When you suffer from a chronic disease, such as lupus, arthritis, fibromyalgia and other illnesses that cause chronic pain, you probably find yourself at the doctors office more than you would like. When the discussion of chronic pain comes up (yet again) how do you talk with your doctor openly about your chronic pain needs? Here are some helpful tips to encourage open and honest communication with your MD.
Understand your Doctors Perspective
In the book Healing Fibromyalgia by Dr. David H. Trock and Frances Chamberlain [Published by John Wily & Sons, Inc., 2007], Dr. Trock says that chronic pain patients should take a deliberate approach to their treatments. However, more often, the pain a patient is in dictates a course of action, leading panicked patients to try every medication and treatment, instead of going slow.
When you talk to your doctor about your chronic pain, keep in mind your doctor's perspective:
- Your doctor is concerned about helping you return to a high level of functionality.
- Your doctor has to look past emotions in order to treat your pain.
- Your doctor is required to follow certain protocols in treating chronic pain [See the February, 2009 issue of The Journal of Pain for opiate guidelines]
Be a Good Patient
To have open and honest communication with your doctor, chronic pain patients need to be good patients. Sometimes, chronic pain patients use narcotics as part of their treatment. This is particularly concerning to doctors as some patients become addicted to these medications. Additionally, there are non-chronic pain patients that attempt to gain access to narcotic medication and other controlled substance for abuse or to sell.
How to be a good patient:
- Follow your doctor's treatment plan: If your doctor has recommended a treatment, pharmaceutical or not, follow these instructions. If you disagree with a treatment plan - communicate this to your doctor right away. They don't know if you don't tell them.
- Be consistent: Let all of your health care providers know about your pain treatment plan. This facilitates a cooperative approach to your pain and limits the guesswork for your doctors when it comes to your medical history. Fill your prescriptions at the same pharmacy every time.
- Be honest: If a medication you are taking for pain is not working talk to your doctor. Let your doctor know about all side effects.
How to Talk with Your Doctor About Chronic Pain
- Be specific: Tell your doctor exactly where you are hurting, what type of pain your are in (aching, shooting, stabbing, throbbing), and how it affects your ability to function.
- Be prepared: Go to your visit prepared with one to three ailments you would like to discuss. Anymore than that and you may overwhelm your doctor. Make additional appointments for follow up for your other symptoms.
- Leave emotion out of it: Pain hurts! And your doctor knows it. Everyone has really bad days, but at your appointment, keep the emotional complaining to a minimum. Instead, focus on solutions.
- Keep your doctor updated: If a treatment worked particularly well, let your doctor know! You may phrase it as, "This therapy really helped with this part of my pain issue, however, I am still having trouble with this pain issue." Your doctors will appreciate the feedback.
Confronting your Doctor
If, after following the good patient rules and communicating openly with your doctor about your needs - you still find that your pain needs are unmet, talk to your doctor first. Try not to be confrontational. If you have a treatment plan in mind, present this to your doctor and bring research, articles and other patient experiences to support your reasoning.
If your doctor implies that there is nothing more he can do to help - don't give up just yet! Instead, talk to your doctor about why he may be feeling this way. Doctors see many patients everyday and may need a reminder of your specific symptoms and issues. Bring a list to every single appointment and refer to this list as needed.
You can also ask your primary doctor to refer you to a pain clinic that specializes in your chronic illness. If that is not a possibility, thank your doctor for all their work. Communicate that you believe it is time to go a different way with your treatment.
Always leave the door open to come back. It is never a good idea to burn bridges with your health care providers, especially those that have known you long term.
Strengthen your Relationship with your Doctor
The key to talking with your doctor about chronic pain is to make a plan of action. If your doctor does not bring it up, ask yourself about your own pain management goals. Perhaps for you, this means being able to work a part-time job, or reduce your pain level in order to take up more physical activity. Make sure you are clear and logical in your consideration. Above all, keep your plan realistic. Chronic pain management is a lifelong process, work towards smaller goals to get to the big ones to avoid setbacks.
Approach communication pragmatically. And, it never hurts to say thank you or ask how your doctors day is going. After all, doctors are just people too.
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