the United States easy or
difficult? Why do you think so?
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Reading One: Making a Doctor’s Appointment
Now you are going to read a story about the experience one Chinese elder had
when he tried to make an appointment with his doctor in San Jose, California.
Please read the story and then answer the questions with your classmates and your
teacher.
“I tried to call the doctor to make an appointment but it is all automated.
Nobody is there. On the phone I hear, “if you want….press 1…press 2.” I
do not understand and get frustrated. I don’t understand. I’m sorry. I
should go back to my country. It is very difficult to live here even with the
amount of English I understand. What about those who do not understand
at all?”
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Questions:
1. What happened to the man when he tried to call the doctor to make an
appointment?
2. How does the man feel about this experience?
3. Have you had a similar experience? Circle the words that describe
how you feel when you have this kind of experience and then tell your
story to your classmates and your instructor.
frustrated angry comfortable nervous
worried indifferent
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Culture Box: Voicemail Tips
According to Paul Wenke from The Kansas City Star, most Americans hate automated
voice-mail systems (September 5, 2004).
But voicemail is supposed to help us — not drive us crazy.
To help us use voicemail systems more effectively, Wenke suggests five voice mail tips:
1. If you feel you are very confused and don’t understand the options press “0.”
Most of the time you can reach an operator who can help you with your question.
2. Once you get a real person, explain exactly what or who you need and ask to be
connected to that office or person.
3. Write out what you want before you call. Then you are ready if you get a
recording that asks you to leave a message. Your message should be short and
clear.
4. If you leave a message on an answering machine, ask for a callback time, for
example: “If possible I would like to hear from you by today at 4:00.” It might
not work, but it sounds authoritative.
5. If you continue to have problems, keep trying. Hang up and call again until you
feel comfortable that you understand.
Discuss the meanings of the words in bold with your classmates and teacher.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee TThhee DDooccttoorr’’ss OOffffiiccee
LLeessssoonn OOnnee MMaakkiinngg AAppppooiinnttmmeennttss
SS oo uu rr cc ee :: hh tt tt pp :: // // ww ww ww .. ss yy mm oo nn ee tt tt ee ss .. cc oo mm // ii mm gg // pp hh oo nn ee -- cc ll ii pp aa rr tt -- gg ii ff .. gg ii ff
LLiisstteenniinngg aanndd SSppeeaakkiinngg PPrraacctt iiccee
Intermediate
Goals for this lesson: Below are some of the goals of this module. Which ones are your
goals too? Check (√) them.
� describe your feelings
� understand a voicemail message
� learn new vocabulary
� describe why you call the doctor
� make an appointment
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Lesson One: Making Appointments
Listening and Speaking Practice
Before You Listen!
Some of the reasons people call a doctor’s office are listed below. Think about all
of the reasons you have called the doctor’s office since you have been to the United
States and check off any that you have experienced.
□ Schedule an appointment □ You feel sick and you need to see a
doctor
□ Confirm an appointment □ Ask a question about a bill
□ Ask the doctor a question □ Request a prescription refill
□ Change an appointment □ Ask the nurse practitioner a question
□ Request a referral □ Talk about an emergency
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Have you called your doctor for any other reasons? List them below:
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Listening One – Understanding an Automated Voice Message
**Note to teacher: Do not pass out the written message in the box below until students are
ready for the “Talk About It!” activity. Record it onto a cassette and have students listen to the
recording (If you have time, it may be helpful to ask a friend or family member to record this
message so that your learner(s) can practice listening to an unfamiliar voice). Play once or
twice before they begin to listen for specific information.
Listen to the following automated voicemail message from a doctor’s office.
Hello. You have reached the Health Center Plus. Please choose from the following
options. Listen carefully. Our menu options have changed. If you are a physician
or this is an emergency, press 1. If you want to schedule, change or confirm an
appointment select 2. If you want to refill a prescription press 3. If you want to
request a referral or if you have a question regarding your referral press 4. If you
wish to speak to the secretary of Doctors Smith, Green, or Nguyen, press 5. If you
are sick and you wish to speak to the nurse practitioner select 6. If you have a
question about a bill press 7. If you are calling from a rotary phone please stay on
the line for the next available representative.
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Now listen again and write the phone number the caller should select for each problem.
After you have written a number beside each problem, share your answers with your
classmates and your teacher.
___ Schedule an appointment ___ You feel sick and might need to see a doctor
___ Confirm an appointment ___ Ask a question about a bill
___ Ask the doctor a question ___ Request a prescription refill
___ Change an appointment ___ Ask the nurse practitioner a question
___ Request a referral ___ Talk about an emergency
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Talk About it!
