Pain Management – Part 2: My experience with PM doctors

After dealing with chronic pain (CP) for over 10 years, I have seen more pain management (PM) doctors than I would like to admit. Not only do I deal with pain related to SB, I also have RSD/CRPS. It seems that every time I find one that I love, I either move, they move, or other circumstances come up and they cannot continue with my case. It has been a difficult journey to find the right doctor, the right care, and the right treatments. I have found that there are a couple different types of PM doctors:

Type 1: Those who love what they do, actually care for their patients, and want to treat them the best way possible. Sometimes that means sending them to someone more qualified when they no longer can provide adequate care for the patient.

Type 2: Those who think a certain prescription can solve all the patient’s pain issues, no matter what the side effects may be, even if they have a negative effect on the patient.

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Type 1 PM doctors are the ones that are a perfect fit for the patient. Your personalities fit, they listen to you and take into consideration all of your symptoms, ideas, and concerns. They go over each recommendation they have to treat your pain thoroughly and address every concern that you present. They understand chronic pain and care for each and every patient and their needs independently. These doctors do not treat you like a number and do not get you in and out so fast just to see how many patients they can get through during their office hours. If their treatments do not work, they are willing to find you other doctors who can help with the treatment, either by referral or by consulting with them themselves.

I personally have found only two doctors in 10 years that have fit into this category. In the past 10 years I have lived in three different states and five different cities. I hate loosing my PM doctors because then it is basically starting over from day one when you have to get a new doctor. The last great PM doctor I had was always on the cutting edge of the medical advancements in the field of pain management. It was amazing to have a doctor that knew what he was talking about, had practiced for many years with patients with unbearable chronic pain, and our personalities clicked. We were always on the same page. His MA (medical assistant) was even amazing. Always easy to get a hold of and if there was a problem, she would always fit me into the schedule. There maybe was one time that we were not and after a great deal of conversation, we came to a mutual agreement. Unfortunately, for reasons I have not yet had the privilege to know, he resigned. This upset me tremendously because we were just getting to the point where we were ahead of the pain and almost little to no break through pain.

Then there is the Type 2 PM doctors. These are the doctors that want to hand you a prescription that they guarantee will work. Usually it is based on how well it has worked on all of the other patients. They tend not to consider each patient is different no matter if their diagnosis is the same. They also can be the type that swears by a certain injection or procedure, even if you explain that those procedures are not exactly helping, they want to continue to perform them because at some point they say it will work. Their staff is usually not helpful and they tend to want to just get you in and out as fast as possible.

This was the last PM doctor I had and ended up firing! He wanted to treat me with a very strong narcotic that is incredibly addictive and had major side effects. One of them actually ended me in the hospital for a week!!! I actually called and told him that I needed to titrate myself down to lower doses so I could come off the medication. He totally disagreed and was really not wanting to work with me on the situation nor did he want to come up with any alternatives to help my chronic pain. At that point I knew this was not the doctor for me! So with the help of my GP and pharmacist, I was able to get off the medication safely and the negative side effects went away!!! I also was able to fire him (which I LOVED!) and my GP and I decided that he would take care of my chronic pain.

Finding the right doctor for your CP is important. They have to be willing to work with you and listen to all of your past history and concerns. You have to feel comfortable with the doctor so that you can be opened and honest with him/her, so that you get the best medical care that you deserve! the best thing to do when finding the right PM doctor is to interview them at the first appointment, before signing any contracts. Remember, only you know how bad your pain is and what you can tolerate. The last thing you need is a Type 2 doctor that won’t work with you and that you are uncomfortable with, no matter the reason!

Pain Management: Part 1 – Dealing with break through pain & the ER

When you have a chronic medical condition sometimes you have chronic pain that is not easy to handle without medications. Due to strict laws through out the U.S., most of the time your general practitioner cannot provide you with the medication that you need, so they refer you to a pain management doctor. Most of the time, these doctors are trained in anesthesiologist who have concentrated their studies in pain management.

