Orientation to Pain Center

1. Orientation to Pain Center www.healthcare.utah.edu/paincenter 546 Chipeta Way SLC, UT

2. Orientation Welcome • The goal of our center is to help individuals with chronic pain problems learn to manage their pain as independently as possible. • Independent is a key word here as this will allow you to continue your treatment long after you leave our center • There are many effective treatments for pain other than medications and medical interventions. • We are a interdisciplinary approach to chronic pain. • This means all providers have equal “input” into your care. • You must attend all appointments with all providers • This approach is evidenced based and gives us the best outcomes for your care.

3. your ability to self-manage chronic pain Self Manage is key physical strength and endurance ability to maintain productivity quality of life pain and suffering Some goals of the center

4. Myths about chronic pain • When you can’t find the exact cause of pain the person is faking it. • Psychological treatment is for crazy people • Exercise is dangerous because it hurts • Medications are not good for you.

5. Our program • After a comprehensive evaluation is completed, the results are discussed at a team meeting at which time a plan of care is determined. • These meetings are done once a week for EACH doctor • The decision from this meeting will be discussed with you at your next appointment with the doctor. • Treatment may consist of medical visits, physical therapy, behavioral medicine or continue care with primary care physician. • Not every patient is a candidate for our programs.

6. Treatments • Treatments may include the following: • Procedural therapy • We perform 8 procedures in our clinic • Ask us for patient information on any of these • Medication optimization • We have Pharmacists on our staff who can interview you and determine if there is a better way to take your medications • Behavioral medicine • Physical therapy • Our physical therapists are specialists in chronic pain. • Pharmacology • Nursing care • or any combination of the above.

7. Our procedures • These are only three of the eight state of the art procedures that we perform: • Epidural steroid injections • May be performed to decrease pain when the nerves of the epidural space are irritated or pinched by a bulging disk, narrowed “nerve canal” or bone spur. • Radio frequency ablation • An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area. • Diagnostic procedures • Spinal injections typically used to control pain are also used diagnostically to locate the pain source.

8. “Truths” about pain • Pain is down up and up down.  • Whatever happens in the body ends up in the head and whatever is in the head affects the body. • Without a brain you wouldn't have any pain so we have to deal with what goes on up there. • Learning confidence in coping with your pain is necessary to pain management. • without confidence in self management of pain nothing we do to you will last very long • Pain affects all areas of your life so we need to talk about all areas of your life

9. More “truths” • There are more comfortable ways to move. • Habitual tension overloads muscles, joints and nerves. • Appropriate movement increases blood flow and oxygen to tissues that are overloaded and painful.

10. “Nuts and Bolts” of the clinic • Keep your primary care physician • Colds, Break your toe • If you have surgery, the surgeon writes for your acute pain, we write for chronic pain. You need to let them know what medicine you are taking. • On call physician and emergencies • Our doctors on call do NOT call in medicine • Nor can they meet you in the ED or call the ED to tell them how to treat you. • Some patients are consultation only • Prescriptions are not written on your 1st evaluation day • “No-Shows” are billed to you. • Too many cancelled appointments even with notice to ANY provider are counted and considered.

11. More “Nuts and Bolts” • Your medication contract is taken seriously by our facility. • Breaking it results in being discharged from our center. • Medication prescriptions • 3000 active patients who receive monthly medications • Monthly refills can be • Pick up, mailed or pharmacy faxes • If you pick them up allow three business days for a fill • If you have them mailed allow seven business days for a fill

12. Which brings us to Medications • Federal law requires us for certain prescriptions to have original prescriptions every time. • No early refills. • No replacement for lost, stolen, vomited, dropped down the sink medications. • If you can’t prove it to us, we can’t prove it to regualtory agencies. • Take meds as prescribed – don’t treat yourself • You are responsible for your medications! • Lock them • Get a prescription dispenser box • Set yourself up for success with medications

13. Information about our lines • Calling over and over actually delays your meds because you go to the bottom of the pile again. • Our calls are date and time stamped. • Some days we don’t have any doctors in the clinic • When you call for a doctor, you will always get a nurse. We are their voice.

14. Medications truths • Last year, unintentional prescription pain medication overdoses were the number one cause of injury deaths in Utah, even more than motor vehicle crashes. • ARUP (Red Butte) has an on-site pharmacy. • Click on this web site listed below and make sure the sound is on your computer. • www.useonlyasdirected.org

15. Prescription Drug Abuse • Click on the following web site http://www.notinmyhouse.com/

16. Medications truths • Never take prescription pain medication that is not prescribed to you. • Never adjust your own doses. • Never mix with alcohol.Taking with other depressants such as sleep aids or anti-anxiety medications can be dangerous. • Always keep your medications locked in a safe place. • Always dispose of any unused or expired medications.

17. Paperwork and more paperwork • We are “rich” in paper. • In order to get an excellent history, we ask you to fill out a lot of papers – be prepared. • Please come to the clinic with all paperwork filled out

18. Finances • No business is complete without this aspect. • Co-payments are due at the time of service • Self pay are due at the time of service • Broken appointment fee • Insurance pre-authorization are your responsibility to get to the center • We deal with > 25 insurance companies

19. You have rights and responsibilities • We strive to protect and promote the rights of the people we serve. • If you have questions, comments or concerns, we want to hear them • You have many forums to discuss any problems • Members of the care team • Medical Director • Patient advocate program at the University of Utah • Phone numbers are in your orientation packet

20. Thanks you for entrusting your care to us. We strive to serve our patients in a caring environment where they can expect to receive high quality care with dignity and respect.