Pain adjectives. Can you rate them?

In English we have many adjectives for pain including stabbing (bıçaklama), terrible,
slight (hafif), shooting (ateş etme)…
Some adjectives describe the intensity of the pain while other adjectives describe the
frequency of the pain.
It is important to be familiar with pain adjectives patients typically use as well as the
information the adjective gives you about how the pain makes them feel.
Example of pain rating (1 is the most painful, 5 is the least
painful)
dull – 5 (Donuk)
burning – 2
excruciating – 1 (Dayanılmaz)
nagging – 4 (Dırdır)
throbbing – 3 (Zonklama)

Show up: Ortaya çıkmak

Pick up: Almak

Reporting verbs are a simple but effective way of improving your sentences. Not
only does it prevent your writing from becoming repetitive and boring, it can also
help you better interpret what the writer or speaker is saying.
You can usually replace ‘said’ with a far more descriptive verb which gives the reader
or listener information about how the speaker was feeling at the time.
Good alternatives for the referral letter are: complained, mentioned, stated,
demanded, explained etc.
Example sentences:
‘ Sally complained she had been kept waiting for more than
1 hour.’
‘ James’ mother mentioned he is not sleeping as well as
normally’
Practice task:
Take a look at the sentences below and use a reporting verb to replace ‘said’.
 ‘Frank said the music in the waiting room was too loud.’54trfd7
 ‘Priya said that the medicine needs to be stored at 36-degrees Celcius.’

Demand: Talep etmek

This week’s post is going to tackle a word that causes many of you problems and it
all comes down to your choice of 1 single letter: is it ‘s’ or ‘c’ that you want? Many of
you are aware that the word has 2 forms noun and verb – but it is knowing which
one you need in the sentence you are forming – is it advice or advise?
Advice

Let’s focus on advice the noun first of all. Advice is similar to information, which we
give to patients about their health. Advice is also like information in that it is
uncountable. Please do not write or say: ‘Zoe’s mother was given advices’, as it just
makes your reader or listener feel a bit queasy. Generally speaking you can use it in
its uncountable form:
‘Can I give you advice?’
However, if you want to specify how much advice you are going to provide then, like
information (or cake if this gives you a good visual to remember), you can add a
number + pieces:
‘I want to give you 3 pieces of advice.’
Less specific? just add ‘some’:
‘Mrs James mentioned the doctor had given her some advice
about lowering her blood pressure.’
When using advice the noun, you need to use the right words before and after it. So,
as you have seen from the examples, we ‘give’ someone advice but we don’t ‘make’
or ‘have’ advice. We can ‘take’ advice, which has the meaning of asking a medical
professional for help about a problem e.g.
‘The physiotherapist recommended the patient take advice
from a knee surgeon before making a final decision about
surgery.’
In your writing task, you are likely to use it in a passive statement such as:
‘the patient was given advice to avoid heavy lifting for 1
week.‘
In this type of statement, an infinitive verb follows advice to detail what the advice is.
Having difficulties using advice or advise is not restricted to writing. It also causes
problems with its different pronunciation: advice is pronounced with an /s/ sound
and sounds just like ‘ice’ while advise is pronounced with a /z/ sound and sounds like
the ‘s’ in realise.
Advise
So, advise the verb. Advise is the action of providing information (advice) to patients:
‘I strongly advise you to reduce the number of cigarettes you
smoke every day.’
As with this example, you can add adverbs in front of advise to emphasise your
meaning. Other adverbs that collocate include: definitely, seriously, generally and
specifically.
Advise can have a number of options after it. In the last paragraph was an example
when advise is followed by a pronoun but it can also be followed by: an adjective-
noun combination:
‘Physiotherapists advise regular exercise is the best way to
regain mobility’;
a gerund:
‘I don’t advise eating soft cheeses during pregnancy’
or that:
‘Mr Stevens was advised that his recovery would depend on
his compliance with his prescribed medication.’
(We can omit the ‘that’ in informal speaking and writing).
Try it out
So, it’s over to you now. I have advised you of a few of the rules and you need to try
to put this advice into practice. The main thing to remember is whether you are
trying to communicate advice as a kind of information in which case you need the
noun or advise as a kind of spoken action in which case you need the verb.

