Nurse.Com Forums - Blogs - Shauna's Life In Pain And Other Fun Things by makeupgal

Making Your Pain Doctor A Partner

makeupgal — Mon, 17 Aug 2009 01:33:55 GMT

I saw my Pain Management Doctor last week. It is time for a medication change due to my ever-increasing pain. I don't take medication changes lightly; the process can be particularly non-pleasant at times, depending on what you are doing with the change. This decision has been awhile coming, right alongside the pain that just keeps coming. My choices are few. I need a partner to help me with this.

Enter the kindest, most professional, (without being like a robot), empathetic, with an 'I want so much to know what you feel when you tell me of your pain' look in the eyes; Pain Management Doctor. It was time to get down to business as we began. We consistently have a nice time together; we talk well. You know 'those' kinds of doctors?? I was married to one, {gasp} and feel that he is such a kind, caring, thorough and empathetic doctor, whose patients just adore him. We'd get the most wonderful gifts at Christmastime; mmmm fresh Persimmon cookies from one lovely patient--every year like clockwork, I was faced with a huge tin of the best cookies I have ever tasted, and what is a girl supposed to do?? Admire them? Ahhh NO, I made great use of them!! Point is that doctors whom patients can talk to, and feel deeply heard by, is the key to the successful partnership of the doctor-patient relationship.

My doctor and I worked together to come up with what to do as far as what medication to change, and when we figured out which one, it was up to me in the end as what to do. This is the #1 most important attribute that we, as pain patients, simply must have with our doctors. The ability to work together on any part of our pain management care.

When you visit your pain management doctor, the feeling in the room is ultimately that of teamwork. Talk together. Figure out what you are trying to accomplish first and foremost during that visit. Remember, come prepared!! Help your doctor out a bit too. I brought my daily medication log, jotted down the monthly 'total' of how my pain had done over the time since I last saw my doctor, and that helped so much in my visit.

I spoke with my doctor about feeling that deep pain the most when I stand up, and that I felt as if I would benefit from 2 rods in my back, long enough to cover 12 levels, (all the Thoracic vertebrae), and he said, "You feel unstable in your spine?" Yes!! That was perfect! The word described exactly how I feel in my spine. And it's a great medical term to put down in my chart.

It is through our talking, getting to pinpoint exactly what we are there to do: Accomplish solving a problem. And for that, we all need ourselves and another person who will talk openly, honestly, seriously, and with an attitude of doing it together.

I could never do this myself. I know what to use, how to take it and how to titrate up or down. Nursing and years of pain have taught me this. Options for complete medication change are not many in the pain arena. Then there is the how to change it when things need to be altered. I knew the options available to me, and therefore, had been considering them days before the doctor visit. This made the decision simpler, faster, and more of a feeling of unity when my doctor totally agreed at what I chose to do.

My spine feels unstable. Great word doc! Today is one of those days when the pain is constant, unrelenting, deep, with neuropathy (**nerve pain), and severe muscle spasms. My back has gone through a real workout, and the paraspinal muselces, (**the muscles that run along your spine in the vertical position) are now extremely tight. When I stand up, my back says, "I don't want to be in this position." I am compacting my spine, yet laying down is not an option. I must SIT, and always against heat. Yes, yes, I've tried heat for 20 minutes and cold for 20. That was more effective when I was recovering from a surgery. But now I speak of what works for pain that lasts all day sometimes, with no relief, such as today has been. The cold and hot are long gone as I have found that heat is the only relief, modality-wise. (Modality--**A method of application or the employment of any therapeutic agent.)

In an office visit, we are all aware that time is, and always will be an issue. In any medical exchange. Yet there are time issues with those on the phone, your appointment to have taxes done, your haircut; oh it would be nice to have the person you are working with spend as much time with you as you'd choose; but we all know it just doesn't work that way!

Ergo, (wow I really don't like that word, but it is a good one!), why I make the most out of the time with my Pain Doc, by bringing daily notes and things that jog my memory. The relationship with your doctor needs to be one of openness, almost like one you'd have with a psychologist. The doctor needs to know everything you feel, every medication you are taking, if anything as in a fall or accident has happened, and just to cover everything that could have precluded the increasing pain. This needs to be talked about with precision and knowledge, as serious decisions are involved.

