Dr Patty's New Chronic-Intractable Pain and You Main Site - Vote 4 Your Health Activist

Dr Patty's New Chronic-Intractable Pain and You Main Site - Vote 4 Your Health Activist

Dr. Patty's New Chronic-Intractable Pain And You Sites, Inc. Pain Around...

Please watch another home made video about our new site "Chronic Pain Around The World". Please watch!

Dr. Patty's New Chronic-Intractable Pain and You Sites, Inc. Advocacy Course

Dr. Patty's New Chronic-Intractable Pain and You Sites, Inc. Advocacy Course. This video and song go very well together! Those of you who are familiar with the song, it could be discussing an advocate. This song was danced to on our wedding day when I got up with 2 canes that were hidden to dance with my new husband. I am thankful for being able to do that!

▶ Dr. Patty's New Chronic-Intractable Pain and You Sites, Inc. End The War On Drugs Website - YouTube

The Story Of Dr. Patty's New Chronic-Intractable Pain and You Sites, Inc.

While still in the hospital, I wanted to picturily give you all an accounting of the old days of a group to the brand new redesigned website with full nonprofit 501(C)3 status that it is today!  Please watch and enjoy! 
Dr. Patty's New Chronic-Intractable Pain and You Sites, Inc. 
www.chronicintractablepainandyou.net www.chronicintractablepainandyou.org Under New Management

Please Join Our New Website! Think about becoming a part of our volunteer Family

A Gift For All Pain Sufferers! This is my second home made video! Enjoy! Please Join Our New Website! Think about becoming a part of our volunteer family!

Hugs & Prayers To Pain Sufferers Around The World,
Dr. Patty Verdugo PsyD
President and Founder of Dr. Patty's New Chronic-Intractable Pain and You Sites, Inc.
www.chronicintractablepainandyou.net

Doctors and Patients are the Latest Drug War Casualties

 It’s uncomfortable to hear Dr. Frank Fisher speak. His eyes are usually glassed over, seemingly on the verge of tears.
Above them rests a sweeping coif of white hair; below, a thick, well-manicured white bear....http://members.webs.com/MembersB/editAppPage.jsp?app=forums&pageID=303402233#forums/topics/show/9345917-doctors-and-patients-are-the-latest-drug-war-casualties

The DEA War on Doctors

Since the late 1990s, the U.S. Drug Enforcement Administration has allied with state and local law enforcement agencies to stamp out abuse of the painkiller OxyContin. Citing rises in emergency room episodes and overdoses associated with the drug (both of which have been roundly disparaged by critics), the DEA insists....http://members.webs.com/MembersB/editAppPage.jsp?app=forums&pageID=303402233#forums/topics/show/9345923-the-dea-war-on

Using Marijuana to Treat Pain? A Pill May Outlast a Puff

A pill may work as well as a puff when it comes to using marijuana to treat pain, according to a small but carefully controlled new study. Pain relief from pills may last longer, however, and may not leave people feeling as high as they do after they smoke....
http://members.webs.com/MembersB/editAppPage.jsp?app=forums&pageID=303402233#forums/topics/show/9345993-using-marijuana-to-treat-pain-a-pill-may-outlast-a

Topic: Using Marijuana to Treat Pain? A Pill May Outlast a Puff

Using Marijuana to Treat Pain? A Pill May Outlast a Puff:  A pill may work as well as a puff when it comes to using marijuana to treat pain, according to a small but carefully controlled new study. Pain relief from pills may last longer, however, and may not leave people feeling as high as they do after they smoke the drug... To read more please click on our link: http://drpattyshowtobeabetterhealthadvocate.webs.com/apps/forums/topics/show/9343564-using-marijuana-to-treat-pain-a-pill-may-outlast-a-puff

More About Chronic Pain, Opioids, & Suicide

More About Chronic Pain, Opioids, & Suicide

 

