FALL EDUCATION AND PREVENTION (PART 2)

FALL EDUCATION AND PREVENTION (PART 2)

One of the subjects the Invisible Illness Awareness Week page asks us to blog about is "what advice would you give someone recently diagnosed." I am very passionate about fall education and prevention for all those living with an invisible illness due to the high percentage of falls and injuries that occur! I hope you are able to stay safe!

In my previous blog post,  FALL EDUCATION AND PREVENTION (PART 1)  I discussed research findings regarding falls and many physical factors that cause us to be  high risk for falls. I strongly believe that being aware of what can potentially lead to a fall and the injuries that can be sustained is very important! It is also necessary to be aware of what we can do regarding our physical conditions, as well as changes in our environment, to keep us as safe as possible and potentially prevent a life altering tragedy.  So, in this article, I will cover some interventions that you can implement to decrease your chances of falling and keep you safe as possible. 

Remember, as a part of our new “normal” of living with chronic pain, not only do we all need to be aware of what we can do to keep us living as functional and safe as possible, but we all also need to share this information with others to help educate them to deal with similar risks of falling.  Please share this information to help keep others as safe as possible! It could save their life.

Environmental factors around our homes that can increase our risk of falls:
Be aware! We all need to take a look around our homes, as well as wherever we are, to see what potential dangers are around us and know the changes we need to make to keep ourselves safe and hopefully free of falling!

• Throw Rugs-can be dangerous, tripping on the rug or the rug slipping can lead to a fall – you should seriously consider removing throw rugs.

• Electrical cords-from lamps, extension cords, computer cords, phone charging cables, etc. going across where you walk should be removed. They can cause you to trip.

• Items lying around on the floors in your pathway-books, magazines, papers, shoes, clothes, towels and any other items lying around should be picked up off the floor to keep you safe and free of falling.

FALL EDUCATION & PREVENTION (PART 1)

FALL EDUCATION & PREVENTION (PART 1)

One of the subjects the Invisible Illness Awareness Week page asks us to blog about is "what advice would you give someone recently diagnosed." I am very passionate about fall education and prevention for all those living with an invisible illness due to the high percentage of falls and injuries that occur! I hope you are able to stay safe!

FALLS

Does just seeing that word bring about a frightening memory for you? You are not alone!  It frightens many people!  With good reason!  Falls occur frequently among those of us with chronic pain.  Injuries obtained from a fall may have even been the origin of your chronic pain, or your chronic pain may have caused a fall.  Either way, falling has negatively impacted many lives!

Working in Occupational Therapy for almost 25 years, primarily with the elderly, I have experienced treating firsthand many patients that suffered moderate to severe injuries due to falls (various head injuries, broken shoulders, broken arms, broken pelvic bones, broken hips, and legs, etc.).

Not only that, but over the past five years, being involved with several spine surgery and chronic pain support groups, I have been a part of many discussions with various ages of people that have reported falls, as well as the resulting pain and injuries. Unfortunately, statistics show many of these injuries  may have been preventable! 

Meeting with Your Health Care Provider -During and After the Visit

Meeting with Your Health Care Provider – During and After the Visit

In the previous blog post, Meeting with Your Health Care Provider – How to Prepare, (click here to access that post). I shared many tips on how to arrive at the appointment as prepared and organized as possible. Having a basic plan can help make the most of your appointment whether you are starting with a new health care provider or continuing with one you've seen for years. This is extremely important, not only for yourself, but also for the health care providers you see.  

In this blog post we will look at tips for how to best utilize that information we prepared during the limited amount of time they have to spend with you for the best chance to leave with all the answers you need, a proper assessment and a treatment plan, as well as what to do after the appointment.

During the Visit

•  Medical history – don’t forget to have this with you so you can refer to it as needed. I bring a copy for them. That way if the health care provider chooses to review it they can. Many have asked if they could keep it for my medical record (this was discussed in the previous blog post, click here to access it).

•  Arrive 15 minutes early – this allows for you to complete any paper work required.

•  Fill out any forms completely and legibly – be honest with all questions asked and refer to the medical history you have for any information requested.