I have had the pleasure of dealing with PM doctors over about the last 10 or so years. Some of them were amazing and knew what they were doing, how to treat the pain appropriately and understood how having chronic pain affects your daily activities and your life. There have been many evenings I have been in so much pain, that medications did not touch, that unfortunately I ended up in the ER.

Treatments in the ER range the same way depending on the doctor. You could have amazing care or you can have a doctor tell you they cannot treat you. Break through pain happens! If you are in a contract with a pain management doctor, those contracts apply to prescriptions, meaning you cannot have another doctor write you a prescription for pain management (ex: narcotics, muscle relaxers, ect). However, this contract does not apply to break through pain that your medications are not controlling, which then leads you to the ER. They can treat you for that particular episode, but not write a prescription.

My recommendation for those who have a severe break through of pain that is not able to be controlled by your regular medication, to call your PM doctor before heading to the ER. Always maintain a honest, opened relationship with your PM, so that there is trust between the doctor and patient. This also helps you when you go to the ER, because your doctor can always call ahead and let them know the best way to treat your pain during your visit. Also, remember a follow up with your PM is very necessary.

I can tell you that certain ER doctors will not treat the break through pain, either because they do not understand chronic pain or because they absolutely refuse. Due to the influx of people seeking out pain medications some doctors are very hesitant to treat these conditions in the ER. Many people whom have chronic pain are viewed as drug seekers to the medical communities. It is very important not to hop around to different ERs to treat your break through pain. This will alert every hospital in your area, which in return they will see you in a negative light.

Also when or if you have to go to the ER, have your medical history typed or written out to give to the triage nurse. This way they are aware of every condition you have been diagnosed with, your surgical information, your allergies, and list of all the physicians that are currently treating you for all your health conditions. (See my post on traveling with medical conditions.) This information can help the medical staff at the ER treat you efficiently and with the care and consideration you deserve!!!

Understand that every condition and person will be treated differently, due to medical background and history. Also note that the ERs first step is triage to access you and the your needs for treatment. Depending on the ER, you may have to wait longer than others depending on their conditions and the level of medical treatment they require.

However if you feel that you have not been treated adequately or have any other issues, you have the right to a patient advocate. This may help your process and provide constructive feedback for the hospital when dealing with patients who have chronic pain.

I hope this gives you some insight and helps your battle with chronic pain. Please note that all states are different and have to follow policies and procedures laid out by the hospital and state laws. Look for future posts regarding pain management!

Shuffle on my friends!!!!

My Experience with Social Media and SB: Part 4

The online SB world is a very interesting place to participate in or like me, sit back and enjoy some entertainment. Now I will say there are some FB pages run by some very amazing people that have SB pages. In these pages we crack jokes, give helpful information, agree to disagree on certain subjects or content, and these sites actually are beneficial when dealing with so many issues we have as people with Spina Bifida.

So then there are the “other” pages. Those are the pages I am in for pure entertainment and for blogging purposes. The questions or statements they post are just so unbelievable to me. Now, I have started this series based on some of the things that have posted that have frustrated myself and others, whom may or may not be, members of both groups. (I will never divulge my sources!) However frustrated I was when I wrote those other blog post, I think this tops my cake! (Well so far anyway, who knows what these people will say next!!!)

I’ve said this before, that living with a disability is hard. However just like Wayne Gretzky says, “You miss 100% of the shots you don’t take.” Yes, he played hockey but he meant this quote to be about your life too. So why do you put so many limits on yourself, no matter what your ability or disability may be, without even trying to score a goal?? There are things I am unable to do, however it doesn’t always stop me from trying, attempting, or even adapting. It is all about your attitude and how you view yourself, inside and out! So, this is where it leads up to the post that just set me off!!!!