This is your partnership. This is your LIFE! Work on having a close, open, honest, respectful relationship with your Pain Management Doctor. Above all, work on your own side of this partnership, by keeping a pain journal, pain log, whatever works for you. Be kind to yourself, respect your doctor just as she/he respects you as a person, and I wish you the best of care for your pain.

It takes two!!

Gentle Hugs... <3

Digg - Home Care Nurses Drive More Each Week Than UPS Drivers

makeupgal — Mon, 12 Jan 2009 08:04:33 GMT

In this article from the site: http://www.nahc.org, which is the National Association of Home Care and Hospice; it is noted that the nurses out making house calls cover more miles per week than a UPS driver! I found this so fascinating because I worked as a Hospice Nurse for years and used to put 120 miles/day some days I was on call. Nuts!

http://www.google.com/url?sa=t&sourc...LcZluTIUpam-dg

The Gratidude Attitude

makeupgal — Mon, 12 Jan 2009 07:55:14 GMT

Just for a moment; imagine suffering with pain on a daily basis. What is it like? How does it make an individual feel?

Pain can give ALL of us a negative attitude, many times mixed with other emotions: depression, anxiety, anger, frustration. Those who do not suffer from Chronic Pain can easily look back over times in which they had acute pain from a fall, a cut, (even paper cuts hurt quite a bit!), a stubbed toe, or a finger caught in a door being closed; and remember the stabbing feeling of the pain, along with the emotions felt in that moment.

Those who have felt the anger and despair of being in pain, even those whose pain resolves, will tend to lean toward looking at the negative of this experience. It is not easy, nor does it feel natural, to be happy and feel 'up', when pain is involved.

Three days ago, on a very high pain day, I was thinking about what I couldn't do; walk my dog, do the wash loads, clean up the kitchen, and all the other 'normal' things that those without pain can do so easily after a day at work, and especially on a day off.

I realized I was thinking in an "I can't" attitude. Yet what was I to feel so grateful for when all I could do was sit against the heating pad? Sit, and not be able to feel very grateful for the pain I have been given.

When I examined the depth of my tears in that moment, I saw so much inside them.

I saw my son. My handsome, funny, intelligent, empathetic, quick-witted, lovable son. I saw gratitude then. I saw that my attitude of what I don't have, can't do, or was unable to involve myself in, was completely unnecessary.

I HAVE! I CAN! I AM ABLE! I have an Attitude of Gratitude when I look at the people in my life that have impacted me in a positive way. When I realize what I have in my jewel of a son. In my best friend. In my siblings. In the people I have met through this blog.

Being in pain is not something that is easily dealt with. Yet I can, will, and do have 'The Gratitude Attitude'. No, I am not grateful for my pain. I am in no way happy that I was in an accident that has started a life of Chronic Pain. I don't understand why my Spinal Cord is getting impeded by my own bones. But if I think about that, if I think LIKE that, there is no room for Gratitude.

I choose to begin working the 'Gratitude Attitude'.

All I need to do, is focus on the wonderful people in my life. However close, however far away, these people can become part of my daily thinking in a positive way; actually helping me to achieve the type of thinking I need to practice. Especially when I really hurt!

I'd love to hear what YOUR 'Gratitude Attitude' is.....What do you think about? What are YOU grateful for??? There is so, so much if you thoroughly examine your life. We pain sufferers have much to be grateful for; even though our lives are extremely hard and a huge daily struggle. Just try it out.

The 'Gratitude Attitude' can, and will change your outlook on your life.

http://shaunaslifeinpain.blogspot.com

Is Your Medication Ready For Evacuation?

makeupgal — Mon, 12 Jan 2009 07:52:16 GMT

As October breezes it's way into Southern California, so does the very breezy Santa Ana Winds, a novelty to our area, and a firefighter's worst nightmare. Add some very dry brush, a lack of rain, (again), to the area, and still summer-like temps of up to 100 in the Valleys and Inland areas.

