Saturday, May 4, 2013

A problem shared is a problem halved

Problem solving is a big part of patient navigation. I practice my problem-solving skills on myself.

I’m a bit surprised that I’m keeping pace with a 9-to-5 as well as I am, given the type of boundary-less worklife I had previously. Each workday ends with preparation for the morning. Each morning starts with a modest amount of caffeine and half a vitamin pill. Yep, somewhere along the way I realized that those megavitamins I had rejected because they gave me gas or worse could be cut and served in halves. Duh!

I am often humbled when a solution reveals itself simply by changing my perspective of the problem. It's neither black nor white; the answer is not "all or nothing."

Patients can find themselves backed into what feels like a corner, e.g., “I need this surgery but I can’t handle this surgery.” What is the middle road? Do you need this surgery now? Do you need this surgery? Is it truly the surgery or the recovery that’s creating a problem? If it’s the recovery (usually) how might we support your best recovery?

Catastrophizing is the enemy of problem solving. Instead of conflating the issues, let’s break it down: what do you need on surgery day? How about post-op day two?

If your doctor’s office hasn’t explained to the level of detail you seek, remember there are many patients who have walked in your shoes before whose tips come from practical experience.

For example: Google “recover from knee replacement” and you get 426,000 results in .26 seconds. Sources range from websites of major medical centers to videos created by patients.

Lorraine Yapps Cohen, advocating for her husband several years ago, was full of tips for communicating with healthcare providers. Wikihow includes illustrations. A 60-year-old school teacher’s video provides motivation for the work of physical therapy.

Online forums can be a source of support, information, and collective knowledge and experience. “The constant outpouring of sympathy and support that we observed in interactions among community members surpassed anything a patient might conceivably expect to receive at a doctor’s office.” (Hoch D, Ferguson T (2005) What I've Learned from E-Patients. PLoS Med 2(8): e206. doi:10.1371/journal.pmed.0020206)

As a navigator I coach patients to give up thought patterns that are keeping them stuck, such as attachment to being “right.” My goal is to help them acknowledge that fear sometimes clouds our thinking and pride shouldn’t interfere with asking for help.

Where that help originates is limited only by our imagination.

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