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Put off Part 2

stockbrokersstockbroker Posts: 464
edited 06/11/2012 - 8:25 AM in Pain Management
As I had explained in my original post, "Put Off", I've been waiting what seems like an eternity to get a date for a stimulator trial. I had my psych eval the beginning of Oct. and the psychologist typed the up the report and had it in the surgeon's office the very next day. There it sat for two or three weeks without being faxxed to the PM who is going to do the trial. What's making the wait so difficult is that I just got through the world's longest pain flare (over 30 days) plus my business is hectic and my office is moving and not having any time schedule for this trial is problematic. When I had the psych eval, the psychologist said that he saw chronic pain patients so I thought he might have some tips for me as to how to get through the next several months (in really bad pain and having no control over my situation). I went to see him last week and I was a little late (he's really far away). Much to my disappointment, he told me he wanted me to take the MMPI. I told him about the pain flare and the frustration of waiting and how since he worked with people in chronic pain he might have some practical tips for me. He pointed to his watch and said he wanted me to take the test. I told him I didn't want to take a test, that I wanted some suggestions, he shrugged pointing at his watch and I left. When I got to my office I called thie neurosciences department out of which the neurosurgeon and the psychologist work and I asked about taking the MMPI; was this something I had to do for the SCS? I was told no that it was because I has asked to see the psychologist and that it had nothing to do with my going ahead with the SCS. Today, the psychologist called me and told me that I had to come in and take the MMPI or I wouldn't get the SCS. I asked if he would have the NS call me. He said he didn't think the NS would call me and the PM doc wouldn't do the trial. I told him I found this all very odd since we had done the evaluation almost two months ago and had proceeded to get a predetermination from the insurance company and now he wants to back up and would he mind telling me why. He wouldn't. No one is in the office today so I can't get any verification of what this guy told me but it does contradict what I was told last week. My husband says just go and take the test. C--I would never survive in the military. My insurance does not pay for this sort of testing. This sort of seems like its been one big mess. On the other hand, maybe this is what everyone goes through getting a SCS. If things are so disorganized, maybe I should go elsewhere. I wouldn't be that far beind as I don't think the NS would be able to get to me until March. I think the psychologist didn't like me saying "no". Hey, Am I insightful or what???
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Comments

  • That sure sounds odd. I took mine and I was asked how my life was, how I coped, how the marriage is going, etc. I took no test of any kind. It was like a conversation. At the end I was told that I was emotionally stable and was recommended for the stim trial. I had it, but it went bad for me. Get a hold of your PM and ask what they expect from psych. I had to pay out of pocket for my evaluation too. I hope it gets settled so you don't get put off any longer than necessary.
  • I got the okay from the insurance company. A copy came to my house on Friday. The original went, of course to the PM doc. I've spoken to a couple of psychologists who both think this guy was way out of line to be so dishonest with me: to refuse to tell me why he decided he wanted me suddently to take the MMPI --156 questions--on day #28 of a God awful pain flare and a full month and a half after he had sent in an okay on my psych eval. And then to call me and tell me he would see to it that I wouldn't get the stimulator if I didn't take the test. The NS has been out of town and will be back tomorrow. I've written a letter to the psychologist but won't send it until after I hear from the NS office. I think this guy sure got a bug up his butt about something. But --hey--like I need more stress??? "I'll show you, Missy, I'll see to it that you don't get any relief from your intractable pain you can S-U-F-F-E-R." And then, to have to put yourself at the mercy of these guys. What happened to the "help" in "helping professions"?
  • I can't believe the run around you are getting. I know with my PM office, I HAD to take the MMPI2, which was 567 questions ( :''( :''( ). Physically getting through that test was horrible. I ended up laying on the floor because I can't sit longer than 20 minutes, let along the 3.5 hours the entire appointment took (with the verbal chat, the other pain scales and paperwork he asked me to fill out, plus the MMPI2 test.) I liked the neuropsychiatrist - he was very nice. This was just mandatory for my clinic (and possibly my insurance, haven't asked for sure.) I just went along because I wanted to get things going as quickly as possible.

    I guess you need to make sure that you aren't rocking a boat, but I would hardly think so if he already sent in the OK, your insurance has already approved it, etc. Only thing I'm thinking is that the last time you saw him he saw something in you emotionally that worried him? Because he can't LISTEN and hear that you have been in a terrible pain flare?

