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Effective Pain Management
By Cheryl Ellis, Staff Writer


(Page 2 of 6)

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.

PAIN MANAGEMENT IS A SCIENCE

Over the decades, the perspective on managing pain has widened.  Healthcare practitioners and patients have a closer relationship in deciding pain management routes, incorporating “natural” and prescribed medications and “alternative” methods of pain relief. 

Pain management was once considered “doping up” the patient in some circles.  Today’s viewpoint incorporates consistent pain relief with keeping the patient alert and functioning. 

The variety of conditions that require pain management has created a demand for an accurate “science” to provide help based on condition and individual need.  The World Health Organization has a “ladder” for managing cancer pain.  Level One uses non-steroidal anti-inflammatory medications (such as aspirin) and “adjuvant,” or supplementary medications that have a secondary effect of controlling pain by eliminating a side effect.  As pain increases with cancer progression and/or treatment, professional caregivers step to the next level of pain management.  By Level Three, opiates are incorporated and the adjuvant medications are there to assist with opiate side effects.

OPIATES AND PAIN CONTROL

In the classic film “The Wizard of Oz,” the Wicked Witch deters Dorothy and her friends by creating a field of poppies they must walk through before reaching the Emerald Castle.  Dorothy and the Lion fall asleep until the Good Witch intervenes with snowflakes to wake them up, and the crew moves toward their destination.  

The poppy plant is used to create opiates such as morphine and codeine, which relieve pain, but also make the individual sleepy or lethargic. The effects of “Opiates from Oz” are shorter lasting than those administered for those in chronic pain.  Since alertness is a factor in complying with pain medications, patients may be unwilling to try them, looking to “natural” remedies instead.

 

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