Dizzy  is an  adjective  that patients use when they  feel unsteady
on their feet.
Sometimes it can lead to the patient fainting (losing consciousness). It could be
related to problems with the inner-ear, which can affect balance, or caused by a
migraine or even hunger. It’s also a symptom of drinking too much alcohol. These
are all things to consider when taking a patient history.
 My mother has been having a few dizzy spells in the last month
In this example, dizzy is used with spells which is an informal expression for an
episode of something. The son or daughter is explaining that their mother has had
more than one episode of feeling dizzy in the last month.

When explaining the reason for an action or event use the

infinitive form.

A common mistake is using ‘for +ing’ but the infinitive is the correct way to give the
explanation.
TRUE:   Mrs Wu requested crutches to help her mobilise after
the surgery.
FALSE:  Mrs Wu requested crutches for helping her mobilise
after the surgery.
Mr Sanchez believes he caught a cold from working outside on the weekend.

Catch is a common informal verb patients may use to explain how they developed conditions such as
a cold, the flu or viruses.

It can only be used for illnesses that are contagious.

To go down with is also a common way of saying the same thing:

Sarah went down with the flu last week.

Do you know the formal verb equivalent for catch which healthcare professionals might use when
communicating with each other?

Mr Jackson’s wife, Jessica,  was shown how to change the

dressing on the wound site.
When introducing the name of a family member or other person into your letter,
separate their name from their relationship to the patient by commas before and
after.
Mr and Mrs Vu,  Mr  Nguyen’s son and daughter-in-law,  will
collect him from hospital on the day of discharge.
It’s also possible to introduce the family member(s) first and then the relationship to
the patient (in this example, Mr Nguyen). In the same way as te first example,
commas again separate the name(s) from their relationship to the patient.

1. Kings Cross ER. Set in one of Sydney’s busiest hospitals. This series focuses on
the emergency department and the treatment provided to patients from life-
saving surgery to treating multiple stab wounds. 2.  Embarrassing Bodies. A
team of British doctors talk to patients with problems they believe to be too
embarrassing to discuss with their regular GP and provide them with advice
and treatment. At the same time they remove the embarrassment by proving
all bodies are the same. 3. One born every minute. Set in maternity wards
 around the UK. This series focuses on the different staff who assist parents-
to-be during labour and birth while celebrating the moment a new child
enters the world. 4. Outback ER. Set in one of Australia’s remotest hospitals,
the staff in this series never know what to expect from one day to the next.
5. Hospital. This series looks at some of the challenges facing the healthcare
system in the UK, the NHS [National Health Service]

Tips for while you listen

While watching these programmes, these are 5 tips of things to do at the same time:
 Listen to the language used by the medical professional to start the conversation with the
patient.
 Listen for the responses the medical professional uses to answer questions or comments
made by the patient.
 Listen to how the tone, speed, intonation and language choices change for different
medical situations and for different types of patient e.g. emergency/routine, old/young
 Listen for the language used by the medical professional to explain, reassure and persuade
 Listen for the language used by the medical professional to communicate with patients
who are emotional e.g. angry, confused, frustrated, scared.
Note down examples of this language and then try it out in your own
communication as soon as you can to make your English sound more natural and
improve your range of language choices.

Miss Richardson has been in labour for last night.

The use of ‘for’ and since’ is something which confuses many students of English.

In the examples above, they have been used incorrectly.

For is used to say how long something has been happening for:
for 10 years, for some time, for 15 minutes, for a while.
Since is used to say when something started: since last night,
since 2005, since birth, since last week, since arriving in
Australia.

Match up these common medical verb/noun phrase

collocations
take  someone’s blood pressure
make            a complete recovery
have                      an allergy to something                   
give                       advice to someone
see                         some improvement

It’s important to use collocations correctly as using the wrong combination will be
really obvious to your listener. It can be hard to re-learn incorrect combinations you
have been using for a long time but it will be a noticeable improvement to make.

Odd is an informal word to mean occasional or now and again.

– My knee gives me the odd problem, but mostly it’s fine
It is completely different to odd when the meaning is ‘strange’ or ‘unusual’ so it’s
really important to understand from the context which ‘odd’ the patient means.
One way to tell it apart is that odd meaning occasional often comes in this structure:
the odd (noun) e.g. pain, problem, difficulty.
Odd when the meaning is strange on the other hand often comes in this structure:
a/an odd (noun) discharge, lump, feeling.

If a patient were to say this to you,  would you know what they

would be looking for?
Specs or spectacles, to use the full word, is another word for glasses and may be
used in an informal way by patients such as in the sentence above.
You might also hear a patient referring to them in a Listening Part A task e.g.
I’ve come in for you to check my eyes. My specs are giving me a
headache.