    I don't know how you guys work with this pain, I really don't. I'm in a recliner 23 hours a day and suffering. Have you read the Intractable Pain Survival Guide? It is an amazing resource and will give you validation and tips on survival when the world doesn't understand, even these "pain psychiatrists".

    My frustration is that before we moved, my former doc was going forward with the SCS. Were we still there, I would have had the trial last summer. We moved over here, I took my referral to the neurosurgeon here, and he refused to do it without me going through his "rigmarole" first. Just his persnickety rules and regulations. So, several more months of suffering.

    Do doctors do this because they can? I was told the trial is only a few thousand dollars. Why would this be so hard to get?? Just the trial???? Why withhold it from pain sufferers? I hope to understand this someday.

    I go in Thursday at 1:30pm unless I get a call to come in the morning. It can't get here soon enough, as I'm sure you totally understand. I'm hoping you get a date soon as well.

    I called my programmer this morning and asked how long it might be for the final placement if the trial is successful. I was hoping to get right on it, but again, the PM office only does the trial, and then that neurosurgeon does the final surgery. His rules, his procedures. We're probably looking at January I'm praying. I already had to cancel my Thanksgiving travel plans due to horrendous pain and it looks like Christmas too. (Our family is all 8 hours away.) I'm hoping hubby can get his vacation extended and we can take a January or February trip instead of December, when I would have the final SCS and hopefully be a new woman! lol Here's hoping and praying for all of us who are on the path to the SCS trial.