“How many SB friends/people whom have died before the age of 30 or 40?” (Now my quote is not a direct quote because I do not really want you to see so many grammatical errors!)

Now my rant begins:

WTF??????? To quote the movie, Sweet Home Alabama: “Are you shitting me???” (I know some are thinking that!) “I never fully understood that expression, but no, I am not “shitting” you!”

First to begin with, people pass away for many reasons even when they seem young and healthy. Next, as I have mentioned, SB affects people differently, so then in return, that adds certain other medical conditions. However, not everything is related to SB.

Now comes my favorite part of my rant. Why the hell are you all doomsday and zombie apocalypse all the time when it comes to SB? Do I, or anybody want to be focusing on that crap all the time?? Most of these doctors do not know what they are talking about when it comes to the life expectancy of someone with SB! For the love of anything, they don’t know what exactly causes it!!! Then why focus on all this negative, woe is me, I’m never ever going to do this or that, and because my friend of a friend’s, cousin’s girlfriend’s, ex mother-in-law’s sister’s daughter’s kid died when they were 19 and had SB, is that going to happen to all of us???? Well what they might have failed to mention is this kid was in a really bad car accident, or he refused to go to the doctors for pneumonia in both lungs, or something else – who really knows???

My point to all of this is WHY??? Why are we focusing on negative issues? Why are we not speaking with the older people with SB and asking how they maintained an amazing quality of life? Why aren’t we fighting the medical community for better health care and acknowledgement that we do exist, even as adults? Why are we sitting behind a computer depressing the shit out of everyone??? Why don’t you go outside and get some Vitamin D from the beautiful sun and lift up your attitude and personality??? If you want to focus on all this negative crap, where and who do you think you will be in 5 more years???

Personally I choose to be conquering my world with a smile on my face and a finger to all those who said that I wouldn’t be able to accomplish what I have and what I will in the future!!!!! Continue to shuffle on my friends!!!!!!!!!!!!!!!!!!!!

Most embarrassing: Medical tests

So what is the most embarrassing part of SB??? For me there is so much!!! From testing that I’ve had with doctor’s whom never buy you dinner before they do these things to what has happened at home or out in public.

So I am not sure if I am at the point to share what has happened at home or in public because I may or may not be still dealing with how to get them out of my head. When I get to the point of sharing those, I will definitely write a post about that and fill all of you in on those moments. I will share however the endless testing that is so embarrassing!

I do not know who comes up with these medical test and how they are actually performed, but whomever it is or was really needs to see a shrink if not be admitted into a padded room. Seriously, surround yourself with people in white coats other than you!!! I won’t tell you what I think of waterboarding but if I had a choice……

Urodynamic testing. Okay picture this: You sit on a toilet like thing in a room with a doctor, maybe a nurse, a tech, and whomever else likes to watch medical torture. They insert a catheter into your bladder and fill it up with water/saline and they see how long and how much you may or may not be able to hold in your bladder. Also during this time they are taking images and other measurements. Now maybe for a person who has a normal functioning bladder, only the catheter part sounds painful but to me that is the least painful part of this whole messed up test. I have a neurogenic bladder, so I cannot hold by bladder as long if at all and I have spasms, which can lead to leaks. So the pressure of having to hold this in hurts like hell (at least for me). And you try to hold it all as long as possible one because you really wish your bladder worked properly and two because do you really want all these people to see you pee? Hell no!

Colonoscopy. Do I have to even go into detail??? Can I ask, why do I not get a date before hand? Like a nice dinner and possibly a movie, preferably a comedy. I mean if this doctor is going to get that personal with me, why can he not be like any other guy in my life? Not that I get that personal with even my husband, but take a girl out like a proper gentleman!!

