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Dontfixit.org Managing Post-Vasectomy Pain

Managing Post-Vasectomy Pain
The role of the primary care physician (PCP)

Provided by Stephen Hilty, MD, an internist practicing in San Luis Obispo, CA

Finding a PCP:
Resources: friends, Hospital/ER nurses, Urologist
Internal Medicine (Adult Medicine) vs Family Practice (Adults/Children)
Check MD's background/training: Board Certification/Re-certification
: http://www.abim.org/
ABFP: http://www.abfp.org/

Discussing Your Expectations:

Coordinator Specialists:

Letter of referral to Urologist, Massage Therapist, Accupuncturist, Chiropractor, Pain Specialist, Photon Therapist, Psychologist/Psychiatrist, etc.

Supervise All Medications:
If someone else prescribes something new, notify your PCP Keep a list of what you take, what you've tried (including so-called "alternative" medications)

Interpret test results
Discuss a specialist's recommendations
Research a question

Pain Management (Bone Pain vs Nerve Pain)
Example: Broken Arm VS Hypersensitive, Electric, Numb, or Burningpain

Bone Pain: Acetominophen, Ibuprofen, Tramadol, Morphine-like medications

Nerve Pain:
Tricyclic Antidepressants, Anti-Seizure Medications (Neurontin), Anti-arrhythmic Medications (Mexilitine)

Psychological Support
Relationship with "S.O."
Work/Financial Pressure
Living with Chronic Pain


Psychosocial Aspects of Chronic Pain Management:
Because of the effect pain can have on one’s life the psychosocial aspect of care can have significant impact on treatment. Studies have shown that almost two thirds of patients with chronic nonmalignant pain have coexisting symptoms of depression or anxiety.

Because of a feeling of helplessness many patients have when trying to relieve chronic pain, patients are in danger of assuming what is called a "sick role." After countless doctors office visits, referrals upon referrals, and a myriad of diagnostic tests, some patients will become the victim of their pain symptoms. This sick role can have "positive" benefits such as attention, sick leave, and sympathy from others. However, it can also cause significant isolation and feelings of worthlessness.

Learning to manage the pain can be just as important as treating the pain. By not falling victim to chronic pain, patients maintain control of their health and the potential for curing their symptoms. The Mayo Clinic offers the following suggestions for managing chronic pain and avoiding the sick role:

Stay Active
Chronic pain has been shown to improve only when a patient’s level of activity increases. While many patients will feel bound to a sedentary lifestyle because of their pain, there are always exercises and rehabilitation no matter how difficult the situation. Physical therapy should focus on reconditioning, stretching, and pain reduction modalities (e.g. ice, heat, ultrasound, etc.).

Focus on Others

Be active in your community, stay in touch with friends and family, and look for volunteer activities. By keeping active with friends and family you will feel less isolated, and by maintaining active in your community you will pay more attention to others’ problems and less to your own.

Accept Your Pain
Don’t deny or exaggerate your symptoms, and perform your daily functions accordingly. If there are things you need help with, don’t be afraid to ask. If you are avoiding things you can do, make an effort to do those activities.

Stay Healthy

Abnormal weight and sleep disturbance have both been shown to adversely affect pain treatment. Get a good night of sleep on a regular schedule and eat a healthy diet. Harmful habits such as tobacco, alcohol, and drug use all make pain more difficult to treat. Specifically, nicotine is associated with increased pain levels, and may decrease the effectiveness of treatment medications by altering their blood levels.

Suggestions from Patients with Chronic Pain


What We Have Learned In 20 years of helping each other, we’ve learned a lot. Here is a bit of that wisdom:
We need the support of others who experience and understand chronic pain.

Recognizing emotions helps us to understand ourselves.

While our pain is certainly not all in our heads, attitudes and expectations do make a difference.

Learning how to relax is essential. It helps prevent tension and redirects our attention on to things we have some control over.

Staying active, within realistic limits, can help us remain flexible and strong and reduce our sense of suffering.

It is important to set realistic goals and chart our progress toward them.

Chronic pain not only involves the person with pain but the family as well.

Hearing others talk of similar feelings and experiences caused by pain reduces our isolation.
There are no wrong feelings.

Half the battle is won when you begin to help yourself.


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2001-2006 Kevin C. Hauber