    Hang in there,

    Cheri
  • He actually has succeeded in seeing to it that my PM will not go ahead will the stim trial. Keep in mind, he gave me a pass on my psych eval at the beginning of October. Had I not (STUPIDLY in retrospect) asked to see him for counselling that would have been that. But since we had gotten along so well (I thought)and since I had always wanted to talk to a pain psychologist.....oh well. So, a month and a half later even though he had never seen me or spoken to me he decides ( when I've gone to see him for pain management counselling) that I need to take the MMPI. I've explained all of this. My plan was to go on Thursday to see my primary, explain everything to him and then do whatever he recommended but then this psychologist called me again. At home. I had asked if I could take the test elsewhere in so far as I don't trust this guy, He hasn't been honest with me. (My actual psychologist thinks I should report him to the psychological examining board--sure, in my free time). Surprise. He won't let me take the test anywhere else. I just don't like the whole situation. I have a doctor I can't talk to. In fact I've never spoken to him. He "outsources" everything save the actual implantation so the continuity of care is non-. existant. I will see my primary but I'm 99.9% sure I'm moving on. In fact, the PM doc who was to do the trial also does the permanent implant and I'm seeing him in the middle of December. That could be awkward but if I've already fired the other guy, the PM should feel free to say okay. At least I kow I'm going to have Christmas this year. I didn't know with moving offices and the stim trial if I would have the time or energy for Christmas. Cherish22, work really helps me keep my mind off my problems. I can work at home and have an assistant who can cover for me when I'm having a really bad pain day. Thanks for your kind words. I've been pretty blown away by this guy. He really is an A-h-le (can I say that?) Lots o luck again on Thursday.
  • The MMPI 2 is the Minnesota Multiphasic Personality Inventory. I had the "2", and it had 567 questions, which basically were the same questions repeated 8 different times, worded different ways. Therefore, if you are truly depressed but pretending you aren't (for example), you will most likely slip up and be "caught". Things like: I love parties. I am outgoing. My friends would call me shy.
  • When I went to see my primary, I got to see a copy of what the psychologist claims happened the day I went to see him for counselling. OMG. It is 100% pure fiction. He said I was very angry. He said (correctly) that I was late. That made me a little flustered as I am a very punctual person. But he omitted the fact that I gave him a little hug. )It was not returned. He must have a strict "no hug" policy. He immediately told me he wanted me to take the MMPI. I asked why and he wouldn't asnwer but just kept pointing at his watch. In his report, he said I was extremely emotionally upset. He said I was angry with my doctors, that I was very angry with the PM doc (who I adored, by the way). He then said it had been recommended that I have a psychological evaluation done by the psychologist at the PM doc's place. This is true. But I had been told NOT to do that but to have the evaluation done at the medical college, where, in fact i had it done, by this very same psychologist and passed with flying colors. So, he was trying to make me look like I had done something wrong when I had, in fact, done exactly what I hade been told. Then, he said he asked me (none of these conversations took place) if I were taking a ny psychotropic drugs. At first I responded no, he said but after further consideration I admitted I was taking Klonopin for anxiety. Well, he must have looked over the list of medications I sent in with all my medical records. I do take Klonopin (though I refer to it by its generic name clonazapam. It was prescribed for me by my spine surgeon because I wasn't able to sleep through the pain and so he had me take 2 mgs. in addition to the Ambien at bedtime. There were other inaccuracies I could point out but the fact of the matter is none of these conversations ever took place. AND. There is nothing i can do about it. I faxed a letter to the PM doc and he won't have anything to do with me. My primary is going to give me my meds until I find someone else. In the meantime, he scanned that report into my electronic record, Why??? And what did I ever do to this psychologist for him to do this to me? I have two appointments next Wednesday with two docs who do spinal cord stimulators. Not sure how to handle the question, "What went wrong with your last doc?" I wish I knew. I never spoke to the surgeon. Never was able to. The only person I was permitted to speak to was the receptionist. I'm feeling pretty bummed. Susan
  • This is beyond belief. This guy really screwed you over with a capital F. It's horrible that they can get away doing this, and for no reason! He must have some kind of bias but why? You have done nothing for him to slam you like that.You can file a grievance with the state board that regulates physicians. Give them a call, and they will probably have you write a formal letter detailing the events. I know you have so much on your plate right now, and this is the last thing you need. This doctor has wrecked the relationship you had with your PM doctor, and then took away the chance for you to get your SCS to feel better. This is downright wicked. What worries me is that fact that we are not privy to our medical records, so we wouldn't know if some doctor might have slammed us in that way. Then it is circulated among doctors, and they might prejudge you. You really need to fight this thing when you get a chance. I am so sorry this happened to you.
  • You can ask for an amendment to your record. You simply tell the receptionist that you feel that there are inaccuracies in your record and that you want them fixed. They have to provide you with the form, you detail the inaccuracies, and the physician has 60 days to either fix the inaccuracies or provide an explanation of why he won't.
    Since this is in your permanent record, and you can not see your PM or surgeon to discuss this, I would certainly demand the amendment to your records.
    Sandi
  • The support I get here means a lot. With all the pain we have to put up with, how are we expected to take on this additional crap. Actually, we are legally entitled to copies of all of our medical records. I have already complained to the hospital and have requested a complaint form from the psychological examining board but ultimately it will be his word against mine, I'm more bummed that I was so close to getting my SCS. Maybe its for the best. Maybe I'll find someone who'll give me more direction during the whole process. I don't need to have the big who-ha MD do the permanent implantation. Tomorrow, i have an appointment to get my hair cut. The surgeon is my hair stylist's ex-boyfriend. I haven't decided what I'm going to say to her, I don't want her to feel bad since she recommended him, but it might be a chance to get him a message.
  • I'm sorry you had to go through all that. When I read another person's story when she had to lay on the floor to continue the test, I was blown away. If you could get another chance to write the exam you should go for it. Just look at it as business. They would be accountable if something went wrong during the trial. Of course it won't but they are like that. Then maybe he'll clear your record. I would go not for the fact that you're right but because you desperately need the SCS. I don't know? Hope it turns out for you. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Oh my goodness, I'm so sorry. It just keeps piling on, doesn't it!! I had never heard of the amendment option regarding medical records, so I would pursue that, definitely. That is good to know.

    For me, I was told early on that a psychiatric evaluation was mandatory (even in our previous state with an entirely different doctor) and I knew I would have to take that MMPI 2 test thing. Dreading it, for sure, but that's due to my pain level and inability to sit or stand beyond 30 minutes max. But I wasn't surprised.

    You know what, though? Here's a shred of positive for us. There are studies and statistics that show certain "types" of people are not good candidates and if those people get SCS's anyway, then the success rates are much lower, more complications and then the removal surgery is not easy. I guess I'm glad I could be told ahead of time if I did not "qualify".

    But I'll be honest - when I was told I had passed, I was so relieved. As we walked got to our car, I looked at my husband and started crying. From relief. After having the verbal interview, filling out the other pain description paperwork and then that major test, I felt like I was under a microscope.

    Gosh, I hope you can start over quickly and I would just quietly and quickly go through their rigmarole. As frustrating as that is. Because honestly? What choice do we have?

    I'm so sorry. I will pray and send many positive vibes your direction. I hope your primary will be a good advocate for you and find you someone perfect. I guess there is just a much better doctor for you and that must be why this all happened. Perhaps there will be a bigger blessing in the end, just hard to see it now.