Making Polite Requests:
One way of making a polite request is to phrase it as a question with could or
would while using polite language:
Wait here. →→→→Would (could) you wait here, please?
Sit down. →→→→Would you like to sit down?
Drive me home. →→→→Could you drive me home, please?
In general, would like is more polite than want.
Another useful phrase: would you mind + the –ing form of the verb.
Would you mind holding the phone?
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Now you try it: Rephrase the following into polite requests:
1. Ask someone if that person desires a cup of coffee.
2. Rephrase Help me out as a polite request.
3. Rephrase more politely: Wait a few minutes. (Two possibilities.)
4. Rephrase more politely: Fill out this form.
5. Rephrase more politely: Help me onto the table. (Use mind.)
6. Rephrase more politely: Write down the instructions.
7. Rephrase more politely: Call my son.
8. Rephrase more politely: Do me a favor.
9. Rephrase more politely: Make an appointment for me for next week.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Activity One:
Compare the different speakers in a doctor’s office. Which speakers use polite
language? Underline language you think is polite.
Receptionist: Dr. Lopez’s office. How may I help you?
Maria: Hi. I need more medicine.
Misha: I would like to schedule an appointment please.
Secretary: When would you like to come in?
Nurse Practitioner: Hello, this is Judy Smith.
Jana: I am sick and want to see a doctor.
Nurse Practitioner: Ok, could you tell me what’s wrong?
Jana: I feel terribly dizzy when I stand up.
Nurse Practitioner: Ok, let me help you schedule something. Could you come in
tomorrow?
Roberto: Hi, I have a big problem with a bill.
Secretary: Could you tell me the invoice number or date of service?
Roberto: It’s for May 5. You charged me for laboratory fees but I wasn’t
in a laboratory. Fix it please.
Now…correct the speakers who do not use polite language. Now practice each corrected
dialogue with a partner.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Activity Two:
*NOTE: Copy these roles onto index cards (or cut these roles apart) and give
learners cards with different roles so that they cannot see each other’s character.
With a partner, practice using automated answering messages. First, read the
roles below. Then prepare an appropriate message for each role. Next, one
partner should be the automated message by reading the text your teacher gives
you. The other person should call, press the appropriate number and then leave a
voicemail message. Refer to the Culture Boxes “Voicemail Tips” and “How to
Make Polite Suggestions” for ideas.
1
Carlos: You saw Dr. Green a month ago for pain in your back and yesterday you
received a bill in the mail. The bill says that you should pay for laboratory blood
tests but you did not have any laboratory work done. Call the office and ask them
to fix your bill.
Anna: You have heard people talking about flu shots. Because you are 70 years
old, you fall into the high risk category for the flu and would like a flu shot. Call
your doctor’s office and ask how you make an appointment to receive a flu shot.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Ping: You have been suffering from a bad cough and shortness of breath for about
two weeks. Call your doctor’s office and make an appointment to see someone.
Alexander: Your prescription for Micronase (diabetes medicine) has expired and
you need more. Call to ask for a prescription refill.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee TThhee DDooccttoorr’’ss OOffffiiccee
LLeessssoonn OOnnee MMaakkiinngg AAppppooiinnttmmeennttss
SS oo uu rr cc ee :: hh tt tt pp :: // // ww ww ww .. tt ee ll ee pp hh oo nn ee aa rr tt .. cc oo mm // cc ll ii pp aa rr tt // tt ee ll ee pp hh oo nn ee 11 11 22 33 .. gg ii ff
RReeaall PPrraacctt iiccee
IInntteerrmmeeddiiaattee
Goals for this lesson: Below are some of the goals of this lesson. Which ones are your
goals too? Check (√) them.
� describe your feelings
� develop strategies for listening to automated telephone
messages
� understand common phrases used in automated messages
� describe common reasons you need to call a doctor’s office
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Lesson One: Making Appointments Real Practice!
Call your doctor’s office after hours. Listen to the voicemail message, writing
down all the options. Call the number again until you are sure that you have the
correct information written down.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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A Thematic Unit for Intermediate Level ESL Teachers Intermediate, Unit One: The Doctor’s Office
Lesson One: Making Appointments
Checklist for Learning
Vocabulary Log:
In the space below, write down all of the new words you learned during this lesson that
you want to remember. Try to separate your list of words into nouns (person, place or
thing), adjectives (describing words) and verbs (action words). For extra practice use
them in sentences of your own.
New words I learned during this lesson:
Nouns:
Adjectives:
Verbs:
What can you do?
Below are some of the language goals you worked on during this lesson. Check (√)
what you learned from this lesson. Add more ideas if you wish.
