•Asks questions
•Takes notes
•Recommends possible treatment options
•A referral if appropriate, with expected wait times
•Prescriptions
What You’ll Probably Get from Your Doctor
•A little time, but not enough
•Some questions, some of which you may not see the relevance of
•Confirmation of medications
•Suggestions of treatments and therapies
•Possible confusion (especially if they’re not trained in chronic pain)
•A statement that pain is tricky and they cannot be certain what is going on
What Your Doctor Can Expect from You
•Honesty
•Respectful attitude
•An honest, up-front assessment of what you can and cannot manage, given your lifestyle
•An open mind
•Awareness that they are working to a certain mandate and under certain restrictions
Things You Didn’t Know You Could Say to Your Doctor
•“I would like another doctor.”
•“I would like a referral.”
•“This prescription has bad side effects: I need another.”
•“You are not listening to me,” or “I feel as if you’re not listening to me.”
•“This is not a normal pain and I need you to recognize that.”
•“This is causing serious problems in my life, and I need you to help me.”
•“Your behavior is making me anxious, and I am unable to continue with this appointment.”
•“I need to come back another time.”
•“Please give me a moment; this is difficult to talk about.”
Know Your Rights
Each country and each medical system is different, so this is a tough topic—especially if you have transitioned from one system to another because of a relocation or financial change. But it is extremely important to know your rights as a patient, under the law, wherever you are. The law and medical governing bodies will set out a wide range of influencing factors in your health care, including: data protection, privacy, complaint procedures, extent of financial coverage, extent of financial liability, doctors’ required qualifications, medical practice insurance requirements, your medical insurance requirements, access to care (both primary and ongoing), and a million other things. Your ability to pay, ask for a referral or a new doctor, lodge a complaint, see your own records, or pursue alternative treatment avenues will all depend on your particular medical system. So research it. Know your rights—it will put you in a much stronger position when discussing your health care with your providers.
Exercise: Making Notes for Your Doctor’s Appointment
Making notes for a medical appointment is an important skill. Before your next discussion with your doctor, try the following:
1.Write down, in any format you like, everything you wish to discuss.
2.Under each topic, list the symptoms you are concerned about.
3.Under each symptom, write as much detail as you can about it. Include medications, treatments, and any other factors (lifestyle and otherwise) that you think may be affecting it.
4.Under that, write down how this symptom affects your day and give it a seriousness rating from one to ten.
5.Finally, read back through your notes. Are they clear? If not, try organizing them. Have a planned order in mind to frame your upcoming discussion, and set out your notes in that order.
6.List your questions at the end.
7.Consider typing up brief, bullet-pointed notes to give to your doctor during your appointment—this may save time for you both and will give them something to reference.
Example
| Symptom 1 | Symptom 2 | Symptom 3 | Symptom 4 |
| Any meds used | Any meds used | Any meds used | Any meds used |
| Any treatments | Any treatments | Any treatments | Any treatments |
| Factors affecting this | Factors affecting this | Factors affecting this | Factors affecting this |
| Seriousness 1–10 | Seriousness 1–10 | Seriousness 1–10 | Seriousness 1–10 |
| Description of its effect | Description of its effect | Description of its effect | Description of its effect |
Question 1:
Question 2:
Question 3:
A small note about pain as it relates to some basic aspects of you: firstly, age. It is a well-known fact that, as we age, our bodies deteriorate, and once-simple tasks may become painful or even unachievable. That is a normal and expected part of life. However, the rate at which we deteriorate can vary widely, and, for those of us who have chronic health problems from a young age, the process starts earlier and can proceed more swiftly than average.
While many aspects of pain management apply to the expected symptoms of aging—such as arthritis—there is an aspect of pain management that the young have to perform, that the elderly do not. The fetishism of youth (a.k.a. health) makes it much, much harder for younger sufferers of chronic pain to live openly managing their pain. There is an awful phrase that I’m sure many, many of you have heard: “Well, you look fine.” Ah, of course. I look fine, therefore I must be fine. I am only twenty, or thirty, or forty, so by your standards there really can’t be anything much wrong with me. I must be exaggerating. I must be lazy, or a hypochondriac. There are no physical symptoms like a cast on my leg, and I am not eighty and therefore immune from your judgment about my health, ergo everything is well. This is, sadly, an opinion that even some doctors profess—if they can’t find anything wrong with you on first examination, then there is nothing wrong. Pull yourself together. Only the elderly experience physical deterioration.
Sadly, younger sufferers of pain do not experience camaraderie with others—friends in a similar physical state—or shared understanding of the world at large. It would be patently wrong to hurry along an elderly person in front of you on the sidewalk, but doing this to a younger person is socially acceptable. And complaining about a sore hip may be normal for a seventy-year-old, but being twenty and doing this makes you a whiner. No, it’s not fair.
It’s easy to look at those attitudes in the abstract and know they are wrong, know that those judgmental people don’t know you, don’t know that you are doing the best you can. But knowing that and feeling that way in the face of bemused stares and probing questions are two very different things. We will talk later about shoulding and its negative effects. There is a very difficult, specific part of shoulding that happens only to the young, and it is all-encompassing: you should be healthy. The fundamental belief that ill-health only comes with age is a pernicious and dangerous one and leads many people to ignore or try to tough their way through pain, without ever understanding the cause or becoming able to make it better. Again, knowing that someone is doing this to you is a very different thing from being able to say so, or being able to recognize it in the moment. More often than not, even for the