More About Chronic Pain, Opioids, & Suicide: A virtual avalanche of articles has appeared in the medical literature recently discussing opioid analgesics for chronic pain. Almost without exception, the news and views are disparaging; in some cases reflecting a poor quality of evidence and, in others, conveying biases of the.... http://chronicintractablepainandyoufrankandtaboogroup.webs.com/apps/forums/topics/show/9343543-more-about-chronic-pain-opioids-suicide 

More About Chronic Pain, Opioids, & Suicide

More About Chronic Pain, Opioids, & Suicide: A virtual avalanche of articles has appeared in the medical literature recently discussing opioid analgesics for chronic pain. Almost without exception, the news and views are disparaging; in some cases reflecting a poor quality of evidence and, in others, conveying biases of the.... http://chronicintractablepainandyoufrankandtaboogroup.webs.com/apps/forums/topics/show/9343543-more-about-chronic-pain-opioids-suicide

Suicide and Chronic Pain: The Facts, Risk Factors, and Warning Signs:

Suicide and Chronic Pain: The Facts, Risk Factors, and Warning Signs: 
The possibility of someone taking his/her own life is real. Every year, people commit suicide when least expected. Unfortunately, denial allows the warning signs to go unnoticed and the facts to be buried six feet under.  When someone does commit suicide, a community, family or circle of friends is forced to face the reality that certain....http://chronicintractablepainandyoufrankandtaboogroup.webs.com/apps/forums/topics/show/9343522-suicide-and-chronic-pain-the-facts-risk-factors-and-warning-signs

Topic: Suicide and Chronic Pain: The Facts, Risk Factors, and Warning Signs

Suicide and Chronic Pain: The Facts, Risk Factors, and Warning Signs: 
The possibility of someone taking his/her own life is real. Every year, people commit suicide when least expected. Unfortunately, denial allows the warning signs to go unnoticed and the facts to be buried six feet under.  When someone does commit suicide, a community, family or circle of friends is forced to face the reality that certain....http://chronicintractablepainandyoufrankandtaboogroup.webs.com/apps/forums/topics/show/9343522-suicide-and-chronic-pain-the-facts-risk-factors-and-warning-signs

Dashboard - Google

 Behance Laision (Volunteer Position)



“Friend” Dr.Patty and all staff

Customize your profile and put up a picture, it can be a tag or a pet or an avatar.

Check your private email daily as notifications and private messages are sometimes routed through general email. A CIPAY mailbox will be provided for CIPAY business only (chronicintractablepainandyou.net).

Check your inbox when you are online.

Post information from the main sites into Behance and keep the information updated.

You will report to Dr Patty

Must know how to write and proofread documents

Must know computer operations and have a Word or other writing program

Have an understanding on what social media does to help get the companies name more visible.

Must know how to use spell check and grammer check

Must be able to go into some of the sites and update and create information on the specific site you are working in.

Must familiarize yourself with the New Chronic-Intractable Pain and You Sites, Inc.

Must be able to talk with Dr Patty on the phone at least once a week.

Training will be given

Dr Patty's Course On How To Become A Better Advocate For Yourself And Others?
http://www.chronicintractablepainandyou.org/events/dr-patty-s-course-on-how-to-become-a-better-advocate-for-yourself#.UTjcylfkd_Q

What To Expect From Your Depression Treatment Please come to the main site to read and comment!
http://www.chronicintractablepainandyou.org/forum/topics/what-to-expect-from-your-depression-treatment#.UTfs8Ffkd_Q

FDA Announces Medtronic Pain Pump Recall - Chronic-Intractable Pain And You, Inc. (Main Site)

FDA Announces Medtronic Pain Pump Recall

On Monday, the FDA announced that Medtronic has issued a Class I recall of their SynchroMed II Implantable Infusion Pump, models 8637-20 and 8637-40, distributed between May 2004 and July 8, 2011. These are the same pumps for which an alert was issued in July of this year.