Anesthesia. Though this is not actually a test, going under can be quite embarrassing. Especially when you are like me and never have an inside thought plus have had a lot of anesthesia so it takes a little more than normal to put you under!! Apparently I tend to hit on everyone in the operating room and by hit on them, yes I mean I was making passes at them. According to my one doctor’s PA, who would fill me in on what I said, everyone in that operating room was fair game to me. Thank goodness my doctor had the good sense to inform the anesthesiologist that he really needed to give me more meds!!!

There are other embarrassing testing, such as the sphincter test, but I am nice and do not want to put those kind of images in your head. I mean I don’t even want them in mine let alone actually going through with the tests!!!! Though I have issues with MRI’s, because I am claustrophobic and my pain sky rockets when I have to lay on my back and that still, but other than having to be put asleep they really aren’t that embarrassing. Just really creepy to me! If anyone of my SB friend’s would like to share an embarrassing moment they have had in the comments, I would love to read them!!!

Interesting findings…

So as I was researching for a new blog post, I decided to check out the wonderful research of the great CDC and their information on Spina Bifida. Wow!! Thinking of how well they handle outbreaks and other diseases it shouldn’t surprise me on how they also handle Spina Bifida.

Under their facts tab they state “We do not know all of the causes of spina bifida”! However then they lead into folic acid and how much you should take while pregnant to prevent your child from having SB. Yes, it says prevent! Is that kind of an oxymoron, or am I reading it wrong?? Now I am not a doctor of any kind, however when a birth defect develops within the first few weeks of pregnancy, how are you sure that it is because of a deficiency of folic acid? They do not post the folic acid study on their website, however I would love to know if you have tested every mother that has a child with SB to determine this prevention method during the first month of their pregnancy. My opinion is they throw this at women of bearing age a little too much. there is more to developing SB than folic acid. I cannot wait to shake the hand of the geneticist whom discovers the true cause of SB.

My issue is that if you, meaning a doctor, tells a new mother that it is totally her lack of sufficient amounts of folic acid caused her child to have SB (which they do quite often) it is absolutely damaging to this new mother. Especially if the mother has no idea what SB is let alone what she is already feeling because they have rushed her baby off to another room. Spina Bifida is not covered fully in medical school unless you specialize in neurology and neurosurgery. It is covered slightly more in the OBGYN and pediatric field but not like the neuro fields.

My next issue with this CDC site is under the Living with Spina Bifida tab. Here are their links:

Newborns and Infants(http://www.cdc.gov/ncbddd/spinabifida/infant.html)

Toddlers and Preschoolers(http://www.cdc.gov/ncbddd/spinabifida/toddler.html)

School-Aged Children(http://www.cdc.gov/ncbddd/spinabifida/school-age.html)

Adolescents and Teenagers(http://www.cdc.gov/ncbddd/spinabifida/teen.html)

Young Adults(http://www.cdc.gov/ncbddd/spinabifida/adult.html)

Now can you tell me where the Adult tab/link is?????????? Hello, anyone??? Now I am starting to understand why all these young adults on Facebook have a negative outlook towards their diagnosis!!!! Then they direct you to the SBA for support and information, which is an organization that focuses their primary attention on the youth with SB and has no real information or support for adults with SB.

Also their articles and key findings tab (CDC website) has mostly to do with babies to young adults with SB. It’s almost nauseating because on their home page they want to develop a national SB registry. Now I understand how this would help future studies and SB patients, however I don’t know if I really want this group of people to keep tabs on me. Just kind of creepy!

I think my whole point of this particular blog post, is I’m glad I didn’t have access to the internet (well didn’t have internet) when I was growing up. I think if I did my outlook on my life would be totally different and I don’t know if I would have ever been able to talk about having SB as openly as I do now. The stuff out there is not all correct nor does it really give you information about all of those that live with SB. I pray one day that it does but then again it is the CDC and government funded!!!

