[dahlek]

Was watching PBS's Second Opinion show this last weekend about 'Chronic Pain'...diagnosis and treatments...And one thing hit home...Person/patient is experiencing 'excruciating pain'... and some quest docs just rolled their eyes...etc. Who here hasn't seen THAT?

For a while, it's seemed to me, that most [but for a few gifted listeners]docs and patients really don't know HOW to communicate effectively TO and for each other efficiently! Is there any way, such as guest docs who could provide some sort of 'forum' whereby they could describe the differences [in the varied fields, of course] of maybe WHAT they deem to be ideal patients vs. the ones they go 'UhOH!' to?
For us to be able to get OUR points across, vis-a-vis pain and other issues, we need to learn to speak either 'doctor-speak' or find a fast, succinct common ground. It would benefit us both...as long as it didn't turn into a DIAGNOSE ME on-line thingy. I guess what I'm trying to get at here is that we both have to HAVE some IDEA of the language the other is receiving facts in and NOT lose key facts in the translation?

Since I have a chronic and truly painful condition, I do know that I've not found many substantive nor accurate 'terms' for use in describing current, past, different, or new pains.... Just maybe even a source of hearing 'docs' telling of perfect patients and, honestly, those from deep down SOUTH [no-offense southerners, but ya know what I mean?] A way -that we could establish useful consistent vocabularly to describe things that cuts the mush and gets down to 'business' well, would be a useful TOOL for folks new to this whole world, usually one they never expected to be IN? BTW, I do not DO happy faces...EVER!

We as patients have to be, well, succinct. We do not know HOW to be so. Docs are, at times, are too much so for the mere mortal to asorb, process and react to...

Lets' cut the fruitcake and get down to business? Words are tools, How do/can we use them most effectively? Thanks - j

[Jomar]

At one of our meetings at work{when I worked} our manager was talking about how different people get and process information.
It may not be the words but how we say them and how the Doctors process them.

I think it fits in with your topic - Communication

[Extroverted or Introverted
This category deals with how we prefer to interact with the world and how we prefer to get our energy and stimulation. Extraverts are energized by other people and action. They are talkers, often thinking out loud, interrupting people at meetings, or bursting into a co-worker's office to ask an opinion, and then not really listening to it. Extraverts become drained when they have to spend too much time alone; they need other people to function. Introverts, on the other hand, get their energy from their own thoughts and ideas, rather than heated discussions. Introverts rarely speak up at large meetings, preferring listening to talking. Introverts need alone time, especially after spending a few hours with people.

Introverts are outnumbered by extraverts by about three to one in America. Extraverts are often rewarded in school, by participating in class discussions, and at work, because they are popular and outgoing. Introverts, on the other hand, are often undervalued because they keep their best to themselves.

Sensor or intuitive
This category deals with how we prefer to gather information about the world. As the name implies, sensors prefer to use their five senses to gather information. Sensors are quite literal, preferring facts and details to interpretations. If a hard-core sensor asks what time it is, he or she expects to hear "11:07 a.m.," and not "a little after 11" or "about 11." About 70 percent of Americans are sensors. For iNtuitives, on the other hand, everything is relative. They aren't late unless the meeting has started without them. iNtuitives look at the grand scheme of things, trying to translate bits of information, through intuition, into possibilities, meanings, and relationships. Details and specifics irritate iNtuitives.

iNtuitives see the forest; sensors see the trees. When working with sensors or iNtuitives, it is important to remember these differences. Sensors prefer to learn through sequential facts; iNtuitives through random leaps. The task- "Please sort through these surveys" - means something entirely different to sensors and iNtuitives.
Thinker or Feeler
This category deals with how we make decisions. Thinkers base their decisions on objective values, and are often described as logical, detached, or analytical. Some thinkers are thought of as cold or uncaring because they would rather do what is right than what makes people happy. In contrast, feelers tend to make decisions based on what will create harmony. Feelers avoid conflict; and will overextend themselves to accommodate the needs of others. Feelers will always "put themselves in somebody else's shoes" and ask how people will be affected before making a decision.

