A plea to providers: This is why biopsychosocial treatment of chronic pain works [Guest post by Devra Sheldon]

A plea to providers: This is why biopsychosocial treatment of chronic pain works [Guest post by Devra Sheldon]

Healthcare providers may be aware of the presence of yellow flags in a patient’s history, such as a major accident, depression, catastrophization, or prior trauma or abuse (to name a few), but not consider it related to the patient’s clinical presentation of pain. But it is. Prior pain experience shapes pain perception.

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A few bad apples: Don't let a rotten provider stress you out (& find a better one!)

A few bad apples: Don't let a rotten provider stress you out (& find a better one!)

Sometimes, I leave a doctor’s appointment and think “gawd, that was an awful experience.”  And for most patients, bad experiences equal bad doctors.  The doctor may be brilliant, published, and well-respected, but if she’s rude, condescending, or freaks me out, she gets a failing grade from me. 

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Why providers should hear my patient story

Why providers should hear my patient story

If you’re a provider who treats those who hurt, I urge you to stay above the chaos of pain’s wrecking ball.  You need to remain logical, focused on the end-goal and the pain science and the sensitivity of the patient’s nervous system.  You need to be willing to refer patients to other providers.  Be careful not to attempt treatments that are likely to worsen the patient’s suffering, simply because you’ve exhausted all other treatment modalities.

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Let's talk about sex. (+ vaginal pain + patient-provider communication)

Let's talk about sex. (+ vaginal pain + patient-provider communication)

For years, my pelvic pain prevented me from having the fun, spontaneous, gloriously cliché 20-something sex that my friends were enjoying. You know – the kind of sex that they gushed about at brunch.  Sex that was breaking their hearts and exhilarating their sense of liberated womanhood and adulthood.  Sex that their doctors were lecturing them about.  I couldn’t have that kind of sex because my vagina (and vulva and back and thighs) were excruciatingly painful.  That was my dirty little secret.

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When the "best" treatment fails.

When the "best" treatment fails.

This treatment, and these PTs, weren't going to be the ones to get me better. This was true despite how badly they wanted to help me and despite how compliant I had been with their treatments.  It was true despite how passionately they felt about pelvic floor disorders, how much book knowledge and certificates about my issues they possessed, and how personally involved with my case they felt.  These women genuinely, deeply cared for me. 

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Finding your voice when your care goes from bad to worse

Finding your voice when your care goes from bad to worse

In 2011, I lived in New Mexico and was navigating the challenges of law school, as well as ongoing pelvic pain (which, at that point, I was simply ignoring for lack of available care).  Facing mounting stress, I started developing GI issues (big surprise, right?). So, I made a doctor's appointment (crazy idea, huh?).

I wrote this letter to the hospital's patient advocate after my appointment that day.  It tells the story from there.

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IUD Nightmare No More: Special patients deserve special treatment!

IUD Nightmare No More: Special patients deserve special treatment!

When I got my first IUD, it was with a rotten doctor and no compassion.

It was December of 2010, I’d just finished my first semester of law school, and my gynecologist told me it was a simple in-office procedure. I picked up my cervix-dilating medicine at the pharmacy and followed the instructions exactly.  I had also asked my doctor about pain meds for the procedure.  She said none were necessary but I could take something of my own if I wanted.  I brought an old bottle of Vicodin.

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Cycling for change (& not the way you think)

Cycling for change (& not the way you think)

"When was the first day of your last menstrual period?"  Every woman who has gone to the doctor for any reason can relate to this.  Upon your first interaction with the nurse or medical assistant, you're asked a series of questions, usually while they take your blood pressure, and they ask about your LMP (last menstrual period) in a monotone way.  If you hesitate, they hand you a mini-calendar.

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