You can read the details of the July alert here: Pain Pump Alert: Potential Problem With Medtronic SynchroMed II Pump

Reason for Recall

The reason given for the recall is that “there is a potential for reduced battery performance in the SynchroMed II infusion Pump. Medtronic’s analysis of the problem indicates it is related to the formation of a film within the pump battery. This problem can lead to the sudden loss of therapy and the return of underlying symptoms and/or therapy withdrawal symptoms. For example, patients receiving intrathecal baclofen therapy for severe spasticity are at risk for baclofen withdrawal syndrome, which can lead to a life-threatening condition if not treated quickly and effectively.”

Recall or Alert?

The FDA listed this as a Class I recall. Class I recalls are the most serious type of recall and involve situations in which there is a reasonable probability that use of these products will cause serious adverse health consequences or death.

That being said, Medtronic is not retrieving any implanted SynchroMed II pumps from the field. The announcement says, “Medtronic does not recommend prophylactic replacement of SynchroMed II pumps because of the estimated low occurrence rates, the presence of pump alarms, and the risks associated with replacement surgery.”

Instead, Medtronic encourages patients to carry their patient identification cards with them at all times and to contact their physicians immediately if they experience a return of symptoms or hear a device alarm.

My Thoughts...

I find the term “recall” a bit misleading since Medtronic is not actually replacing the pumps in question. This seems to be more of a strong alert warning you that there could be problems ahead. Actually, this seems to be little more than a repeat of the July alert. I'm not really sure why it is being reiterated unless the FDA is just a couple of months behind in making the announcement.

Although I don't personally have any experience with pain pumps, I know a number of our community members have them. If you have one of the models involved in this recall, I would encourage you to talk with your physician about what you should do if you experience a sudden return of symptoms or begin to go through withdrawal . . . particularly if this should happen at night, on a weekend or over a holiday when your doctor is not in his/her office.

If you have additional questions about this recall, contact Medtronic Patient Services at 1-800-510-6735, Monday – Friday, 8 a.m. to 5 p.m. CDT.
_______________
Source:
Medtronic Model 8637 SynchroMed II Implantable Infusion Pump. U.S. Food and Drug Administration. 9/12/11.
http://www.healthcentral.com/chronic-pain/c/5949/144117/fda-medtronic

Steroid Injection, Carpal Tunnel

Overview
Carpal tunnel syndrome (CTS) is a compressive focal mononeuropathy that is brought on by compression of the median nerve as it travels through the carpal tunnel. Patients commonly experience pain, paresthesias, and weakness in the median nerve distribution. Carpal tunnel steroid injection at the wrist is used to treat the symptoms of carpal tunnel syndrome by injecting a steroid solution into the ulnar bursa surrounding the median nerve.
For mild to moderate carpal tunnel syndrome, carpal tunnel steroid injection can be used in conjunction with other conservative measures such as splinting, physical therapy, ergonomic modifications, rest, and regular exercise.^{[1, 2, 3, 4, 5]} Conservative modalities, including median nerve steroid injections, should generally be attempted prior to pursuing surgical options.^[6] Historically, carpal tunnel steroid injections were typically used for only mild median nerve entrapment (as documented by electroneurography) as well as for temporary pain relief in anticipation of definitive flexor retinaculum surgical release. In general, injected corticosteroids appear effective in reducing subjective symptoms for 1-3 months when compared to placebo.^[7] While short-term relief of symptoms after injection appears superior to relief after carpal tunnel release surgery, the advantage is lost over the course of a year.^[8]
Electrodiagnostic studies such as nerve conduction studies and electromyography are typically obtained to determine the severity of nerve damage prior to performing the procedure.^{[9, 10]} Steroid injections should be avoided prior to planned electrodiagnostic testing, as the presence of steroids may alter test results. Several clinical tests can be used to diagnose carpal tunnel syndrome. One is Tinel's sign, which is done by over the median nerve at the volar crease at the wrist to reproduce the paresthesia. The Phalen test involves holding the flexed wrists against each other for several minutes to provoke the symptoms in the median nerve distribution. Manual carpal compression testing is done by applying pressure over the transverse carpal ligament and evaluating for paresthesia within 30 seconds of applying pressure.^[11]
Carpal tunnel anatomy
The carpal tunnel of the wrist is defined anatomically by the transverse carpal ligament on the volar surface and the carpal bones on the dorsal surface. The transverse carpal ligament, also known as the flexor retinaculum, attaches radially to the trapezium and scaphoid tuberosity and ulnarly to the hamate and pisiform. The contents of the carpal tunnel include the 4 flexor digitorum profundus tendons, the 4 flexor digitorum superficialis tendons, the flexor pollicis longus tendon, and the median nerve. See images below.
Carpal tunnel anatomy. Carpel tunnel anatomy, cross-section.
There are 2 bursae in the wrist. The radial bursa contains the flexor pollicis longus tendon. The ulnar bursa, also known as the common flexor sheath, holds the flexor digitorum superficialis and profundus tendons. When the hand is supinated, the 4 superficialis tendons lay on top of the 4 profundus tendons, forming a U-shaped structure referred to as the ulnar bursa. On top of the ulnar bursa, and below the transverse carpal ligament, lies the median nerve. Although the median nerve itself has 2 sensory branches and 1 motor branch, only 1 sensory branch and the motor branch traverse through the carpal tunnel and are affected by carpal tunnel syndrome. This sensory branch is responsible for sensory innervation of the thumb, index finger, middle finger, and radial half of the ring finger. 
Indications

