ENDO Messages for April, 2002: Re: Chronic Pain Article ( Lauren this may help you at the moment) LONG

Re: Chronic Pain Article ( Lauren this may help you at the moment) LONG

From: anonymous (anonymous@obgyn.net)
Tue Apr 16 10:06:32 2002

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At Sat, 2 Jun 2001, B. wrote: >
>*** These Guide lines.. have been created through my own experiences with
>Chronic, Severe pain.Through many trials and errors, I have come up with a
>few ways, of learning to deal and cope with chronic, unbearable pain and
>how to learn to adapt.. with the things it effects, in our life in
>general***
>
> Firstly, How do I know if I have Chronic Pain or a Chronic Pain State ?
>
> ** If your pain has lasted for 3 months or longer and it has been
>continuous.Then this pain is classed as Chronic. **
>
>-:- In Most cases this means pain that is... 24 hours a day, 7 days a
>week....then this is classed as "Chronic Pain " Some pain clinics will not
>take you unless you meet their criteria.
>Which can be extremely frustrating and hard for some patients and an
>endometriosis sufferer is a good example, especially if their pain and
>suffering happens to be cyclic but some endo sufferers, do suffer pain 24
>hrs per day..7 days per week..this is when you should definately be
>referred to a pain specialist, no one should have to suffer like this, not
>in this day and age...with the options that are available.
>
>***Finding a Good Pain Specialist & where to begin ***
>
>-:- You can start by asking your local Doctor if he/she can recommend a good
>pain specialist, in your area.Remember the closer to home the better.
>
>*You could also try calling the largest teaching hospital in your area and
>ask what programs are available for the chronic pain sufferers and what kind
>of doctor heads this clinic,what is his/her specialty ?
>
>* Finding a good Pain Specialist,can be difficult, as we all have different
>needs, with different diseases and conditions, causing our different pain
>states. Finding one who will listen and take your pain seriously, is of
>number one importance.
>
>** Types of Pain Specialists **
>
>-:-There are different kind of pain specialists, some are -
>Anaethetists,Neurologists,Rheumatologists and others are Oncologists. All
>these doctors have branched in to pain management, each offering some kind
>of Pain Management clinic, each with their own ideas and methods,each with
>their own approach.
>
>What type of treatment do you want ?
>
>*Some use pharmaceutical medications, such as narcotic pain relief and some
>don't.
>Some use hypnotherapy and relaxation techniques. You have to decide what has
>helped you in the past or what you are willing to try in the future.
>
>** Asking around at a local support group or association**
>
>-:-They may be able to recommend a local pain specialist,one who may be
>helping some of the other members with the same disease or condition and who
>also has ...some valid references.
>
>*** Different Types of methods and practices and medications....which are
>all aiming... in reducing the amount pain and suffering***.
>
> ** Relaxation, Meditation & Massage **
>
>-:-This can help some people and they may get a lot of relief..just through
>relaxing their bodies.Hot baths with Radox(herbal bath salts & minerals) and
>other bath salts and minerals.. can also help you to relax a lot .
>
>*Finding somewhere close to home or that does home visits of any type of
>massage.. maybe you have found a certain type that gives you relief ,if you
>have never tried, ask others what they have tried and what has helped them.
>This can work so well for pelvic pain, infact a lot of different pains can
>be eased by massage. If you get a good masseur, who knows a good technique
>of swedish,remedial or even Shiatsu and any other types that they are
>trained in, that helps and eases the pain.This can give alot of relief..
>through my past experiences.
>
>**Reflexology**
>
>* Also known a Foot massage.This has also helped some people and maybe used
>in conjunction with any of the above treatments.
>
> ** TENS Machines **
>
>* Have helped many Chronic Pain Sufferers(From endometriosis to Chronic pain
>states).Transcutaneous electical nerve stimulation, commonly known as a TENS
>machine. This is where electricity is applied through an electrode to the
>site .. where the pain is located..The increased volume of electricity can
>help to releive the pain. This works for some but not others..we must
>remember we are all unique .
