Chronic pain Support - Doctor Question list

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2004-11-16, 4:29 pm

After waiting about a month, i finally have my first visit with Physical
Medicine tomorrow. I was referred by my primary care doc to there as well as
Physical Therapy, but PT basically released me to wait until i go to PM,
that's been a week.

Already did ibuprophen, relafen, prednisone taper, traction, x-rays, MRI and
now i'm just hanging in there w/vicodin i happened to have on hand from
something else.

All i know is it's a cervical radiculopathy and some form of stenosis in the
cervical spine.

What i want to know is what exact questions should i be asking tomorrow.
I'm confused and ... well.. scared. I've already printed out a list of
symptoms and treatments so far, including medical history, family history and
meds, to give to the doc. But i want to print out a specific list of
questions for me to ask and write down all the answers, as i get confused and
forget what drs tell me sometimes.

I guess the things i need to know are:

what exactly is the stenosis and what could happen w/that in the future?
how can the radiculopathy be treated now?
what about my work (data entry)?
driving? pain meds? exercise?
surgery in the future?
lifestyle changes?
do people get paralyzed or die from this eventually?
how quickly can it progress and how to slow that down?
i guess questioning the cause of it is irrelevant, but what aggravates it?
if there's no "cure", refer me to a support group?

any other ideas as to what i should ask would be appreciated.

Michael S.

2004-11-16, 4:29 pm

In article <1%tkd.92690$bk1.22479@fed1read05>, m@m.commm (ml) wrote:

> After waiting about a month, i finally have my first visit with Physical
> Medicine tomorrow. I was referred by my primary care doc to there as well as
> Physical Therapy, but PT basically released me to wait until i go to PM,
> that's been a week.
>
> Already did ibuprophen, relafen, prednisone taper, traction, x-rays, MRI and
> now i'm just hanging in there w/vicodin i happened to have on hand from
> something else.
>
> All i know is it's a cervical radiculopathy and some form of stenosis in the
> cervical spine.
>
> What i want to know is what exact questions should i be asking tomorrow.
> I'm confused and ... well.. scared. I've already printed out a list of
> symptoms and treatments so far, including medical history, family history and
> meds, to give to the doc. But i want to print out a specific list of
> questions for me to ask and write down all the answers, as i get confused and
> forget what drs tell me sometimes.
>
> I guess the things i need to know are:
>
> what exactly is the stenosis and what could happen w/that in the future?
> how can the radiculopathy be treated now?
> what about my work (data entry)?
> driving? pain meds? exercise?
> surgery in the future?
> lifestyle changes?
> do people get paralyzed or die from this eventually?
> how quickly can it progress and how to slow that down?
> i guess questioning the cause of it is irrelevant, but what aggravates it?
> if there's no "cure", refer me to a support group?
>
> any other ideas as to what i should ask would be appreciated.

Oh, I remember those days of waiting, wondering what was going to
happen, if anything. It's not easy, it can seem scary, but it DOES get
better! You're doing the right thing in preparing for your meeting with
the doc tomorrow.

My questions are:
1. What's "Physical Medicine" -- ? Is this something peculiar to your
insurance or some kind of hospital system?

2. Is there anything like a Pain Management Clinic is this system? If
so, can they refer you there, as well as pursue "physical medicine"
treatment options, just so you can get the pain under control?

3. Depression is also treated by pain clinics, because it comes with
chronic pain, so I'd also ask about that, especially if they DON'T have
a pain clinic in your system. Also, if not, do they plan to treat your
pain, and the resulting depression?

Hang in there! I think if you're well prepared, and have a balanced
attitude of wanting to take charge of your own medical situation, it
will probably go well.

Best,
Michael

2004-11-16, 4:29 pm

In article <Michael_S2-9CA1EE.12005610112004@news.supernews.com>, "Michael S." <Michael_S2@Yahoo-dot-.com> wrote:

>Oh, I remember those days of waiting, wondering what was going to
>happen, if anything. It's not easy, it can seem scary, but it DOES get
>better! You're doing the right thing in preparing for your meeting with
>the doc tomorrow.
>
>My questions are:
>1. What's "Physical Medicine" -- ? Is this something peculiar to your
>insurance or some kind of hospital system?

I have an HMO (Kaiser). This is a separate department from primary care, yet
i never heard of it before this. Apparently it has to do with dealing with
chronic conditions, pain and rehabilitation. Guess maybe that should be my
first question, what *is* this?!

>
>2. Is there anything like a Pain Management Clinic is this system? If
>so, can they refer you there, as well as pursue "physical medicine"
>treatment options, just so you can get the pain under control?

