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Had my psych evaluation for the SCS trial - Update

cherish22ccherish22 Posts: 706
edited 06/11/2012 - 8:24 AM in Pain Management
I wanted to share my details and am curious if this was “normal”. My appointment a week ago and I wrongly assumed there would be something like a couch to recline on. Guess I have watched too many movies. lol I have severe S1 nerve damage, and must stay reclined or within 20 to 30 minutes my pain starts skyrocketing.

The neuropsychiatrist chatted with me for 20 to 30 minutes, asking about my schooling, my family, my life, etc. Why do I want the SCS, why do I think I deserve the SCS over someone else.

When he was done with the verbal questioning, he took me to another room with a countertop and standard office chair, the kind that you can lean back in if you have control with your feet on the ground. I thought that chair would be fine, but I was wrong. It only came across my mid-back and did not support my back and head. He then gave me several things - a pain rating sheet, asking many questions, wanting the best thorough answer I could come up with. It had options to click what type of pain - stabbing, burning, constant, etc. What are the first 5 things I would do in priority order if my pain were diminished?

What meds am I currently on. What things help lessen my pain. What triggers my pain or makes it worse.

He also gave me the 567 question MMPI2 test, with a question booklet and answer sheet, with ovals to color in with a pencil. All true/false, asking the same questions over and over but in different ways. Example: I love to go to parties; I tend to talk to people I meet; I consider myself outgoing; My friends would describe me as shy.

From what I have read, these questions are repeated/rephrased to evaluate if you are being truthful. They have all kinds of ways to rate it - faking good, faking bad, etc.

In my case, after my 20 minutes or so in that office chair and after the 30 minute interview, my back started spasming something awful so I quickly got on the floor, which was a concrete floor with commercial carpet. I lay on my back and worked to complete the test, holding it up so the light wasn't in my eyes. At one point, the doc left his office and saw me on the floor. He brought me a clipboard and a cushion to put under my head. (I had already explained to him my limitations with sitting/pain.) :''(

I think I took 35 more minutes that they expected, but it really slowed me down lying on the floor. After a while, I was able to get back up and try to finish. The pain was getting really horrible and I didn't have any options. If I got up to take a break, my back would have still been killing me. The answer is always to lie down or fully recline, and the only option I had was the hard floor.

My husband had come to pick me up (oldest son had driven me) and when we got to the car, I was trying to be really upbeat and hold it together. But when he stopped to get me something to eat and went in the store, I fell apart. My pain was at an 8+ and hadn't been that bad in a while. We had the van seat reclined with a pillow for me, the heated seat on, and were doing the best we could. It has now been 8 days, and the pain flare this visit triggered is finally calming down.

I got to the appointment at 1:00 and left at 3:40. I think they expected me to be done around 3pm. I had to really focus on the questions to make sure there was or was not a "not" in that question. Missing that "not" changes the entire answer for that question.

I simply answered all 567 questions truthfully, trying not to overthink the answers. Some really odd ones, such as “Did I abuse animals as a child” type questions. By the time the pain really escalated, it was getting really hard to read the questions and fill in the ovals on the answer sheet. I was mentally and physically worn out by the time I finished and wished I hadn’t had such a pain flare during the experience.

I will find out this coming week if I “passed”. My doc can’t imagine that I wouldn’t and I am trying not to worry about it. If I am found to not be a good candidate for the SCS, we will continue with meds adjustments and eventually end up with a pain pump (per the doc on the last visit). I really would like an opportunity to see if the SCS could diminish the S1 nerve pain signals. If so, I think it is highly probable that I could be much more active and return to doing some of the things I used to enjoy.

Did anyone else have such an involved psych evaluation? I apologize for the length of the post, but when I was searching for information, I would have loved to find one full of details. Hope this helps someone else who may be searching or info.

Thanks for reading,

Cheri

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Comments

  • Yes i had the Psych eval, filling out the history of your life as a matter a fact i stayed in counsl for three months i was so depressed i had the trial spinal stimulator, but it did not help me. since aug 08 i had a series of test discogram ct scan 2 mri with and without contrast, i was getting lots of groin pain (burning0 so bad Dr. gave me a block, still feel pretty good left side now my right side is burning yucky feeling, i had a 4-5 S-1 with Rods on nov 21 06, my mri now says the bottom was never filled with bone or anything else as a matter of fact it feels like a glass busted in side me and the pain same as you cant sit or stand mor than 20 min.Now Dr. says i need to do a reconstructin surgery, take it all out go a level higher scape the scar tissue which is so much,rods are un-even no one can answer why the 1st surg forgot to fill the DISC, went for 3 opin all say i need reconstructive surg it really sux i wish they got it rite the first time lol,,,so now just waiting for an approval so i can go on with my life the recovery is the worst pain i ever felt,, to do that all over again. with i can hardly walk and in so much pain i start walking on he treadmill believe it or not it really helps, go figure,i have to be positive. i was hopeing to do it before Thanksgiving but at this time i do not think so. can you tell me why you had 3 surgery and were they back to back?
  • My chosen profession involves administering a whole host of those tests, so they couldn't use them to evaluate me. My psych eval consisted of the doctor saying "Do you think it's going to work for you?" and me saying "God I hope so." I refer to that as my last fringe benefit from my job. :))(
  • I had my SCS implanted in June of 08 and my PM Doctor did not put me thru the Psych Eval. He said that my insurance company did not find them necessary and honestly, I agree!
    Sorry about your ordeal and good luck!