>
>** Acupuncture and Acupressure **
>
>-:- This Treatment Has helped many people but finding a good traditional
>acupuncturist, is the main concern.Also, Finding a good acupressurist is
>also beneficial..Try finding some one who massages well and does acupressure
>also. This usually works the best.
>
>** Positive Thinking, Imagery and Progressive Muscle Relaxation**
>
>-:- We all need to be thinking positive ...even though negative thoughts
>will continually follow you..Pain is pain and its something that brings us
>all down..We must try and turn negatives thoughts into positive thoughts..we
>need to retrain our minds..again behaviour modifcation(See Counsellors)
>
>*Imagery is great as it can take you away from your pain..to an island with
>aqua blue water... with palm trees and a gorgeous man serving us cocktails
>in the
>the warmth of the sun..which is easing all our pains and worries...This is
>imagery.
>
>**Progressive Muscle Relaxation**
>
>-:-This is a great way to try and relax your entire body..especially tired
>and aching bodies..Its very simple and is best done in bed just before you
>go to sleep or in the middle of the day to try and help you through a bad
>pain episode.
>Lying in bed Or some where comfortable and quiet..
>Firstly relax and concentrate on your breathing..in and out trying to do the
>breaths deep and slow..in through the nose out through the mouth..Then start
>by squeezing and curling your toes up and hold them tensed up.. for a count
>to 10 and release and relax..
>Then progressively move up your legs..from your toes to your ankles and then
>knees and thighs and repeat the same process, as you did the first time,
>with your toes..holding each part of your body for a count of 10 and then
>releasing and relaxing..This is to continue to your torso and then your
>chest and then .. to your arms and elbows and shoulders until you reach
>your face and tense up and release..By the end you may just find your self
>asleep..This is a good trick for insomnia also.
>
> ** Hypnotherapy **
>
>-:-Has helped many people and can aid in helping you in many different
>areas...including relaxation .If your counsellor practices it..ask about it
>and talk with others who may have tried it.
>
> ** When Looking for New Options Available.. RESEARCH --From medications to
>Alternative Treatments **
>
>-:-Look for as many new options as you can(some pain clinics will make you
>stop.. all out side input and treatments) like for instance seeking
>alternative treatments.. such as osteopaths,chiropractors and acupuncture
>....these treatments may work for some but not for others..The reason the
>pain clinic does this..is because they want to see if they can help you and
>your pain, without any outside factors.If you are requested to do something
>by your doctor or pain clinic.. or not to do something, its important that
>you do as you are requested.. This give yourself the best chance possible..
>of letting it work. Always Do as your doctor requests and if you don't let
>him/her know.. ..or you may damage a good relationship.
>
>*** Osteopathy( The study and Treatment of bones by manipulation)***
>
>-:-This treatment has helped many endometriosis sufferers and it has helped
>me personally for many years.Actually it helped me until the car accident
>and after I experienced nerve damage, this has now made it impossible for me
>to receive this type of treatment, except, I am able to have gentle work
>done by my physical therapist..which is still very painful because the
>nerve damage.
>
>*** Chiropractor***(Treatments deals with the spine.There are different
>types of treatments, some relate to manipulation of the spine or other bony
>structures. Some practitioners use blocks to help with alignment of the
>spine)
>
>** Treatments like Chiropractors, which have helped many other chronic pain
>sufferers..some of these practitioners also do Acupuncture..which makes life
>easier but finding a well recognized practitioner ..is the MOST important
>thing.
>Do NOT go to just anyone, especially off the street.You could cause
>yourself more harm than good.
>
> ** Narcotics & Medications **
>
>-:-Help a lot of chronic pain sufferers and narcotics such as opiates, have
>been used for many centuries and with good effect.
>*There are different types of opiates, that have been created over the
>years and some are short acting and some are long acting..meaning slow
>release. Its a matter of finding one which suits you, as a patient.
> Its a matter of trial and error and sometimes a combination may work
>better,than a single drug.
>
>* Narcotic Pain Relief...*
>
>-:- It is not a crime, if this type of pain relief works for you..
