The Power of Pushy


Standing up for yourself can improve your pain, here’s how to do it.

Making the most of the time you have with your doctors and other healthcare providers is one of the most powerful ways to effectively manage your pain. From addressing any shortcomings in in your treatment plan to making crucial decisions about your medication, communicating with your doctor is key to living as pain-free as possible. Still, many chronic-pain patients worry about bothering their doctors and have a hard time being assertive, says Teresa Flynn, former director of public awareness and project development at the American Pain Foundation.

For Cheryl Neuenschwander, dealing with doctors was long a major source of anxiety. There were many times when I felt like my doctors were too busy for me and my symptoms were discounted, or I was simply told, Here, take a pill, she says of her experience coping with fibromyalgia, myofascial pain syndrome, two herniated discs in her lower back and spinal pain from two failed cervical surgeries. I was afraid to speak up for myself for years, she adds, noting that taking part in an integrative chronic-pain management program has transformed her relationships with her physicians.

Neuenschwander’s anxiety is understandable, says psychotherapist Lisa Frankfort, Ph.D., author of How to Stop Backing Down & Start Talking Back (New Harbinger, 2005). For people with chronic pain, the experience of being in pain day in and day out can be exhausting and debilitatingcertainly not conducive to putting yourself out there, she explains. To make matters worse, research shows that people with chronic pain especially women often struggle to have their pain concerns taken seriously by doctors. A lot of women have been socialized to believe that standing up for themselves is impolite at best, and in turn fail to ensure that their concerns are addressed, Frankfort adds.

Rather than resigning yourself to feeling powerless at office visits, you can make improving communication with your providers a top priority. For help in getting pushy about your pain in a positive way take these six steps toward more successful visits with all your providers.

Patients have to really work on their ability to express their pain, instead of minimizing their concerns out of fear of irritating their doctors, says Russell Portenoy, M.D., chairman of the department of pain medicine and palliative care at Beth Israel Medical Center, in New York City. A good place to start: Stop trying to second-guess what your provider is thinking, Frankfort says. If you are thinking that your doctor is going to think you’re whining, or you’re wasting her time, stop right there and remember that you actually have no idea what’s going on in your doctor’s mind, so you might as well focus on you and your agenda, she says. Your doctor’s bedside manner isn’t personal. Many excellent doctors don’t have people skills, Frankfort adds.

Being careful about the language you use to talk about your pain can go a long way in helping your doctor treat you, says Portenoy. Most patients aren’t so skillful in portraying their pain, he says. But the more precise and descriptive you get, the better you and your doctor will be able to communicate. Frankfort recommends keeping a small notebook on hand to track your symptoms and record any specifics you’ll want to share at your next visit. In addition to homing in on the words that best depict your pain (such as burning, throbbing or stabbing but quickly disappears, jot down details like timing, where it hurts and possible triggers. Before a doctor’s visit review your notebook or pain journal and make a bulleted list of problems you want to discuss, as well as any questions.

To take charge right from the start of your visit, acknowledge the short time available and let your doctor know that you’ve prepared a list of questions and concerns about your condition. This will engage you two in a collaborative relationship, rather than one in which your doctor has to ask all the questions and you have to ask all the questions and you have to take up your time answering them under stress, Frankfort explains.

One of the best ways to maintain a sense of assertiveness especially in a situation that might cause you anxiety is to stay on target, Frankfort says. Keep your notebook in your hand for easy reference. This will also remind your doctor that you have specific questions or information you wish to know. Steer the conversation by beginning each sentence with I’d like to know or My concern is that and refer back to your list of questions if you feel flustered.

Because remembering all your doctor’s advice can be difficult when you’re feeling anxious, write down the answers to your questions and concerns throughout your visit. If you can’t follow the terminology, ask your physician to clarify it in laymen’s terms, advises Teresa Flynn. And remind yourself that understanding each other benefits both of you and not knowing the meaning of a term or phrase doesn’t say anything about your intelligence.

If your doctor seems irritated, rushed or impatient, it’s OK to acknowledge that. You might say that you realize your time together is limited, and ask him directly if there is time to quickly address a few more concerns. By putting the ball in the doctor’s court, you’re forcing him to refocus on you and your needs, Frankfort explains.

Above all, Flynn urges, bear in mind that it’s your absolute right to have your pain treated. A key part of that treatment is being listened to and taken seriously by your doctor, she says. But you have to be proactive and take the first step in tackling the problem and remember that ultimately you’re the one who’s the top expert on your pain.


Written by: Elizabeth Barker, freelance health writer living in Los Angeles
Published by Pain Solutions Magazine, Spring 2010
Photo Credit: by Orangeline, courtesy of Stock Free Images

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