Sunday, April 17, 2011

Spinal Cord Stimulator: Psych Eval and Approval

In order to get approved for the Spinal Cord Stimulator, as I mentioned before, I had to undergo a psychological evaluation. I went to the psychologist's office 2 weeks ago, went through the charade, and went home to wait. A week and a half later, I was notified that I passed the evaluation, and therefore would be allowed to continue on to the trial round. I am thrilled I get to do the trial stimulator, and am keeping my fingers crossed that it helps the flank pain. I will be at the surgery center tomorrow morning getting the leads inserted!

For those of you interested in the psychological evaluation, the rest of this post is dedicated to the appointment, and I am writing it so you have some sort of idea what you are in for. I certainly would have loved to have had some insight to this process beforehand. I jotted down the names of the tests while at the office so I could leave them in this post for you. Hopefully this helps anyone who may have to undergo this same scrutiny.


The psychologist's office was supposed to send paperwork for me to complete before my appointment, but they rushed me in due to a cancellation, so the papers hadn't even arrived in the mail. It wasn't a big deal, it just made the appointment even longer. I was in the office filling out questionnaires and completing multiple choice and true/false tests for roughly four hours, then I had an hour-long appointment with the doctor. By the end, not only was my back/flank on fire, my hands and wrists were hurting me so much I had to go sit in my car with ice packs on them for a half-hour before I was able to drive away. While I understand that psychological factors play a big part in patient care, and especially treatment for chronic pain patients, I was appalled at the length in which I had to prove my pain to a doctor who had never even met me. I was frustrated that I was being asked asinine questions like, "Do you enjoy science?," "Would you like to be an artist?," and "Was there ever a time when you were a child that you were considered a trouble-maker?"

I found myself over-thinking every question during the appointment. There were multiple questions asking if I enjoy crime shows. If I answered "yes" to these questions, would it make me seem like I was interested in crime, murder, violence? I love the show Law & Order: SVU, but, what would it mean for my horrific flank pain if I said I enjoy watching it? I also had to answer a question about being gay, like that has anything to do with my flank pain. Hours and hours of questions, mostly personality tests. I was hurting so badly, I was having a hard enough time focusing, let alone filling in the bubbles on the scantron sheets. I barely finished, really had to push myself to complete all of the tests. There must have been over 2,000 questions, and that isn't an exaggeration. Information regarding the two largest tests is below.


LAQ-2: The Life Assessment Questionnaire (click here to view entire test):

According to HealthNetSolutions, "The LAQ-2 is a well-validated instrument for determining the likelihood of deception and malingering in the chronic pain population. The majority of the LAQ-2 requires patients to indicate if they are experiencing various physical and psychological symptoms. They are queried about symptom complaints across all major bodily systems. Patients are also asked questions measuring a variety of beliefs such as perceived suffering, cynicism, and general health."

Deception and malingering? Basically, this test is to decipher whether or not you are lying about your pain.


The Minnesota Multiphasic Personality Inventory, Version 2 (MMPI-2):

According to Wikipedia, the "MMPI is one of the most frequently used personality tests in mental health. The test is used by trained professionals to assist in identifying personality structure and psychopathology." Topics: concern with bodily symptoms, depressive symptoms, awareness of problems and vulnerabilities, conflict, struggle, anger, respect for society's rules, stereotypical masculine or feminine interests/behaviors, level of trust, suspiciousness, sensitivity, worry, anxiety, tension, doubts, obsessiveness, odd thinking and social alienation, level of excitability, people orientation. A lot of the questions on here were meant to figure out textbook cases of depression, bipolar disorder, schizophrenia, etc. I was concerned if having bipolar disorder and PTSD would ruin my chances of trying the stimulator.

Since I wasn't able to find a copy of this test, thankfully a kind person on AntiPolygraph.org typed out the first 75 (567 total) questions from the MMPI-2. I don't attest to the accuracy of these questions, but I can tell you they all look very similar to what was on the test I took. They are as follows (and no, this isn't a joke, these are really the questions):