> It is our right to be Pain Free...It is everyones right no matter what
>country you come from.
>Narcotics can be delivered in a Slow Release tablet and can be used in
>combinaton with short acting narcotic.
>
> ** Non Steroidal Anti- inflammatory Drugs**
>
>-:- These can work very well and relieve good amount of pain..IF the patient
>can tolerate this type of treatment..These type of drugs should not be taken
>long term but can help a lot with acute pain, associated with flare ups and
>taken for a short period than be helpful.
>
> The non steroidal anti-inflammatory drugs are a group of drugs used in the
>treatment of arthritis. They releive inflammation and pain by blocking the
>production of a pain-producing chemical known as prostaglandins.
>This makes these drug useful in the treatment of Predicted
>ain...( Endometriosis Pain, associated with ovulation and period pain) BUT
>the only way these drugs can work is by taking them before the prostaglandin
>is produced..So it has to be taken BEFORE the pain begins.This is not
>effective for long term use, due to the GI poblems that they can cause.This
>is to be used in flare ups and for acute pain and can be used in conjunction
>with narcotics.
>
> ** Nerve pain Drugs **
>
>*Neurontin is a drug originally prescribed for epilespy but it is now being
>used for nerve pain(a drug not to be taken lightly, it is a strong
>medication).
>
>** Anti Depressants **
>
>-:-These can also help with chronic pain by helping to extend the lengths or
>increase the effect of any narcotic medications that are used. Often these
>medications are necessary anyway, as chronic pain nearly always causes
>depression,low self esteem and alot who suffer from chronic pain..end up at
>some stage having to give up work or even have had to leave the work force
>altogether.. due to the pain .
>
> ** Mental Health **
>
>-:-A Counsellor or Psychiatrist should be apart of your pain management
>team, this type of doctor..is essential .You should be seeing this person at
>least once a month, it is important that you are monitored and that any
>anti depressants you are taking..are being monitored or watched by a
>psychiatrist.
>
> ** Pain Clinics **
>
>-:-Do Some Home work on the local pain clinics, call around and ask how
>there programs work.Some people will suit group support but some of us need
>to be seen.. one on one... with our Doctors. Different Hospitals have
>different approaches, call and ask what their methods are...Tell them you
>are comparing clinics for a friend or family member...you don't have to tell
>them its for you...They may treat you differently if you are enquiring for a
>loved one..who has been in continuous pain for over 3 months.....
>
>* When you find a pain specialist or clinic that you think may suit you, go
>back to your local doctor and ask for a referral and ask if he knows anyone
>who has attended this clinic.
>Remember Each Situation is different..If you are unable to make your mind
>up about the doctor or clinic...Try to Give the doctor another chance, do
>not decide after one visit, remember you are assessing each other.......
>EXCEPT If your experience is SO Bad..that you are left feeling sick or in
>more pain..Then these people maybe toxic to your health..We all know a bad
>experience...when we are in one.. so don't stay, leave if you are not being
>treated with respect or compassion.
>
> *Another exception...... is if the doctor Refuses to treat your chronic
>pain..then just get up and leave the appointment and thank them all the
>same.
>
>*Unfortunately Some times a pain clinic will put you through a series of
>appointments with a pain specalist,psychiatrists,physical therapist and
>this can sometimes take most of the day...(These appointments must be with a
>carer) so if you have a bad experience..it can be a traumatic day..(which is
>what happened to me,with my first pain clinic experience)
>
>*Other clinics, will consist of a complex appointment with a pain specialist
>and he/she will test you in all areas himself. If you have been told that...
> "your pain is for life" or " Get use to this, its chronic" then you might
>be better with a pain specialist, who will stand by you and who believes and
>understands your pain..Only you will know, whether the doctor understands
>and listens to you and your pain.... especially because you will begin to
>feel like someone is on your side and supporting you and they some how,
>understand what you are trying to say and you then may start to recieve
>proper treatment and relief and if you don't, then she/ he will try to help
>you obtain relief..some way or some how.
