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- "Those not suffering from chronic pain have never felt what you feel. It is a physically different experiance. If you tell someone about something they've never had, they have trouble believing believing it. If the doctor doesn't believe you, then you should be looking for a new doctor. They are starting to learn that everything that the patients have told them for the last 100 years is the truth. That's a scary thought, because people have been called liars and other names.... Our most important teachers are the patients." Who knows better about what is going own then the person that is going through it every day.
- "The medical definition of pain is that it's an unplesasant, emotional; condition, in the presence or absence of tissue damage. The nursing definition of pain is far more interesting and says'If your patient says they're are in pain, they are in pain.' Nurses are the visionary leaders in pain treatment today."
- "Dr. Brookoffs definition of pain: Pain does not have a moral value. Life is good...to be cherished, promoted and supported. We as physicians, should not be moralizing about pain or it's treatments. We should be asking 'Has pain changed the lives of our patients?' If it has, we have to work to testore their lives"
Three Types of Pain:
1) Everyone has had somatic pain. When you cut yourself, it hurts intensely and them a few minutes later, it doesn't hurt as much. We don't suffer for days and days with this pain. We don't lose our emotional composure and it turns itself off eventually.
2) Visceral pain has a more agonizing quality. It's carried to a dirrerent part of the brain then the somatc. It goes to the part of the brain that deals with emotions. So people with visceral pain have emotional content...they get more upset. It's unfortunate that when you go to the doctor with visceral pain, they often get mad at you because you're emotional. The emotions are a physical quality of the pain. It doesn't mean that you are weak.
3) There's another type of pain that may be happening it is called neuropathic pain. It is due to nerve damage. If we let the pain go on too long, the nerves get damaged, changed, and they then carry pain messages more intensively. So when somebody is having pain that is bad, its an emergency. We have to get them out of pain before it can become ingrained and harder to get out.
What is "Breakthrough" pain?
Breakthrough pain comes hard and fast. It can be
stantaneous intensifying of all-over dull pain, or
it may come as a localized sharp stab or fiery
sensation.
It can summon someone out of a deep sleep or freeze
him mid-motion like a vicious bolt out of the blue. Its
unpredictability and severity make an immediate
antidote imperative. Guarding against the possibility
of breakthrough pain should be a part of any
prescription for end-of-life pain, or severe chronic pain.
Speed is of the essence in devising a weapon for
breakthrough pain. Traditionally, the fastest
treatment has been doses of potent opioids (such as
morphine) administered by mouth or through an intravenous tube into a blood vessel heading for the brain. A
remarkably effective way to do this is called
patient-controlled analgesia device (PCA).
A PCA device lets the patient control the flow of pain
medication and is especially effective against
breakthrough pain. It is regularly used by patients
recovering from surgery and can also be used by
someone at home with a terminal, or chronic illness/injury. This is another reason for patients that have severe chronic pain to have a chance at using something like Intrathecal Drug Delivery (Internal Infusion Pain Pump), or Neurostimulator. When you start to have breakthrough pain quite often then it is time for the pump to be turned up. Their are several alternatives to treating breakthrough pain, you just have to find what works best for you. Because quality of life means so much, waiting in constant fear for breakthrough pain to hit is not something that anyone wants to live through.
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