Oakes and Oakes
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Oakes and Oakes Consulting |
WHAT IS A BEHAVIORAL MEDICINE PSYCHOSOCIAL ASSESSMENT? A comprehensive evaluation of the pain patient’s behavior, lifestyle and emotional functioning secondary to their chronic pain. The assessment may be use to identify: 1. Appropriateness of surgery, implanted pain technologies, or other invasive pain treatments. 2. Alternate pain treatments. 3. Ways to improve chronic pain management. 4. Relationships between personality style and chronic pain. 5. Mistaken beliefs that exacerbate and perpetuate chronic pain. WHY DO I NEED THESE SERVICES? Patients may receive these services for many reasons: Physicians require patients who wish to have medication pump or dorsal column stimulator implantation because the manufacturer’s guidelines strongly recommend that the optimum evaluation include it. Some patients exhibit significant behavioral distress and the physicians would like more information for medical planning purposes. Other patients may need information about their pain condition. Treatments that help acute pain not only do not work for chronic pain, but can actually make it worse. Patients may inadvertently work against themselves and increase their pain, without realizing that they are doing so. Still other patients may be wrestling with one or several emotions commonly associated with chronic pain - anger, anxiety and depression. Left uncontrolled, anger, anxiety and depression will increase pain perceptions on a neurobiochemical level, and pain killers alone do not usually help. These services help all these patients decipher their situations, to prudently identify better pain management, with advice of physicians. After all, your pain affects your whole life. It is reasonable to also say that you your whole life affects your pain. When considering pain treatment decisions, getting the most information is a sensible approach and the one that best serves patients. If something in your life impedes your pain relief, then an implanted device or other invasive treatments may not help and you will have gone through all that trouble and expense for nothing. Reputable implantable device manufacturers strongly recommend psychosocial evaluation, for the patient’s safety and to improve treatment outcomes. DOES SOMEONE THINK MY PAIN IS ALL IN MY HEAD? All pain is processed and interpreted in the brain, so technically, all pain is all in your head. Present medical research suggests that three centers of brain activity strongly influence the processing and interpretation of pain signals. What works well with one brain area may not help another. These evaluation services can give information suggesting which pain treatments are the most effective to manage your pain. HOW IS THIS EVALUATION PERFORMED? We use evaluation protocols that are specifically recommended by Medtronics® Corporation and are appropriate for any pain patient or implanted pain technology. These industry-standard techniques include behavioral interview and standardized (pencil and paper) testing. The questions and information gleaned help us get better acquainted with you and reveal areas where you may require more information to manage your pain successfully. No needles or heavy lifting involved. HOW LONG DOES IT TAKE? The total patient contact time required is three hours. Because of insurance reimbursement, this requires three visits. This is a packed three hours. The time includes both interview and pencil-and-paper questionnaires. The paperwork must be done onsite and may not be taken home. You may take breaks any time. WHAT SHOULD I BRING? Please bring a list of current medications and your reading glasses, if you need them. CAN YOU TELL ME HOW I DID THE SAME DAY? No, but we would be glad to schedule a feedback appointment, if that would be helpful to you. Behavioral health insurance usually pays, code 90806 for an individual appointment and 90847 for family feedback (which we recommend). WHY FAMILY FEEDBACK? Pain affects the individual but it also affects the family system. Having family members on board with pain treatment is helpful to everyone. HOW LONG MUST MY PHYSICIAN WAIT FOR THE REPORT? Reports are usually faxed within three to seven days. WHO DOES THIS EVALUATION? Marilyn T. Oakes is a Licensed Professional Counselor in both Georgia and Alabama and has worked with chronic pain patients more than 25 years. She was a member of the Pain Team at the Center for Spine Care at Shepherd and the University of Alabama - Birmingham Pain Center. She is presently a member of the Northside Hospital Multidisciplinary Pain Team and is the only rehabilitation counselor in Georgia with dual certification in pain management. She uses the Medtronics® protocols and is very familiar with their application. IF I DECIDE TO HAVE THE IMPLANT, THEN WHAT HAPPENS? Dr. Dan Doleys, co-author of the Medtronics® behavioral evaluation protocols, has identified that patients do better with implanted technologies when they have multidisciplinary pain management support both before and after the procedure. We offer a weekly pain patient group that focuses on living well despite pain, and implant recipients are welcome to participate, both before and after their procedures. Most health insurances with behavioral coverage pay for the therapy group through codes 90853 or 90857. MARILYN T. OAKES is a rehabilitation counselor in Atlanta, Georgia. She attended the University of Kentucky and graduated from Peabody College at Vanderbilt University and the University of Alabama-Birmingham. She has worked with pain patients more than 25 years and served on pain teams at the University of Alabama - Birmingham Pain Center and the Center for Spine Care at Shepherd; she is presently a member of the Northside Hospital Multidisciplinary Pain Management Team. In 1998, she became a pain patient herself, and uses her experiences to help patients. She is a Licensed Professional Counselor and nationally board-certified in counseling, rehabilitation counseling, rational hypnotherapy and pain management. She is presently the only Certified Rehabilitation Counselor and Licensed Professional Counselor in Georgia with dual certification in pain management. |
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