The first set of fires threatening homes, people, animals; started almost as if on schedule. To let us all know it was time to look at our kits for evacuation, whether it is for a fire, flood, earthquake or hurricane, tornado, thunderstorm....all the nature we live with; slamming the ground with such force that we need to leave. And FAST!!

Are you ready? It is not only important papers that need to go with you, but all of your medications, if you take them on a daily basis.

It is a good idea in any home with possible meds that are readily stolen by many people, these drugs are to be locked away at all times, and the rest kept on your person during the day. The bottles keep you safe with the law,instead of just keeping meds in a little carrier for the day. Many times, people will carry their meds that way, but this presents a problem: If you are stopped and the police find a medication holder full of different pills with no name, no doctor's name, etc. These MUST be kept on your person in the prescription bottle the meds came in originally.

When you lock up the bulk of your meds, make sure they are all in the same container that is either part of, or with your documents and other important papers. That way, if you need to evacuate, you and your meds will be together and no thought of withdrawal with have to enter minds.

During Katrina, and the suddenness of the levy breaks, many, many people had no time or chance to gather anything, they headed for their roofs to simply save their lives.

When I saw on TV the different people that were Chronically Ill, and had no insulin, no heart meds, no pain meds, nothing; I immediately thought of those with Pain and possible other illnesses. How hard it would be to go through evacuation, which must be painful to all bodies getting rescued from a helicopter, then know that you have no medicine to take. NOTHING. Then what? Some will begin to go into a diabetic shock, be completely incoherent, no food, no sugar, no carbs right away to stop the quite out of range blood sugar.

When you think of a person who has chronic pain, the meds taken most often are the very ones that begin a withdrawal syndrome in the patient very quickly. It just happens that the meds used for pain have a very bad side effect: Withdrawal from the meds cause extreme uncomfortable feelings, physical signs of not having the dose your body is used to on a daily basis.

What did these people do during the horrid mess that followed Katrina? How long did they suffer before their meds were available? When would their meds be available? What a horrible thing to have to endure. And while in even worse pain than usual!

When you first get your meds for the month, (keep some older bottles for this to help out), put about 3 days worth in your purse, in the original bottles, and pour the bulk of the med into last month's bottle. Keep these full bottles in your evacuation box, plastic holder, safe, wherever you have your important papers, etc. Make sure the room locks where you store the meds, or get a safe, keeping the aforementioned items there. Make sure there is no humidity in the area you keep meds in, the bathroom is the worst place to keep medications. The humidity has an adverse affect, along with warmth also. No meds in the bathroom medicine cabinet!!

I've seen some people, while doing Home Care Nursing, that have their meds spread out all over the house. There is no way they could leave in an evacuation, with those meds in time!! There would be too much searching. This has always made me crazy, and I taught my patients how to keep their meds all in one place; many older patients always picked a little basket in the kitchen, one lady even used it for a kitchen table centerpiece after she had gotten them all put together!

So, no matter where you love to live, and what kind of Mother Nature's wrath you must put up with there, keeping those medications that just may save your life, or keep you from going to the Hospital at least; by keeping them all together, safely locked, and easily gotten into by you, will prove to be the smartest thing that you have ever done--Whether you are asked to evacuate--or not!!!

I ask Mother Nature now that California is spared from a "Firestorm-- 2008", on the local news channels this year. Haven't missed the continuing coverage daily, of fires everywhere, some of which I've seen right out my window!

Just make sure your medications are ready to evacuate with you!

http://shaunaslifeinpain.blogspot.com

Are You Leaving The Pharmacy With YOUR Meds?

makeupgal — Mon, 12 Jan 2009 07:48:14 GMT

This post may open the eyes of many patients that must visit the Pharmacy often, picking up prescribed medications for pain, or other illnesses. Many of us just run in or drive through, pick them up, pay, and leave.

When you pay for those medications, and leave the pharmacy, you are now responsible for what is in your bag. How do you really know that your meds are in that already closed and stapled bag? Have any of you ever gone home to find that not only are the wrong medications in the bag, but there may be an indiscriminate amount of the meds that are yours; but not the amount, or dosage your doctor prescribed.