I'm hoping this will be the department for pain management. ?

>
>3. Depression is also treated by pain clinics, because it comes with
>chronic pain, so I'd also ask about that, especially if they DON'T have
>a pain clinic in your system. Also, if not, do they plan to treat your
>pain, and the resulting depression?

I've been in and out of their psych department for a few years due to a
tendency towards depression and anxiety since my hysterectomy in '97.
I've always felt it is too separated from their non-psych departments. Seems
like every little thing gets referred to a separate "specialist" department,
such is the HMO adventure i guess. But at this point i need them on my side,
so i don't want to criticize. I can do that later. :-) Gradually learning
"the system" and how to work with it.

>
>Hang in there! I think if you're well prepared, and have a balanced
>attitude of wanting to take charge of your own medical situation, it
>will probably go well.

Thank you.

IPGrunt

2004-11-16, 4:29 pm

m@m.commm (ml) confessed in news:1%tkd.92690$bk1.22479@fed1read05:

> After waiting about a month, i finally have my first visit with Physical
> Medicine tomorrow. I was referred by my primary care doc to there as
well as
> Physical Therapy, but PT basically released me to wait until i go to PM,
> that's been a week.
>
> Already did ibuprophen, relafen, prednisone taper, traction, x-rays, MRI
and
> now i'm just hanging in there w/vicodin i happened to have on hand from
> something else.
>
> All i know is it's a cervical radiculopathy and some form of stenosis in
the
> cervical spine.
>
> What i want to know is what exact questions should i be asking tomorrow.
> I'm confused and ... well.. scared. I've already printed out a list of
> symptoms and treatments so far, including medical history, family history
and
> meds, to give to the doc. But i want to print out a specific list of
> questions for me to ask and write down all the answers, as i get confused
and
> forget what drs tell me sometimes.
>
> I guess the things i need to know are:
>
> what exactly is the stenosis and what could happen w/that in the future?
> how can the radiculopathy be treated now?
> what about my work (data entry)?
> driving? pain meds? exercise?
> surgery in the future?
> lifestyle changes?
> do people get paralyzed or die from this eventually?
> how quickly can it progress and how to slow that down?
> i guess questioning the cause of it is irrelevant, but what aggravates
it?
> if there's no "cure", refer me to a support group?
>
> any other ideas as to what i should ask would be appreciated.

Hello,

You have done a bit of homework already, and that's a good thing. Really,
it sounds as if you are prepared. Perhaps you might buy an adequate medical
dictionary, but most of that stuff is available online these days.

Basically, think like a doc here. You want to know:

1. diagnosis - what is wrong.
2. etiology - What caused it.
3. prognosis - what's could happen to you.
4. treatment options - what can be done. what will happen if nothing is
done.

You should explore a chronic pain clinic if this option is possible with
your situation. A clinic treats the patient in many ways and can include
physical therapy, medical therapy, psychological counseling, occupational
counseling, and other avenues.

Perhaps primary to your mission is to get things resolved. Be assertive.
Ask questions. Set limits.

Above all, enjoy yourself. You are making positive steps towards a better
life.

-- ipgrunt

old goat

2004-11-16, 4:29 pm

Dear ML,

Michael brought up an excellent point about depression. The descent is
sometimes so subtle that you don't really notice it happening, you just get
bummed out bit by bit. Next thing you know you're at the bottom looking up.
Good idea about the support group, but medications can be a help too.
There's absolutely nothing wrong or abnormal being depressed in a chronic
situation like most of us have. We'd be abnormal if we didn't feel it.
Something others have found helpful, mostly with pain doctors but it could
help here too, is to keep a "pain diary". How bad, when, what you were
doing at the time, what helped, how long it took to help, etc. If it seems
you're having problems in the morning, they may give you a med to take at
bedtime that will still be working when you wake. It can point out things
that you do around the house or during the day that you should avoid. Try
not to just throw a number from 1-10 on how you feel, since everyone can
interpret it differently, try to be descriptive.
It may be a bit late for this appointment, but it may be something for the
next one. Good luck with it. Just be as candid as you can be about what you
feel, your concerns, and what you hope for as an outcome. Ask what kinds of
tests you may be looking at in the future and what they're for. You may
want to ask here afterwards about any tests. Doctors always seem to say
something like "it's a little uncomfortable", and while it may be
uncomfortable for the doctor, it's hell on earth for the patient. Actually,
I found most of the painful ones not too bad as compared to the "regular"
pain, but everyone's different.