    Many gentle ( ( HUGS) )

    Cheri
  • Just a reminder that I had my psychological evaluation and passed it back at the beginning of October. There was an interview as well as some written tests.
    According to this psychologist in his office notes of Nov. 20, it was because of my hating my doctors, not taking the other guys evaluation (that I was told not to take), that I had hid the "fact" that I am taking drugs for anxiety all of which is false and none of these conversations ever took place that he now has decided he wants to "void" my pass and have me take the MMPI2. Since he has demonstrated himself to be a liar and since the test is subjectively graded I said I would take it if I could have it administered by someone other than this guy. I am not able to speak to anyone else about the situation. Cherish, I'm not trying to get around the psych eval. And I had a really bad night last night. I couldn't sleep, the pain was so bad. I didn't go to work today. Again. And I gave this guy a little hug. Maybe he has a problem with smart strong women. Or maybe it was just because I was late. I guess I'll never know. Susan
  • The "dissatisfied with medical care" trigger, either past or present, is a HUGE predictor of success and will stop most implanted techologies dead in their tracks.
  • Couldn't you sign a disagreement form?

    It gets nothing done other than go into your file-therefore anyone who sees it knows that you are aware of what was written is in your file & you disagree with it.

    I don't know how these things are done,and hope that I never have to,but now is as good a time as any to learn.

    As far as hugging the Dr.-I always use the same ruls as a handshake,men always wait for a woman to extend her hand in a handshake.I always wait for the Drs prompt in that situation,only because I am on his/her 'turf'.My PM started hugging me after about our 5th meeting,but none of my other Drs ever have.

    All of the psychologist claims sound terrible.It's obvious that he needs help himself.I would think that if he has treated you in this manner that there are probably others that have had issues with him.Of course you may never know or have any way of knowing,but other Drs may be aware or have their ways of finding these things out if they felt inclined to do so.Just thinking.
  • I didn't say these things. I did not see nor speak to this man from the time he gave me a pass on my psych eval to the time I walked in the door and he told me (this is a month and a half later) that he wanted to do more testing: the MMPI. We wouldn't tell me why. I should never have gone to see him but I was having a month long pain flare and since we seemed to have gotten along so well......But clearly, you're right. This report was constructed in such a way to keep me from getting the SCS as he told me he would. My problem now is how do I explain this situation going forward. I will file a complaint. But now, Bionic Woman, I'm unhappy with ANOTHER doctor, right? Oy vay. This is the way I'm looking at it now. I didn't get married until i was 48. It took me a long time to find the right man. Everyone told me i was being too picky. Somewhere out there is a PM doc for me. He will "get me". I will feel comfortable with him (or her). And we will live happily ever after. I just hope I find this person SOON. Susan
  • I'm sorry, I guess I worded that wrong. I generally type a whole bunch and then go back and delete the majority (for clarity's sake or if I think I've gone off on a tangent, lol) and I guess I deleted too much.

    What I had also typed (and then deleted) was - doesn't this change of mind on his part, saying you were cleared and then saying you're not, make him look bad? Did insurance pressure him to do a more thorough evaluation? I really hope it is something else like that because I would hate to think that a patient cannot go to a counselor and complain without having their entire treatment jacked around!!! That's what I was trying to say. I know you had already been "cleared", but I thought it had upset you that he wanted you to take that test way after the fact, and that maybe you were seen as "refusing" to take the test. Sorry about that.

    Picky? Well, I don't know you in person yet, but I think being somewhat picky is a good thing. I had my 2nd surgery with a guy a few people liked, I liked his bedside manner, and they he did terrible damage to me. My 3rd surgeon I massively "vetted", and didn't so much care for his bedside manner, but he was technically excellent and very picky for whom he operated. And it appears now that my 4th doctor here in our new state (2nd neurosurgeon, other 2 were orthopedic) is even pickier than the other one. He has hoops to jump through that are almost ridiculously strict and I'm not sure I see the benefit in forcing a patient to suffer for months longer. But, I keep my mouth shut when I see him because, like what happened to you, I am worried he could change the plan. They have the power, don't they?

    I'm just angry for you - WHY would he do this? Was he a pain psychologist? I just thought of that. Is he used to seeing patients in pain? I guess we've all learned a valuable lesson from your experience - don't use the same doctors for regular pain counseling as the one who does the psych eval for SCS, huh!

