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Effective Pain Management
By Cheryl Ellis, Staff Writer
In both acute and chronic health conditions, pain is top
on the list of concerns for patients, caregivers and
physicians. Effective pain control improves the
individual’s state of mind and ability to move through
the healing process. There are a variety of
options for pain control, and doctors work toward
addressing side effects that can occur with pain
Coming to terms with being in pain, acute or chronic, is
a hurdle for many folks who grew up learning to “put
aside” pain. Individuals who have been vocal about
pain levels and received negative responses may feel
angry, refusing treatment as an expression of emotional
Fortunately, pain control centers, physicians and other
healthcare personnel have become more aware over the
years. Asking about pain levels during office
visits is as common as checking vital signs.
TYPES OF PAIN
Acute pain can occur at the same time chronic pain is
experienced. The euphemism “breakthrough pain” is
one type of acute pain an individual can undergo.
This pain can occur because of movement or activity, but
it can also happen when the body has involuntary
movements, such as expelling gas or muscle twitches.
Medication can be prescribed for the “break” in pain
that around the clock medicating provides.
Breakthrough pain may occur in the same area as the
chronic pain, but not always. Noting the events
leading up to the episode of breakthrough pain can help
caregivers adjust activity levels if needed. In
some cases, the area in pain and/or the event that
contributes to it cannot be pinned down. Recording
episodes, including seemingly random incidents, will
still help when pain management is reviewed.
When pain resurfaces before the next scheduled dose of
medication and isn’t associated with a voluntary or
involuntary action, the physician can be notified to
examine the timing and amount of around the clock
medication. Noticing the time of pain onset and
keeping a record can help the doctor make a decision
about keeping pain relief consistent. Caregivers
will find their loved one complains at or about the same
interval of time prior to their next dosage.
Chronic pain is consistent and “stable”. While
there may be some fluctuating of intensity, it is
“reliable” in its characteristics. Medication for
this type of pain is generally around the clock to
provide continuity of relief. Over time,
medications are adjusted to account for changes in the
pain cycle, including a patient’s tolerance to a given
AGE DOESN’T MATTER
Children and adolescents with cancer or AIDS experience
pain just as deeply as an adult. They may be
better equipped to admit to pain and track where they
are hurting, as opposed to adults who may have dementia
as a hindrance to assessment.
Physicians have a specific protocol, or pathway, to
follow when managing pain for adults and children.
When dealing with “pain psychology”, caregivers will
learn to watch facial expressions, body positions and
other gestures to determine if their loved one is
understating their pain level. Kids may not want
to worry their parents, or be afraid of a visit to the
doctor or hospital. As the healthcare experience
continues, parents become more attuned to what their
child is feeling, and may find that personnel involved
in their child’s care are able to help them understand
what is typical at different stages of treatment.
While the same is true for caregivers of adults, the
adult-to-adult psychology can have a wider range of
variation. Children helping their parents through
a health crisis may take time to relate to them on an
adult-to-adult level, and parents may attempt to mask
their fear and pain by amplifying “Parent Mode”.
When possible, ask the doctor to allow for some time
alone with the parent, to allow them to express their
needs without feeling “weak”.
Relationships of every kind are
challenged when there is a health problem, and
relationship dynamics should be evaluated at the time of
diagnosis by loved one and caregiver.
Understanding that there will be changes in any
relationship is a first step toward coping with those
changes, and making them positive ones.