Pain management and medical treatment

3 Nov

In the past eleven months, I’ve learned more about pain management than I ever wanted to know.  One of the best lessons I have learned, however, has been about the TENS unit.

Like most people, I had never paid much attention to TENS units, although I knew they existed and were used sometimes for treatment of various kinds of nerve/muscle issues.  They weren’t my issues, and I gave it no more thought.

In the course of treating my shoulder injury, I was introduced to one as the result of a prescription for it, specifically for pain management.  Managing pain is important as part of the overall picture of one’s quality of life–when you are in pain, everything else is worse.  With pain relief, everything else becomes much more manageable too.

I’m not sure how it works.  It was set up by my physical therapist, and that’s all I knew other than I was to use it twice a day for the twenty minutes it was programmed to run.  Since then, I have learned a lot.

It is a drug free treatment, which means I’m not worried about being impaired either in terms of mental or motor control.  It is non-addictive, which means I’m not worried about an addiction to a TENS unit.  It does not seem to have any side effects, at least at the strength I’m using it at, so I’m not dealing with any additional issues, unlike medications.  I can’t overdose with it, so I’m not worried about the clock in regards to using it.  There are no interaction issues, so I can use it in conjunction with the medications without worries there.  There is no waiting for it to go into effect either, unlike medication.  I can apply the pads, plug them in, turn on the machine, and almost instantly have some relief.

In short, the TENS machine is a huge asset for me in terms of pain relief.  Without it, I would probably require at least twice as much pain medication.  My perception of how it works may be entirely wrong, but to me, it is as though it irritates the muscles and nerves to the point of exhaustion with tiny trickles of electrical impulses, forcing them to stop sending pain messages AND micro-sized muscle cramping, at least surface micro muscle cramps.  (Deep ones still seem to occur, but with a lower frequency.)  I don’t know if it is such a miracle treatment for everyone, but for me, it definitely makes life far more bearable.  It even has an emotional effect, in a sense, because as anyone who has dealt with long term pain knows, the pain becomes depressing and over time, you start losing hope of relief, all of which are undoubtedly not going to contribute to recovery.  It’s very hard to smile when inside, you are wishing for someone to just come and cut off the offending body part, irregardless of how traumatic that would be.  So, pain relief doesn’t just benefit the patient herself, but rather everyone I come into contact with during the course of  a day, and obviously, your significant other is highly motivated to ensure that you obtain that relief.  I’m not sure our relationship could have survived the past eleven months without the medication, TENS unit, and treatment.  On a bad day, I still bear a strong resemblance to a bear freshly emerged from hibernation–I growl, I snap, I rip off heads without reason, and at best, I’m snarling.  The pain disrupts my sleep as well, as I almost never sleep very long because I’ll inevitably roll over and irritate my shoulder with the new position.   Sleep deprivation does not contribute to a happy camper either, and also probably does not help with recovery.  Whether it is true or not, I have always been told that our bodies heal far faster when we sleep than when we are awake and busy.

Many people live with chronic pain, as a result of old injuries, arthritis, and current injuries or illnesses.  It’s one of my fears, that I’m going to endure this to the end of my days, that I will never recover from this injury.  Facing permanent impairment or handicap is never an easy thing either.  Having ways to cope with pain is very important to the patient, because without the pain relief, everything negative is magnified tenfold.

So how do you find pain relief?  It has to start with your doctors.  Once the source of pain is diagnosed properly, it is often reduced by appropriate treatment and medication.  Pain can be treated with additional methods such as pain medication (there are a lot of them out there too!) physical therapy, bio-feedback, massage therapy, hot/cold therapy, whirlpools (gotta love the hot tub, right?), lifestyle changes, dietary changes, and the TENS unit that I love so much.  There are probably other treatments and therapies out there that I don’t know about too–I’ve had limited personal experience, and only know so many people, after all!

