Man vs. Paper Clip

My patient Bob told me his story: “Look, Doc, all I did was bend over to pick up a paper clip. Wham! I was down on the floor, sucking wind. The pain in my lower back was so intense, it brought tears to my eyes. Just breathing caused excruciating pain. I don’t even want to remember what happened when I tried to move. I have had treatment, but I still have some level of pain every day.”

Bob initially had an acute (new) injury—a sprain/strain of his lower back. Now his condition is chronic (ongoing). According to the International Association for the Study of Pain, pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Chronic pain is pain that lasts more than six weeks and is resistant to treatment. It can be physical and/or emotional. Chronic pain can occur in conditions such as colitis, multiple sclerosis, burn injuries, anxiety disorders, arthritis, and diabetes.

Quite often, the patient who comes to my office with chronic pain has seen his or her primary care physician, a physical therapist, a chiropractor, an orthopedist, a massage therapist, and/or an acupuncturist. The patient may be on medications for pain, depression, sleep difficulties, and stomach discomfort (most likely caused by all the other medications). The usual presentation of a chronic pain patient in my office is fifteen to twenty weeks after the initial injury. By this time, the patient is wondering, “What in the world has happened to me? Four months ago, I was in control of my life. Now, I wake up in pain, and I go to sleep in pain.”

Many questions and thoughts run through the mind of someone suffering from chronic pain: Does anyone believe I am in pain? Does anyone even care? No one understands the pain I have. Simple movement kills me. The heat bothers me. The cold bothers me. The rain bothers me. Why doesn’t my spouse understand? Sneezing bothers me. Coughing bothers me. I am depressed. I easily get headaches. I can’t pick up my kids. I can’t toss a ball with my kids. I don’t want to drive or ride in a car. I am tired of taking these medications. My stomach hurts. I have reflux. I get pains in my chest. It hurts to do the laundry, cook, and wash the dishes. I’ll probably be like this for the rest of my life.

Everyone wonders how a small injury can become a chronic injury. Was the condition or injury incorrectly diagnosed? Was the wrong medication prescribed? Did the patient receive improper therapy? Are secondary issues (lawsuits, addiction to medication, etc.) a concern? What did the patient do wrong? What did the doctors or therapists do wrong? The answer is nothing. Everyone did his or her best. The most important question now is, What can a chronic pain patient do to achieve a pain-free life? The patient must take responsibility for his or her own care.

Step 1

Research your problem, and educate yourself on your specific condition. This is not to act as a doctor or to impress the doctor, but to make sure you understand what the doctor is explaining. It is your responsibility to educate yourself.

Step 2

Learn about the traditional branches of medicine such as internal medicine, family medicine, orthopedics, neurology, psychiatry, psychology, osteopathy, physical therapy, and pain management. Learn about alternative or holistic health fields such as chiropractic, acupuncture, massage, homeopathy, and naturopathy. All disciplines and all practitioners are not created equal.

Step 3

Find a multidisciplinary facility. These facilities may combine treatments such as alternative with traditional, traditional with traditional, or alternative with alternative. Usually, the best type of facility provides a cross between traditional and alternative treatments.

Step 4

If you choose a multidisciplinary facility, ask if you can be afforded the opportunity to learn more about the types of care and patient management before you agree to treatment. You want to find out if the doctors truly communicate with each other. Doctors who work together in the same facility don’t necessarily speak with each other. Remember that you want a true team approach. You also want to find out if the facility has treated problems like yours and what the specific outcomes have been. Often, by the time a patient reaches this type of facility, insurance benefits have been exhausted. Therefore it is important to learn all the costs that will be associated with your care at the facility of your choice. Always ask about payment plans.

Step 5

Have all your previous medical records mailed to your new medical team prior to your first visit. This will allow your new doctors ample time to review the records.

Step 6

Keep a typed chronological history of your injury and treatments. Note the doctors’ names, types and durations of treatment, what helped you and what didn’t help. Keep track of all your medications (current and past). Don’t forget to include any vitamins or supplements you may be taking as well. Always share any allergies or sensitivities to medicines. Obtain copies of any special reports such as blood work, MRI scans, CAT scans, ultrasounds, and so on.

Step 7

During your first appointment, tell the doctor everything. Include all your past medical history and current complaints, even those you think do not matter. What seems trivial to you might be very important to your doctor.

Conclusion

Remember, the goal of treatment should be to determine the cause of your pain, then to set out a specific regimen combining the best of both worlds of traditional medicine and alternative treatment to address your individual needs.

In today’s society of failing health insurance and mismanagement of care, you must become responsible for your own health. Health and time are our most precious gifts.

In the words of Johann Wolfgang von Goethe, “Take care of your body with steadfast fidelity. The soul must see through these eyes alone, and if they are dim, the whole world is clouded.”

** This article is one of 101 great articles that were published in 101 Great Ways to Improve Your Health. To get complete details on “101 Great Ways to Improve Your Health”, visit http://selfgrowth.com/healthbook3.html