Chronic Migraine, Community, Coping, Doctors, Society

Seeking Patients’ Perspectives on Pain for Journal Article

Trisha, an RN with chronic migraine and occipital neuralgia, is seeking patient input for an article for she is writing for a nursing journal. Her focus is patients’ perspectives on chronic pain and what their health care experiences have been. She says,

The reason I want to write this article is because after almost two years on the other side of the fence, so to speak, it’s become glaringly obvious that there is a need for the healthcare community to hear first-hand how it feels to be treated with discrimination simply because you have a disability that isn’t visible to the naked eye. Being refused treatment in the ER, being accused of drug-seeking behavior, and not having access to adequate pain relief complicates the issues at hand and may, in fact, make the pain and suffering we face worse than it already is. Chronic pain sufferers deserve just as much respect and dignity in treatment situations as any other person with a disabling disorder.

Trisha has created a questionnaire for patients who would like to contribute. She asks many questions, but many only require short answers. More importantly, they are questions that anyone with chronic illness should think about. Your responses will help you better understand your headache history and the impact of illness on your life. Think of it as self-administered therapy.

Chronic Pain Questionnaire
I have a questionnaire I’d like to get as many people to fill out **realistically and kindly** as possible in order to base the article on as wide a reference base as I can reach and get responses from. If you’re interested, please fill this out and email it back to me by September 1.

Thank you in advance for taking the time to fill out this questionnaire. Please note that doing so gives me permission to use this information, in context, in an article or articles having to do with chronic pain and associated issues. If you prefer not to answer a question or two, please put N/A in that spot so I know you didn’t overlook it. I appreciate your input.

  1. What is your diagnosis?
  2. How long have you been ill?
  3. What would you say is the attitude of society today toward people with chronic pain issues?
  4. What is your biggest struggle in day-to-day life?
  5. If you could say one thing to the healthcare community, what would it be?
  6. In your opinion, what is the biggest obstacle to receiving quality care and pain control?
  7. Do you feel your pain relief needs are adequately met?
  8. How many doctors did you have to see before you found one willing to treat your pain in an effective manner, if you have found one at this point in time?
  9. Do you feel that chronic pain sufferers are seen as people with legitimate complaints?
  10. Does the use of illegally-obtained medication by high-profile individuals negatively impact the chronic pain patient seeking relief today?
  11. What would you tell society about your situation if you were given the opportunity?
  12. Do you believe there is a medication that, if made available to you in the correct dosage, would assist you in living a more pain-free life?
  13. Do you feel that chronic pain sufferers face discrimination when applying for Social Security Disability?
  14. Do you feel that chronic pain sufferers face discrimination in the workplace?
  15. How has your quality of life been affected since you became ill?
  16. Have you ever been refused treatment or accused of drug-seeking behavior in an emergency room setting when you’ve gone to one while in intense pain?
  17. Have you ever been told that your pain is all in your head?
  18. Does your pain significantly impact what you can do on a day to day basis?
  19. Have you lost your job or livelihood because of chronic pain?
  20. Has your family situation changed because of chronic pain?
  21. Have you lost friends because of chronic pain?
  22. Do you need help doing things that you used to be able to do independently because of your pain?
  23. Does your pain cause you to say or do things that embarrass you?
  24. Are you being treated for depression or anxiety due to chronic pain?
  25. Do you often pretend to feel better than you actually do in order to avoid uncomfortable situations or comments?
  26. What modifications have you had to make to your home to accommodate your chronic pain?
  27. Do you take narcotics for your pain?
  28. Do you take anti-seizure medications for your pain?
  29. Do you have trouble sleeping? 30. Do you have trouble concentrating?
  30. Do you have trouble staying awake?
  31. Are you able to exercise on a regular basis?
  32. Have you gained weight since you became ill?
  33. Have you lost the ability to enjoy the things you used to look forward to?
  34. Have you had to change careers or cut back on your work hours due to chronic pain?
  35. Do you feel like people avoid you because you are ill?
  36. Do you see a pain management specialist?
  37. If so, is this sufficient for pain control or relief?
  38. Do you feel that people with invisible disabilities are looked at differently than people with obvious physical handicaps?
  39. Is there anything else you’d like to say?
  40. Please provide your first name and last initial or a believable pseudonym I can use:
  41. Just for statistical purposes, can I please have your gender and age? You don’t have to answer this one, but it would assist with data groupings.

Thanks again. I appreciate your time and effort. –Trisha

Meds & Supplements, Treatment

Balancing Compassion and Cynicism in the ER

Unless a migraine is intolerable, a migraineur won’t go to the loud, bright, frenzied ER. Who would willingly subject themselves to that without desperately needing pain relief? But for most migraineurs, the visit is a harrowing back-and-forth between patient and staff. They don’t get their pain treated adequately and they leave furious with doctors and nurses who question the legitimacy of their complaints.

While patients know what their own pain is like, ER staff don’t know the individual, but the patterns of many people. Some of these patients are truly in pain and others are looking for a fix. The patterns leave an imprint so that even the most compassionate doctors and nurses struggle to be caring, not naive, and cautious, not cynical.

Using migraine patients as an example, Kim from Emergiblog, who has been a nurse for 27 years, fights to balance this contradiction. Although she is sympathetic to chronic pain patients, she can’t forget the times that she’s been fooled. She illustrates the dilemma eloquently and has terrific tips for chronic pain patients to get better care in the ER.

[from Jessica via Migrainepage]

Meds & Supplements, News & Research, Society, Treatment

ER Docs and Chronic Pain Patients Clash

When chronic pain gets so bad that patients head to the emergency room for treatment, many of them leave the ER in pain and angry. Patients feel that they have been ignored, reprimanded, dismissed and degraded. A preliminary study on how how ER docs and nurses think about and treat pain patients appeared in the February issue of Clinical Psychiatry News. The basic finding is that patients and providers often butt heads.

“Patients were more likely than providers to believe that chronic pain has little chance of improving, and to think that providers don’t believe pain complaints if they lack physical or objective findings. Patients strongly disagreed that they were addicted to their pain medications, and providers were more ambivalent about patients’ potential addictions. Patients feared the risk of dependence on opioids more so than did the providers.”

Study Probes Care of Chronic Pain Patients Among Emergency Physicians

(via Tick Tock from the BrainTalk Headache forum)