Your Health Matters
By Claudia Parks, R.N.

Our "fifth vital sign"- PAIN! Almost no one escapes it. "Pain is vastly under-treated today for several reasons" says Jim Guest, (the first and former) executive director of the American Pain Foundation in Baltimore Maryland. Until recently, health care professionals (doctors & nurses) received little training in pain treatment. Patients hold low expectations for relief and don't want to be seen as whiners. Many doctors and patients are wary of strong painkillers, such as opiates (derived from opium) like morphine. Patients fear addiction, often needlessly. And doctors are concerned about increased scrutiny from drug regulatory agencies when prescribing stronger medications.

 

Despite the hesitation to talk about pain, it is epidemic: 75 million Americans have chronic pain (lasting six months or longer), and 50 million experience shortterm pain from injuries or surgeries annually. Numerous women tend to experience daily pain, miss work due to pain, and develop conditions that cause chronic pain. (I'm sorry to say this, but their physicians often ignore women when they mention pain!)

Send a clear message--speak up! You can sound off about pain without feeling self-conscious. Both the Joint Commission on Accreditation of Healthcare Organizations and the Department of Veterans Affairs call for pain to be treated as the "fifth vital sign" and assessed as vigilantly as blood pressure, pulse, temperature, and respiration.

Doctors can't feel your pain. Their ability to understand pain is determined by their patients' ability to describe it. This calls for straight talk. Tell your doctor:

* When the pain started

* Where it is located

* What makes it better or worse

* Whether it radiates

* How it feels presently * How it feels in its worst form

* How it feels in its mildest form

* How the pain rates on a scale of one to 10

Choose words carefully to describe pain: stabbing, aching, dull, piercing, tingling, gnawing, deep, pounding, shock- like.

Share your ideas about the cause of the pain. Explain- directly and succinctly- the methods of relief you've tried and the results. It's important that you explain how the pain affects your life. Keep a journal/calendar with the details about your pain and possible "triggers".

LISTEN. It's the doctor's turn. Expect your doctor to explain clearly the probable cause of the pain. He/she should present a treatment plan, including potential surgical options and medication side effects. In addition, make sure your doctor discusses how often the treatment plan will be assessed.

Be sure your doctor understands and believes you. If that level of confidence isn't there, ask for a referral to a pain specialist. Or contact the nearest teaching hospital for a recommendation.

Banishing pain, especially chronic pain, involves more than popping the latest pill. You may need a multidisciplinary approach, which may include drug therapy, pain rehabilitation or physical therapy program, and psychological help. Massage, biofeedback, or acupuncture, is not unusual.

Seeking psychological help does not mean the "pain is all in your head." Chronic pain is going to cause changes that affect all aspects of life, including psychological health, family life, sexual life, and social life.

Even with new treatments, good communication remains important. A lot depends on the patient taking action. Be vigilant, whatever your level of pain, and get answers before pain worsens.

PRECAUTIONS: Before taking narcotic pain medications, tell your doctor if you are allergic to any medications. Also, be sure to reveal any difficulty urinating, (e.g., enlarged prostate, urethral stricture), alcohol use, drug dependency, heart and breathing problems. Be sure to tell your doctor all of your conditions! Read the entire Patient Prescription Information sheet that you receive from the pharmacist before taking your medications.

More--FYI:

APF: Will Rowe, president and CEO

American Pain Foundation www.painfoundation.org 888/615-7246

American Chronic Pain Association www.theacpa.org 916/632-0922

Arthritis Foundation www.arthritis.org 800/283-7800

Massage Therapy Association www.amtamassage. org 888-843-2682

Claudia Parks, RN, is a former doctor's office and emergency room nurse and retired as an educator from Fulton County Schools. She writes Your Health Matters as a public service; the information here is designed to help you make informed choices about your health. It is not intended as a substitute for the advice of your physician. Claudia and her husband make their home in the beautiful north Georgia Mountains, near Blairsville. Claudia can be reached at yhm@windstream.net