My Experience with Social Media and SB Part 3

WARNING – Same as before!!! Brutal honesty that might upset many individuals!!!I

As I scroll through these Spina Bifida Facebook groups, I find many issues with certain post, comments, and advice. It fascinates me how many people post questions about medical situations that they find themselves in but never mention going to see the doctor. They try to connect anything and everything to SB! The comments and advice are even more fascinating as it seems everyone gives advice but yet most of them do not mention going to the doctors. While I know some of them work in the medical field as RN’s and in other positions, their advice is pretty actually relevant and coming from their background in the designated fields. These are not the people that I am fascinated with, those are the people that they should be listening to!

Spina Bifida, no matter where your lesion may be, comes with so many other medical issues. Mobility, urinary, and bowel issues are major problems. Other diagnosis could include (but not limited to) Tethered Cord Syndrome, Hydrocephalus (which may or may not require a shunt), Chairi Malformation, neurological problems, orthopedic problems and some learning problems especially with math. However, again this all is determined by the severity of the particular Spina Bifida that someone has (there are three types) and where the lesion may be on the spine. Also, just to state this, the medical community still does not know why SB happens. It happens so early in the pregnancy (around 28 days) that most people don’t even know they are pregnant. So all of this Folic Acid stuff is not a guarantee that the baby will not develop SB.

So back to my fascination with these post. It seems like everything from a sore throat, a cold, a funny shaped mole, to even personality they want to relate back to SB. Now understand I am exaggerating a little, however when you see these post it tends to get annoying. There are going to be a lot you encounter in life, but trying to relate all of this back to SB is absurd to me. It seems like some of these people do not want to take ownership for issues in their lives. You can’t go through life saying that your negative attitude is because of SB. You choose how you want to live with the cards you have been dealt. You choose whether or not you want to be positive or negative in your attitude and towards others. Spina Bifida does not choose for you!!!

I understand having SB is hard and we go through so much medically and psychologically, however it is what you do with that experience that makes you become the person who you are today. I am not going to let the surgeries, the “no we can’t help you”, and the “you can’t do this” effect my outlook on my life. It also isn’t going to stop me from proving doctors wrong. SB is definitely not going to make me so thin-skinned that I get hurt by something someone might say about me or if they tell me something I don’t want to hear!

I just want to tell these people to take ownership and stop blaming your disability for the things you can control. However, if you can’t take ownership then maybe you need to speak to a professional about those issues. I promise that a negative attitude and blaming certain things on your disability will not get you very far in life. If you want to be respected and looked up to, please stop complaining and asking for pity. Take a stand and be a better version of yourself. Start a new chapter, a brighter chapter that will lead to a brighter, happier future!

My experience with Social Media and SB Part 2

Again, I will preface this with a warning! This possibly and could upset some people. I am sorry but I am brutally honest!!!

I have a problem with the new phrase “Politically Correct” or for short PC. I understand that some words should not be said, especially in certain environments. However, no matter how PC you try to be, someone will ALWAYS be offended. What I cannot comprehend, is why we have to walk on eggshells all the time???

So relating this to SB and the groups I am in, there have been some huge debates and blowups from people of this politically correct verbiage. People have become upset in these groups about the term wheelchair bound. They become offended when others say they “do not have to use a wheelchair” or “no, I do not use a wheelchair”. They claim those statements are belittling people in wheelchairs and that it puts some kind of negative connotation on them because they do have to use a wheelchair. They also say that a wheelchair is an acceptable mode of transportation.

I guess what I don’t understand is when someone states “I do not have to use a wheelchair”, especially when in a group of SB people, it is not meant negatively against anyone who happens to be in a wheelchair, it is just a fact statement. It does not mean that you are putting yourself above someone in a wheelchair. This statement is just a response to do you use a wheelchair as a form of mobility.

My issue is that when you have SB, especially when dealing with the medical community, the question of using a wheelchair for mobility is almost always asked. Also, if they see that you are ambulatory they (those in the medical community) are usually surprised that you do not use a wheelchair or at the very least some type of crutches, arm brace crutches, or braces on your legs.

