How to Get the Most Effective Visit for Your Pain

June 21, 2009 | Filed Under: Tips | Comments(0)


1. Prepare – get informed as you would about anything else that’s new to you. Get answers to core questions. I have several types of media here – posts, audios and videos – that can help you make effective decisions if you have a chronic pain condition and, if so, how to get the most effective treatment according to state-of-the-art research. A good deal of that media is free while some of the audios and most of the videos of me addressing specific treatment issues carry a nominal fee that helps us maintain the site. I also provide a limited number of personal consults to those who believe that will help them too. However most visitors get the treatment guidance they need to begin to, first, connect with the right type of treating physician for the right pain meds and, second, start the behavioral and lifestyle changes you personally will have to make to rehabilitate your ability to function and return to work as soon as possible, learn to self-manage the conditions needed to maintain yourself functional over the long term, and to begin to reduce pain in a stable manner and maintain it over the long term. If it hasn’t come across yet, let me state it clearly: This is a working chronic pain specialty site for patients who are willing to work to restore their functionality, using the same effective approach that I would offer you, as a credentialed pain specialist with years of experience and randomized controlled trial data to support the effectiveness of my approach, in a  regular face-to-face office visit.

2. If you need venting – about how terrible your pain is, or how terribly doctors have treated you up to now, or about how the government should be doing something about the terrible treatment pain patients are getting – there are many “chronic pain support groups” on the Internet under that title where you can do just that. Here, if you vent briefly and get to making a “pain point,” or asking a specific question about chronic pain, your comment gets posted. If it’s just venting, likelihood is your comment won’t get posted. And if it’s not posted, all it means is that it’s probably time to switch from venting to working practically towards gaining control of the life conditions and behavior associated with your pain’s occurrence. So, if after venting a bit, you’ve decided you’re ready to work, come back, we’d love to have you and your practical observations

Don’t forget I’m a survivor of chronic non-cancer pain, and today I’m functioning better than I  was when I was half my age. However, I follow my own program fanatically, and that keeps me from having pain. So when I speak about pain I speak not as an academic but as a survivor. If I recommend anything it will invariably be because I have seen evidence that the approach actually deliveres increased functionality.

3. Prepare your own case. Prepare it as if you were going to Court. You’re here to work, so do me and others who are here to work with and for you, the courtesy of reviewing your case and understanding the “objective findings” behind your pain. Make a medications chart. For that, get all the bottles of prescription medication you’ve taken for pain since you started having moderate to severe pain (5+ on a 10-point scale, where 10 is the worst pain). All of us metabolize chemicals differently, so your response to medication is unique and we need to know how. Make 3 columns: Helped Noticeably, Didn’t Help, Not Sure. Put each drug in its respective column. Next gather all your Operative Reports, if you’ve had surgery and put them in one folder. Do the same with all your imaging studies (MRIs, C-scans, X-rays). Do the same with any other special procedures, like Nerve Conduction Studies, or any other diagnostic procedure, as well as all recent laboratory results. Also prepare a list of any Family or Personal History of any chronic, inflammatory or congenital disease. Finally, make a timeline, starting with the earliest possible date, detailing when, where and what happened and how, of all broken bones, motor vehicle, sport or industrial injuries, lengthy exercise routines and finally all surgeries. Now you know, and I will be able to get an accurate picture, of who you are as a pain patient, and why.

4. Practice being brief and focused on pain issues and successes. It’s tough to work at building something that helps you succeed royally at something important to you. I call it “going for the gold.” It’s like the training Olympic champions engage in. They’re focused and focused on success rather than failure. Here there’s no such thing as “learning by trial and error.” There’s no such learning technically. The way it really works is “learning by trial and success.” So, here you’ll hear very few negatives, and even less focus on how doctors and patients failed, but on the small, positive steps taken by doctors and patients in succeeding, if only in tiny steps. I really want to hear about successes you’ve had in controlling the conditions of your pain’s occurrence on a daily basis. I don’t want to know how many times last week you had pain, nor do your fellow pain patients. We will want to know everything you have to say about how many times last week you didn’t have pain, and why and how you did it.

In short, the entire site, including me, is aimed at helping you learn how to attain optimal self management of the conditions of your pain’s occurrence in your own life situation. Why? Because there is no healthcare “system.” There never was and there is none now. A “system” requires management, and there’s been no evidence for half a century of any control over the nation’s healthcare expenditures. The numbers speak; no evidence of control means no evidence of “system.” And the government’s passive role:  to simply monitor the numbers, as they go up, and up and up. So all patients are really on their own, and the more you’re in  personal control, the better. That’s at least proof of a “system.”  So, join me, and people with pain with the mindset that I’ve just laid out for your consideration, and  start your fascinating road back to optimal restored functionality, return to work, less pain, decreased dependence on medical services, and personal empowerment. Welcome.

Dr. Henry Adams, AAPM Diplomate in Pain Management