February is Heart Month, and we are all about our loved ones and taking care of them! When Dr. Scaringe-Dietrich first meets her patients, she seeks to find the root of their pain, what the pain generator is, and its impact on their lives so that she can create positive goals.
People may wish to discuss other parts of their life, rather than focusing on the root of their pain, or they leave something out, like the patient getting surgery. “We talk about the impact and how to communicate with their surgeon in order to optimize his perioperative course,” she points out. “There are times they may not be ready for treatment because there are other things happening in the patient’s life.”
Another type of patient that Dr. Scaringe-Dietrich assesses is one that has spent a large part of their life caring for a family member, and now that family member has passed on. The patient now realizes they need to prioritize their self-care. “I’m always listening to them. There’s always a very algorithmic way of managing people; it’s between that, what the patient can tolerate, and what they want,” she explains.
Helping patients manage their pain is multi-layered, involving the patient and their loved ones with in-house visits as well as telemedicine visits. “I had a lady in her 90s with her great-granddaughter saying goodbye, and her extended family was there. So, I knew that her medication management would be good,” Dr. Scaringe-Dietrich says. It is important to keep that communication open with people so they know what to ask or they know what to do during their visit.
This kind of communication gives insight to the doctors when they treat patients at home via telemedicine. “There’s certain things you don’t get in the office that you can see at home; it’s a window into what people’s home lives are like.”
Sometimes families are aware of the pain their loved one is in, so they tell them to stay put and the families will do everything for them. “We want them to function. You don’t want the family to take over because the patient gets de-conditioned and not doing anything for themselves,’ Dr. Scaringe-Dietrich points out.
“We see people who are highly functioning, and then on the flip side, the people who identify that they want to function and then they can’t because of the pain. Sometimes psychological interventions with our Pain Psychologist Dr. Brecher helps people to have appropriate goals as well as how to pace themselves so that they can do the things they need to do. I think there’s a lot of psychology in what we do. It helps us to develop a plan to improve their pain and their function.”
The end goal of ReclaimAbility is to treat patients so that they can function better. Sometimes that is to help a person who can’t golf anymore, or lift their grandkids, even vacuum without pain. “The limiting factor is that they’re not able to do something that they really love to do, so we talk about function, their activity, their sleep, and create some concrete goals—perhaps even some goals the patient hadn’t thought of.”
Another aspect of managing pain during a pandemic is isolation. People tend to be very hard on themselves for not doing what they used to be able to do, and they are in pain, and they can get down, and then worry about COVID-19, and it’s overwhelming.
Sometimes it’s a matter of just encouraging patients and loved ones to check in during this epidemic of loneliness and those in solitary confinement for months on end. It’s realizing that you can phone call or check in with your loved one, and you can do that safely, Dr. Scaringe-Dietrich explains.
The ReclaimAbility team is dedicated to helping patients and their families communicate and work out goals to function without pain.