Understand that every one with SB is different because everyone’s lesions are on different levels of the spine. Even then, depending on the lesion and the severity your functions (what you can and cannot do) are completely different. Hence SB is called the Snowflake birth defect. This does not mean those that are ambulatory are any better off than those who may have to use some type of aid to help them get around. So why get so upset when someone states a fact.

From my personal experience with SB and dealing with the Spina Bifida Association and others whom I have conversed with over Facebook, not to mention the medical community, I get questioned about my SB more often because I am ambulatory. I have been told by quite a few people (with SB and parent’s of those with SB) that I don’t understand what it is like to have Spina Bifida, when actually it is quite harder for me!!!

Just because I can walk people assume that there is nothing wrong with me, unless they notice my slight limp. Even then they do not relate it with having a severe birth defect. For so many years, I hid my secret of having Spina Bifida from a lot of people in my life for fear of what they will say and how they will judge me. When everyone thinks you are “normal” (whatever that is) because of what they see from the outside, they already have judged you with preconceptions. It’s hard when you park in a handicapped parking place and people start yelling at you saying you are using your parent’s placard or other nasty things. How do you handle that? It makes me even more self conscious of myself and really wonder if sharing my story is really worth all of this mess!!

So my point, why do I have to be PC when talking to others who have SB?? Yeah we all are different when it comes to our abilities, but why get so upset about it????

My experience with Social Media and SB Part 1

Let me preface this blog post by stating a couple things. First, I never have grown up around others that have Spina Bifida. It wasn’t until Facebook was developed, and really just within the last year, that I have found Spina Bifida groups. These groups primary focus is to connect people across the world whom have Spina Bifida and to learn from each other on a medical and social level. Second, I may not look like I have SB because I can ambulate without the use of a walker, crutches, braces, or wheelchair, though from time to time I have had to use such equipment, especially after a surgery or when I was not as strong as I am now. Third, and most importantly, this post might upset some people however that is okay with me. I am honest and sometimes become so blunt that many take offense to what I say even though it may be the truth. I intend to stay true to myself and that may or may not come at a risk of making others upset with my viewpoint.

As I have stated, I have been following a few, well many, SB Facebook pages. I have come to the conclusion, even though some of the information has been useful and it is great to know that their our others out there that are dealing with hard if not harder situations as I am,  that I am happy with the way my parent’s raised me in relationship to SB.

I have found that on these Facebook pages that there are too many whiners. I know how harsh that sounds, however it is the truth. Most of these adults (18 years +) complain all the time. Yes, having SB is a bitch (excuse my language!). We, as adults, get pushed out of the pediatric medical community if were lucky in our early 20’s and sometimes it is sooner. Quality, knowledgeable healthcare for us is hard to find and many of us have to travel to major hospitals and many of those are out of state. This can be very expensive because many are on a fixed income due to SSD, SSI, and SSDI. It is also hard when you have to schedule transportation and other services. I know all of this because I have been through this and have had to and continue to fight for better healthcare for myself. I have traveled to many different states and clinics, praying that I can find a doctor who is knowledgeable and competent enough to handle my very complicated medical history. I am still trying to do that, even now.

To fight the medical community for better healthcare, you have to be strong, knowledgeable, and understand that you can fire any doctors that you do not deem adequate enough to take on your medical case. Trust me, I have fired my fair share of doctors!!!

I know that Facebook, especially in the SB groups, are an outlet for individuals with SB to vent. However, while venting is one thing, constantly whining about your situation (ex: housing arrangements, doctors appointments, expenses, family dynamics, etc.) is not the way to go about these situations. I am so tired of the “have pity on me” personalities. Learn to stand up for yourselves. Whining will not solve any of the issues you are facing because honestly it just makes the situation worse. If you want to constantly be negative, then that will continue to affect your situations in a very unhealthy way.