• Bring something to keep you occupied while waiting - sometimes there are unavoidable delays.  

 

• Be respectful - staying focused with your questions and concerns shows respect of the health care providers’ time during the appointment. Refer to your list of issues, symptoms and questions you wrote down ahead of time in your notebook so you don’t forget anything. 

• Function - Share how your problems are affecting your everyday life, what you’re not able to do during the day because of the issue you’re dealing with (sleeping, bathing, dressing, walking, standing, sitting, cooking, getting in and out of bed, off and on the toilet, to the toilet, etc).

• Take Notes - Write down in your notebook things discussed by your provider that you don’t want to forget. Remember it is okay to ask for clarification if you do not understand what a prescription is for, why a test is being ordered or any other treatment that is needed.

• Ask for clarification - Remember it is okay to ask for clarification if you do not understand what a prescription is for, why a test is being ordered or any other treatment that is needed.

•  Be honest - with ALL the information you provide. Even with the embarrassing questions they ask! It is tempting to say things like you are, “pooping just fine!” because it’s too personal to answer that you’re constipated or have the “D” word. Or you tell them what you think they want to hear about your drinking, smoking, exercising, sex life, etc. However, how can they properly diagnose you or recommend the best treatment if don’t share what is really going on? (Pssst…By the way, we all poop and pee! And if we are having issues with pooping, we can become impacted and people do die from that!)

• Ask for a referral - many chronic pain patients need to be seen by other specialists, ask if he feels you need a referral if not offering one or if you think he isn’t helping you as you’d like.

• Discussing a referral - if you have a particular specialist you would like to see, ask if he/she feels that particular specialist is appropriate for your situation. This will save a lot of time and money if you by chance go to the wrong type of specialist.

• Follow-up appointment – if a follow-up appointment is not mentioned or is not scheduled, be sure to ask if you need to have a follow-up visit.

• Questions - ask who you can call if you have any questions after the appointment. Many physician offices now have services called a Patient Portal that is available to patients. You can access a Patient Portal from any device with Internet capability to view your personal health information, communicate with your providers, request medication refills, and view lab results, as well as many other services.

After the Visit

If you were given a referral make sure to:

•  Verify Your Insurance and Referral Information - contact your insurance company for referral requirements. Check that the physician you have been referred to is a preferred provider and that your visit will be covered. Check their ratings to be sure you want to see them. See this blog article, Tips for Finding a Physician and Other Health Care Provider, to find information and links on how to find information and ratings.

•   Make an Appointment with the Specialist - once your health plan has approved the referral, you may call and make your appointment with the specialist. In some cases, the referring doctor may book the first appointment for you.

 

• Verify Medical Records Sent – you will want to call and make sure that any relevant medical records have been sent to the specialist prior to your appointment.

•  Patience - Remember, it can often take time to resolve an issue, so be patient! It may take several trials of different medications or treatments’, testing of various kinds and several visits with a variety of specialists to find out what is going on and get a plan of care. Often people will get frustrated and go see another provider when they have been trialing various treatments and nothing has been working.

•  Switching Providers - Don’t be afraid to switch health care providers if you find that you are not compatible or are not getting the results you want with your concerns. However, before switching, consider the following:

o   Don’t up and leave if the health care provider is not able to help you on the first or second try. (Unless of course there are extenuating circumstances).

o   Discuss your concerns with the health care provider before leaving to be sure there is no miscommunication. It may save frustration, time and money.

o   It requires being assertive and explaining specifically what your concerns are.

o    Make a list of these concerns before you go into see your physician so you’re able to completely discuss them and ask what specifically they can do to help you.

o    However, if you feel it is not a good fit for whatever reasons, know it is okay to find someone who is able to address your issues and do something proactive.

 Don’t settle for being told that there’s nothing wrong with you due to they aren’t able to find anything with blood tests, x-rays, MRIs, or other tests. Get another opinion! Sometimes tests are not read properly, or some other error may have occurred. 

NEVER GIVE UP!