    Millie
  • I HAD MINE ABOUT A MONTH AGO AND IT WASN'T NEARLY THAT INVOLVED. IT LASTED MAYBE 40 TO 45 MINS. I CAN RELATE THOUGH TO HOW TRAPPED YOU FELT IN YOUR SITUATION. WHEN I CAME HOME FROM THE HOSPITAL AFTER MY FUSION I WASN'T TOLD TO LIE IN THE BACK SEAT FOR THE RIDE HOME (HOME BEING A ONE HOUR DRIVE). AS WE GOT CLOSE TO HOME, WE STOPPED AT THE DRUG STORE TO FILL MY PRESCRIPTIONS. I TOLD MY HUSBAND THAT IF THERE WAS A LONG WAIT TO JUST DROP THE PRESCRIPTIONS OFF AND GET ME HOME. FIFTEEN MINUTES PAST, THEN THIRTY, FORTY-FIVE. I COULDN'T WALK. I COULDN'T REACH THE CAR KEY TO ROLL DOWN THE WINDOW TO ASK SOMEONE TO GO IN THE DRUG STORE AND FIND MY HUSBAND. AND, OH, THE PAIN I WAS IN!!!!!! IT WAS SUCH A TRAPPED, POWERLESS FEELING. IF THAT'S HOW YOU FELT, ITS EVEN A LITTLE SCARY, NO? SUSAN
  • Long time no see girl! How the heck are you? Where ya been? Everything okay? You seemed to have just dropped off the face of the earth.

    "C"
  • Oh girl~ I bet you were ready to crack your husband on top of the head by the time he got back to that car!">image Unless someone experiences the same kind of pain as you, they just can't understand what you are going through. Hopefully you were well taken care of when you got home.
    Hope you have been recovering well...
  • was in Dec. 2005 and was a simple laminectomy/discectomy for a severely herniated disc. It was almost extruded. There are many details of what happened after, but the short version is I fell while moving to a new state, and was in surgery within 2 weeks - March, 2006, this time with an extruded disc floating in my spinal canal. That doc did a fusion with bmp, but no hardware.

    I was NEVER normal after that surgery and suffered in pain for many months. It was a pain that was hard to describe. I was finally talked into going 2 hours out of our rural area to a wonderful neurosurgeon. (Other 2 docs had been orthopedic.)

    This ns could tell on xrays even before the MRI that I was missing one of my facet joints at L5-S1, which was causing shearing and overotation every time I tried to move. MRI confirmed it. In Dec. 2006, I have a 360 PLIF fusion with rods, cages, screws and bmp. Almost immediately, I felt different. I could tell my back was stable. My leg, though, that had been burning since August 2005, continued to burn through all these surgeries, with every doctor hoping the nerve would heal and repair.

    It just never did. So now I sit here with a stable, fused back but 24/7 S1 burning nerve pain. Occasionally, I will have what I describe as "fire" shoot from my buttock and out my feet. When this happens, I can't predict and it hurts so bad I stop breathing and panic a little. When I get several "fire shots" in a row, I get in bed and stay there. For this reason, I very rarely drive. If a fireshot were to hit me while driving, I might end up in a ditch. Very hard to maintain composure during the episode.

    I do get back pain and have a generally sore back frequently, but that pain is nothing like the nerve pain. And with the back pain, I can really shut it down, get in bed, etc., and feel better in a few days. With the nerve pain, there is absolutely nothing that helps, nothing that lessens it. All I can do is stay reclined and hope not to trigger it. Once triggered, it takes a good week to calm down. And by calm down, it gets back down to a 6-7, rather than an 8+

    As far as depression, I know I was pretty depressed before the 3rd surgery because I didn't know if I should trust a new doctor, had already had 2 surgeries so close together and still wasn't any better. Since then, though, I haven't felt depressed. When in terrible pain, I will cry if someone asks me about it. If people leave me alone and just let me cope, I'm usually better. I hate to talk about it because I don't want people who don't already know to know about how limited my life is, I don't want they to feel sorry for me. My pain doc also said she doesn't think I am depressed. She believes that anyone in this much pain will cry over it occasionally and she thinks that is normal.

    I am hopeful for the SCS and my primary emotion would be impatient/excited. Hopefully, I will hear that I am a candidate and that the trial will be successful. If not, on to plan B.
  • Had mine about 1 month ago for my SCS and my visit lasted about 1 hr. Same deal asked alot of questions about my growing up how I viewed my pain and my current treatment but about 45-50minites into it he stopped and said he had want he needed and made the comment I was about as normal patient as he has seen. Not really sure what he meant by that but I also did not do an MMPI so according to my pain doc we are going to look at the 2 options SCS and a pain pump after they try a couple more epidurals. That makes 3 this month with the one I am having today and the last set of 3 I had really did not help so we will see. Good luck and god bless
  • Only, I kind of rushed through the coloring in of the circles part. I thought the only problem I would have had would be that I colored outside the ovals.... I work fast. I always feel like time is running out; or thinking of things I could/should be doing other than what I am working on at any given moment (pending tasks, if you will). I read and understood the questions perfectly. I started around 11:30 and walked out at about 12:15 (and I had about a 10 minute break in-between). I was hungry - it was lunch time after all! Plus, I am always doing things (maybe subconscious) so that I am never working on one thing for too long. If I do, I lose interest and the end product becomes a little... hey look! a butterfly!
  • I was approved for the trial!!! Such a relief!! The trial will definitely be before Christmas, but I am waiting to hear back from the office once they coordinate with the doc and the programmer.

    I don't have details yet on what I am getting, but I do believe it is the ANS brand. I was told they use ANS for radiating nerve pain, and Advanced Bionics for people with more back pain. I definitely have the radiating nerve pain.

    Very excited and hopeful!!
  • That's fantastic news.

    "C"
  • CONGRATULATIONS! I have read so many posts here stating what a difference the stimulator has been in the lives of people in chronic pain. What a great Christmas present you will have!!!

    Keep us posted and I am praying you too get the pain relief you deserve!

    Jeaux
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