Tag Archives: pain

Thoughts On Pain


A few years ago there was a frank, open, and honest discussion about pain among patients, staff, family and community members that was quite enlightening.  Several important and interesting things were brought up that today’s “Opiate Abuse” culture could learn from:

  • Patients need to be included in discussions about their pain, and pain management plans.
  • People have differing pain tolerances – some can stand only a little pain while others feel they can handle a great deal of pain.
  • People have differing pain expectations.  They may not understand the full implications of what will happen and/or what options may be available to help them.
  • Clinicians sometimes expect that patients must be feeling pain (or shouldn’t be feeling pain) when that may not necessarily be the case.
  • Clinicians (i.e. physicians and nurses) should always discuss the following types of things with the patient:
    • How much pain can usually be expected in this type of situation?  How long could it last?
    • Perhaps some pain will have to be present, it is not always possible (or wise) to completely get rid of all the pain.
    • What is the patient’s expectation around pain relief?
    • Does the patient want pain medications?
    • Does the patient desire no pain medications?
    • Has the patient had reactions to pain, or other, medications?
    • What is the patient’s pain goal? (it may not always be zero)
    • What is the patient’s normal pain level? (esp. for chronic pain patients)

The important thing to remember is that every person is an individual.  The more open and frank the discussion between patients and clinicians is, the better the outcomes will be for all concerned.

There is no “one size fits all” solution to pain and pain management.  Person-centered care is the answer.  The more that society, government officials, the health care industry, and the media start working to that end, the better off individuals, their families, and the country will be.

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Adventures With Healthcare


My experience with the healthcare system has been vast and varied.  Recent events have reminded me once again how important it is for both sides to try to communicate properly with one another; not presuming that the other knows everything about your side of the situation.  Even when it seems the other knows you, what you expect of them, the situation, and its outcome, there is plenty of room for misunderstanding, miscommunication, and mistaken conclusions.

In other words, for best possible outcomes, both patients and caregivers must ask for and give lots of information.  Over-communicating is better than under-communicating.

One situation I am quite familiar with is chronic pain.  Happily I can report that healthcare has made great advances in dealing with people who have chronic pain.  With the pain scale having become the gold-standard for assessing the amount of pain patients are feeling, physicians and other caregivers can have a much clearer picture of what is going on.  This helps guide their decision-making processes, enabling them to give greater comfort and aid than might otherwise be possible.

There are healthcare professionals who are very aware of chronic pain and how it affects patients.  They strive to take proper care of all patients, even hiring pain management teams to assist.  They see the situations their patients experience, and are increasing their knowledge in order to relieve greater suffering.  They take into account that not all patients feel pain in the same way, that some have an incredibly high threshold for pain while others have a very low tolerance for it.  And they seek to treat each as an individual with his or her own treatment plan.

They have talked with patients and learned that some, particularly those with chronic pain, are never pain-free and must be kept at a pain-medication maintenance level at all times, even when in the hospital.  They have acknowledged the fact that these patients need pain medicine to make the pain tolerable and help them function.  These patients do not ask for ever-increasing amounts of the medicine, they remain at the same dosage level for years.

These patients need additional pain medication when having had surgery or a serious injury that causes increased pain.  Well-informed caregivers realize that it is much easier, and takes less medication, to stay on top of the pain than it is to try to play catch-up after the pain has reached searing heights.

Additionally they recognize that there are some patients who should be, or perhaps are, feeling great pain because of their situation, yet are more concerned with remaining drug-free or at least under-medicated.  Reasons for this can vary from having previously had a negative reaction to the normal pain medication regimen all the way to believing they will be driving themselves home soon and wanting to remain clear-headed.

I have experienced situations where the attending physician went to great lengths to solve the underlying problem and continue treatment until it was resolved.  And I have experienced situations where the caregivers simply act along the baseline for that type of situation, not looking any deeper to become familiar with the whole picture (or perhaps just failing to review the situation with the patient where assurances could have been given, and needs properly addressed).  The more we know and understand all sides of issues within healthcare, the better off all will be.  Suffering can decrease and wellness increase as pain and other complications are handled properly or avoided altogether.

What types of healthcare experiences have impacted you?

25 Days of Christ – Day 19


Does the Christmas season get you down?  Is it hard to feel the spirit of Christmas?

In the story, The Timepiece by Richard Paul Evans, Mary and David Parkin lose their young daughter in a fire started by an angry young man as retaliation against David.  Of course Mary and David are heartbroken, and depressed.

At Christmas time several months later, they are still grieving terribly, especially David who has long since thrown himself entirely into his work, barely stopping even long enough to eat or sleep.

One day their minister stops by to see how they are doing.  He tells Mary of a child who will have no Christmas and invites her to go with him to bring the child a present.  Mary goes with him.  They are greeted at the small home by a young mother.  Her little girl is peeking around her to see who is there.  Mary gives her a doll and the child’s eyes light up!  She hasn’t had a present in a long time.

As they leave, the minister tells Mary that this is the family of the young man who started the fire and is now in prison.  Mary’s heart goes out to the mother and child.

When her husband finally gets home that night, Mary is brimming over with the joy she felt when giving the gift to the little girl.  David sees her love and happiness with the experience, and agrees to help provide Christmas to the family.  They deliver food and presents to the doorstep of this family who have almost nothing, and watch from afar as they excitedly gather the gifts and take them inside.

Despite their great loss, Mary and David have found the true spirit of Christmas through selflessly giving to those in greater need.

“Then shall the King [Christ] say unto them on his right hand, Come, ye blessed of my Father, inherit the kingdom prepared for you from the foundation of the world:

“For I was an hungred, and ye gave me meat: I was thirsty, and ye gave me drink: I was a stranger, and ye took me in:

“Naked, and ye clothed me: I was sick, and ye visited me: I was in prison, and ye came unto me.

“Then shall the righteous answer him, saying, Lord, when saw we thee an hungred, and fed thee? or thirsty, and gave thee drink?

“When saw we thee a stranger, and took thee in? or naked, and clothed thee?

“Or when saw we thee sick, or in prison, and came unto thee?

“And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me.”  Matthew 25:34-40.