>
> *** Support and Referrals ***
>
>-:- You could ask around at a local support group or association, maybe they
>can recommend a local pain specialist who may be helping some of the other
>members and has had some good reviews
>
>* You may like to find a local support group or even start one of your own,
>on the computer or off ..Find an Association that has been formed for your
>disease or condition, join up and be apart of the latest
>developments..through their news letter and see if they have a support
>group..and find out where they meet. ( from Endometriosis to Chronic pain to
>Cancer, support groups and associations can help you a lot in the long run)
>Ask around and see if there are good or bad comments on this particular
>clinic or doctor.... even call the local association that you are a member
>of and ask if they have dealt with this particular clinic or doctor,
>Research.....It is your best chance of finding a good doctor or clinic which
>will suit and help you.
>
>** IF ITS ALL TOO MUCH call a Crisis help line..Especially if you are
>suicidal, talk to someone..there will be horrible days,that are dark and
>gloomy..but these days or nights will also soon pass and you will have
>better days....always remember that this is not a permanent state..In
>time...It will get better..
>
>-:-Call a Friend who understands or is sick themselves,may be even with the
>same disease or they suffer a chronic illness themselves, someone who cares
>and understands what you are feeling....these people can be a life line in
>times of distress and need. It is said " To Share Your Pain is to Cut it in
>Half ".In other words ..it helps to talk about your pain and share
>it....whether it be with a counsellor or a friend, someone who will listen
>to you and not judge you.
>
>*** Things we can do to help ourselves.**
>
> ** Get yourself a few heat packs**
>-:-Get a heat pack that can be used for both hot and cold,these can be
>purchased from a pharmacy or medical appliance shop.
>A wheat or rice pack is easy to make..and can be used as an emergency heat
>pack..It is made with rice, which can be placed in a sock with the end tied
>and a few drops of lavender placed in with the rice , this is a relaxing
>scent.This can be popped straight into the micro wave and heated for a
>minute or 2..depending on the size of the sock and power of your microwave.
>
> ** Get yourself a couple of pillows**
>Get one that you can take with you when you go out, it will help you to get
>more comfortable..and lessen the pain of car rides.I hugged mine for the
>first 12 month after hospital and was placed in between me and the seat belt
>and it gave me a lot of relief. I also had an extra two for bed, one that I
>placed in between my legs, so my knees didn't touch,when I lay on my
>side..The most comfortable way for me...to sleep and I also had a pillow
>behind my back, so I didn't roll..when the pain to move was too much.
>
>** Hot Water Bottle** I
> -:- My Hot water bottle..not only soothed my pain...it comforts..especially
>in bed at night.
>
>** ** If you are using a computer, make sure you get up and stretch and
>change your positions frequently.** **
>
>* ** An Exercise for Computer uses ** *
>
>-:-An exercise which can benefit us all, especially for anyone who uses a
>computer..for any given length of time.
>
>Lay out a towel on the ground get a smaller towel that is the length of your
>spine, fold it over continuously to make a splint for your spine, make sure
>it is smooth and evenly folded and place it on top if the other towel, get a
>small pillow or another towel to use... to help support your head and make
>sure its not too bulky or it will ruin the benefit of the exercise. Lay down
>and have the rolled or folder towel the length of your spine with your head
>supported on the small pillow or towel. Lay there still, when you are
>comfortably place on the rolled towel.. for anything from 20 minutes
>onwards, longer if you like, especially if you feel the relief is helping
>you.
>This exercise is for resting your shoulders and puts you into the correct
>position that you should stand and sit. It will help your posture and your
>pelvic and back pain. Its a wonderful exercise for everyone from young to
>old.
