A recent blog post got me to thinking about what I call my TN safety plan.
A real challenge for me is the fact, as a recovering alcoholic I made the decision to stay away from opiates as much as possible. Please note, this was a personal decision, and I do not sit in judgment of anyone that does use them. I have struggled with depression due to pain not well controlled. Thing is having been treated like a drug seeker every time I would go to the local ER, I quit going, and would just try to ride out the pain.
Last year I read a interesting book by a man that survived a suicidal fall from the Golden Gate Bridge. In the very last chapter, he talked about his safety plan, and gave great advice on how one could write one themselves. While he struggled with mental illness, I thought how can I write a safety plan for the times I struggle with TN pain? I took the book to my doctor and we talked for a good half hour. The following is what we decided. The fact is the ultimate decisions were mine, but I based those decisions on input from my primary care doctor, and later on my neurosurgeon's PA.
1: I am not to wait until I come in. If what I do at home does not break the pain cycle within one day, I am to walk into the doctor's office, and ask to speak to the nurse. My primary care doctor has a standing order in my chart, that states I am to be given a pain shot. The longer the pain is allowed to continue the harder it can be to treat. Partly, between my up bringing, and then being in the military, I was taught you just tough things out. My primary care doctor constantly gets on to me about that.
2. If what I do at home does not work, nor does the pain shot at the primary care doctor's office, the next step in my safety plan is to call my neurosurgeon's office, and leave a message with his PA, letting them know I am on my way to the ER at OHSU. This is to let them know they may be getting a page from the ER.
3. I have in a notebook my doctor's business cards. If my primary care doctors office, and OHSU did not use the same computer charting system, I would also have written down, all the meds I am taking, and all the surgeries I have had to deal with the TN. I am lucky in that they both have easy access to each other's chart notes through the computer.
4. I have the notebook sitting on a bookshelf in the living room. My partner, and my best friend as well know if I say grab the safety plan, I am in trouble, and they are to call. One of them will get me to the right doctor.
The goal is to have the plan in place before you need it. I understand often easier said than done. On a very positive note in the 9 months I have had my safety plan in place, I have only gone to the primary care doctor for the shot twice. I had another MVD, and a Internal Neurolyis as a result of a return trip to the neurosurgeon, but am doing very well. I find on a bad day I may get one or two shocking TN pains. Those happen most often when I am tired. Not at all bad if I say so myself
Remember everyone is different. What works for one, may not work for another. Personally, I do know I feel safer having a agreement with my doctors.
Sarah