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E E S S L L H H e e a a l l t t h h U U n n i i t t U U n n i i t t O O n n e e T T h h e e D D o o c c t t o o r r s s O O f f f f i i c c e e 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

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Page 1: ESL Health Unit - Spring Institute ESL Students [licensed …springinstituteeslstudents.pbworks.com/f/Talk+to+Doctor...ESL Health Unit/Intermediate, Unit One: The Doctor’s Office

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

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ESL Health Unit/Intermediate, Unit One: The Doctor’s Office

2

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.

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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

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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

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5

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

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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?

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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?”

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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

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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.

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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

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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

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Have you called your doctor for any other reasons? List them below:

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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.

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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.

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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.

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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.

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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

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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.

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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

� ________________________________________________________

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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

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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

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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.

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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!”

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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?

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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!”

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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

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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/."

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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

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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.

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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

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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

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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.

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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?

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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?”

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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.

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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!

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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

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Chest

Arm/hand

Abdomen

Foot/leg

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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.

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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?

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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

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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.

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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

� ________________________________________________________

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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

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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: __________________________

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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):______________________

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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? __________________________________________

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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): __________________________

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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).

__________________ ______________________

__________________ ______________________

__________________ ______________________

__________________ ______________________

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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)

________

________

________

________

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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)

________

________

________

________

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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

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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?

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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.

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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

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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!

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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…

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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?

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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

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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

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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.

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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)

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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

� ________________________________________________________