>
>* ** Things we have to deal with..even though we don't want to ** *
>
>* ** Society ** *
>
>-:-Society can make us feel weak,as if we can't cope with the pain or we
>are sick,it is not socially accepted to be sick or in chronic pain but
>remember these people have no idea what you are suffering from, nor have
>they felt the pain like you are feeling.These people have never been really
>sick or in pain for a long period or a long length of time, not many active
>people that you will meet..will have suffered like this...which is really
>Chronically..meaning for longer than 12 months at one time..even 6 months is
>forever, when you are in pain.. all day, every day ..Sleepless nights..a
>pain that has no beginning or end....Only another real chronic pain
>sufferer..will understand..this never ending road of pain and suffering.
>*If they did understand and knew how you felt.. you would just know that
>they understood....It is an unspoken understanding ..a language from one
>chronic pain sufferer to another.
>
> ** How to cope with society **
>
>-:- Its time to find other sufferers you can chat with, others who
>understand how you are feeling..Whether on the internet or finding an a
>chronic pain association or maybe to a specific disease association, that
>you can attend support group meetings and maybe even get some phone numbers
>of others who are also suffering..It helps so much to share your pain..it
>cuts in half..when you share it.
>
>** Try and make sure, that you always have your pain medications with you
>while you are travelling or just out for lunch. It may save an outing if you
>do have your pain relief.
>
>*** Find a documentary or video that may explain your disease or condition
>to your family or friends, this is a great way to try and make them
>understand..Visual is alot easier ..sometimes than showing them a book.
>Articles are great, as long as they are not too long, boring and technical.
>
> * ** Family and Friends ** *
>
>-:- It is important to take a carer with you, when you are searching for
>help and treatment .Make sure someone drives you to doctor and pain clinic
>appointments,especially in the beginning.. So they understand what is going
>on and the treatment you may have to receive.
>
>**Its very difficult to concentrate when you are in Chronic pain and it
>helps if someone (a carer or family member would be ideal) is with you, at
>ALL your doctors appointments ..so you understand what has gone on and you
>don't leave the appointment not understanding or remembering what has
>transpired.
>
>* **Friends and Partners... who just Don't Understand** *
>
> We have all lost friendships through being chronically sick or in pain or
>both.Some of us have lost partners and husbands, through being chronically
>unwell and in pain.
> Its devastating at the time but if these partners or husbands can not stick
>by us.. in sickness and in health..then they were not really the person..we
>are meant to be with..Someone who really loves us... feels our pain and
>suffering..They can not bare to see a loved one suffering..This is a true
>partner and husband..We are better off... on our own, than being with
>someone who doesn't care and expects us to continue taking care of them,
>while we are sick and trying to care for ourselves...This is a toxic
>relationship...Get out before it kills you.They will never change
>
>** Take Time for you, you need time to do something that makes you feel
>good..whether its a walk along the beach or just sitting in the sun **
>
>-*- We can not help our moodiness, through sleepless nights and always being
>in pain..its hard to focus, on much more than the pain we are suffering or
>experiencing but in time..if we receive help with our pain..and counselling,
>we can learn how to deal with all of this BUT ...We have a lot to
>re-learn,a lot will be dealt with in counselling, learning to adapt to your
>new limitations and life..it is not easy and changing the way we do
>things..This all takes time and patience..Its not an easy process but in
>time if we have love and patience and support from loved ones..we are able
>to start again..and regain our life and independence.
>
>-*-We took along time to become the way we are and things will not change
>over night, nor be will they be fixed ..it will all take time,patience and
>counselling and a good pain specialist and an understanding support group...
>will help you more than you can imagine, especially the other sufferers..
>who will become new friends and your new life will begin to unfold.
>
>* ** Lack of Sleep ** *
>
>-:-We all know what its like, Not to sleep for days and weeks and months on
>end..its something you would not wish on your worst enemy...This is when a
>hot bath can help a lot. Discuss it with your doctor or counsellor for
>..there are different techniques that each doctor uses.
>
>**There are natural remedies like Chamomile tea, another called sleepytime
>and some natural herbs available..all that will relax you and help to get
>you off to sleep.(a naturopath can be of great assistance in this area)
>
>***Alot of Pain Doctors will use a combination of anti depressants and pain
>relief that should help in time, to get you back into a sleep pattern.