Also to look for on the bottle are the main things that the Pharmacy has the responsibility to fulfill, and these are the things that they check to make sure that the correct dosage has been prescribed and filled, the correct amount filled, to the correct person, by your doctor, with their name on the bottle, their phone number, your phone number, and your address.

Yes, this seems like double checking what the Pharmacist has already double checked. They usually fill meds automatically with a computer-only ability to access certain schedules of medications. Then, they count the meds by hand, for the double check. We all know how busy most Pharmacies are, and considering all the different people they fill for, all the range of meds they must work with, and all under a certain amount of time, when requested prescriptions come in from the doctors office, that is a lot of work. As in any job, there are mistakes to be made, hopefully inadvertently.

I am no way putting down Pharmacies, I respect very highly what they all do there, whether the Pharmacist, the pharmacy Technicians, or the cashier, who is usually one of the above two. I just know, from a great Pharmacist friend, that they are usually over worked, and there are many times they are either short an actual Pharmacist, putting the one left there to fill all the scripts, putting more pressure on them. Some companies, especially the bigger ones, may need to call in a Pharmacist that is a fill-in, and who is not familiar with the store, where everything is, does not know the regular patients, and may be either over-worked, or over the top on who you really are when you pick up your meds.

I have always found it very disturbing that basically anyone can go in, say they are picking up for "Joe Smith", and receive Joe Smith's meds without showing ID, and here we run into a problem that is not easily rectified. What if Joe Smith just had surgery and literally cannot pick up his own meds, and sends his family members, or a friend to pick up his meds. There are people who are in such pain when meds are due and ready, that they must send someone else to pick them up. This is a situation that I find no answer to. But if someone is hanging around the Pharmacy, hears the patient at the counter leave their scripts, enough is usually talked about between the staff and the patient to alert that person that a script or 2 will be ready to be picked up in an hour or so. When the time comes for pickup, that person could easily go to the counter, say they are picking up for ''Joe Smith", and usually no questions are asked, unless the patient had made a point of telling the staff that they will be picking them up, waiting for them, or shopping in the store while they wait for the meds to be ready. What about "Joe Smith's" meds that were turned in by someone, and the person hanging around in a waiting chair hears enough to be interested in the meds, he/she can then go to the counter, say they are picking up for 'Joe', and basically pay and walk out with someone else's medications. HIPPA rules and regs say the privacy of patients comes first, but I have never heard low voices used when a Tech asks for your phone number, address, etc., which can be easily written down and used by the false person who then picks up 'Joes' meds for 'him'.

To save yourself the problem of taking home either someone else's meds, or ending up with a short amount of your own meds, there is a solution. As 'silly' as it may sound, or look to others waiting in line, remember they are not the ones to worry about here in this situation. These are your meds, your lifeline to be able to lead a life of some sort, and those that have to pay the full price amount, will not feel shortchanged.

When the Pharmacist or Pharmacy Technician, brings your already stapled bags to you upon check out, do we really know what exactly is in those closed bags? Remember, as soon as you leave the Pharmacy, they do not know if you have reached in and scooped out some, then gone back and complained that the full amount was not there.

I am not saying that you need to count out every single medication. To do that properly, you need the little blue counter that they use to hand count your meds, and then pour them in the bottle. You can not pour them out on the counter, (unsanitary), or try to count them while in the bottle, but if you have been taking the same meds for a long time, it is quite easy to eyeball the amount dispensed.

I am suggesting that you: Open the stapled bag and look at the label, make sure that you check that it is prescribed to you, it is the right medication, the right dosage, the right amount, and the right price. After that check in front of the Pharmacy Tech or Pharmacist, you have made sure that you are getting YOUR meds! If you can make this fill on a Monday through Friday, (I know that is not always possible), at least if there is any problem, the Pharmacy can call your doctor then and there for you, if there are any discrepancies.

This is just one more bag unstapled in our lives of the many stapled bags that will liberate us, and allow us, the patient; to have full control over a most important part of our pain or illness therapies.

Gentle Hugs to all....

http://shaunaslifeinpain.blogspot.com