Monday, June 22, 2009

Making Your Pain Doctor A Partner

I saw my Pain Management Doctor last week. It is time for a medication change due to my ever-increasing pain. I don't take medication changes lightly; the process can be particularly non-pleasant at times, depending on what you are doing with the change. This decision has been awhile coming, right alongside the pain that just keeps coming. My choices are few. I need a partner to help me with this.


Enter the kindest, most professional, (without being like a robot), empathetic, with an 'I want so much to know what you feel when you tell me of your pain' look in the eyes; Pain Management Doctor. It was time to get down to business as we began. We consistently have a nice time together; we talk well. You know 'those' kinds of doctors?? I was married to one, {gasp} and feel that he is such a kind, caring, thorough and empathetic doctor, whose patients just adore him. We'd get the most wonderful gifts at Christmastime; mmmm fresh Persimmon cookies from one lovely patient--every year like clockwork, I was faced with a huge tin of the best cookies I have ever tasted, and what is a girl supposed to do?? Admire them? Ahhh NO, I made great use of them!! Point is that doctors whom patients can talk to, and feel deeply heard by, is the key to the successful partnership of the doctor-patient relationship.


My doctor and I worked together to come up with what to do as far as what medication to change, and when we figured out which one, it was up to me in the end as what to do. This is the #1 most important attribute that we, as pain patients, simply must have with our doctors. The ability to work together on any part of our pain management care.


When you visit your pain management doctor, the feeling in the room is ultimately that of teamwork. Talk together. Figure out what you are trying to accomplish first and foremost during that visit. Remember, come prepared!! Help your doctor out a bit too. I brought my daily medication log, jotted down the monthly 'total' of how my pain had done over the time since I last saw my doctor, and that helped so much in my visit.


I spoke with my doctor about feeling that deep pain the most when I stand up, and that I felt as if I would benefit from 2 rods in my back, long enough to cover 12 levels, (all the Thoracic vertebrae), and he said, "You feel unstable in your spine?" Yes!! That was perfect! The word described exactly how I feel in my spine. And it's a great medical term to put down in my chart.


It is through our talking, getting to pinpoint exactly what we are there to do: Accomplish solving a problem. And for that, we all need ourselves and another person who will talk openly, honestly, seriously, and with an attitude of doing it together.


I could never do this myself. I know what to use, how to take it and how to titrate up or down. Nursing and years of pain have taught me this. Options for complete medication change are not many in the pain arena. Then there is the how to change it when things need to be altered. I knew the options available to me, and therefore, had been considering them days before the doctor visit. This made the decision simpler, faster, and more of a feeling of unity when my doctor totally agreed at what I chose to do.


My spine feels unstable. Great word doc! Today is one of those days when the pain is constant, unrelenting, deep, with neuropathy (**nerve pain), and severe muscle spasms. My back has gone through a real workout, and the paraspinal muselces, (**the muscles that run along your spine in the vertical position) are now extremely tight. When I stand up, my back says, "I don't want to be in this position." I am compacting my spine, yet laying down is not an option. I must SIT, and always against heat. Yes, yes, I've tried heat for 20 minutes and cold for 20. That was more effective when I was recovering from a surgery. But now I speak of what works for pain that lasts all day sometimes, with no relief, such as today has been. The cold and hot are long gone as I have found that heat is the only relief, modality-wise. (Modality--**A method of application or the employment of any therapeutic agent.)


In an office visit, we are all aware that time is, and always will be an issue. In any medical exchange. Yet there are time issues with those on the phone, your appointment to have taxes done, your haircut; oh it would be nice to have the person you are working with spend as much time with you as you'd choose; but we all know it just doesn't work that way!


Ergo, (wow I really don't like that word, but it is a good one!), why I make the most out of the time with my Pain Doc, by bringing daily notes and things that jog my memory. The relationship with your doctor needs to be one of openness, almost like one you'd have with a psychologist. The doctor needs to know everything you feel, every medication you are taking, if anything as in a fall or accident has happened, and just to cover everything that could have precluded the increasing pain. This needs to be talked about with precision and knowledge, as serious decisions are involved.


This is your partnership. This is your LIFE! Work on having a close, open, honest, respectful relationship with your Pain Management Doctor. Above all, work on your own side of this partnership, by keeping a pain journal, pain log, whatever works for you. Be kind to yourself, respect your doctor just as she/he respects you as a person, and I wish you the best of care for your pain.


It takes two!!



Gentle Hugs... <3

Thursday, June 11, 2009

June's Change of Shift Is Up!

June's Change of Shift is up over at Florence dot com, and I am grateful to be included in Barbara Olson's wonderful (and innovative!) hosting this monthly Carnival.

There is some awesome reading to be done with her choices of posts/blogs. I'm looking forward to this!

If you are not familiar with 'Change of Shift', it is a gathering of Nursing, Medical, and Patient blogs that give great information to the public, not just to other Health Care Professionals.

Please stop by Babara's site!!


Gentle Hugs... <3