What to say in the first sixty seconds.

The first minute of an appointment does more work than the twelve after it. Whatever you say first becomes the frame, and everything else gets read against it.

That is not a criticism of anyone. It is how people listen when they are short of time.

Lead with what changed

Not how you are in general. What is different since last time. "The tiredness is worse in the mornings now" is a sentence a clinician can act on. "I have been alright" is not, even when it is true.

Say when it started

A symptom with a date attached is a different object from a symptom without one. "Since the Tuesday after the last cycle" tells your team where to look. "For a while now" does not.

This is the single hardest thing to do from memory, and it is the main reason to write things down as they happen rather than the night before.

Name the thing you want back

Most people describe symptoms. Very few describe what they want to be able to do again. A dose is a number, and it is hard to argue about. Getting back to walking the dog by September is a goal your team can aim at, and it changes what they suggest.

Then let them lead

You have set the frame. Sixty seconds is enough. The rest of the appointment works better because the first minute was spent on the three things only you know.