How to Talk About Your Chronic Pain With Your Doctor More Easily
If so, you're not alone. Over seven million people in the U.S. alone experience chronic pain, and out of that sizable number, a great many of us have had similar "sinking feelings" of our own. Whether this is because we're used to not being believed, or because the medical profession is susceptible to being highly skeptical of chronic pain in general, the end result is the same: we tend to shut up, and our pain goes untreated, or under treated.
This is an unacceptable state of affairs. To be an empowered patient, we need to learn how to communicate our pain effectively to our physicians. And when we're not heard, despite our best efforts, then we have the right and the responsibility to seek out another physician who doesn't operate under such encumbering misconceptions.
But before you cast your current doctor aside and go looking for a new one, ask yourself these three questions.
One: Am I Communicating Clearly and Objectively About My Chronic Pain?
Do you use words like "it hurts all the time" or "it always feels like this"? Next time, try using more objective-sounding language. While all pain is by nature subjective, we can express our sensations more objectively by focusing on two pain characteristics: intensity and quality.
Intensity means simply "severity." The old and much-used method of "on a scale of 1 to 10, 10 being the most excruciating pain you can think of" is one example of communicating objectively about intensity. Another, perhaps more beneficial method is to use a scale of 1 to 100. This allows for greater flexibility and nuance. You can also give ranges that may mean more to your doctor than "About a six or seven" -- "in the sixty- to seventy-five range, out of 100" may communicate your pain's intensity more effectively.
Quality simply refers to the type of pain you're experiencing. Some examples are burning, aching, stabbing, shooting, stinging, and tingling. How you characterize the pain's quality can be very beneficial to your doctor. For instance, if you describe a deep aching pain which indicates a muscular issue, that will lead your doctor's diagnostic thinking in a very different direction than if you describe a surface tingling pain, which indicates a neurological issue.
Two: Have I Taken Responsibility For Discovering All I Can About My Condition and Symptoms?
Have you kept a logbook of your pain symptoms? This is perhaps the single most effective tool the patient has in her arsenal when seeking better pain management. Use any notebook you like -- even an ordinary legal pad -- and keep daily notes about your activity level, your diet, your sleep and rest, your medications, and your pain symptoms. By tracking these five aspects of your health care simultaneously over time, both you and your doctor can begin to discern patterns. These patterns in turn can be extremely helpful in deciding which conservative, surgical and pharmaceutical options would best suit your needs.
Besides keeping the logbook, which I encourage every chronic pain patient to do, you can also take some responsibility for doing a little research. While you should take care to rely only on sites that are properly fact-checked and accurate, within those parameters there is a wealth of consumer-oriented health care information available on the internet. Look up your condition in one or more site, and make notes about common symptoms, prognosis, treatments and new studies. Come armed with this information to each doctor's visit, and share what you've found with her.
Three: Am I Projecting My Own Fears Onto My Doctor?
Finally, ask yourself whether it's possible that your difficulties in communicating with your doctor might be more the result of past difficulties with other doctors or your own fears, rather than a specific problem with this particular doctor.
From my own history, I know all too well how one bad experience with one bad doctor can color your perceptions of the medical profession as a whole. I've been incredibly fortunate to enjoy a positive relationship with an excellent general practitioner for over 10 years now, whom I "inherited" from my mother who was also his patient. Even so, after I had a horrible experience with an incredibly arrogant surgeon who worked on my brother's cancer care team, I found myself feeling anxious about talking to my GP, who had never given me any reason to feel that way.
Give this some thought. If it's really a problem with the doctor you're seeing, and not a generalized fear or a particular experience with someone else, then you'll need to decide whether the relationship is worth saving. If so, speak up to your doctor. If it helps, practice ahead of time with a friend by doing some role-playing. But if all else fails, then you can hold your head high and seek out a better doctor -- one who listens to you with respect.