Chapter 1. Coping with Pain

1.1 Coping with Pain

Short Description

Pain has often been poorly managed. Today, medical facilities are required to assess and control patients' pain or risk losing their accreditation. Pain is difficult to define. Ultimately, it is whatever the experiencing person claims to be painful.

Long Description

Pain has often been poorly managed. Today, medical facilities are required to assess and control patientsí pain or risk losing their accreditation. Pain is difficult to define. Ultimately, it is whatever the experiencing person claims to be painful. Anesthesiologists at the University of California, San Francisco (UCSF) hospital attempt to eliminate postoperative pain. Indeed, some patients come out of surgery pain free. If patients remain in pain, recovery occurs more slowly. Those who resist medication must be encouraged to take it. The failure to treat pain may result in it becoming permanent. Untreated pain can produce changes in the spinal cord, which then continues to send pain signals to the brain long after the distress should have ended. The goal is to eliminate pain messages being sent to the spinal cord before this process gets started. Pamela Palmer, director of UCSFís Pain Management Center, reports that those who experience chronic pain are often most distressed by how it interferes with normal living. Bob, a former physical education instructor, describes how the harrowing pain that followed surgeries for his deteriorating spine disrupted every aspect of his lifeófrom his relationship with his wife to getting dressed in the morning. Dozens of pain medications provided Bob with little relief. Dr. Palmer took him off most of the medications and implanted a pain pump under his skin. The pump delivers a preprogrammed level of morphine directly to the site of his pain. Now, Bob remains clear-headed and gets more relief with less morphine. Management of excruciating spinal pain may demand not only a morphine pump but also other strategies like spinal nerve blocks, physical therapy, psychotherapy, biofeedback, and acupuncture. Ironically, friends and relatives may not always be supportive. Susan reports losing her marriage over her use of morphine and other pain management techniques. Her husband viewed her reliance on these techniques as evidence of weakness.

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