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How
can I prepare for it How
do I enroll What
happens after Insurance/claims
information
14 Day Program
What is it?
Like our full, comprehensive 26 day in-patient program,
the 14 day comprehensive pain management program is
intense and residentially based at our out-patient Cold
Springs facility. Patients usually do not need preliminary
hospitalization for evaluation and stabilization. This
can take place at Cold Springs at the beginning of the
program of care.
More often than not we select patients for this program
when there is not a need for prescription narcotic withdrawal.
Patients in the 14 day program are less disabled and
can return to health patterns and functioning in a briefer
treatment cycle.
When chronic pain triggers a “collection” of difficult,
interacting symptoms that added together with the pain
itself results in significant suffering and disability
comprehensive treatment may be necessary. These symptoms
grow out of our physical, psychological, and chemical
reactions to pain. Typical symptoms can include:
- Persistent pain
- Insomnia
- Depression
- Medication dependence
- Muscle wasting
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- Weight gain
- Decreased sex drive
- Loss of employment
- Relationship problems
- Litigation
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To begin unraveling this “knot” of problems, we first
complete an initial evaluation of each patient’s medical
records, examine the potential patient, and complete
comprehensive questionnaires.
If suitable for treatment, a date is set for admission.
On the first day of admission, patients arrive at our
Pacifica
offices at St.
Helena Hospital and begin the admission process
into Cold
Springs.
In some cases patients may be admitted directly to
the Cold Springs Center, skipping the hospital in-patient
stay altogether if found suitable for this approach
during the initial evaluation. All attending doctors
and therapists follow each patient throughout their
entire program.
During treatment several important things are undertaken:
- Development of improved pain
tolerance and reduction
- Physical and psychological
strengthening
- Weight loss
- Improved overall functioning
- Endurance, flexibility, range
of motion
- Reduction of depression
- Improved self-discipline
- Education and re-learning
- Skills at personal pain
management
- Acquire 8 - 10 hours of daily functioning
Patients are assigned a prescribed
set of therapies and activities
and are assisted in the successful completion of these supervised activities. Our focus in on effective management and pain reduction, not cure. A
typica day can include exercise physiology, psychotherapy, group therapy, pain education, medication management, pain management, stress management, aquatic therapy,
biofeedback, family therapy, occupational therapy, chemical dependency counseling, nutritional assessment, and massage therapy occur each week and
off campus physician visits are once weekly. Family therapy is encouraged which entails a family member or “significant other” being
available to participate on a once weekly basis with the patient and staff in the therapy/education process. Additional consultations for radiology,
orthopedics, neurology, or any other medical need beyond our immediate staff are available if we think necessary.
Visitors are encouraged to call first before visiting and to come after 5:30 pm on weekdays or after 1:00 pm Saturdays and all day Sunday.
At the end of 2 weeks (14 days: admit on Monday and discharge on Friday), we expect our patients to feel improved. This sometimes includes more energy, less pain focus
and disruption and far more strength without narcotics or benzodiazepines. Other medications such as anti-inflammatory, anti-convulsant, anti-depressants
and other medications are sometimes used instead.
After successful
completion of the residential out-patient program for 14 days, patients return home and continue follow-up at PPM for one 6 months on a twice monthly basis. Since patients
sometimes come to our programs from long distances telephone appointments are sometimes arranged on an "as needed basis".
How can I prepare for it?
Once a patient has completed the evaluation process for enrollment we normally suggest that they continue their current treatment plan recommended by their community physician and make no changes. We at Pacifica do not assume treatment responsibility until you are formally admitted for treatment at our facility which is a date we confirm with you after your in-person evaluation at our offices. Completing our questionnaires on-line or otherwise or having medical records sent or having phone calls with our staff does not begin your treatment with us. That occurs only at the point you are admitted formally into our program.
Be sure to be in contact with our offices with any questions you have (800-964-1493). We take pride in our personal service and communication at all points along the way towards admission to our programs.
Carefully evaluate your particular insurance coverage and have our office assist you if necessary.
