Psychological Evaluation B4 Implant
 

Just wanted to start a thread on this subject, as I recall how I felt when first told I need to have this before being considered a candidate for SCS Implant.

At first I felt intimidated and paranoid wondering if I was being perceived as 'crazy'.

This was not the case. Most insurance companies require a psychological assessment as protocol before being considered as a candidate for this procedure. What they are looking for is your expectation of what the implant will do, what is your perception of the pain you suffer, and if you are truly willing to accept this 'foreign object' put into your body.
From the physician's perspective, they are mainly looking to rule out any type of somatoform or conversion disorder, and perhaps to make sure there is not an untreated drug/addiction dependency.

I was told that, in the past, before these assessments were mandated, there was a higher rate of failure with the implants for several reasons, one of which the patient did not have a clear and realistic expectation of what the implant would do. Insurance companies were losing alot of money over this.

So, relax, be open and honest and in the end everyone will be on the 'same page' and feel better about the procedure.
Afterall, it does take quite a teamwork to make it a success - You, your family, your primary care physician, your pain specialist, and the representatives of the company who will be rendering your new 'bodypart'. :p

Anyone care to weigh in?

As far as the 'assessment' goes, mine consisted of a 200 question form to fill out (similar to an ACT/SAT test) and a 45 minute visit with the therapist. He mainly focused on asking me about my family life and how the pain has affected my quality of life.

they are all tricky questions arent they.....:D


it depends on what test they decide to use.

They tend to ask the same questions in several different ways. I guess the figure that if you're lying then you can't possibly remember the answers to each question. lol. Just be honest. They just want to make sure you are ok with having somethiing implanted into your body, and that you understand it will not cure you.

Hugs
Mary\

Evaluation
 

I also had an evaluation but mine was for the initial visit with my first PM doctor (whom I eventually fired!). This was part of his patient profiling before he would diagnose or treat me. I have since found out the my Work Comp would have made me get an Eval anyway, so it worked out to my advantage.

When I first received the packet I was blow away at how big it was. There were two test all multiple choice and they were very similar in concept and questioning. I was overwhelmed at first because I didn't want them to think I was crazy or that I was making things up. Of course, you could look at my leg and tell that I had full blown RSD. I decided to just dig in, be totally honest and not get frustrated. Took forever to complete but I did and turn it in at my initial visit. They took it and scanned it into the computer to get the various results.

Then I meet with the psychologist who did a one-on-one evaluation (took about an hour). During that visit he informed me that the evaluation is to determine several factors (here are a few that I can remember); how you mentally and physically react/handle pain, how your lifestyle (family, work, etc.) effect and/or contribute to your pain, how you handle and process stressful situation, make sure that I am not a person seeking a source for prescription drugs (drug addict), and gave me information on how Work Comp usually handles cases involving RSD. I insisted that my husband be present to make sure that I was not pressured into a situation that would result in a negative diagnosis.

I received a favorable diagnosis... I am not crazy, I do have REAL pain and I do handle stress well. The only thing he recommended is that I quit smoking - which I am doing very well with.

When I changed PM doctors, he reviewed my Eval and then proceeded with treatment of drugs and eventually, implant of SCS.

If you are required to complete an Eval I would recommend that you take your time, have a quiet place to concentrate on the test and don't try to beat the test... just be honest. You want to get an accurate reading because it will help you in the long run for the proper treatment.

My test was like that. The only thing is I had to take mine in the drs office. Mine showed that I was normal. (what is normal when you are in pain 24/7). It did say that the test showed that I would be inclined to become an alcoholic That is so funny to me, as I don't drink. I hate feeling sick, so anything that would make me feel that way is out the door. lol It also said that I hate to ask for help in any way. (so true). That is because growing up, being sick in our house wasn't a good thing, so I learned just to do for myself and not to say anything. I guess sometimes you just can't shake the way you were raised. It turned out I'm normal enough to get the scs twice and now the pain pump. Just be honest and you will be fine.

Hugs
Mary

Thank you all for weighing in on this. I too had the evaluation before my implant. The only thing that bothered me was having to take this in severe pain and on lots of Meds. Of course it was favorable and I had the implant. Wonder if I could pass without the severe pain and not heavily medicated!!!! LOL Just kidding.

The advice above is correct -Just be honest-Fondly-carol

I too had to have a evaluation before my SCS implant. I had only about 10-15 question sheet to fill out. Then the doc did about an hour long interview. My doc pointed out my OCD and said that I seemed depressed. I knew about the OCD, I think I've had it since high school. I ask him do you not think any one in as much pain as to be willing to have an invasive procedure such as a SCS, don't you think they might be just slightly depressed. So he says yes. He said that if you have pain all the time like that, that as your depression gets worse it can actually make the pain worse. He said that I should treat the depression and the pain and maybe we could achieve a happy median. So with that said I started on depression meds. He gave me the go ahead for the surgery. At the time it made me feel as if I were a nut case, but the more people I talk to do take meds for depression if they are in pain. I guess now I just feel like they go hand in hand depression and pain. Maybe I might not be a nut case. LOL With that said I guess my main thing is don't feel embarresed to have a physciatrist they do help alot if you truly need them.:hug:

I very much appreciate the posts to this thread, as I am in the process of diagnostic evaluation precedent to an SCS implant and soon I have the psychological eval. I have spoken with a patient ambassador for the manufacturer of the device, and that went very well. I just hope to attain a reduction of meds approach to my pain management if, as my physiatrist and prospective surgeon believe, I present as a patient who is right for the procedure. This is just one more in the many hurdles necessary to clear for both the medical and my personal evaluation of the process as a whole. Thank you all very much! Mark56

Good luck Mark 56
 

Best wishes to you on the eval. and the procedure!
Please let us know how it all turns out!
Glad you found this wonderful forum....full of caring, loving folks who TRULY know the meaning of pain....

Hope to get to know more about you!
Rae:hug:

Thank you, Rae- I have been posting quite a bit on a discussion forum we started on facebook called Sciatica Sucks! We have close to 700 members there. We also started a .org under **and all of this effort because my son encouraged me to reach out to try to help others in my circumstance.

I was injured in a high speed car wreck 5 years ago, and pain has been my constant companion ever since. I have followed all steps my docs have prescribed, and yet the levels do not abate. So..... well, my physiatrist recommended the SCS procedure. I am pretty far down that path, anticipating the psych eval, which is what brought me to your thread.

Thank you for your help in posting. I was wondering at the full range of inquiry, and I now have a better grasp than before. :grouphug: Mark56