Working with your healthcare team

Managing chronic pelvic pain usually requires a team approach and often includes multiple doctors and other health care providers. A health care team for chronic pelvic pain might have a good primary care doctor or primary ob/gyn, in addition to specialists and other medical professionals as needed.

Doctors and other health care providers can use procedures, therapies, medications, and devices to manage individual pain conditions and to help you modify how the brain processes pain. But the person with the best understanding of your symptoms, your concerns, and your goals is YOU. Thus, the best approach for managing chronic pain is a partnership between what your doctor can do (i.e., professional care) and what you can do (i.e., self-care).

We’ve all had the experience of leaving a health care visit and feeling like we didn’t get to address the issues that were most important to us. It can feel extremely overwhelming to review your history again and again, or quickly summarize symptoms that vary so much from week to week. Your health care provider may also feel overwhelmed trying to get all the necessary information they need from you to make thoughtful and accurate recommendations in a limited amount of time.

When working with your healthcare provider, effective communication is an essential part of building a collaborative relationship. Using assertive communication style and organizing your thoughts are two strategies that make communication more effective (see Communication for tips).

Navigating care for a complex condition like chronic pelvic pain can feel daunting. Below are some tips and resources that you can use for before, during, and after your doctor visits.

Before Your Visit

During Your Visit

After Your Visit

Videos on Communication

Before Your Visit

Be prepared. Take a few notes about changes in symptoms since your last visit and to spend some time before the visit thinking about any changes in medications, activities, stress or other issues that may be related to this change.
Prioritize your concerns. If you want to talk about more than two or three items, make a list and put the items in order of importance. That way you can make sure to talk about the most important items first.
Think about what to bring with you. Bring a copy of your health history to your appointment, especially if it is your first visit to a particular doctor. Your health history may include a record of the dates and results of past tests, major illnesses, hospitalizations, medications, chronic illnesses, allergies, and a family history of any physical and mental illnesses. If you’re seeing a doctor to discuss chronic pelvic pain, having copies of prior operative reports and pelvic imaging results is extremely helpful. Make sure to bring all relevant health insurance cards.
Bring someone you trust to your appointment with you. Tell them what you want to get out of the appointment ahead of time. They can help you remember what you want to discuss and take notes for you during the appointment.
Track your symptoms with a symptom journal. You may notice an improvement in one symptom but no change in another. But sure to be specific about which symptoms have changed and which remain most bothersome. Write down in your calendar or a notebook the types of symptoms you experience and their intensity. This information can be helpful to both you and your doctor in tracking your medical condition and it can help you identify potential triggers that aggravate your symptoms. See Monitoring Progress to help with symptom tracking.

During Your Visit

Start the visit by mentioning that you’d like to discuss the one or two issues that are most important to you. This can help you and your healthcare provider budget time effectively during your visit. If you are unsure about what to go over first, show your list to your healthcare provider and let them choose the most important items.
Share information. Tell your doctor about any current symptoms or concerns during your visit. Explain how you feel physically, share your emotions, and give examples. Tell your doctor if you are having trouble with activities of daily living. Tell your doctor about other health care providers (like specialists or therapists) you have seen and any treatments they have prescribed or recommended.
Take notes at office visits to make sure you understand and remember what you need to do. Bring a pen and paper to your appointment so you can write down what your doctor tells you.
Audio record your visit so that you can play it back later. This way you can be sure that you don’t miss any information and get the most out of your doctor’s appointments. Be sure to ask your provider for permission before starting to record.
Ask questions and be honest with your healthcare provider so that they will be better able to help you. Explain how you feel physically, share your emotions, and give examples. If you do not understand something your provider says, ask him/her to explain it. Ask the same question more than once or ask if your doctor can explain something in a different way, if you need more time to process an answer. If you need further clarification, consider scheduling a phone conversation or speaking to a nurse or other provider.
Get it in writing. Ask your doctor to write down what you should do between now and your next visit. This may include instructions for how to take medications, specialists you should see, and/or lifestyle modifications.
Be brave! Health issues, especially sensitive issues like sexual function, can be hard to talk about, but it is important that your doctor has as much relevant information from you as possible so that they can recommend the best possible care.
Ask for a sooner return visit to finish discussing questions that you didn’t have time to address during that visit. Your healthcare provider may be able to address quick questions or request for clarification over a portal message or phone call, but it may be necessary to have a scheduled virtual or in-person visit to have enough time to answer a more complex question or change treatment strategies.

After Your Visit

Keep a medical folder of health papers, including those you take to office visits and those you get from your healthcare provider. A medical folder is good to have in case you switch healthcare providers, travel, or want to have a medical history.
Follow the plan that you and your healthcare provider agree on. You may feel skeptical that a particular treatment method may be helpful for you. But your provider is making that recommendation because it has been helpful for other people with similar symptoms and conditions. Most of treatments for chronic pelvic pain unfortunately do not work overnight, so it is important to commit to the full trial of a medication or therapy before concluding that it is not effective for you. If you have problems or side effects, call to report it so that your provider can assess need for change in dose or additional evaluation. Do not wait for a problem to become too big before seeking medical help.
Schedule regular follow up appointments to talk about managing your symptoms, to address your concerns, and to track your progress. This can be a more helpful way to manage your symptoms instead of making appointments only when symptoms worsen. Your treatment is an on-going process, and they need to know when you are having both bad and good days.
Find a new doctor. You should feel that you have a collaborative relationship with your doctor. You have the right to change doctors or get another opinion. You should ask your primary care provider or primary ob/gyn for recommendations about other doctors or specialists.
Utilize electronic medical systems for communicating between visits. Many clinics and hospitals offer an online health portal where patients can communicate directly with their physician. You may also be able to refill prescriptions and access ‘after-visit summaries’ of your appointments through this resource. Ask your physician if they offer this resource and how to set up an account.