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Changes in Pain: It’s Time to Talk with Your Doctor

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by Dr. Michael Kaye

Changes in Pain: It’s Time to Talk with Your Doctor

The percentage of people suffering with chronic pain continues to rise with each passing year.
If you are a chronic pain patient, you may have experiences that are common with extended pain care.

Unless your physician knows how to manage pain beyond pharmaceutical management, you will most likely continue to suffer on a daily basis. If your doctor is only offering medication, you may want to question him/her about other pain management possibilities.

If you have been diagnosed with a chronic pain syndrome such as fibromyalgia, Lyme disease, Epstein-Barr virus or chronic fatigue syndrome, your doctor may have a tendency to blame any new symptoms on your diagnosis. In fact, some patients share with me that they have actually seen their doctor roll his eyes after they share how they feel.

Sometimes patients themselves become jaded, especially if they have experienced such a reaction from their doctor. They hold back information about how they feel or about any new symptoms because they don’t want to be seen as a complainer or a whiner. Unfortunately, this lack of sharing can be detrimental to the patient’s overall health.

I explain to my patients that it is important to share all symptoms, even when they feel the symptoms seem silly or trivial. If there are any changes in your symptoms, definitely tell your doctor. Let me give you a couple of examples:

-Barbara has been my patient for many years. She came to the office one day and reported the following: “I have been experiencing weakness in both my legs for the last week. I think I spent too much time gardening about two weeks ago.”

A complete neurological evaluation revealed weakness in both lower extremities. She was immediately referred to the neurologist, who determined she had a thyroid myopathy. I asked her why she hadn’t come to the office a week earlier. She answered, “I thought the weakness would go away; I didn’t expect it to linger for so long.”

If you experience any symptom or “odd pain or sensation” which does not change over two days, it is time to report to your primary care physician.

-Kyle was being treated for pain in the right upper back region involving the scapula (wing bone). He had been reporting increasing pain in this region and had already received a significant amount of therapy. Many of the therapists and doctors thought his pain was the result of on-going musculo-skeletal problems related to his job as a mechanic. I treated him for five visits, but the pain continued. He was referred to a specialist who determined he had gallstones. He received surgical treatment which cleared his symptoms.

“Doctor burn-out” can also contribute to the chronic pain patient’s experience. Sometimes doctors continue to prescribe and manage patients the same way, day in and day out. They participate in seminars that offer them easy continuing education credits to maintain their license, but they are not open to learning anything new. They continue to prescribe and manage patients the same way, day in and day out, without any change. They become stagnant. They are “burned out.” If your treatment has not changed and you are not experiencing any relief from your symptoms, it’s time to get a fresh pair of eyes to evaluate your health and condition.

If you are being managed by a doctor or therapist and the frequency, duration or intensity of your pain does not change in 10-15 visits, some action should be taken. For example, your medication should be changed or you should be referred to a different doctor or for special studies such as an MRI, CAT scan, or blood work. If this does not happen, it is time to consult another doctor or therapist.

To summarize, if you are a chronic pain patient, don’t be afraid to speak up about any changes, however slight, minimal or odd to you. If you experience any new symptoms, let your therapist or doctor know immediately. Don’t let your doctor “blow off” the symptoms. If your doctor does not give you an answer regarding your new symptoms or if you do not experience any improvement with your pain, choose a different doctor.

To Your Health!
Dr. Michael J. Kaye

Tags: chronic fatigue chronic fatigue syndrome fibromyalgia lyme disease medication pain management

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