I learned to…
� describe your feelings
� understand a voicemail message
� learn new vocabulary
� describe why you call the doctor
� make an appointment
� ________________________________________________________
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee TThhee DDooccttoorr’’ss OOffffiiccee
LLeessssoonn TTwwoo DDeessccrriibbiinngg PPaaiinn//SSyymmppttoommss
hh tt tt pp :: // // ww ww ww .. rr aa nn cc hh oo ss aa nn dd ii ee gg oo dd ee nn tt aa ll .. cc oo mm // cc ll ii pp aa rr tt %% 22 00 aa nn dd %% 22 00 bb rr oo cc hh uu rr ee ss // hh ee aa dd aa cc hh ee // cc ll ii pp aa rr tt .. jj pp gg
RReeaaddiinngg aanndd WWrrii tt iinngg PPrraacctt iiccee
Intermediate
Goals for this lesson: Below are some of the goals of this lesson. Which ones are your goals
too? Check (√) them.
� discuss common health problems and symptoms
� use different words to accurately describe pain
� talk about past experiences
� describe your symptoms to a doctor
� prepare for your visit to the doctor so that you will be able to
communicate more effectively
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Lesson Two: Describing Pain/Symptoms
Reading and Writing Practice
Before You Read!
In this lesson, you will read Nina’s description of her headache symptoms. Before
you read, complete the following activity with your classmates and your teacher.
dull, burning, aching, stabbing,
throbbing, tingling, sore, stinging,
and sharp
1. With your classmates and teacher, place the following words that
describe pain on a continuum from mild pain to severe pain.
Mild Pain Moderate Pain Severe Pain
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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2. Now ask a partner about his or her past experience with headaches (or
another pain he or she has experienced). Talk about your pain using the
words above.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Reading Two - Describing the Symptoms of a Migraine Headache
Now you are going to read a story about Nina’s migraine headache. Please read
the story and then answer the questions with your classmates and your teacher.
“A few years ago I suffered from migraines. First my peripheral vision would
become blurry. Then, I would get a stabbing pain in one of my temples. The pain
would be intense. For four years I had a headache every day, but 3 to 4 days every
month during the full moon, I had a severe headache. I could only lay in silence
and darkness with my eyes closed, without movement. I couldn’t eat or drink
anything because I felt nauseous and threw up 4 to 5 times a day. I went to the
doctor who checked my head. I took medicine. After four years, the headaches got
weaker. Now some days pass when I don’t have a headache. I have headaches
when my blood pressure or the weather changes. This is a chronic condition. I hope
I will not have headaches in the next life!”
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Questions:
1. How strong is Nina’s pain? On the scale below, place Nina’s pain level.
0____ 1____ 2____ 3____ 4____ 5____6 ____7 ____ 8____ 9____ 10____
No Pain Mild Moderate Severe
2. What makes you think so? What describing words does Nina use to describe
her symptoms?
3. Read through the text one more time. This time underline all of the action
words, or verbs of the text. What do you notice about how Nina uses these
verbs to help the reader understand the timeframe of her story? What other
words or phrases does Nina use to help the reader understand the timeframe
of the story?
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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“A few years ago I suffered from migraines. First my peripheral vision
would become blurry. Then, I would get a stabbing pain in one of my
temples. The pain would be intense. For four years I had a headache every
day, but 3 to 4 days every month during the full moon, I had a severe
headache. I could only lay in silence and darkness with my eyes closed,
without movement. I couldn’t eat or drink anything because I felt nauseous
and threw up 4 to 5 times a day. I went to the doctor who checked my head.
I took medicine. After four years, the headaches got weaker. Now some
days pass when I don’t have a headache. I have headaches when my blood
pressure or the weather changes. This is a chronic condition. I hope I will
not have headaches in the next life!”
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Grammar Tip: Using the Simple Past Tense to Tell Stories
When telling stories in English, we most often use the simple past tense. The
regular simple past is formed by adding "ED" to the base form of the verb. (Base:
walk + ED = walked)
The irregular simple past is left up to the irregular verb to decide. Irregular verbs
must be memorized and used until they are learned. There are many lists of
irregular verbs in English. You can learn a few every week until you know the
most common ones.
Example:
go -- went
speak -- spoke
give -- gave
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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/id/ (syllable) - if the base form ends in /t/ or /d/. Example: "rate" (/t/)
becomes "rated," pronounced "rate /id"; “mend" (/d/) becomes "mended,"
pronounced "mend /id/."
2 J
Pronouncing "ED" Endings
Many people have had great difficulty pronouncing the /ed/ at the end of regular verbs in
the past.