·         Hopefully, these suggestions will give you enough information to have a successful visit with your health care provider which can lead to obtaining the best plan of care possible.

• Sadly, it often takes seeing a few health care providers to find one that is a good fit. If things don’t work out with a health care provider, please don’t make the mistake many people do, don’t go home and give up! I have come across too many suffering over the years that do this! Your health and happiness is too important for that!

Keep seeking another health care provider until you have answers and results you deserve! There are many great physicians out there; sometimes it takes a few trials to find one. Click here to see the blog post regarding Tips for Finding a Physician and other Health Care Provider.

NEVER GIVE UP!

YOU ARE WORTH IT!

Meeting with Your Health Care Provider - How to Prepare

Meeting with Your Health Care Provider - How to Prepare

The NIH of health defines chronic pain as pain that lasts more than several months (variously defined as 3 to 6 months, but certainly longer than “normal healing”.  Frustratingly for many, this diagnosis provides a plethora of opportunities to visit with not only our primary care physicians, but various other specialists as well (neurologists, rheumatologists, orthopedic surgeons, neurosurgeons, physical therapists, occupational therapists, physiatrists, etc.). I could safely say that for the majority of us going to the doctor, or any other health care provider, is not a favorite activity. I could also say that many of us have headed home (perhaps just walking out of the appointment) only to declare to ourselves, “Ugh! I forgot to ask….!” or ‘I didn’t get information about…!” or “I didn’t tell them…!”  Sound familiar?

This is completely infuriating! Especially after going through all it takes to get to that point. Such as, finding a physician or health care provider we hope will be compatible, making the appointment (making sure insurance will cover it, etc.), looking for someone to take you, waiting for the appointment, (sometimes months in pain, if not longer), getting ready (which is no easy task), getting there (up to several hours for some), struggling with pain as you try to sit comfortably in the waiting room waiting to be called, and then the extended amount of time in the examining room seeking patience from the far corners of your soul that’s now cringing in pain as well! All the while performing calisthenics in the overheated cooped up room to keep the pain at bay, (I KNOW you’ve been there sitting, standing and lying down on the paper bedding with that “WHY do they bother” flat pillow)! Then the physician finally arrives! He’s done; you’re checked out and as you’re walking out you’re remembering what you forgot! This is completely irritating! Yes, indeed! The memories are coming to mind of the times you left exclaiming expletive words that I refer to as ‘therapeutic cussing!”

During the time I was going to multiple appointments before and after my first cervical surgery, I was tired of forgetting to ask things, as well as irritated with having to constantly repeat my health information so I had decided to arrive at the appointment as prepared and organized as possible! Having a basic plan can help make the most of your appointment whether you are starting with a new health care provider or continuing with one you've seen for years. This is extremely important, not only for us, but also for the health care providers we see. Due to their schedule, which limits the amount of time they have to spend with us, we need to go into the appointment organized with a list of problems and questions, as well as provide complete and thorough information for the best chance to leave with all the answers we need, a proper assessment and a treatment plan.

The following tips on how you can organize yourself beforehand will make it easier for you and your health care provider to cover everything you need to talk about and make the best use of everyone’s time.

Before the Visit

• Making the appointment - if doable, make your appointment first thing in the morning or right after lunch to hopefully eliminate waiting.  

• Schedule extra time - it is important that if you think you need extra time that you share this with the scheduler when you call to make an appointment so you can be scheduled to have the time you require.

• Test Results - if you had recent tests completed before the appointment call the office to ask if the results have arrived. If not, ask who you can contact to make sure that information is received on time.

