MAKE CERTAIN YOU HAVE THE BEST DIAGNOSIS ( or DIAGNOSES) POSSIBLE
Make Certain You Have the Best Diagnosis (or Diagnoses) Possible
(Even if you feel certain of your diagnosis, keep reading!)
~ ~ Pain-related disorders are probably the most under diagnosed and misdiagnosed disorders in the world.~ ~
There are lots of reasons why... We can’t see or use diagnostic testing for pain, which makes the research for treatment of pain-syndromes difficult, when comparing pre and post treatment data; most cultures are prejudiced against people who suffer long-term pain whether they recognize it on a conscious lever or not; although people who suffer from pain syndromes number in the millions, individual disorders themselves may be rare, new, difficult to diagnose; and physicians are under-educated about pain-related syndromes.
When that third physician told me he thought I had trigeminal neuralgia (TN), he had only recently learned about TN from one of his partners, when his partner returned from attending a medical conference where TN was one of the topics. Coincidence? I don’t believe so. I call such a thing a “God-incident”.
We can’t expect over-worked GP’s or even specialists to be familiar with all of pain-related disorders. Below I’ve listed ones I only have come to recognize as result of my work. About how many of these have you heard, I wonder?
complex regional pain syndrome Tendinitis Regional syndrome Arthralgia
disease bladder pain syndrome, Small Fiber Sensory Neuropathy, Schnitzler syndrome, PSORIATIC ARTHRITIS
Here’s even more problems with getting the right diagnoses: Once undiagnosed pain patients get into the medical maze of treatments, likely being passed from one speciality to another, symptoms become misinterpreted and confused. In addition, people with ongoing severe pain usually find the physical nature of our pain changes, plus, we may experience, what I call logical add-ons such anxiety, depression, sleeplessness, stomach disorders, to name a few.
Yep, I been there, done that, bought the t-shirt!
Those were just the reasons I came up with off the top of my head--you, no doubt, could add to that list. Naturally, all of this compounds the difficulty of discovering the basis of the real problem.
Getting the right diagnosis for right now
is worth a good amount of effort on your part.
1 - We cannot under-rate the importance of how a diagnosis validates our symptoms as being real. so we need no longer fear (nor others around us) that it is all in our head. (I will provide help for those who can find no diagnosis next time--I have something that has helped others and I hope it will help you.)
2 - The right diagnosis also directs you and your medical practitioners (along with any alternative and complementary practitioners you utilize) towards the best options for your care.
I encourage all who live with pain-related disorders
to assess our pain at least yearly, in order to
keep track of what was, and what is now.
This is crucial for making
future treatment plans, and also helps us to look at
how we are living now so we may consider
what changes we want to make to feel better.
Assessing Your Pain:
What you will find below is the gold standard for patient assessments. It is likely what your physician has used to try to diagnose you. It’s called the PQRST METHOD.
If you haven’t done this already, you would be wise to create and maintain a personal medical history in a 3-ring binder. If you are on the front-end of what looks to be a difficult-to-treat pain, or if your illness has lasted beyond six months or so, you are highly likely to regret it if you do not organize your journey. It becomes pretty hard to remember over time, and complicates your treatment and living style hugely. The assessment below, will be a great way to get started if you don’t have a book going already, or will provide an excellent 2014 update if you do. (I will give you some about the binder another time.)
Regardless of how new or how long-term you have journeyed with pain, this may be the best way to find out if you are on the right path as far as diagnosis and/or treatment is concerned.
1 - You can copy and paste the PQRST Assessment right from the blog into a word
processing document, to complete it.
2 - If your pain is new, it will be clear as to how to answer the questions.
3 - If you have lived with pain for a while now, answer the questions in two ways:
first, how your pain was when it began; second, how it is presently.
People always, always, always, always (are those enough alwayses?) tell me they are glad I made them do this, when I am helping them to better manage their pain. I bet you’ll be happy you completed it too.
I’ll bet most of you can complete the self-assessment within an hour- that’s less than the time I have to wait for a doctor much of the tie! You have a week to complete it-- I am praying for you!
Let’s feel better!
---------------------------------------------copy below and paste to new doc-----------------------------------------------------
PQRST Method of Patient Assessment
P = Provocation/Palliation
What where you doing when the pain started? What caused it? What makes it better? Worse? What seems to trigger it? Stress? Position? Certain activities?
What relieves it? Medications, massage, heat/cold, changing position, being active, resting?
What aggravates it? Movement, bending, lying down, walking, standing?
Q = Quality/Quantity
What does it feel like? Use words to describe the pain such as sharp, dull, stabbing, burning, crushing, throbbing, nauseating, shooting, twisting or stretching.
R = Region/Radiation
Where is the pain located? Does the pain radiate? Where? Does it feel like it travels/moves around? Did it start elsewhere and is now localized to one spot?
S = Severity Scale
How severe is the pain on a scale of 0 to 10, with zero being no pain and 10 being the worst pain ever? Does it interfere with activities? How bad is it at its worst? Does it force you to sit down, lie down, slow down? How long does an episode last?
T – Timing
When/at what time did the pain start? How long did it last? How often does it occur: hourly? daily? weekly? monthly? Is it sudden or gradual? What were you doing when you first experienced it? When do you usually experience it: daytime? night? early morning? Are you ever awakened by it? Does it lead to anything else? Is it accompanied by other signs and symptoms? Does it ever occur before, during or after meals? Does it occur seasonally?
You may add anything else here you believe is pertinent to your pain.
Yaah! You’re finished! You may now eat an entire box of chocolates! Buy yourself one of those pretty heart-shaped boxes . Send me one too, I like dark chocolate the best.