Weather in Napa Valley, California is temperate so bring enough clothes for about one week (we have washer/dryer available) including comfortable, easy on and off clothes. You may be changing for massage, pool, or exercise throughout the day. Bring tennis shoes, swimming suit, sweat clothes and personal hygiene items. In winter months bring a warm jacket and in summer months bring lighter clothes. Reading glasses, canes, TENS units, special shoes, braces, trusses, etc should also be brought.
Summary of Preparing for Admission:
- Continue your normal treatments until after we admit you to our
program.
- Complete our questionnaires
on-line and/or fax or mail them to Pacifica.
- Evaluate your insurance
coverage. We can help.
- Bring enough clothes for about
one week, lighter in summer and heavier in winter.
- Bring any necessary medical devices, braces, etc. with you.
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How do I enroll?
We can accept patients without a doctor’s referral however we strongly encourage patients to discuss their intentions with their healthcare providers and enlist their support so that our pain management program will become an important "part" of the overall plan of care for effective pain management.
Each patient should visit our website at Pacificapain.com
and thoroughly explore our approach to treatment and then
complete all questionnaires.
Some of the questionnaires are interactive and can be
finished and sent back to Pacifica staff directly from
this website and some are downloaded and printed to be
completed at home and then faxed, mailed, or brought in
for a first appointment.
Then, direct telephone contact with our office (800-964-1493) to set up a first appointment can be made.
Patients should have their medical records relating to
their pain and it’s medical treatment forwarded to Pacifica
offices by fax or mail. They will returned after evaluation/treatment.
It is ideal and desirable to have the patient’s community physician write a brief summary of treatment and diagnoses including prior radiology evaluations and surgeries as a referral letter.
In the case of Worker’s Compensation, it is mandatory
that the physician or healthcare provider recognized by
the insurance carrier write a letter of referral and obtain
authorization for the initial evaluation at Pacifica.
Our office can help
you with this process.
Summary of Steps to Enroll:
- Evaluate our pain management services thoroughly
at this website, by calling us, and by reading our
brochure.
- Complete the questionnaires
on this website.
- Obtain your doctor’s referral
to us for evaluation.
- Have medical records of your pain treatment sent
to Pacifica.
- Call
to make an appointment.
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What happens after?
6 months of follow-up:
After completing the intensive 14 day pain management program successfully it is hoped that you will feel better and be
on the road to health and better functioning. You will, in all likelihood still be somewhat “fragile” physically and emotionally therefore it is very
important that you participate in the aftercare or follow-up program for 6 months.
If you live
nearby, your schedule will be as follows:
- twice monthly visits after
discharge for 6 months.
- depending on patient need, periodic telephone appointments.
The actual frequency of visitation in the follow-up program can vary depending on patient need but the above “ideal” follow-up pattern averages about 11 visits in the 6 months following the intensive 14 day residential program.
In the case of distant patients, some of the follow-up can be by way of telephone check-ins with your assigned staff member to strengthen and maintain progress. These forms of follow-up are best when combined with the scheduled in-person follow-up visits. Internet (e-mail) transmission of updates from patients are also possible as our e-mail is encrypted (coded) for privacy. In some instances, webcam appointments are available by arrangement.
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Insurance/Claims Information
We can help. Give us a call at (800)-964-1493:
Given the intensity of treatment, length of stay, high staff-to-patient ratios, and small number of patients treated at any one time (6 patients maximum) some insurance coverage is usually necessary to offset direct costs to the patient.
Neither MediCare nor Medicaid have adequate coverage for in-patient pain rehabilitation services at St. Helena Hospital or Pacifica.
Private insurance may sometimes cover aspects of both in-patient and residential out-patient pain management services but careful evaluation of each separate insurance plan is recommended. Some personal costs are usually anticipated.
With worker’s compensation, a direct referral from the “doctor of record” in the eyes of the insurance carrier is usually necessary as a first step. Then, after utilization evaluation and approval an evaluation appointment can be confirmed. Patients usually cannot secure their own treatment without express permission from the adjustor or nurse case manager if that treatment is to be paid for by worker’s compensation.
Click
here for information about how we can help you with this
process.
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