If your doctor isn’t able to help you or you lack confidence that they are doing the best that can be done, there is nothing wrong with a second opinion or changing doctors.  The best trained and most skilled doctor on earth cannot help you if you don’t interact well with him or her, and that’s a very personal and personality thing.  Change doctors, get that second opinion, talk to your insurance provider, find out what options you have.  Research online, typing in the disease or condition you have been diagnosed with into the search engine such as Google or Bing.  Read the articles, and look up unfamiliar terms.  In this day and age, patients are often forced to become very informed consumers of medical care, and its not uncommon to feel as though nobody is on YOUR side, whether it is the insurance company, the pharmaceutical company, or your doctor.  Be aware of drug interactions or potential ones, especially with the medications you may be taking for other, unrelated issues and prescribed by other doctors.  With the way prescriptions are handled, potential interactions can be missed by both your primary care physician and your pharmacy.  It is your body, and the potential victim of problems is you…therefore, you need to do the best that you can to protect yourself.  With the access to information we have today via the internet, there is no reason to NOT be an informed and proactive patient.  Your primary care physician, as well as any other specialists you may be seeing need to be able to listen to what you have to say and ask, and give answers…and if they don’t, you need to look elsewhere for treatment in a situation where you are not expected to silently accept whatever they want to hand you.

Ultimately, the winner should be you.  Malpractice lawsuits won’t bring you back to life, nor restore your health.  We have one body, and we can only recover from so much.  Listen to yourself, and if you are saying, “Gee, s/he didn’t listen to what I had to say, and didn’t do anything to help me or find out what is wrong” then you are in the wrong office with the wrong person wearing the white coat.  In the old days, a single doctor might have been a person’s only hope.  These aren’t the old days.  We have more doctors per capita in the USA than ever before, and more and more of them are specialists in one area of treatment.  So whether it is your primary care physician or a specialist, expect personal attention with consideration for you as a person, not a brief appearance as though you are greeting royalty after waiting hours in the waiting room.  Don’t accept rubber stamp or assembly line treatment either-we are not automobiles all getting an identical tune up!

The same goes for medication.  Not everyone reacts to all medications the same, that’s why there are often even hundreds of potential medications to treat some conditions.  Some medications may be used to treat multiple conditions that often seem very dissimilar to the lay person. Other medications may have side effects that preclude you from being considered as a candidate for them.   If you are prescribed a medication that leaves you feeling worse or somehow has an unpleasant side effect, whether or not it is in the included list of side effects from the pharmacy, talk to your doctor about using a different one.

If the medication is too expensive, there is often a less expensive alternative that may work for you.  Many people find themselves in the situation of not being able to afford their medications despite insurance.  If that is the case, TALK to your doctor.  There are programs to help with medication expenses, as well as less expensive alternatives.  If it boils down to an economic choice of which medications to eliminate due to being unable to purchase them, your doctor needs to advise you on which medications are most necessary for your health and well being.  Sometimes, a doctor can give you samples of medications to see if you are going to have a positive reaction to a medication change, which can reduce the overall expenses of changing your medications too.  ALWAYS take your medication exactly as prescribed, and if you are not taking it, make sure your doctor knows this as well as the reason you are not taking it.

While we all wish for a doctor that can magically diagnose us perfectly each and every time, it isn’t a realistic expectation either.  Your doctor needs information from you that only you can provide, whether it is about symptoms, reactions to your medications, your level of pain, your concerns about your treatment, as well as whether or not your are actually taking your medication as prescribed.  It is because of this that it is so important to have a doctor that you feel comfortable talking to, as well as one who is going to give you the necessary time to talk about your condition, diagnosis, treatment, and concerns with him or her.

The best doctor in town may not be the best doctor for you if she sails in like she is the queen, waves her scepter about you, pronounces you sick with disease A(the latest fad diagnosis) and then vanishes as though she was a magician, leaving a nurse to bring you prescriptions and the paper to take to the desk so that you can be appropriately charged.  In the meantime, you are wondering about that strange spot that has began growing on some body part and why you are  so tired and have such terrible stomach cramps after you take your medications…

Find a doctor you like, that takes the time to listen to you, that asks questions, that answers questions, and you are comfortable with.  It helps if you don’t have to wait a month to see him or her either–it’s hard to plan ahead that far as to when you are sick!  Often, a young doctor just beginning a private practice is a good choice.  While they may lack experience, they are well trained in the latest diagnostic methods, the newest drug treatments, and are familiar with the specialists too.  They often are more willing to do more research to improve their own skill level, and show more concern on a personal level for their patients than the older, well-established doctors.  Don’t turn your nose up at a doctor just because he or she is young and new to private practice–they have spent years under other doctors’ supervision to get to that point, and often done a stint elsewhere prior to going into private practice.  That lack of experience is relatively minor compared to the latest training and fresh education in many cases.   Besides, it is often a breath of fresh air to deal with a young and enthusiastic doctor compared to one with decades of experience that has left them tired and disconnected from their patients.