Hang in There and Good Luck--og
ml <m@m.commm> wrote in article <1%tkd.92690$bk1.22479@fed1read05>...
> After waiting about a month, i finally have my first visit with Physical
> Medicine tomorrow. I was referred by my primary care doc to there as
well as
> Physical Therapy, but PT basically released me to wait until i go to PM,
> that's been a week.
>
> Already did ibuprophen, relafen, prednisone taper, traction, x-rays, MRI
and
> now i'm just hanging in there w/vicodin i happened to have on hand from
> something else.
>
> All i know is it's a cervical radiculopathy and some form of stenosis in
the
> cervical spine.
>
> What i want to know is what exact questions should i be asking tomorrow.
> I'm confused and ... well.. scared. I've already printed out a list of
> symptoms and treatments so far, including medical history, family history
and
> meds, to give to the doc. But i want to print out a specific list of
> questions for me to ask and write down all the answers, as i get confused
and
> forget what drs tell me sometimes.
>
> I guess the things i need to know are:
>
> what exactly is the stenosis and what could happen w/that in the future?
> how can the radiculopathy be treated now?
> what about my work (data entry)?
> driving? pain meds? exercise?
> surgery in the future?
> lifestyle changes?
> do people get paralyzed or die from this eventually?
> how quickly can it progress and how to slow that down?
> i guess questioning the cause of it is irrelevant, but what aggravates
it?
> if there's no "cure", refer me to a support group?
>
> any other ideas as to what i should ask would be appreciated.
>

Gigglz

2004-11-16, 4:29 pm

On Wed, 10 Nov 2004 19:29:19 GMT, m@m.commm (ml) wrote:

>After waiting about a month, i finally have my first visit with Physical
>Medicine tomorrow. I was referred by my primary care doc to there as well as
>Physical Therapy, but PT basically released me to wait until i go to PM,
>that's been a week.
>
>Already did ibuprophen, relafen, prednisone taper, traction, x-rays, MRI and
>now i'm just hanging in there w/vicodin i happened to have on hand from
>something else.
>
>All i know is it's a cervical radiculopathy and some form of stenosis in the
>cervical spine.
>
>What i want to know is what exact questions should i be asking tomorrow.
>I'm confused and ... well.. scared. I've already printed out a list of
>symptoms and treatments so far, including medical history, family history and
>meds, to give to the doc. But i want to print out a specific list of
>questions for me to ask and write down all the answers, as i get confused and
>forget what drs tell me sometimes.
>
>I guess the things i need to know are:
>
>what exactly is the stenosis and what could happen w/that in the future?
>how can the radiculopathy be treated now?
>what about my work (data entry)?
>driving? pain meds? exercise?
>surgery in the future?
>lifestyle changes?
>do people get paralyzed or die from this eventually?
>how quickly can it progress and how to slow that down?
>i guess questioning the cause of it is irrelevant, but what aggravates it?
>if there's no "cure", refer me to a support group?
>
>any other ideas as to what i should ask would be appreciated.

I think you will be amazed at how wonderful it is to have a physical
medicine doctor! All those questions you posted, he/she will answer.
I do not know what a "radiculopathy" is, but I do have the stenosis.
Don't be scared, because you have nothing to fear from a good physical
medicine doctor...this is their specialty. I'm sorry I've been out of
touch with you. I haven't been on line much. Please let me know how
things go for you. Feel free to email me, as I haven't been reading
the group often lately. I wish you well!!!!

Hugs,
Nada

Kath

2004-11-16, 4:29 pm

ml wrote:
<snipped>
> I guess the things i need to know are:
>
> what exactly is the stenosis and what could happen w/that in the
> future?
> how can the radiculopathy be treated now?
> what about my work (data entry)?
> driving? pain meds? exercise?
> surgery in the future?
> lifestyle changes?
> do people get paralyzed or die from this eventually?
> how quickly can it progress and how to slow that down?
> i guess questioning the cause of it is irrelevant, but what
> aggravates it? if there's no "cure", refer me to a support group?
>
> any other ideas as to what i should ask would be appreciated.

Well by writing down the questions, and being prepared to write down the
answers means you're half way there already! There's nothing worse than
coming out of an appointment and realising you've forgotten to ask
something, or can't remember an answer they gave you.

It also means you've thought hard about things before going to the
appointment, which should give you brownie points with the doctor.

--
Katharine
Study reveals that studies reveal nothing.

2004-11-16, 4:29 pm

Thanks, everyone, for the input.
I'll let you know how things turn out.