There are three pronunciations for the regular past tense ending "ED."
/t/ (unvoiced) - if the base form ends in an unvoiced sound. Example: "work" (/k/ is
unvoiced) becomes "worked," pronounced "work /t/."
/d/ (voiced) - if the base form ends in a voiced sound. Example: "name" (/m/ is a voiced
sound) becomes "named," pronounced "name /d/."
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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Health Watch
Just Relax! Tips for Handling Headaches
The National Headache Foundation estimates that 28 million Americans suffer
from migraines. One cause of migraines and other types of headaches is
believed to be stress. Because stress can make any headache worse, it is
important to learn how to relax.
What Are Some Techniques You Can Use to Relax?
In order to learn how to relax, you need to become familiar with your own
breathing patterns and change them in ways that will help you relax. Below are
a few relaxation exercises. But first, be sure that you have a quiet location that is
free of distractions, a comfortable body position, and a good state of mind. Try
to block out worries and distracting thoughts.
Rhythmic breathing: If your breathing is too fast, slow it down by
taking long, slow breaths. Inhale slowly then exhale slowly. Count slowly
to five as you inhale, and then count slowly to five as you exhale. As you
exhale slowly, pay attention to how your body naturally relaxes.
Recognizing this change will help you to relax even more.
Deep breathing: Imagine a spot just below your navel. Breathe into that
spot, filling your abdomen with air. Let the air fill you from the abdomen
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
32
up, then let it out, like deflating a balloon. With every long, slow
exhalation, you should feel more relaxed.
Progressive muscle relaxation: Switch your thoughts to yourself and
your breathing. Take a few deep breaths, exhaling slowly. Mentally scan
your body. Notice areas that feel tense or cramped. Quickly loosen up
these areas. Let go of as much tension as you can. Rotate your head in a
smooth, circular motion once or twice. (Stop any movements that cause
pain!) Roll your shoulders forward and backward several times. Let all
of your muscles completely relax. Recall a pleasant thought for a few
seconds. Take another deep breath and exhale slowly. You should feel
relaxed.
Relax to music: Combine relaxation exercises with your favorite music
in the background. Select the type of music that lifts your mood or that
you find soothing or calming.
How do you relax? Talk about some of the things you do to relax with your
classmates and teacher!
Adapted from medical information from The Cleveland Clinic.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
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EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee TThhee DDooccttoorr’’ss OOffffiiccee
LLeessssoonn TTwwoo DDeessccrriibbiinngg PPaaiinn//SSyymmppttoommss
LLiisstteenniinngg aanndd SSppeeaakkiinngg PPrraacctt iiccee IInntteerrmmeeddiiaattee
Goals for this Lesson:
Below are some of the goals of this lesson. Which ones are your goals
too? Check (√) them.
� list common health problems and symptoms
� use different words to describe pain
� describe your symptoms to a doctor � prepare for your visit to the doctor
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
34
Lesson Two: Describing Pain/Symptoms
Listening and Speaking Practice
Before You Listen!
Read through a doctor’s description of conversations he had with two of his
patients and discuss the questions with your classmates and instructor.
Sasha was quite anxious about his visit. He doesn’t seem to like health care
professionals. He came in because he sometimes feels throbbing pain in his head.
He has taken medication in the past for high blood pressure but doesn’t remember
the dose. He says that he doesn’t smoke, drink caffeine or take any over-the-
counter drugs. He thought his pain might be related to stress or mild depression
but wanted to see someone to calm his nerves. We had some problems
communicating effectively because we didn’t have an interpreter. It was very
difficult for me to give Sasha helpful instructions or to diagnose his problem.
Hyuncheol had concerns about symptoms related to his diabetes. He said his
blood sugar readings have been high after breakfast. He was well-organized and
had a list of all of his drugs, vitamins, herbal and other supplements. He told me
that he usually takes the drug Micronase after he eats breakfast. I explained that he
should take it 30 minutes before breakfast. He agreed with this plan but would
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
35
also like to see a diabetes specialist for a second opinion. He wanted to take
responsibility for his own healthcare.
1. Which patient do you think is communicating better with his doctor? Why
do you think so?
2. What are some things the poorly prepared patient can do to more effectively
communicate with the doctor the next time he visits?
3. Read the following pairs of sentences. Which sentence would be more
helpful to a doctor? Put a check next to that sentence.