    I still believe you will find someone new as a PM and you will say "Now, I understand why I had to wait - this doctor is great." I'm praying .

    ( (HUGS ) )

    Cheri
  • Susan, I hope you find doctors who will take care of you next week. Please let us know how things go. We will be thinking of you and hoping this whole situation turns around. Meanwhile, try to take things easy and I hope you have a relaxing weekend.
  • That's the catch 22 of that portion of the psych eval, because it basically removes our right to be unhappy with any medical care we receive, even if another normal, rational person would be equally unhappy with the care - or lack thereof. ~X(
  • Cheri. I didn't take your comment wrong. (I don't think). You've always impressed me as someone who really wants to help. I had already gotten my insurance approval. My guess and its only a guess 'cause I surely am no mind reader is that he was ticked off because I was late. He then, excontemporaneously (wow--thats a long word) I mean in his ticked offed-ness decided he would "punish" me by having me take another test. When I called the neuroscience dept after leaving that appt I was told that taking the MMPI had nothing to do with my getting the stimulator. I think this guy just felt backed into a corner and had to concoct something to justify his request but you're right Cheri, I am going to be the model of MOUTH SHUT until that stimulator is in my butt. I plan to bring my darling husband with me on every visit. I've been joking with my primary (a habit that will stop immediately until that stim is in my butt) that I'm like Elaine on Seinfeld when she was banned by the AMA---remember that one? She looked at her chart? She had a rash? My first test of the mouth shut policy is now. My primary said he'd give me my pain meds for one month so I wouldn't have to go to the new PM doc asking for drugs. Well, my husband went and picked up the script after work and then went to the pharmacy and filled it and its the 4 mg dilaudid instead of the 8mg. The pharmacist told my husband "maybe they are trying to wean her off". I don't think its the doc. I think its the "leave a message system". I don't have enough 8s to last me until Monday but I don't want to go to my Wed. PM appts with 4mg. Dilaudid and tell the guy I really take 8 mg. so I'm going to have to practice not being frustrated when I call the clinic tomorrow. That frustration can really come across.
  • I had two appointments scheduled Wednesday. The second one turned into a mess. I kept getting calls (at my house when I'm at work--pet peeve)telling me my appointment is being cancelled because they hadn't received an order from my PCP but my PCP twice sent the order. That's okay because I used all the fouls ups as my reason for not going, saying I didn't know if my appointment had been cancelled or not. Actually, my earlier appointment went really, really well. The doc actually lives in my little town. We spent a bunch of time talking about my crazy anethestheologist neighbor and the stock market. It was really nice to have a doc that was friendly and NICE. He said he would have his collegue do my stimulator because its a little sticky to include the feet. He said its typical to develop foot pain after L5/S1 fusion surgery when scar tissue forms adhesions around the L5 nerve root. He said its unfortunate surgeons don't actually tell you that you can come out of surgery worse than you go in. I told him I thought the surgery was the biggest mistake of my life, but like an investment, I made the best decsision I could at the time given the information that I had. So he has a partner that has done THOUSANDS of stimulators. This doc has only done hundreds so he will send me to the other guy. In the meantime, he wants to give me an injection. I'm going to let him, even though I've never had any benefit at all from an injection and, in fact have felt worse for a few days a couple of times. But, its part of keeping my mouth shut, This group does not have any info about the recent fiasco at the medical college. So, ordinarily I would say "no" to an epidural, I'm just going to let him do it. They use the Medtronic devise exclusively. I got to pick up and feel the little piece that goes in my hip/butt. I'm keeping my eye on the prize. Susan.
  • I also have a new physical therapist who says my sacrum is tilted to the left instead of the right (or the right instead of the left). He thinks he might be able to reduce some of my nerve pain by working on my sacrum. AND. I'm all moved in to my new office in the suburbs (instead of downtown) cutting my drive time in half. I still have all my files in boxes and I miss my old assistant alot but generally things are looking up for me. There's a big beautiful snow storm. I stopped after work at the grocery store and you'd think it was the day before Christmas. Everyone was gathering provisions for the storm. Now the snow is coming down in big fat fluffy flakes. Its beautiful. I've given up on the notion of sending out Christmas cards. They'll be Happy New Year Cards instead.
  • My PM doc, who is wonderful, suggested to me either the SCS or pain pump. Of course, I jumped through the hoops because after hearing all of the success stories, I felt this was indeed my next step.

