On a scale of 1 to 10, how would you describe your pain? This is a question that gets to the heart of assessing the severity of pain. And yet, how accurately can we quantify pain given everyone has a different pain threshold?Pain perception varies from person to person, and can be affected by different conditions.
Patients with fibromyalgia experience a lower threshold of pain (they are more sensitive). There are certain trigger points where pain is most pronounced; patients will experience muscle, joint pain, and fatigue.
Today in preceptorship, we confronted the issue of pain management and fibromyalgia.
***
It was a nice sunny day walking to Dr. D's office. While walking, I pulled out my camera and snapped some photographs of the neighborhood. Emily and I performed intake and took patient histories today. Going into the room, we had little knowledge about what brought each patient to clinic. And we walked out, fully aware of not only the present medical illness, but each patients entire medical history.
***
In talking with patients, the issue of pain management came up over and over again. Patients living in chronic pain have to be concerned about the pain management, which is often complicated and requires medication that have side-effects, such as constipation and fatigue. Also, what happens when patients become dependent (or addicted) to their relief source?
"You do not hunt a rabbit with a cannon," said Dr. D.
Dr. D extended this analogy to pain management; you do not overuse opiates or pain killers when managing pain.
"You do not hunt a rabbit with a cannon," said Dr. D.
Dr. D extended this analogy to pain management; you do not overuse opiates or pain killers when managing pain.
Image: Image from the Neighborhood (off Filmore Street)
Dr. D has a good point--but I wonder about how to adequately help patients in pain without making them dependent on medication. And we must remember pain sensation is subjective, with a different scale for each individual.
Dr. D has a good point--but I wonder about how to adequately help patients in pain without making them dependent on medication. And we must remember pain sensation is subjective, with a different scale for each individual.
Posts
1 comment:
As someone with chronic pain, I don't understand the great concern over physical dependence (vs. addiction, which is a different matter) in people who take pain meds. If the pain meds let people function again in society, enjoy life sometimes, and maybe work again, what does it matter if they are dependent? The only situation I can think of is if they have to evacuate their home quickly or get lost in the mountains on a hiking trip or otherwise are separated from their meds unexpectedly.
That said, I think doctors need to broaden their thinking when managing pain. For some people, yoga, meditation, exercise, or antidepressants can make the unbearable bearable, and then they can cut back on pain meds or move to a unscheduled drug. Doctors also should refer chronic pain patients to specialized pain clinics much more often than they do.
Post a Comment