____I have a pain in my head.
____I have a stabbing pain on the left side of my head.
____I have a burning and sharp pain in my stomach.
____I’m having some problems in my stomach.
____My eye feels bad.
____My vision is blurry and I have a sharp pain in my right eye.
____My back is not feeling well.
____I have a throbbing ache in my lower back.
____There is an intense, shooting pain going down my left arm.
____My left arm hurts.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
36
Listening Two - Improve Your Communication with Your Doctor
Imagine you are attending a health workshop at a local senior center. Dr. Sam
Fuentes is giving a talk about how to improve your communication with your
doctor. Listen to Dr. Fuentes’ talk and answer the questions with your classmates
and instructor.
Questions:
1. What is important to do BEFORE you go to the doctor?
2. What is important to remember when you are describing your symptoms
to your doctor?
3. What other kinds of information does your doctor need to help you?
4. In the country where you were born, did you feel comfortable talking
with your doctor and asking questions?
5. In the country where you were born, did you feel comfortable disagreeing
with your doctor or asking for a second opinion?
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
37
Improve Communication with Your Doctor
If you feel anxious or uncomfortable at your healthcare appointment, you may not
be able to describe your symptoms clearly or to ask questions. This can result in
problems because your doctor will not be able to diagnose your illness and help
you.
To make yourself feel more comfortable, take the time to organize yourself before
your doctor visits. This can help reduce at least some of your anxiety Never be
afraid to ask questions. Effective communication with your doctor is an important
part of your health care.
Write down a list of your health concerns and give it to your doctor at the
beginning of each appointment. List your most important concerns first.
Be clear and specific when talking about your symptoms.
– Clearly state the purpose of your visit. Be specific.
• SAY: “I’m here to see you today because, for the past two weeks, I’ve had a
throbbing pain in the middle of my chest. It comes and goes. I just don’t
feel right. Could it be my heart?”
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
38
DON’T SAY: “I am not feeling very well. I’ve been under a lot of stress
lately.”
• SAY: “I get very tired going up the stairs. I’ve never had a problem
climbing stairs before.”
• DON’T SAY: “I have no energy. I must be depressed.”
–Describe your symptoms until you are understood.
• SAY: “I’m not comfortable simply taking a medication to calm my nerves.
Please refer me to a specialist who understands my needs. I must have
further testing to ease my mind.”
DON’T STOP: Continue to seek care if you have a problem that needs a
diagnosis, even if your doctor fails to find anything wrong or says it's just
your nerves. If you feel you are not getting the care you deserve, you can
obtain a second opinion or you can change doctors.
3
Keep a record of all the medicines and supplements you take and bring it with
you to doctor appointments. Let all of your doctors and your pharmacist know
about every medicine you are taking, including over-the-counter drugs, vitamins,
herbals and other supplements.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
39
Be honest about your health habits and be willing to make changes. Tell your
health care professional if you don’t exercise regularly, eat all the wrong foods,
drink too much caffeine or smoke cigarettes.
Get written instructions from your healthcare professional. You can ask for
instructions in writing, you can take notes, or use a tape recorder. It may help to
bring along a friend who can write down the doctor's instructions for you. Ask for
an interpreter if English is not your primary language. Make sure you understand
your diagnosis and the plan of care so that you can participate in regaining your
health.
You are responsible for your own healthcare. Taking steps to improve
communication with your doctor will result in better healthcare for you!
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
40
Talk About it!
Activity One:
When you go to the doctor, it is very important that you can describe your pain or
symptoms clearly. Work with your classmates and instructor to think about the
box below. Next to each body part, describe symptoms or pain that you (or
someone you know) have experienced.
Body Part
Description of Symptom or Pain
Head
(eyes, ears,
nose)
Example: Throbbing pain behind the eyes and near the temples.
Severe pain when looking up or down.
Skin
Neck/back
ck/Back
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
41
Chest
Arm/hand
Abdomen
Foot/leg
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
42
Activity Two:
In the space below, write about a time when you were sick. Describe what kind of
pain or symptoms you had (headache, toothache, chest pain). As you are writing,
think about Nina’s story about her migraine headache. Like Nina, try to describe
your symptoms as clearly as possible. Also, remember that you are describing
something that happened in the past; as you are writing, try to use the past tense of
each verb.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
43
Activity Three:
Once you have completed the description of a time when you were sick, work with
a partner to role-play a visit to the doctor’s office. Your partner will play the role
of doctor and ask you the following questions.
What are your symptoms?
Where is your pain on this scale?
0____1_____2_____3_____4_____5_____6_____7_____8_____9_____10
no pain mild moderate severe
What does your pain feel like?
Does your pain make it harder for you to do anything? If yes, what?
As your partner asks you questions, you will describe your pain/symptoms to the
doctor based on what you have written above. Practice being the doctor and the
patient.
When you and your partner have each had a turn being doctor and patient, present
a role-play to the class. Who is the best doctor? Who is the best patient?