    Get to the psych's office. Nice enough guy. Did the initial review. Did the MMPI portion with all those questions. I rushed through it because I did not want to drag it out. I can't sit for long periods, either. I didn't want to have to keep taking break after break (which would have dragged it out even more). I am a quick reader (but not Evelyn Woodhead School of Quick Reading-quick ;) ).

    So, about 6 weeks go by and am at my monthly PM appointment. The Nurse Practitioner asked if anyone had discussed the report from the psych with me. APPARENTLY, this psych felt I was not a good SCS candidate due to my depression.

    Can I tell you my demeanor changed like Sybil. I told my NP I am sick and tired of being labled as depressed when I am mostly FRUSTRATED. The NP said he and my PM Dr. were both surprised with the report because they had felt I was a good candidate for the SCS. After ranting a bit longer I told the NP "I guess - what - he needs more patients? He wants to start treating me or something?" and the NP said "well, actually, he does want to see you - Just a couple sessions with him". So, now I'm too depressed for the SCS trial, but he can fix me in a session or 2.

    OY. I tell you. I was disappointed. BUT, then I got to thinking, what if he is right? What if I am NOT a good candidate? Do I really want to go through with this and be disappointed? I don't know if I could handle any more disappointment at this point in my shift here on earth...
    :?

    Sorry for going off track there. What I really wanted to say Susan, is that I had the mocrodiskectomy or laminectomy (can't remember which right now) and now I have scar tissue wrapped around the L5/S1 nerve. But, the problems I have experienced from this is NOTHING compared to where I was before my surgery. I am glad I had it. I would do it again even knowing what I know now. For ME it has been a successful surgery. I just traded one evil for another lesser (but still) evil.

    Good luck to you Susan. Keep us posted, okay?

    Jeaux

  • Comment ca va? (I'm dazzling you with my 2 years of college French. Believe me, the actual French, were even less impressed and made no bones about telling me so.) Back to the matter at hand. I am greatly offended on your behalf. I don't know you well, but I have been reading your posts and
    you do not seem mentally disturbed to me. I think you may have hit the nail smack on the head that the psychologist just wants an extra couple of pay checks. Sometimes I think, "Hey", it doesn't hurt me any, I'll just go along with it but other times I have to wonder about the honesty of the group and if that's who I want to have taking care of me. That MMPI is not objectively graded so if you have a squirrely psychologist (as I semed to have) you have to worry bout how he or she might rate you on that test. One should expect to find higher depression scores among a population of chronic pain sufferers. Depression should not exclude you from getting a SCS. It should be all the more reason (within limits, of course.) When my pain is realy, really bad, like a high 7 or 8 and its been there for seven days and seven nights, I AM DEPRESSED. If the pain goes away the next day (by going away I mean drops back down to a manageable 3, my depression goes away. I have in front of me my psych eval, the report (the only one I took and I passed) I am going to quote from the end of the report: " the nine exclusionary criteria for a neurosurgical intervetion were also reviewed today. There is no evidence of alcohol abuse, misuse, drug use or addictionl There is no evidence of somatization disorder in that these symptoms were situation specific and site specific consistent with underlying identifiable medical pathophysliogic condition. There is no evidence of ongoing depression although she acknowledges that she was clinically depressed at one time but has since resolved with treatment. Ms. K---- has very adequate family support and freely converses about a positive relationship with her husband, Dennis and producing a photo of him and their four (sic) dogs.There is no evidence of secondary gain and no evidence of nonphysiologic/nonorganic symptomatology. In summary, Ms. K------does have complaints about some of her previous providers. Based on objective evidence of the record, she does not meet any exclusionary criteria and therefore could be considered a reasonably good candidate for a positive outcome.... ( I always wanted to write in a sic which means as written because I do not have 4 dogs. In the photo, there were three but I only have 2 currently) So I guess the depression thing is there. I didn't even realize it. Being ever so recently a member of the "keep your mouth shut school of patient philosophy", I would put on a happy face and go charm the pants off of Dr. Psycho and get your stimulator under the theory that taking away your pain would take away your depression. I did find our that i had a very low vitamen D level and after taking megadoses of the vitamen lost the depressed feeling and gained tons of energy. Its very common. It might be more common in chroic pain people because we don't get out in the sun' Its a simple test, Jeau bert, you could present the results to Dr. Psycho. I felt better immediately--within days. it was amazing.
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