Also, what bothers me is that some of these people become butt-hurt over the littlest of things especially when others are being completely honest with them. It seems when you tell them the brutal honest truth, they fly off the handle and take personal offense to almost everything you say from that point on in the conversation. I have seen people get kicked out or banned from these groups by giving younger people the honest raw truth. These particular people are speaking from an advantage point of having been in these kids shoes many years ago before Facebook even existed. I just don’t understand how kids are taught today because they should be listening to their elders whom have been through all of this and even more because they did not have the medical advancements that these kids have today!!!

My biggest pet peeve out of all of this, is these SB pages (not all of them), seem like a dating webpage for those with SB. I cannot stand that because most of them specifically state in their rules that they are not a dating site!! When your post start off with “Hi, my name is Jane Doe. I am (fill in the blank) years old. Single. SB (fill in the details about their particular form of SB and more personal information) and I live in (fill in city and/or state). I live with (fill in the blank). Anyone want to chat??

I didn’t know nor did I intend to join a SB dating site. I also am not quite sure these people understand that this is the internet and how much personal information that they are actually giving away!! Not only that, but there is no way the admins of these groups can verify that everyone in these groups have SB. I worry for the safety of these individuals!!!

Traveling with medical contions

Recently I have been on the road, traveling from Florida to Texas and back. Traveling takes a lot out of you. You get out of the daily routine that you are used to, which can be frustrating. You may stay with family or friend’s and try to figure out where you belong in the dance they have rehearsed and perfected of their house. You drive many hours or fly and have to deal with the airlines, security and luggage.  It is all exhausting, especially when you have medical problems. The stress on wondering if you packed everything for the what if’s, could send you to a padded room alone!!!! However, the best thing to do is plan everything out!!!

Funny that I say that when I am not the most organized person. I like controlled chaos. I don’t know why but my brain does not function when everything is in it’s place or organized perfectly. Yet when traveling, I have to overcome the chaos and organize everything. So here are some steps I use when traveling.

1. Know where you are going and staying.

2. Figure out the best way for you to travel there, whether it is flying or driving.

3. Make a list of what you absolutely need to take, from medical supplies to your clothes. Look at the weather for the time you are staying so you know what you will need clothing wise.

4. If you are flying, you want to make your list manageable and not overwhelming. Take only what you will need. This way you do not over pack and do not have to worry about all the luggage.

5. If you are driving sometimes travel plans change so be prepared to have an extra bag in the car with an outfit, pajamas, and extra medical supplies. Also, remember to stop frequently to stretch, use facilities, eat and hydrate. In case a problem may arise, figure out where you can stay (ex: hotel) if you need to stop overnight somewhere. This can save you a lot of frustration.

6. Pack efficiently. When you know where you will be staying, see if there is laundry facilities. This way it cuts down on clothing and the amount of suitcases you have, that way you can wash your clothes and not have to take so much. I tend to over pack and find out that I don’t wear half the clothes that I pack.

7. When flying, carry all your medications and supplies plus a change of clothes on your carry on. This way if your luggage is lost or arriving later, you will not be in need of the most important items. Also, call ahead to the TSA and airline, notifying them that you are handicapped and whatever special needs you might have and if you need help through security and to the appropriate gate. Calling ahead and arriving early will help this process run smoother and help ease the anxiety.

8. Print out a brief medical history and bring it with you wherever you go!!! (This should have been number 1!) This should have your full name, insurance information, diagnosis, medication list, allergy list, a brief surgical history, and contact information for your doctors and for your point of contact in case of an emergency. This is also a great item to keep in your purse, wallet, day planner, vehicle and home.

9. Remember traveling can cause you to have anxiety especially when you have a disability. Stay calm and plan it all out. Notifying your doctors of your travel plans and of any anxiety is always the best thing to do and they can also help ease your mind.

Wherever you might be heading, remember to have some fun!!!! Hopefully your next trip will be easier with these tips!!! Enjoy and safe travels!!!!