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
44
EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee TThhee DDooccttoorr’’ss OOffffiiccee
LLeessssoonn TTwwoo DDeessccrriibbiinngg PPaaiinn//SSyymmppttoommss
RReeaall PPrraacctt iiccee IInntteerrmmeeddiiaattee
Goals for this Lesson: Below are some of the goals of this lesson. Which ones are your goals
too? Check (√) them.
� list common health problems and symptoms
� use different words to describe pain
� describe your symptoms to a doctor � prepare for your visit to the doctor
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
45
Lesson Two: Describing Pain/Symptoms
Real Practice!
A. Make a chart listing your problems and symptoms to take with you on your next
doctor’s visit. Don’t forget to list your problems according to severity; write the
most severe first, etc.
Problem Symptoms When and how often this
happens
1.
2.
3.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
46
A Thematic Unit for Intermediate Level ESL Teachers Intermediate, Unit One: The Doctor’s Office
Lesson Two: Describing Pain/Symptoms
Checklist for Learning
Vocabulary Log:
In the space below, write down all of the new words you learned during this lesson that
you want to remember. Try to separate your list of words into nouns (person, place or
thing), adjectives (describing words) and verbs (action words). For extra practice use
them in sentences of your own.
New words I learned during this lesson:
Nouns:
Adjectives:
Verbs:
What can you do?
Below are some of the language goals you worked on during this lesson. Check (√) what
you learned from this lesson. Add more ideas if you wish.
I learned to…
� describe your feelings
� understand a voicemail message
� learn new vocabulary
� describe why you call the doctor
� make an appointment
� ________________________________________________________
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
47
EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee TThhee DDooccttoorr’’ss OOffffiiccee
LLeessssoonn TThhrreeee KKnnoowwiinngg YYoouurr HHeeaalltthh HHiissttoorryy
hh tt tt pp :: // // ww ww ww .. ll ii ff ee ww aa yy .. cc oo mm // cc ll ii pp aa rr tt // dd oo ww nn ll oo aa dd ss // hh ee aa ll tt hh .. jj pp gg
RReeaaddiinngg aanndd WWrrii tt iinngg PPrraacctt iiccee IInntteerrmmeeddiiaattee
�
Goals for this lesson:
Below are some of the goals of this lesson. Which ones are your
goals too? Check (√) them.
� describe your personal health history
� ask for information about your doctor’s office
� ask questions when you do not understand
� prepare a family health history
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
48
Reading Three: Reading a Doctor’s Form
Reading and Writing Practice
Before You Read!
Look through the following form from a doctor’s office. This form asks you
questions about your personal health history. Read the form and then discuss any
words you do not know with your classmates and instructor. What do you know
about your health history? What don’t you know?
HEALTH HISTORYHEALTH HISTORYHEALTH HISTORYHEALTH HISTORY
Name: ______________________________________Date: __________________ (First) (Middle) (Last)
Street Address: ______________________________________________________
City: _________________________ State: ________________ Zip:___________
Home Telephone: (_____)___________Work Telephone: (_____)_____________
Date of Birth: ____/____/____ Gender: Female Male
Height: ____ feet ____inches Weight: ______lbs
Martial Status: Single Married Widowed
Emergency Contact: ___________________ Telephone: (______)_____________
Relationship: __________________________
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
49
This history form provides us with information to help us understand all your
healthcare needs. Please complete the entire form by answering each question
as thoroughly as possible.
GENERAL INFORMATION
1. When was your last physical exam? (exam in a doctor’s office) ___/___/___
Name of doctor: _______________________Telephone:(______)_____________
2. When did you last visit the dentist? ____/____/____
Name of dentist ______________________ Telephone:(______)______________
3. Place of birth (Where were you born?): _______________________________
4. What is your current occupation (job now)? _____________________________
5. Previous occupations (jobs before):___________________________________
6. Please list all allergies (foods, drugs, environment):______________________
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
50
LIFESTYLE & HABITS
Smoking
1. Do you currently smoke? Yes No
a.) If Yes, what do you smoke? ____________________________________
How many packs a day do you smoke? ______________________________
b.) If No, are you a former smoker? Yes No
If a former smoker, when did you quit (date)? ____/____/____
Alcohol
2. Do you consume (drink) alcohol? Yes No
a.) If Yes, what type of alcohol do you drink (beer, wine, lager)? _________
_____________________________________________________________
How many times a week do you drink? _____________________________
Caffeine
3. Do you consume caffeine? Yes No
a.) If Yes, how (through coffee)? _________
_____________________________________________________________
How many times a day? __________________________________________
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
51
Daily Exercise
4. How many times a week do you exercise? ______________________________
Television Habits
5. How many hours a day do you watch television? ________________________
Reading Habits
6. How many times a week do you read? _________________________________
Sleep Habits
7. How well do you sleep? ___________________________________________
Emotions
8. Please check the emotions that you have experienced now and in the past.
Mood Swings Nervousness
Stress Extreme Worry
Other (please, specify): __________________________
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
52
Illness or Operation
1. Please list all serious illnesses and accidents you have experienced and the year.
Illness or Accident Year of Illness Were you hospitalized?