Another facet of medical care that we often think little about is the pharmacy.  Most small family owned pharmacies have gone the way of the dinosaur, leaving us to deal with primarily chains that just don’t offer much for personal attention.  While we are often forced by sheer economics to find the cheapest place to fill our prescriptions or one chosen by our insurance company for us…when we do have choices, we need to consider some things about our choice.

  • Hours-are their hours convenient for us, even if we have had to visit an urgent or emergency care facility?
  • Wait-how long does it take to fill prescriptions?  I’ve been floored when I have been informed that my prescription would be ready to pick up the next day.  Seriously…how long does it take to drop 90 pills in a bottle?  Find out if you can call ahead to refill your regular prescriptions too.  It saves a lot of time and aggravation if you can get your medications in a timely manner.
  • Packaging-for those of us without small children in the home, but possessing limited mobility/dexterity issues…those child proof caps are a challenge we do not need to face.  Can you get your medications in a container that you can open?  Are you going to have to fill out some form in triplicate each and every time you pick up a prescription?
  • Reliability-Not all pharmacies are the same, and mistakes have been made in the past.  How good is this one?  do they ever give you someone else’s medications?  Are the pills in the bottle the ones that you are supposed to be getting?  If you ever get a bottle of pills that does not look the same as usual, QUESTION it!  I have been personally given the wrong medication before, and while I noticed that the bottle of pills was incorrect…what if I hadn’t?  I was shocked at how quickly the error was hushed up, and how much they hurried to give me the correct one and get me out of the store…obviously, such errors could be potentially fatal.
  • Record keeping-medications are deductible from your taxes…does the pharmacy offer an annual total form?  Do they keep records of your drug allergies?  Can you get medications if you are traveling out of state or out of the area and need it?  Who else would have access to those records?
  • Insurance-find out which pharmacies are included in your insurance plan…and which insurances your favorite pharmacy accepts.  What do you need to do to fill a prescription? Will you need to show your card each time?  What are your co-payments?  Do they offer generic medications or a reduced co-pay option if you get 90 days at a time?  Some insurance companies require you to use a mail order option for your regular medications in order to get the reduced co-pay.  Others offer the option at your local pharmacy too.  Find out what your least expensive options are.

Most of all, be proactive about your medical care and do not accept the minimums as your lot in life.  You deserve the best care and customer service possible, so make your expectations high.  No one is going to be your advocate with as much motivation as you will.  Research both your drugs and diagnosis, and if you don’t agree…challenge your doctor and ask why.  There is no law that says you can’t, and there is every reason on earth to be concerned about your health and your medical treatment.

So what are some resources to help the consumer of medical services?  Search engines such as Google or Bing are always a good start.  If you are taking a medication, entering the name, exactly as it appears on your prescription bottle, should find you plenty of reading material.  To research a medical condition or diagnosis, entering the name will find websites as well.  Another popular website to use is Web MD, which offers a lot of other information.  In addition, many physicians and medical facilities are rated by consumers such as yourself, and these ratings can be found online.  To find out if your doctor, clinic, or hospital has been reviewed by others, enter the name and city/state into the search engine.  Usually, it will appear that way.

If you have serious concerns, contacting the state medical board may be appropriate.  Contact information for your state should be found by entering your state’s name followed by medical board.  This is probably the best resource if you have questions or complaints about someone’s competency to practice medicine or misbehavior regarding patient interaction.  Inappropriate behavior regarding doctors and patients is serious, and you do not have to accept it.  You should not remain silent if a doctor has behaved inappropriately either-even if you were not harmed, that may not be true of future victims in that situation, and you should report anything of that nature immediately.

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