This is the only personality type category related to gender. About two-thirds of all males are thinkers, and the same proportion of females are feelers. There often are problems in the workplace for those who don't conform to their gender's preference. For example, a feeling man is labeled a "wimp." Much more negatively, a thinking woman is "unfeminine," she "has a chip on her shoulder" or much worse. Thankfully, nobody is 100 percent thinker or 100 percent feeler (as with the other personality types). Everyone, to some extent, cares, thinks, and feels, but final decisions are reached through very different routes, based on a person's true personality preference.
Judger or Perceiver
This category deals with how we orient our lives. Judgers are structured, ordered, scheduled, and on-time. They are the list makers. Judgers wake up every morning with a definite plan for the day, and become very upset when the plan becomes unraveled. Even free time is scheduled. Perceivers, on the other hand, rely on creativity, spontaneity, and responsiveness, rather than a plan or list, to get them through the day. They burn the midnight oil to meet deadlines, although they usually meet them. Perceivers like to turn work into play, because if a task is not fun, they reason, it is probably not worth doing.

Experts say that this personality type difference is the most significant source of tension in the workplace and in group work. Perceivers prefer to keep gathering information rather than to draw conclusions. Judgers prefer to make decisions, often ignoring new information that might change that decision. Hence, the conflict. The authors of the book contend that a good balance of judgers and perceivers are necessary for a well-functioning work group. Judgers need light-hearted perceivers to make them relax, and perceivers need structured judgers to keep things organized and reach closure on projects.]
http://www.personalitytest.net/types/definitions.htm

http://webhome.idirect.com/~kehamilt/ipsycom.html

Also many people are Visual - they need to see a list or a pain diagram for it to sink in.

[Doody]

What I wonder is...what is so difficult to understand when you tell someone you are in excruciating, chronic pain? What part of that doesn't a doctor understand? They need to stand in a chronic painer's shoes.

[Julie]

On this same line...I would never, ever and anyway since I'm post-menopausal, see a male OB/GYN. I remember during my many trips to the ER during my pregnancy with Michael and having to deal with male doctors and say...."you know that kind of weird feeling you get when the baby does whatever, well it hasn't happened lately," and just get back that blank stare. There is just something about a doctor that has to have experienced what you are experiencing. ITA about chronic pain and I've even dealt with that blank stare with my neurologist talking about seizures.

[DiMarie]

My thoughts are because pain is objective. There is no test to rate pain or validate.

I do find if I take a pain diary sheet that diagrams the type of pain, burning, stabbing, tingling or numbness, and the outline of a body to place the markings to shoe where we hurt and the patterns, it makes Pain 101 to the doctor down to his level. More credibility to our complaints, and can produce a pattern of similar symptoms in similar patients to make it "Click".

IF there were a test or machine the doctor could hook up like an EMG and it gave a reading where the pain was, how high it was and the type of pain generator, he could understand that.

But, we are often humans with hidden disabilities and complaints, in an age some can ruin it by manifesting pain complaints to seek drugs, also a society that opiate therapy by most doctors is not an option.

I think the next step is to take body paint from the 70's and paint red, in pain generator spots, blue in poor circulation spots, black on the lines it travels and a big frown face on my butt side!

I will never forget Dr.Robert Schwartzman with psych interns sitting in an exam for a family member that SHOWED what pain is. By reproducing the symptoms (which are painful) he demonstrated how the pain generates and affects the person. That although many test show nothing it does not mean the pain is not there.

He even showed the left over Carpal Tunnel scars that the doctors had a positive EMG for Ct operated, found nothing, but pain was still there. HE noted the pain came from a compression higher then the carpal tunnel and how to find out how high and where the compressions are......

Those interns hopefully had something stick in and will never diagx or treat someone as with "Pain is in their head."
Dianne

[dahlek]

Dianne: did you mean 'OBJECTIVE" or Subjective? There are NO standardizations of PAIN to be found other than the 'happy faces' that truly adequately describe Pain, or different forms/types of pain anywhere. Frankly to me, 'Happy Faces' do not cut it ...AT ALL!

I believe it can be further complicated by PAIN and PAIN MEMORY...areas that were researched decades ago...BUT, I've not found any consistent set of VOCABULARY to accurately describe different types other than a non-official [tho good] scale -Mankowski Pain Scale....