Using vocabulary appropriately

As healthcare professionals, you need to be able to ‘translate’ your vocabulary up
and down. What I mean is you need to understand what the patient is saying in non-
medical terms and translate this up when communicating this information to a
colleague (for example when writing). You also need to be able to translate down
medical terms to explain them in words a patient will understand.
Let’s look at a few examples:
A patient, Mrs X, says to you:
“I can’t always get to the toilet in time.”
In a letter or when reporting this to a colleague you might translate this up to:
“Mrs X is having problems with incontinence.”
On the other hand, you need to tell the mother of Dan this information:
“Dan needs to have a tonsillectomy”.
When speaking to Dan’s mother, you would translate this down to:
“Dan needs to have his tonsils out”
or
“Dan needs to have an operation to remove his tonsils.”
Why this is important
This is important when it comes to recording and learning new vocabulary. If you
come across a new medical term, it’s important to stop and think, what’s the
alternative I would use with a patient? And vice versa. So, for example, a couple of
weeks ago our word of the week was ‘catch’. Patients often use ‘catch’ to explain that
they have picked up a viral infection such as flu or a cold. When recording this, it will
be important to note that this word is an irregular, informal verb. Writing down an
example sentence will remind you how to use it. It is also important though to
record the formal equivalent of ‘catch’ which you are more likely to hear from
colleagues: ‘contract’.
‘Contract’ is a really interesting example. Many second language learners know it in
its noun form to mean the document you sign when you start a new job. However,
they are unfamiliar with its formal medical verb form. They are also usually unaware
that the noun and verb forms are pronounced differently. Contract the noun is
pronounced ‘contract (the stress on the first syllable) while contract the verb is
pronounced con’tract (the stress on the second syllable). And so the segment of my
lessons on vocabulary would go!
Show the OET Assessors what vocabulary you know
Assessors also love vocabulary. Demonstrating a range of appropriate vocabulary in
your writing and speaking will make you stand out from other candidates and
impress your assessors. Healthcare has a lot of its own specialist vocabulary. I don’t
just mean technical terms but also verbs, nouns, adjectives, phrasal verbs which are
well-known by patients. Using this healthcare vocabulary in the right place at the
right time will demonstrate a level of mastery in test and real-life situations.

In English, with ‘explain’ we use ‘to you’. Think of it as a gift of information, we give

gifts TO people. It is the same for ‘talk and speak’ but not for ‘tell or say’.
Here are some more correct examples:
I’ve explained the sugery to your mother.
Can I speak to you about your concerns?
I will explain all the options to you before you make a decision.
In the first and last examples you can see that we can put what we are explaining
between the verb and the person we are explaining it to:
I think the nurse has explained the need for resting your
leg to you.
– She had an attack of hay fever and was sneezing non-stop
Attack is used as a synonym of ‘episode’. It is commonly used with chronic conditions
such as asthma, hayfever, angina etc.
As patients can have many repeated attacks in their lifetime, it is a countable noun.

Brackets can be replaced with commas for a more formal

writing style.
Here is how the example in the image above can use commas instead of brackets:
Mr Ferguson is prescribed metformin, a 2mg tablet taken in the
morning, and lactulose, 50mg of syrup, taken after lunch.
Some students would put the doses of the 2 medications in brackets but, in general,
brackets should be avoided in formal writing.
Commas work well here to separate the dose from the name of the medication.
Here’s another example:
Please monitor Mrs Walker’s compliance with her medication.
She is prescribed warfarin, 1 tablet to be taken in the morning, and
Ventolin, to be taken as required.
Commas have many uses:
 to introduce the patient’s family members in your letter.

Relationship statuses: single, engaged, married, separated, divorced, widowed are

described with the present simple.
It is a fact of a person’s current state even if the event such as the marriage or
divorce happened some time in the past.
Many students make the mistake of using the past simple such as in the example
sentence above.
While the mistake is understandable, it identifies the writer as a non-native speaker
and is an easy one to correct.
I am single.
Mrs Singh is divorced.
Mr Sofia is married.
If it is important to say how long this has been their state, then use the present
perfect to show that the state started in the past and is still in progress:
I have been single since 2010.
Mrs Singh has been married for 40 years.
Under is a very basic word but this question during a
conversation with a patient prior to surgery might make you
confused.
The patient is actually referring to the level of anaesthesia they will receive during
the procedure.
In the past, the majority of operations were completed under general anaesthetic.
This meant the patient would be ‘asleep’ or unconscious throughout.
To answer the question, you would need to know which type of anaesthesia will be
used. If it is general anaesthetic, then you can answer yes. If it is local anaesthetic
you will need to answer no and explain that this type of procedure only requires
local anaesthetic.
It might lead into a discussion about why this is the case, so it will be good to have
some ideas ready.

