First . . I am not under the care of a pain management physician or pain clinic. I may not have a comparable experience of disheartening physician inattention as you (and others) write about
Second . . . My health issues are complex and not amenable to improvement or betterment. My appointments rarely/never broach discussing options to find a “fix” or cure. Easing of distressing symptoms (nausea, pain, low blood pressure) is at the centerpiece of my medical care.
The 1/2 page to 1 page synopsis serves as a starting point for the appointment and, most importantly, serves as a guide throughout the appointment to keep physician-patient conversation focused on issues that are of Top Priority to me.
I identify 2-3 most concerning issues that I am experiencing currently. Top Prioroty concerns or issues.
I mention what I am doing on my own to ease the issues/concerns identified (example: holistic and over the counter medications and supplements; diet modifications; exercise, stretching regimens; mindfulness).
I explain how the presenting problem(s) impacts me in the course of a day.
There is a wonderful functional pain scale that is available on line that is helpful in translating to physicians and others how pain is life-altering. It is called the “Ability Scale.” It has 8 different daily activities (ex. Getting out of bed, climbing a flight of stairs) with a pictorial schematic where you then circle the degree of difficulty you experience in accomplishing each task. I complete this survey every 3 months. It serves as a helpful way of communicating how I am fairing in the moment as well as a providing a comparative historical history over time.
I will need to research where I first located the “Ability Scale” and report back as to where to find it on the internet.
I often will offer my own ideas and suggestions, based on research and known best practices, and my rationale for offering the idea or suggestion. Stretching to offer ideas on treatment may not be an option for everyone. I do have the benefit of a long-established relationship with most of my providers. Often I will paraphrase an idea by stating . . . “Are you
open to considering ________ (fill in the blank)?
As I mentioned in the earlier post above . . .
I give one copy of the 1/2 page to 1 page narrative to the physician at the start of the appointment as he/she enters the door. They have come to expect that I will come prepared with an agenda and appreciate the organization it provides to our conversation. The office staff scans the page into my electronic medical record. They become part of my complete medical record.
I keep a second copy for myself and use it to refer to during the appointment. I take notes to what is said and discussed. I keep a copy of each in a 3 ring binder.
I use this technique with each of my providers. A typed 1 page narrative that bullet points my 2-3 most pressing or primary concerns. My providers are Palliative Care, endocrinology, and rheumatology. Palliative Care provides benefit of ensuring communication between my providers. I recognize that communication lapses between different specialists is a real obstacle for most patients.
Creating a thoughtful agenda really makes a physician appointment far less stressful. It also gives you, as the patient, a way to make sure that the appointment serves your needs (and not the agenda of the physician). Most importantly, creating a thoughtful agenda helps even the power balance between you, as the patient, and the attending physician. It can be quite empowering.
Pituitary failure, wide-spread endocrine dysfunction
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)
Post Edited ((Seashell)) : 11/27/2018 6:29:30 PM (GMT-7)