 

·         Write a list – make a list of all your concerns in a notebook to bring with you to your appointment. You can use this same notebook to take notes from your health care providers at your appointments. I usually start mine a week or two before the appointment. (I keep an ongoing list in an app on my phone called AnyList). List all your concerns that are problematic and then prioritize. If you’ve a list of 10 or more issues you probably need to make sure you ask for a longer appointment. Otherwise, narrow it down to the most important. Share how the concerns (for many of us we go for pain) affect your everyday activities. What can't you do because of it? As well as:

o   what you are feeling

o   location

o   type of pain

o   specific times

o   things that make it worse, better

o   how it is affecting you

o   like sleeping

o   eating

o   going to the bathroom

o   bathing

o   dressing

o   sitting

o   standing

o   walking

o   going out in public

o   shopping

o   socializing

o   mood

• Bring ALL your medications – it is important the physician knows what you are taking. Often they ask you to bring all of your medications with you on a first visit, including all the over the counter medications, vitamins, supplements and herbal medicines. You should always carry a complete list of all these items for any emergencies. It should include:
•  name of the medications
• dosage
• how often you take it
• what you take it for
• how long you have been taking it
• any side effects you may be feeling
• prescribing physician

• McGill Pain Questionnaire – The physician’s office most likely will have a pain scale they use and may prefer that. You might want to fill one out ahead of time for yourself so you don’t feel pressured while in the waiting room, causing you to forget something. Many find the descriptions of the various types of pain provided helpful. If you click on the link title McGill Pain Questionnaire at the beginning of this paragraph, it will take you to various other pain scales you may find helpful as well. You can choose any of the charts that works for you, but this one is similar to what many health care offices use.
  

• Keep a pain diary - Consider keeping a pain diary to note how you feel each day. Include:
• what makes your pain worse
• what makes it better
• how long does it occur
• how is it affecting you everyday activities
• What you are doing to try and make it better, such as using a heating pad, ice, Biofreeze, over the counter medications, supplements, creams, stretching, etc.

This will best help the physician, or other health care provider, to come up with a plan of care specific to your needs.

• Bring a notepad and a pen to the appointment – make sure to take notes. Ask them to repeat any information if you need clarification.

• Contact a friend or family member - you may feel more confident if someone else is with you. They can help remind you about things you planned to tell or ask the health care provider, as well as help you remember what the doctor says.

• Insurance card and identification – this is a must! As well as being prepared to pay any co-pays required.

• Medical History – many of us dealing with chronic pain have had multiple doctors’ appointments, surgeries, and other treatments that would be extremely helpful to provide the physician or health care provider with. Keeping a medical history to bring to your appointments is very helpful.  I started going to so many specialists that I got weary of repeating all the information every time. I hand mine over to the nurse when I get there, who gives it to the doctor.  Many have actually used it for a quick review, have thanked me and usually ask if they can make a copy. I keep a copy in my purse in case of emergencies.

Suggestions for what to include in your medical history:

1. Contact information - name, address and telephone number, and birth date at the top

2. Physicians information - names, specialty, contact information, referring physician, dates last seen

3. Diagnoses – Name of diagnosis, physician who gave the diagnosis and date given

4. Medications - name of the medication, dosage, when and how often taken, what taking it for, physician who prescribed it, date started. Be sure to include all over the counter medications, supplements and “alternative” things you are using. They appreciate honesty!

5. Allergies - name of medication, specific allergic reaction (rash, hives, etc.), date occurred

6. Hypersensitivities/side effects to medications - name of medication, specific issue (rapid heart rate, dizzy, nauseous, diarrhea, shaky, etc.) Remember many people have hypersensitivities to medications! YOU ARE NOT THE ONLY ONE! I've heard too many times, “Nobody else has ever reported this!" NOT TRUE!

7. List medications and procedures you have tried for your pain - if worked or not and why. That way they can easily see what has been trialed and know what they may be able to prescribe. Please know that there are many different types of medications that can help pain and often it may take many trials to find the correct one for your situation.

8. Surgeries - name of surgery, physician performed, location, date (include epidermal injections, and other procedures received, location)

9. Tests performed - X-rays, ct scans, MRI's, EMG's, CT Myelograms, etc. where you had it; (Bring the results if you have them). Remember to state if claustrophobic with MRI's. They can sedate you; they do it all the time. There is no need to be embarrassed!

10. Insurance information – make sure it is current

11. Emergency contacts – names, relationship and contact numbers

12. Date last updated - update after every appointments to be sure always current

This article will continue in the next blog post titled, Meeting With Your Health Care Provider – During the Visit