• Carpal tunnel syndrome not relieved by conservative measures
• Electrodiagnostic changes consistent with mild-to-moderate median nerve entrapment

Contraindications

• Adverse reaction to injectable steroid or anesthetic
• Uncontrolled diabetes mellitus
• Active systemic or local infection
• Compromised skin integrity over the area
• Immunosuppression
• Planned electrodiagnostic study

Anesthesia

• Lidocaine (Xylocaine) 1% without epinephrine, 2-3 mL
• Bupivacaine (Marcaine) 0.25%, 2-3 mL
• For more information, see Local Anesthetic Agents, Infiltrative Administration.

Equipment

• Needle, 1 in, 27 or 30 gauge (ga)
• Syringe, 5 mL
• Antiseptic solution with skin swabs
• Small rolled towel
• Triamcinolone acetonide (Kenalog), 10-20 mg; or methylprednisolone acetate (Depo-Medrol), 10-20 mg
• Lidocaine 1% or bupivacaine 0.25%

Positioning

• Patient should be positioned comfortably in a seated or supine position.
• The affected arm should be supinated with the dorsal aspect of the wrist resting over a small rolled towel.

Technique

• First, locate the flexor carpi radialis (FCR) and palmaris longus (PL) tendons. The palmaris longus tendon is medial to the flexor carpi radialis and is best located by opposing the thumb and fifth digit while the wrist is flexed. The image below depicts relevant anatomy and landmarks. For more information, see Flexor Tendon Anatomy. Solid blue line - palmaris longus tendon; solid red line - flexor carpi radialis tendon; dotted blue line - proximal palmar crease.
• Carefully disinfect the skin.
• Draw up 1 mL of 1% lidocaine and make a skin wheal ulnar to the palmaris longus and proximal to the proximal wrist crease.
• In another syringe, draw up the steroid with or without lidocaine or bupivacaine.
• Insert the needle 1 cm proximal to the proximal wrist crease and directly ulnar to the palmaris longus tendon at the skin wheal. Direct the needle distally toward the ring finger at an angle of 30 degrees. See image below. Needle placement - Medial of palmaris longus tendon.
• Advance the needle approximately 1.5-2 cm or until the tendon is touched.
• Aspirate to verify that no vasculature is affected, and inject the steroid solution with little or no resistance.
• Lastly, remove the needle and place the wrist in a gravity-dependent position.
• Advise the patient to actively move the fingers for several minutes to distribute the solution evenly.

