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How
can I prepare for it How
do I enroll What
happens after Insurance/claims
information
26 Day Program
What is it?
Intense and comprehensive, multidisciplinary (many doctors
and therapists) treatment for severe and chronic pain
syndromes in confidential, secure and medically supervised
environments, first at St.
Helena Hospital, a medical facility, for an initial three
day evaluation and then at Cold
Springs Center, a seperate, licensed, non-medical
residential facility (23 days) for detoxofication and
functional restoration.
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
(see our annual calendar
of programs).
On the first day of admission, patients arrive at our offices and begin the admission process. Patients are usually admitted for a three day in-patient stay at
St. Helena Hospital for evaluation and preliminary stabilization. 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.
After hospital treatment, patients are then discharged to Cold Springs to complete the remainder of their treatment program as a residential out-patient.
The complete results of the in-patient evaluation follows the patient through their residential out-patient treatment. All doctors and therapists attending
also follow each patient through their entire program.
During treatment several important things are undertaken:
- slow tapering off of
narcotics and benzodiazepines
- 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 is on effective management and pain reduction, not cure. Daily activities can include, exercise physiology,
psychotherapy, group therapy, pain education, medication management, pain management, stress management, aquatic therapy, biofeedback, family therapy, chemical
dependency counseling, nutritional assessment, and massage therapy. 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, or any other medical needs beyond our immediate staff are available at nearby St. Helena Hospital.
At the end of 4 weeks (26 days: admit on Monday and discharge on Friday), patients in some instances feel much improved with more energy, less pain focus and disruption
and far more strength without narcotics or benzodiazepines. In some instances, medications such as anti-inflammatory, anti-convulsant, anti-depressant, or
other medications are continued if medically necessary.
Visitors are encouraged to call our
office at (707) 963-1493 prior to visiting to arrange
their visit, which is allowed on
weekends.
After successful completion of the intensive in-patient and residential
out-patient program patients return home and continue follow-up at PPM for one year on a tapering basis. Follow-up begins immediately on a twice monthly basis for one year.
Since patients sometimes come to our programs from long distances, telephone or other types of appointments can be arranged on an "as needed basis".
How can I prepare for it?
Once a patient has completed the evaluation process 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?
One full year of follow-up:
After
completing either the intensive 26 day
or 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 one full year or 6 months if completing the 14 day program.
If you live nearby, your schedule will be as follows:
- twice monthly visits after
discharge for 6 months to 1 year.
- 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 22 visits in the year following the intensive 26 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.
Some 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 review 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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