(Write YES or NO)
CURRENT MEDICATIONS
1. Please list all medicines you are currently taking, both prescription drugs
(medicine with a note from the doctor) and non-prescription drugs (medicine
without a doctor’s note).
__________________ ______________________
__________________ ______________________
__________________ ______________________
__________________ ______________________
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
53
FAMILY HISTORY
1. Please complete the following information about members of your family.
Mother
Father
Brothers
Sisters
Age
(if living)
________
________
________
________
Health
(G=Good;P=Poor)
________
________
________
________
Age at Death
(if deceased)
________
_______
________
________
Cause of Death
(if deceased)
________
________
________
________
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
54
2. Check any conditions that members of your family have had.
Mother
Father
Brothers
Sisters
Cancer
________
________
________
________
Diabetes
________
________
________
________
Heart Disease
________
_______
________
________
High Blood
Pressure
________
________
________
________
Stroke
________
________
________
________
Mental Illness
________
________
________
________
Other
(Specify)
________
________
________
________
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
55
EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee TThhee DDooccttoorr’’ss OOffffiiccee
LLeessssoonn TThhrreeee KKnnoowwiinngg YYoouurr HHeeaalltthh HHiissttoorryy
SS oo uu rr cc ee :: hh tt tt pp :: // // ww ww ww .. 44 11 66 22 00 77 00 22 00 77 .. cc aa // cc ll ii pp aa rr tt // GG rr aa pp hh ii cc 33 99 .. gg ii ff
LLiisstteenniinngg aanndd SSppeeaakkiinngg PPrraacctt iiccee IInntteerrmmeeddiiaattee
Goals for this lesson:
Below are some of the goals of this lesson. Which ones are your
goals too? Check (√) them.
� describe your personal health history
� ask for information about your doctor’s office
� ask questions when you do not understand
� prepare a family health history
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
56
Lesson Three: Knowing Your Health History
Listening and Speaking
Before You Listen!
What do you know about your doctor’s office? Work with your classmates
and your teacher to answer the following questions.
1. What are the busiest days at your doctor’s office?
2. When is the best time to call your doctor’s office?
3. What do you need to do if you have an emergency and your doctor’s
office is closed?
4. Does your doctor’s office have a translator who can help you talk with
your doctor?
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
57
Listening Three - Know Your Doctor’s Office
Ramona is a new patient at Dr. Fuentes’ office. Listen to the telephone
conversation between Ramona and Alex Jones. Alex Jones is the
receptionist who works at the front desk in Dr. Fuentes’ office.
Alex Jones: Hello, Dr. Fuentes’ office, this is Alex Jones speaking.
Ramona: Hello Alex. My name is Ramona Jimenez. I am a new patient at your
office and I have a few questions about my first appointment next week.
Alex Jones: How can I help you?
Ramona: Can I get to your office by bus from Center City?
Alex Jones: Sure, from City Hall you just take the number 42 to Howard Avenue and
we are two blocks from the stop.
Ramona: Excuse me...I did not understand. Could you repeat what you said please?
Alex Jones: Take bus number 42 from the City Hall stop. Do you know where that
is?
Ramona: Yes. That is near my apartment.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
58
Alex Jones: Good. Get on bus number 42 at City Hall and stay on the bus until you
get to Howard Avenue. Our address here is 610 Howard Avenue. We’re about two
blocks from the bus stop.
Ramona: Okay…great. Thanks. Also, what information do I need to bring with me
to my first appointment?
Alex Jones: Dr. Fuentes will need to know about ALL of the medicines you take,
including non-prescription drugs, so bring everything with you to your fist visit,
including eye drops, vitamins, and laxatives.
Ramona: I’m sorry…could you clarify…you want me to bring all of my medicines
with me?
Alex Jones: That’s right. You will also need to bring the phone number of your
regular drug store and the names and addresses of your former doctors. When you are
here, we’ll have you fill out a health history.
Ramona: Ah…okay. If you don’t mind, I have another question.
Alex Jones: Go ahead.