Pearls

• Some people do not have a palmaris longus (PL) tendon.^{[12, 13]} In these cases, the needle is inserted at the midline between the radial and ulnar aspects of the wrist, proximal to the wrist crease, and is directed toward the ring finger (see image below). Needle placement in absence of palmaris longus tendon.
• If contact is made with the palmaris longus tendon while advancing the needle, retract slightly and redirect.
• The use of a needle smaller in diameter may require increased effort and slower injection time but dramatically reduces pain at the site of injection.
• Sudden worsening pain or paresthesia indicates the possibility of improper needle placement. If this occurs, retract the needle and redirect more medially (ulnar).
• To avoid potential complications of vascular or nerve ischemia, tissue necrosis, and serious damage to nerve, lidocaine with epinephrine should not be used. 

Complications

• Bleeding
• Infection
• Injury to nerve^{[14, 15]}
• Tendon rupture^[16]
• Temporary paresthesia
• Alteration in blood glucose levels in patients with diabetes mellitus
• Pain^[17]  

http://emedicine.medscape.com/article/103333-overview#a01

Steroid Injection, Carpal Tunnel - Chronic-Intractable Pain And You, Inc. (Main Site)

Steroid Injection, Carpal Tunnel

Overview
Carpal tunnel syndrome (CTS) is a compressive focal mononeuropathy that is brought on by compression of the median nerve as it travels through the carpal tunnel. Patients commonly experience pain, paresthesias, and weakness in the median nerve distribution. Carpal tunnel steroid injection at the wrist is used to treat the symptoms of carpal tunnel syndrome by injecting a steroid solution into the ulnar bursa surrounding the median nerve.
For mild to moderate carpal tunnel syndrome, carpal tunnel steroid injection can be used in conjunction with other conservative measures such as splinting, physical therapy, ergonomic modifications, rest, and regular exercise.^{[1, 2, 3, 4, 5]} Conservative modalities, including median nerve steroid injections, should generally be attempted prior to pursuing surgical options.^[6] Historically, carpal tunnel steroid injections were typically used for only mild median nerve entrapment (as documented by electroneurography) as well as for temporary pain relief in anticipation of definitive flexor retinaculum surgical release. In general, injected corticosteroids appear effective in reducing subjective symptoms for 1-3 months when compared to placebo.^[7] While short-term relief of symptoms after injection appears superior to relief after carpal tunnel release surgery, the advantage is lost over the course of a year.^[8]
Electrodiagnostic studies such as nerve conduction studies and electromyography are typically obtained to determine the severity of nerve damage prior to performing the procedure.^{[9, 10]} Steroid injections should be avoided prior to planned electrodiagnostic testing, as the presence of steroids may alter test results. Several clinical tests can be used to diagnose carpal tunnel syndrome. One is Tinel's sign, which is done by over the median nerve at the volar crease at the wrist to reproduce the paresthesia. The Phalen test involves holding the flexed wrists against each other for several minutes to provoke the symptoms in the median nerve distribution. Manual carpal compression testing is done by applying pressure over the transverse carpal ligament and evaluating for paresthesia within 30 seconds of applying pressure.^[11]
Carpal tunnel anatomy
The carpal tunnel of the wrist is defined anatomically by the transverse carpal ligament on the volar surface and the carpal bones on the dorsal surface. The transverse carpal ligament, also known as the flexor retinaculum, attaches radially to the trapezium and scaphoid tuberosity and ulnarly to the hamate and pisiform. The contents of the carpal tunnel include the 4 flexor digitorum profundus tendons, the 4 flexor digitorum superficialis tendons, the flexor pollicis longus tendon, and the median nerve. See images below.
Carpal tunnel anatomy. Carpel tunnel anatomy, cross-section.
There are 2 bursae in the wrist. The radial bursa contains the flexor pollicis longus tendon. The ulnar bursa, also known as the common flexor sheath, holds the flexor digitorum superficialis and profundus tendons. When the hand is supinated, the 4 superficialis tendons lay on top of the 4 profundus tendons, forming a U-shaped structure referred to as the ulnar bursa. On top of the ulnar bursa, and below the transverse carpal ligament, lies the median nerve. Although the median nerve itself has 2 sensory branches and 1 motor branch, only 1 sensory branch and the motor branch traverse through the carpal tunnel and are affected by carpal tunnel syndrome. This sensory branch is responsible for sensory innervation of the thumb, index finger, middle finger, and radial half of the ring finger. 
Indications

