Hi everyone. I've been dealing with high levels of chronic pain for about 3 years now, and I've seen 7 doctors for pain evaluation and management. In reading through these forums, I realized that I have a mental list of things I make sure I go through with my doctors at a first visit, one I've built little by little in trying to make myself understood. I thought it might be helpful for others who are facing a first visit with a pain doctor, so I've tried to put my thoughts in some sort of order.
I know this is kinda long, but I really hope you find some helpful things in here.
1. It's really helpful to be very clear about the degree to which your pain interferes with life. The most useful questionnaire I was given asked me to list how many days a week pain interferes with: work, social life, daily activities (bathing, dressing, etc.), and relationships with family and friends.
2. Pain scales are very annoying--it's hard to collapse all the things that your pain is down into one number. So, I started doing some things with the scales that seemed to more fully express my pain.
--They often ask how much pain you currently are in. Also make sure they know your minimum pain levels, your maximum pain levels, and how often you hit these highs and lows.
--There are a bunch of different pain scales. Some make more sense to me than others. When I found one that really made sense, I started bringing it with me, and showing them how I scored on that one as well as whatever one they used. Google around and find the one that makes the most sense to you.
3. In addition to pain scales, a list of adjectives to describe your pain can be really helpful. Here's one I've used: http://www.chcr.brown.edu/pcoc/MCGILLPAINQUEST.PDF
4. Tell them everything you are trying for your pain--ice, heat, medications, acupuncture, physical therapy, etc. The broader your attack, the more seriously they seem to take you, so make sure you've tried a few things besides meds before you go.
5. Tell them all drugs, supplements, vitamins, and herbs you take--there are some potentially fatal interactions between some of these and medications that are commonly used for pain. Don't rely on your memory, bring a list.
6. Make a list of the activities that make your pain worse, and how often you have to engage in these activities, or how detrimental it has been to have to avoid these activities.
7. Don't limit your description just to your pain. Also tell them about any limits in your range of motion, weakness, tingling, numbness, changes in gait or sitting/lying/standing position.
Some other tips that seem to help:
1. See your doctor with as little medication in your system as possible. Take what you need to get through the appointment, but no more. This will get you the most accurate evaluation.
2. The examination is, unfortunately, likely to be painful. So bring whatever pain medications you have with you to take as soon as you leave!
3. Tell the doctor before they start the examination what kinds of poking and prodding are going to cause you the most pain. A good doctor will do what they can to limit the pain of the exam.
4. Take someone with you, if you can, and have them take notes. You need to focus on communicating, and there will probably be a lot of information flying around.
5. Don't be ashamed to lose it. This is not the time to play the strong, quiet type, or to skip over topics because you're afraid you might cry. Your doctor needs to know everything, and know just how bad it is.
6. Be explicit about what you're hoping for, in terms of pain reduction, and ask your doctor how realistic that is. They may not be able to give you an answer right away, but it's important to start that conversation. Unfortunately, complete relief may not be possible, and the sooner you get a sense of what is possible, the sooner you can start adapting and living a better life.