As for drug seekers, those who do such have to have Testing...which we are able to achieve results that can Validate many aspects of pain and pain perception...

Julie: Hey, to me, it's the SIZE of the hands? Tell me different, someone... No GUY has ever, ever gone thru the kind of cramps that have a body pass out from the pain etc....no sympatico there whatever! Gloves or not, what about those Hairy hands? Teeny hands - definitely a requirement!

Jo: the question goes further than Patients as to the personality types...I'm trying to get at the issue of THE DEGREE of training docs receive [from what I gather only at first year training] to be able to communicate more effectively with US! I've looked and not seen any types of courses for 'improved communication' vis-a-vis post-grad docs and patients out there. Most practice management offerings are about liability and profit margin management.... The issue is more about HOW we perceive each other...communicate more efficently and effectively. Far, far more basic issues .. such as When I say [patient] X,Y, &Z Doc HEARS A, B & D...

Getting any doc's impressions about patients say, who have the same symptoms, and how one expresses the issue more effectively...thus getting treatment of the right sort...faster is my goal in all this...
I have to admit, that at times, I can and havebeen a probable doc's nightmare...but the doc's ability to REALLY continue communication and LISSEN! to my issues is what got us [together] over the humps?

Maybe, some docs putting a short term effort of their brain matter, together to put out a summary of WHAT they would like us to say, how say, and document to date the SAY could make/help those who don't have docs who listen, if only because WE are able to SAY it in terms they can hear! Relate to?

Do doc's want us to come in 'cold'? Bring past tests? Start over from essentially raw ground? WHAT? HOW do they react to such patients?

I've experienced all the categories doc-wise Jo, and at times, I almost feel I have to be a chameleon to fit in... I do not like being like that. Others can't or unable to compromise as such...Frankly I can't blame them...nor should they have to!

HARD POINT to address is: HOW can we communicate to be faster, more effective, and more efficient? I dunno about YOU, but I want my 10-15 minutes w/a doc to REALLY, really COUNT! Excess verbiage can only take up precious moments - j

Pain free moments to any and all!

[Jomar]

I understand what you mean, but I think even if we said everything perfectly -concise and clear- chances are it wouldn't get translated/processed by the doctor the way we said it.

I'm sure they can't write as fast as I can tell my symptoms- so i try to slow down - but it would help if they would say "ok just a second let me get all this " or something instead of just skipping over something that might be important.

[dahlek]

why can there not be a 'forum' somewhere, to establish some form of common verbal ground? That is the real issue.


Good thoughts and pain free moments to all! - j

[Jomar]

I wonder if the AMA would have something like that?
Or any other medical/doctor oriented website.
I've never thought about looking for anything like that.

[Jomar]

You got me thinking on this -
with a quick search of - "doctor patient communication"

Doctor-patient communication: a review of the literature.
Communication can be seen as the main ingredient in medical care. In reviewing doctor-patient communication, the following topics are addressed: (1) ...
http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Citation - Similar pages
Doctor-patient communication: a comparison of the USA and Japan.
BACKGROUND: Little is known about the differences and similarities between doctor-patient communication patterns in different cultures. ...
http://www.ncbi.nlm.nih.gov/entrez/q..._uids=12738696 - Similar pages
Doctor-Patient Communication
Doctor-Patient Communication. Stephen Barrett, M.D,. Intelligent consumers should locate and use a primary physician (or medical group) who provides care ...
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Doctor-Patient Communication Getting started
The articles in the series “Doctor-Patient Communication” have been adapted from articles that appeared originally in the French-language journal ...
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Improving doctor-patient communication -- Meryn 316 (7149): 1922 ...
Good doctor-patient communication offers patients tangible benefits. Many studies have found significant positive associations between doctors' ...
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Health Report - 21/02/00: Doctor-Patient Communication
A recent study from the Medical Psychology Unit at the University of Sydney looked at how well cancer specialists communicate with their patients.
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JAMA -- Abstract: Doctor-patient communication. Clinical ...
Research in the social sciences has clarified the nature and problems of doctor-patient communication. The development of adequate communication skills is ...
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