TRUE OR FALSE

  1. I like mechanics magazines
  2. I have a good appetite
  3. I wake up fresh & rested most mornings
  4. I think I would like the work of a librarian
  5. I am easily awakened by noise
  6. I like to read newspaper articles on crime
  7. My hands and feet are usually warm enough
  8. My daily life is full of things that keep me interested
  9. I am about as able to work as I ever was
  10. There seems to be a lump in my throat much of the time
  11. A person should try to understand his dreams and be guided by or take warning from them
  12. I enjoy detective or mystery stories
  13. I work under a great deal of tension
  14. I have diarrhea once a month or more
  15. Once in a while I think of things too bad to talk about
  16. I am sure I get a raw deal from life
  17. My father was a good man
  18. I am very seldom troubled by constipation
  19. When I take a new job, I like to be tipped off on whom should be gotten next to (this question isn't correct, but it was something about getting info on who to be buddy-buddy with at your new job)
  20. My sex life is satisfactory
  21. At times I have very much wanted to leave home
  22. At times I have fits of laughing & crying that I cannot control
  23. I am troubled by attacks of nausea and vomiting
  24. No one seems to understand me
  25. I would like to be a singer
  26. I feel that it is certainly best to keep my mouth shut when I’m in trouble
  27. Evil spirits possess me at times
  28. When someone does me a wrong I feel I should pay him back if I can, just for the principle of the thing
  29. I am bothered by acid stomach several times a week
  30. At times I feel like swearing
  31. I have nightmares every few nights
  32. I find it hard to keep my mind on a task or job
  33. I have had very peculiar and strange experiences
  34. I have a cough most of the time
  35. If people had not had it in for me I would have been much more successful
  36. I seldom worry about my health
  37. I have never been in trouble because of my sex behavior
  38. During one period when I was a youngster I engaged in petty thievery
  39. At times I feel like smashing things
  40. Most any time I would rather sit and daydream than to do anything else
  41. I have had periods of days, weeks, or months when I couldn’t take care of things because I couldn’t “get going”
  42. My family does not like the work I have chosen (or the work I intend to choose for my life work)
  43. My sleep is fitful and disturbed
  44. Much of the time my head seems to hurt all over
  45. I do not always tell the truth
  46. My judgment is better than it ever was
  47. Once a week or oftener I feel suddenly hot all over without apparent cause
  48. When I am with people I am bothered by hearing very queer things
  49. It would be better if almost all laws were thrown away
  50. My soul sometimes leaves my body
  51. I am in just as good physical health as most of my friends
  52. I prefer to pass by school friends, or people I know but have not seen for a long time, unless they speak to me first
  53. A minister can cure disease by praying and putting his hand on your head
  54. I am liked by most people who know me
  55. I am almost never bothered by pains over the heart or in my chest
  56. As a youngster I was suspended from school one or more times for cutting up
  57. I am a good mixer
  58. Everything is turning out just like the prophets of the Bible said it would
  59. I have often had to take orders from someone who did not know as much as I did
  60. I do not read every editorial in the newspaper everyday
  61. I have not lived the right kind of life
  62. Parts of my body often have feeling like burning, tingling, crawling, or like “going to sleep”
  63. I have had no difficulty in starting or holding my bowel movement
  64. I sometimes keep on at a thing until others lose their patience with me
  65. I loved my father
  66. I see things or animals or people around me that others do not see
  67. I wish I could be as happy as others seem to be
  68. I hardly ever feel pain in the back of the neck
  69. I am very strongly attracted to members of my own sex
  70. I used to like drop-the-handkerchief
  71. I think a great many people exaggerate their misfortunes in order to gain the sympathy and help of others
  72. I am troubled by discomfort in the pit of my stomach every few days or oftener
  73. I am an important person
  74. I have often wished I were a girl.  (Or if you are a girl) I have never been sorry that I am a girl
  75. I get angry sometimes

Hope that helps! I'm in awful pain tonight, but keeping my spirits up for the big day tomorrow. I am off to get some sleep. :) Love and strength to all of you!

xo
dani

8 comments:

Christa said...

Sorry You were in awful pain as you wrote this... thanks for all the details... I mean we all have a LOT of time on our hands, to watch tv and sit in bed in pain, so I gotta admit that we ALL like crime dramas to bored moments of pain in which we need distraction. Your as normal as they come with the EDS DNA... SCARY!

stretchylesley said...

I really don't get what anyone's sexuality or gender issues have to do with chronic pain. And some of those questions about stomach pain and vomiting etcetera are not going to take into account we have a weird, complicated genetic condition that affects those things and more. That sounds like a very demanding experience, both physically and emotionally!

I'm glad that you are moving on to the next step with this, and hope that it helps your pain and is going to be worth all this nonsense in the end! *fingers crossed extra bendy style*

Also, I second Christa's thank you for typing this up while in pain. Thank you!

mmEDS said...

Hi to all of you, I've never replied before but have read many of your posts. I too have EDS, I was diagnosed in 2008 after an accident in 2005. I had my first SCS implanted last summer and it works great. They are hoping too implant another one in a few months. Hope all goes well and it works as well for you as it does for me. Thank you for all of your SSD advice as I recently got approved as well.

laser spine treatment Houston, TX said...

Informative and interesting. Thanks for sharing very informative and unique post. Keep posting and do stay in touch.

Anonymous said...

The idea is not how you answer any one question, or what your sexual orientation is, or whether you like crime dramas. The idea is to see how your responses on hundreds of questions compare to the responses of others who have known mental illness. The thinking behind this is that people of a certain disorder tend to acknowledge the same symptoms and thought patterns. The psychologist really could care less about whether you like mechanics magazines, it is a statistical analysis that they are after -- that will tell them whether you have some mental illness that indicates you are not ready or should not have such a serious medical procedure with both positive and negative consequences. I hope this helps, I think the doctor was only trying to help you.

Anonymous said...

On the other hand, having you sit in pain for 4 hours is inexcusable. The psychologist should have told you that it was ok to finish the tests another day. I'm not sure if the psychologist (as dumb as it may seem) realized you were in so much pain.

Ghost boys said...

I am dealing with severe neuropathy and my Dr had referred for me to have the SCS done as well. I went and done my evaluation and was told but the psych lady that there were no right or wrong answers on the test and that everything was approved for me to have the procedure done. I go to the Dr who was going to be doing the trail and when I get there my appointment was cancelled because somehow now I'm not a candidate to have it done at this time. Will I be able to take the evaluation again. It's been a year of excruciating pain in my feet and I'm not able to bend my toes. None of the pain medicine is working anymore. I am taking morphine and it doesn't help. This hasn't only affected my life but my kids as well. What can I do to get this procedure done and be pain free? I don't understand how some of the questions on the evaluation has anything to do with what your feeling and going through or how it can stop you from being pain-free. Idk why the psych lady changed her mind or lied to me

Anonymous said...

Those "tests" are a complete waste of time and the only beneficiaries are the idiots who peddle them to doctors. I wondered if they were trying to find out if I was really in pain or if I was really just stooooooopiiiiiid. It was an insulting waste of my time. I wouldn't spend money I can't afford to spend on medical care and prescriptions if my pain wasn't real. I wouldn't have lost my job, house and car.

This was another insult on top of what I must endure already.