• Carpal tunnel syndrome not relieved by conservative measures
• Electrodiagnostic changes consistent with mild-to-moderate median nerve entrapment

Contraindications

• Adverse reaction to injectable steroid or anesthetic
• Uncontrolled diabetes mellitus
• Active systemic or local infection
• Compromised skin integrity over the area
• Immunosuppression
• Planned electrodiagnostic study

Anesthesia

• Lidocaine (Xylocaine) 1% without epinephrine, 2-3 mL
• Bupivacaine (Marcaine) 0.25%, 2-3 mL
• For more information, see Local Anesthetic Agents, Infiltrative Administration.

Equipment

• Needle, 1 in, 27 or 30 gauge (ga)
• Syringe, 5 mL
• Antiseptic solution with skin swabs
• Small rolled towel
• Triamcinolone acetonide (Kenalog), 10-20 mg; or methylprednisolone acetate (Depo-Medrol), 10-20 mg
• Lidocaine 1% or bupivacaine 0.25%

Positioning

• Patient should be positioned comfortably in a seated or supine position.
• The affected arm should be supinated with the dorsal aspect of the wrist resting over a small rolled towel.

Technique

• First, locate the flexor carpi radialis (FCR) and palmaris longus (PL) tendons. The palmaris longus tendon is medial to the flexor carpi radialis and is best located by opposing the thumb and fifth digit while the wrist is flexed. The image below depicts relevant anatomy and landmarks. For more information, see Flexor Tendon Anatomy. Solid blue line - palmaris longus tendon; solid red line - flexor carpi radialis tendon; dotted blue line - proximal palmar crease.
• Carefully disinfect the skin.
• Draw up 1 mL of 1% lidocaine and make a skin wheal ulnar to the palmaris longus and proximal to the proximal wrist crease.
• In another syringe, draw up the steroid with or without lidocaine or bupivacaine.
• Insert the needle 1 cm proximal to the proximal wrist crease and directly ulnar to the palmaris longus tendon at the skin wheal. Direct the needle distally toward the ring finger at an angle of 30 degrees. See image below. Needle placement - Medial of palmaris longus tendon.
• Advance the needle approximately 1.5-2 cm or until the tendon is touched.
• Aspirate to verify that no vasculature is affected, and inject the steroid solution with little or no resistance.
• Lastly, remove the needle and place the wrist in a gravity-dependent position.
• Advise the patient to actively move the fingers for several minutes to distribute the solution evenly.

Pearls

• Some people do not have a palmaris longus (PL) tendon.^{[12, 13]} In these cases, the needle is inserted at the midline between the radial and ulnar aspects of the wrist, proximal to the wrist crease, and is directed toward the ring finger (see image below). Needle placement in absence of palmaris longus tendon.
• If contact is made with the palmaris longus tendon while advancing the needle, retract slightly and redirect.
• The use of a needle smaller in diameter may require increased effort and slower injection time but dramatically reduces pain at the site of injection.
• Sudden worsening pain or paresthesia indicates the possibility of improper needle placement. If this occurs, retract the needle and redirect more medially (ulnar).
• To avoid potential complications of vascular or nerve ischemia, tissue necrosis, and serious damage to nerve, lidocaine with epinephrine should not be used. 

Complications

• Bleeding
• Infection
• Injury to nerve^{[14, 15]}
• Tendon rupture^[16]
• Temporary paresthesia
• Alteration in blood glucose levels in patients with diabetes mellitus
• Pain^[17]  

http://emedicine.medscape.com/article/103333-overview#a01

38 Questions to Ask Your Surgeon Before Having Back Surgery

38 Questions to Ask Your Surgeon Before Having Back Surgery

By: Stephanie Burke

This subject comes up a lot in our forums - "I'm considering surgery, what questions should I ask my surgeon?" From articles on Spine-health.com and contributions from our discussion forum members, we've compiled a list that you can print up and take with you to your consultation. Good luck!