Ramona: When is the best time to call your office? Is there any time when your
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
59
office is not so busy?
Alex Jones: Usually the best time to call is very early in the morning when we open.
Ramona: When is that?
Alex Jones: We open at 8:30 am.
Ramona: And what if I have an emergency when you are not open?
Alex Jones: You call our emergency number: 203-489-0987
Ramona: I’m sorry…could you say the number again more slowly?
Alex Jones: 2-0-3-4-8-9-0-9-8-7
Ramona: Okay…good. Thank you very much for your time.
Alex Jones: Is there anything else?
Ramona: No. That’s all for now. Thanks and see you next week!
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
60
1. Ramona asks several questions about her next visit to the doctor’s
office. Below, write the answer Alex Jones gives to each of Ramona’s
questions. Discuss your work with your classmates and your instructor.
Ramona’s Question Alex’s Answer
Can I get to your office by bus from Center
City?
Also, what information do I need to bring
with me to my first appointment?
When is the best time to call your office? Is
there any time when your office is not so
busy?
And what if I have an emergency when you
are not open?
2. Three different times during the conversation, Ramona has trouble
understanding Alex. Listen to the conversation again. What does Ramona
say when she does not understand Alex? Complete the following sentences
with Ramona’s words:
a) Excuse me...
b) I’m sorry…
c) I’m sorry…
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
61
Talk About It!
Before you begin to talk about the activities, think about your answers to the
following questions.
1. Is there a history of heart disease, hypertension, diabetes, cancer, or
other illness in your family? If yes, what illnesses or conditions?
2. Has anyone in your family ever had surgery? If yes, what kind of
surgery?
3. Do you have any allergies to medication or food?
4. Are you currently taking any medications?
5. What immunizations have you had? What? When?
6. Do you smoke?
7. Do you drink (alcohol)?
8. Do you exercise?
9. How many hours do you sleep each night? Do you have any problems
sleeping?
10. Do you know your normal blood pressure?
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
62
Activity One:
Role-play a visit to the doctor using the questions above. Take turns being
the doctor and the patient.
Activity Two:
Write a story about your family’s health history in the space below. Then,
share your story with your classmates and instructor.
EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
63
EESSLL HHeeaalltthh UUnniitt
UUnniitt OOnnee TThhee DDooccttoorr’’ss OOffffiiccee
LLeessssoonn TThhrreeee KKnnoowwiinngg YYoouurr HHeeaalltthh HHiissttoorryy
RReeaall PPrraacctt iiccee
IInntteerrmmeeddiiaattee
Goals for this lesson:
Below are some of the goals of this lesson. Which ones are your
goals too? Check (√) them.
� describe your personal health history
� ask for information about your doctor’s office
� ask questions when you do not understand
� prepare a family health history
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
64
Lesson Three: Knowing Your Health History
Real Practice!
Before your next doctor’s appointment, prepare a family medical history to
share with your doctor. Going back to your grandparents or great-
grandparents, try to remember or collect details on every family member
who has died and the cause of death. Also, write down the medical
conditions of all family members, including the age at which they were first
diagnosed, their treatment, and if they ever had surgery. Important medical
conditions to document include:
Cancer, heart disease, diabetes, asthma, mental illness, high blood pressure,
stroke, kidney disease, alcoholism, birth defects, learning disabilities, vision
or hearing loss.
For family members with known medical problems, make notes on their
overall health, including if they smoked, were overweight, and their exercise
habits.
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
65
Creating a medical history will not only help you communicate more
effectively with your doctor, but if you have children and grandchildren it
will also help them to get the best health care possible!
For example, use a table like this one to fill in your family medical history:
Activity adapted from information from the Mayo Clinic.
Family
Member
Medical
Conditions
Age
Diagnosed
Treatment Cause of
Death
(If family
member has
died)
ESL Health Unit/Intermediate, Unit One: The Doctor’s Office
66
A Thematic Unit for Intermediate Level ESL Teachers Intermediate, Unit One: The Doctor’s Office
Lesson Two: Describing Pain/Symptoms
Checklist for Learning
Vocabulary Log:
In the space below, write down all of the new words you learned during this lesson that
you want to remember. Try to separate your list of words into nouns (person, place or
thing), adjectives (describing words) and verbs (action words). For extra practice use
them in sentences of your own.
New words I learned during this lesson:
Nouns:
Adjectives:
Verbs:
What can you do?
Below are some of the language goals you worked on during this lesson. Check (√) what
you learned from this lesson. Add more ideas if you wish.
I learned to…
� describe your feelings
� understand a voicemail message
� learn new vocabulary
� describe why you call the doctor
� make an appointment
� ________________________________________________________