Splitting :

This adjective is used to describe pain in one specific location: the head.
It is an extreme pain closer on the scale to 10 than 0, when 10 is
the most painful.
It does not have to mean a migraine but a severe headache which makes the
sufferer feels like their head is splitting open.

Direct empathy
Sometimes, you can literally put yourself in someone else’s shoes because you have
experienced the same thing. For example, a midwife who is also a mother can put
herself in an expectant mother’s shoes because she has experienced pregnancy.
Another example could be a physiotherapist treating a patient with tennis elbow
having experienced tennis elbow themselves.
In this case, you can use direct language to show empathy:
 I understand your concerns about choosing whether to opt for pain relief during labour. I
faced the same decision myself before I was due to give birth.
Or:
 In my experience, the best relief for the symptoms of tennis elbow is complete rest from
the action which caused the injury in the first place.
Indirect empathy
Sometimes though, you can’t so easily imagine what it must be like to be in that
person’s shoes because you have not experienced it for yourself. You might have
treated other patients with similar conditions and prognoses but it’s not the same as
having the experience personally. For example, a doctor who needs to tell a family
that they have not been able to save the life of a family member involved in a car
accident. Or a dentist treating a homeless person with a large number of rotten
teeth.
These situations, therefore, require different more indirect language to show
empathy:
 I can’t begin to imagine how you are feeling to receive this news. Please know we did
everything we possibly could to save your family member.
Or:
 I can only appreciate it must be a low priority for you to care for your teeth when you are
homeless. Before you leave, I will give you a toothbrush and toothpaste to keep you going
for a while.
It can be a small difference such as the replacement of ‘understand’ with
‘appreciate’. Understand suggests knowledge of something while appreciate is
simply awareness that something is possible.
Making patients feel important
It is human nature that we like to feel that our problem is unique to us. Being
spoken to like we are just one of a crowd has the impact of making us feel
insignificant and unimportant. Choosing the right empathetic phrase can avoid this
for your patient.
For more information about OET’s Speaking sub-test, work your wat through
the resources on the Preparation Portal.

Appreciate can be a good alternative to ‘understand’.

When speaking to patients, if you have no direct experience of what they are facing,
it is not very appropriate to say ‘I understand you’. Instead you can use ‘appreciate’
to suggest you can imagine what it must be like even if you don’t know exactly.
Swapping ‘appreciate’ for ‘understand’, can mean a lot to the patient. These little
changes can make them feel you are really listening to their concerns and trying to
help them.

The past perfect is useful for putting past events in order.

You are most likely to use it in your letter to explain previous medical or social
history.
When describing two events which are both in the past compared to the time of
speaking or writing, then the event furthest in the past is described using the past
perfect. The event more recently in the past is described using simple past.
To form the past perfect you use had + past participle
Stephanie had told her mother she felt sick the morning she
fainted.
Mrs Le had taken the medication as prescribed but it did not
alleviate her pain.

“Admitted” is a very common medical verb that explains a

patient will need to stay in hospital!
However, the meaning of the sentence will change depending on the preposition
that comes with it. This is because prepositions can change the relationship between
nouns or a noun and a pronoun.
Can you match up the correct start and end of the phrases using ‘admitted’? Have a
go and let us know on our Facebook page how you went:
Preposition Language Quiz!
admitted with   symptoms   
admitted for       surgery
admitted after    an accident
admitted to        hospital
admitted in         pain
admitted by       the doctor in charge
admitted on       Tuesday

In the UK, ‘sick’  describes the action of vomiting.

Americans and Australians would say, in the same situation,:

‘I’ve vomited every morning this week.’
This is another example of how English is used differently in English speaking
countries.
Americans use ‘sick’ to explain the way they are feeling.
For this meaning, British English speakers would say ‘ill’ or ‘unwell’.
Australians, on the other hand might say ‘crook’.
Isn’t it confusing!
Here are 3 examples to help:
American. Jacquie has phoned in sick. She has a bad cold.
British. Jacquie is unwell today. She has a bad cold.
Australian. Jacquie is crook. She has a bad cold.
Can you think of other ways of saying someone is sick, unwell or crook? There are
lots of alternatives.