Questions before you decide to have the surgery

1.     What type of surgery are you recommending? Why?

2.     What is the source of the painthat is being addressed? How do you know this? (Exploratory back surgery is not done).

3.     Please explain the procedure - at a very high level/with some detail/in great detail. The amount of information depends on your personal preference – some want to know everything, some not so much! To actually see the surgery (animated – no gore) – view our Spine surgery animated videos.

4.     What are my non-surgical options?

5.     What is the natural course of my condition if it is not surgically addressed?

6.     What would you recommend if this were your friend/wife/sister/daughter etc…?

7.     How long will the surgery take?

8.     What are side effects, potential risks and complications?

9.     Please explain the risks and how they relate to me personally. For example, chances of having a non fusion if you are overweight, a smoker, risks if have a grade 3 spondy, etc.

10.                        What if you get in there and see something different than you expected?

11.                        Do I need to donate my own blood? If yes, why? For most types of back surgery, blood does not need to be donated ahead of time.

12.                        Do you perform the whole procedure? Will any students/other surgeons be doing any parts of the operation? If yes, who are they and what are their qualifications? Some surgeons only do a small part of the operation, others do the whole thing. If another surgeon is required, e.g. a vascular surgeon, their role is important and it would be good to know their qualifications..

13.                        Who else will assist you in the operation? What is their background and qualifications?

14.                        What are the long-term consequences of the proposed procedure? E.g. will the operation ever need to be re-done? If it is a fusion, will it lead to degeneration at other levels of the spine?)

Questions about the surgeon

15.                        How many times have you done this procedure? In general, when it comes to surgery "practice makes perfect", so more is better. (However, if the doctor is recommending something that is not often done, such as multi-level fusions, more would not necessarily be better.)

16.                        Are you board eligible or board certified? You can usually look on the wall and see a certificate.

17.                        Are you fellowship trained in spine surgery? This is more important if the surgery is a fusion, artificial disc replacement, or other more extensive procedure.

18.                        If I want to get a second opinion, who would you recommend? (Someone not in the same practice)

19.                        Statistically the success rate for this type of surgery is _%. What is your personal success rate, and how many of this type of surgery have you done?

20.                        Can I talk to other patients who have had a similar procedure?

Any defensiveness on the part of the surgeon when you ask these types of questions may be a red flag. A surgeon with good results and appropriate qualifications will not be threatened by these types of questions and will respect your attention to these matters.

Questions about what to expect after the surgery

21.                        What kind of pain should I expect after the surgery and for how long?

22.                        How long is the hospital stay?

23.                        May a family member spend the night with me in the hospital?

24.                        How do you manage the pain in the hospital?

25.                        Which pain medications will I be sent home with? What are possible side effects of these prescriptions? E.g. Constipation, drowsiness, etc.

26.                        Will you know before the surgery if I will need a backbrace afterwards? If so, will I be fitted for one before the surgery?

27.                        Who can I call if I have questions after the surgery? What is the process for communication?

28.                        How often will I see you after my surgery?

29.                        What symptoms would warrant a call to your office?

30.                        What symptoms would warrant immediate medical attention?

31.                        What limitations will I have after surgery and for how long?

32.                        How long will I be out of work? School? Whatever...

33.                        What kind of help will I need when I return home?

34.                        When can I drive again?

35.                        When can I resume normal (light) household chores?

36.                        What expectations do you have for my recovery?

37.                        When is it safe for my spouse and I to have sexual relations again?

38.                        How soon after the surgery can I start physical therapy?

Good luck with your decision and your recovery!

http://www.chronicpainconnect.com/news-articles/162-5-tips-for-dealing-with-depression-and-chronic-pain-around-the-holidays/portal