National Vulvodynia Association

How to Communicate Effectively with Your Health Care Provider

To receive the quality care you need, you must communicate with your health care provider on a regular basis. In this section, we’ll offer some suggestions for improving communication with your medical providers.

Prepare for Your Appointment

It’s important to take some time to prepare for each medical appointment.

Before your appointment:

• Transfer relevant medical records, films and lab results to your new provider, or fax the information to the office several days before your appointment.
• Request that the provider fax or mail to you any forms that you need to fill out, so you won’t have to rush to complete them in the waiting room.
• Consider keeping a pain diary for several weeks or months prior to your appointment and/or complete the International Pelvic Pain Society (IPPS) questionnaire.
• Write down questions and bring them to your appointment.
• Consider asking a family member or friend to accompany you to the appointment to help you recall the provider’s instructions, especially if it’s the first visit.
• Bring a tape recorder with you, and if your provider doesn’t mind, record the session.

During your appointment, remember to:

• Be concise. Refer to your written questions.
• Give details. It can be difficult to discuss vulvodynia at first, but do your best.
• Ask for clarification if you don’t understand something your provider says.
• Take notes.
• Let your provider know if you need more time to discuss your concerns. If he/she can’t dedicate more time during your appointment, schedule a follow-up appointment or phone call, or ask if you can speak further with the nurse or physician assistant.
• Ask why certain lab work or tests are necessary and make sure the provider contacts you to explain the results.
• Ask your provider about any office policies or procedures. For example, how should you handle prescription refill requests and referrals? If opioids are prescribed, some offices require a written agreement and routine drug screening. Knowing office procedures can prevent future misunderstandings.
• Ask your health care providers to communicate with each other. Because people with chronic pain are often under the care of multiple specialists, it is important for the medical team to collaborate. Make sure that a summary of each visit is sent to other members of your health care team.

Issues to Address During Your Appointment

Chronic pain is complex and can affect you in many ways. Your ability to work, sleep, engage in sexual intercourse and participate in social activities can be affected. Your provider can’t see the intensity of your pain, so it’s up to you to describe your symptoms and how they affect your life. He/she also needs to know your complete medical history, including a list of all your medical conditions and medications (prescription and non-prescription).

You should share the following information with your provider:

• Pain Location: Where is your pain? Is it localized or generalized? Is it superficial or does it feel deep and penetrating? Does it travel or radiate? Do you experience pain in other areas of your body?

• Pain Quality: What does the pain feel like? Women with vulvodynia typically use the following words to describe their pain:

HotBurning Scalding Searing Sharp Cutting

LaceratingStabbing Tight Stretching Sore Pinching

ShootingThrobbing Tender Knife-like Raw Prickling

• Pain Intensity: How severe is your pain? How would you rate your pain on  0 to 10 scale, where 0 indicates no pain and 10 indicates severe pain?

No Pain	Moderate	Severe Pain
0	5	10

• Pain Pattern, Duration & Frequency: Is your pain constant or intermittent?  Does it start gradually or become intense suddenly? Does it increase with certain activities?

• Moderating Factors: Which activities or treatments help to relieve your pain?

• Associated Symptoms: Is your usual pain or pain “flares” accompanied by other symptoms, such as fatigue, fever, weakness or numbness?

• Emotional, Social and Sexual Effects: How does the pain affect your daily functioning and emotional well-being? Are you unable to sit or walk because of your pain?  Does the pain keep you awake at night?  Are you unable to exercise because of the pain?  How does the pain affect your mood, relationships and sexual health?  Would it help to see a therapist who counsels patients with chronic illness?

• Treatment Options: Educating yourself about different treatmentsfor vulvodynia will better equip you to discuss options with your provider. Chronic pain,including vulvodynia, is often managed with a combination of approaches, such as medication, physical therapy and lifestyle changes. Here are some questions about treatment that you may want to ask your provider.
  • What are my treatment options?
  • What are the most common side effects of this treatment?
  • What risks are associated with this treatment?
  • What can I read to help me understand the benefits of this treatment?
  • Do I need to be referred to another specialist for treatment?
  • In addition to medical treatment, what else can I do to feel better?

In addition to recording information in a pain diary prior to your first appointment, use it to track your progress in between appointments.

Other helpful resources to help prepare for a medical appointment or to follow treatments after a medical appointment can be found at the following link: http://theacpa.org/Communication-Tools.

How to Deal with Disagreements with your Health Care Provider

There may be a time when you and your health care provider disagree about a course of treatment or another issue. It’s best to approach the situation diplomatically. For example, if you would like to try a different treatment than what s/he recommended, you can say that you appreciate his/her advice on all available treatment options and that you’d like to keep your options open.

It may also help to:

• Quote respected sources of medical information (such as materials from the National Institutes of Health or the NVA) and provide your clinician with a copy
• Bring an advocate – a family member or friend – with you to the appointment
• Speak calmly and respectfully without raising your voice
• Ask open-ended questions, so that you avoid simply getting ‘yes’ or ‘no’ answers from your clinician

Going To the ER

A helpful resource to prepare you for a visit to the ER can be found at the following link: http://www.theacpa.org/Going-to-the-ER.