Saturday, September 13, 2014

Part Two – Chronic Pain in the Present – The Question by Celeste Cooper

In part one, you read about the historical evolution of patient care and the value of “looking up.” In this segment, we will explore how our provider asking certain questions, in a certain way, can open the floodgates of information that might improve our care.

Every individual has a primal instinct to preserve life and avoid pain. Our ancestors either found a way to treat their pain, live with it, or not. Things are not so different today other than the availability of advanced diagnostic tools and interventions. Despite this, the Institute of Medicine report—“Relieving Pain in America”— states people living with chronic pain are judged, discriminated against, and underserved. Most staggering of all is that approximately 100 million Americans presently live with chronic pain.

No doubt, chronic pain, and other illnesses that can accompany it, has an impact on society. However, the impact is not limited to society. We, as patients, are also affected. Scrutiny by government agencies and non-reimbursement for integrative treatments are two things that make it difficult for our providers to develop care plans. Wouldn't it be wonderful to have a therapeutic massage, acupuncture, or other integrative therapies we know help reimbursed by insurance? At the The Center for Practical Bioethics symposium, Patients as Teachers, we learned a great deal about ethical dilemmas associated with untreated and undertreated pain. There are people who want to make a difference. The wheels of progress may turn slowly, but they turn.

“Continued emotional support is vital to the functioning of a family member 
in pain and to aiding in his or her rehabilitation.”

At the Pain Action Alliance to Implement a National Strategy, where you can now participate by clicking on the “Join” square here and scrolling down to the bottom of the page, we hope to see a movement toward a moral imperative for patient centered pain care. It doesn't just begin with caring organizations, it also begins with the willingness of patients to become involved. We need to give a voice to our pain, raise media attention from our perspective. I don’t know one person living with chronic pain that doesn't want to see a change in the way their pain is perceived, judged, and treated.

Nearly every one of us experiences medication side effects, medical devise failure, or invasive procedures that come with their own risks. We live with the hope that the next thing will get us back on our feet or minimize our pain to a dull roar. We are optimistic when we walk through clinic or hospital doors, but we don’t always leave that way. We become complacent because our provider doesn't listen, or so it seems to us. We understand our providers become frustrated, because we do too.

This brings me to the type of questions every provider should ask. Each is simple and reflects the climate of healthcare in the 19th century that you read about in Part I, A Look Back and Look Up.

"How is your family?" “What do your friends do to support you?” Open-ended questions such as this should be answered with honestly. It is important that our provider understands not only how pain affects us physically. Many of us have no support at home, which makes us feel isolated and alone. We become angry because we have lost control over our lives, and sometimes, we lose even more, our dignity, and our relationships with others,. We need and deserve this balance in our lives. Speak up.
Ask your provider for resources on how to cope. If they don’t have them, talk with them about why it’s important to you. It will not only remind your provider you are a human being with the same needs they have, it may help them change their personal perspectives for making positive change in their practice. Research tells us these approaches influence how we cope emotionally, mentally, and spiritually, which improves they way we cope with physical pain. When we find balance, we regain control.

Management of chronic pain takes an integrative, patient centered approach emphasizing communication, patient and provider education, and ethical preservation of our patient right to choose. These goals are a moral imperative. So, next time you have an appointment with your provider ask yourself, “What one question would I like my provider to ask?” If they don’t ask, simply say, “I wish you would ask me about…” Then ask for resources, you deserve them.

What could the future hold for pain care? That’s coming next.

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Updated Post Script

"Adversity is only an obstacle if we fail to see opportunity."  
Celeste Cooper, RN
Author—Patient—Health Central Chronic Pain ProAdvocate

Learn more about what you can do to help your body function to its potential in the books you can find here on Celeste's  blog

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

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