You're about to see a new patient...
A patient who has recovered from shingles...
A patient who has been through the standard treatment regimen and still has painful burning, itching or even numbness left from his bout with shingles...
He's tired of taking pain medication...
Tired of being dismissed as though his pain was a figment of his imagination...
Chances are, you are his treatment of last resort. And by the time he gets to your office, he's frustrated, angry and disappointed.
As a Neuropathy DR clinician you know you can help him with his Postherpetic Neuropathy and end his pain but you're going to have to get through that wall of frustration surrounding him to do it.
The best protocol for dealing with the frustrated patient is threefold:
Comfort
Educate
Treat
Let's examine each step.
Comfort
The postherpetic neuralgia (Shingles) patient is frustrated. At the beginning of his treatment, he was assured that shingles was not a life-threatening illness, just a painful one and that his pain would resolve once treatment was completed and the rash was gone.
Now he's still dealing with the pain and he doesn't want to live on pain meds for the rest of his life. And he's ready to take all that frustration out on you even though he's sincerely hoping you can help him.
Dealing with a patient at this level of frustration can be difficult. In situations like this, your patience is a virtue. When a neuropathy patient calls for an appointment, block a little extra time for the initial interview.
Ask questions that encourage the patient to speak freely. Pay close attention to what they tell you about themselves and their lives. The more you know about how the patient lives, the better you will be able to design a treatment plan to alleviate their symptoms. Take time to listen to these patients and assure them that their symptoms are treatable, their nerves can be repaired and they won't be a slave to their pain forever.
Listen to them and comfort them. Just knowing that they aren't being dismissed will get your doctor/patient relationship started on the right path.
Educate
Ask your patient how much he understands about shingles and postherpetic neuropathy and listen carefully to his answers. Then you can fill in the blanks and educate them on the issues they don't understand.
Explain exactly what Postherpetic Neuropathy is and that it's caused by damaged nerve fibers sending exaggerated pain messages to your brain. No, that doesn't mean the pain is all in his head. The virus was severe enough to damage his nerve endings and that's what is causing his pain. Once those nerve endings are repaired, his pain will diminish.
As a clinician you have a unique protocol for the treatment of neuropathy. By educating your patient on each piece of the treatment puzzle - lifestyle changes, nutrition and the ReBuilder, you have a wonderful opportunity to involve the patient in their own care. By educating them on their illness and the treatment, you empower the patient and that can only improve the chance for a good outcome.
Treat
The actual treatment of the postherpetic neuropathy patient should address not only the physical symptoms but the lifestyle choices of the patient. For a good outcome, the patient needs to eat properly, manage or avoid stress and adhere to your treatment regimen.
Step 1 - A healthy diet is paramount to give the body of the postherpetic neuropathy patient what it needs to repair itself. Advise them to eat lots of fresh fruit and vegetables. If at all possible, the patient should cut back on sugar and make sure they're getting enough of vitamins C, E, and B12 every day. 1,2
Step 2 - Stress management is essential for the successful resolution of postherpetic neuropathy. 3 Stress wreaks havoc on the immune system and that makes it extremely difficult for the body to repair itself.
Encourage your patient to communicate with you and his loved ones when he's upset or unhappy and figure out triggers his emotional distress. Once he's aware of situations that increase his stress, he can better avoid them or at least take steps to manage them. Teach your patient some deep breathing or meditation techniques to help him calm down when he feels out of control. Finally, as trite as it may sound, encourage your patient to accentuate the positive. When he's down or depressed, have him make a good thing/bad thing list. For every negative there is a positive so encourage him to consider both sides when he feels stressed.
Step 3 - The final piece of the treatment puzzle is the use of this unique protocol, developed in the clinic of Dr John Hayes Jr.
When all three pieces of the treatment protocol are in place, your patient has an excellent chance of a good outcome and relief from not only their postherpetic neuropathy pain but their frustration and depression as well.
Imagine how good it will feel for your patient to live pain free again. That outcome will be worth its weight in gold for you and your patient.