>
>****One way of trying to rectify this, is by staying up until 12 mn every
>night or later,you may not.. go to bed before 12mn, and you are to wait
>until your eyes are ready to shut and only when you are this sleepy, are you
>allowed to go to bed.Then you must arise at 8 am and repeat this every
>night. If you do this for long enough(meaning weeks or months) it will help
>you to retrain your sleeping habits,its a way of using behaviour
>modifcation..and it really works and its easy.
>
> *** ALSO See Progressive Muscle Relaxation ..In The Meditation and
>Relaxation segment***
>
> **Do Not Drive if you are commenced on New Medications..especially if
>they effect your ability to concentrate or make you sleepy..**
>
>It may take up to a week before you feel stable enough to drive.
>
>**Some diseases may also cause migraines, as a complication and even some
>medications, may also cause major headaches.**
>
>-:- A quick treatment for a migraine is an ice pack to the back of the neck
>and head. A glass of water sipped,with 3 teaspoons Glucose or glycogen
>powder mixed in
>(as long as the patient is NOT a diabetic)This will help with the NAUSEA
>OF ANYTHING Related to Chronic Pain, including from a migraine and can be a
>quick and easy treatment if given early enough.
>
> * ** Internet ** *
>
>-:-Some of us are lucky enough to have a computer and we have explored and
>found and joined. internet support groups..We then are able to talk with
>other sufferers..we share and create a common bonds,this can be a great way
>to share your pain and to learn new ways... on how to cope and deal with
>pain and life in general .
>There is so much information in cyberspace..Its a matter of finding the most
>correct and precise..information and not getting taken with people who
>promise miracle cures..There are alot of Quacks and Fakes out there..be
>aware and always discuss new treatments with a support group and see if
>anyone else has heard of it..If its a new treatment or surgical aid..It is
>most likely to be circulating the support groups..that deal with that
>certain disease or disorder.
>___________________________________________________________
>
>___________________________________________________________
>This paper has been compiled through my personal experiences and through my
>___________________________________________________________
>nursing knowledge.
>___________________________________________________________
>Its important to know.. that We can all learn to cope and live with chronic
>pain..
>If we don't get help with our chronic, endless pain.. in the end,it can and
>it will effect our entire Body....Mind and Spirit.. Don't let it...There is
>help available.. its up to you to find it.
>
>Remember Chronic pain can be caused by many different things.. Such as
>..Diseases Such as Cancer,Endometriosis,Fibromyalgia
>( myalgia ..which means pain in the muscles ) and many other types of
>diseases and disorders related to any part of the body and any of these can
>cause continuous,debilitating and chronic pain.
>
>Try and Take Charge and don't let your pain rule your life,I know its easier
>said than done..There are others out there, who know and understand and who
>do care.These people can teach you to cope and help you to regain your life
>and adjust to your pain...I hope this paper helps you to find them..they
>will help you...to get some relief and help you to heal and to get some
>sort of life back..
>
>* Remember this is just a guide and you should always seek medical advice
>..Especially if you are in extreme pain (See my Pain Scale.. as a Guide) let
>your doctor know. ASAP.
>*Keep a Pain Diary and take it to your next appointment..(Print out the pain
>scale and take it along with your diary)The only way they will know that you
>are suffering and in so much pain constantly..is if you tell the doctor and
>have it documented in your notes.
>
>Good Luck.. May Your Pain be managed and under control soon..There is always
>hope..when there is Faith..Keep Your Faith... It will be there , when no one
>else is.
>~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
>My Pain Scale Will Follow ....This chronic pain article... as it is part of
>it and they can be printed up together. I hope these articles are of use to
>you all on how to manage and cope with chronic unbearable pain. Good Luck to
>you ALL.
>-----------------------------------------------------------
> Belle Browne RN Copyright 2001
>-----------------------------------------------------------
>-----------------------------------------------------------
>-----------------------------------------------------------
>President Endometriosis Association (n.s.w)Australia.
>-----------------------------------------------------------
>http://www.endometriosis.org
>-----------------------------------------------------------
>Producer of Endometriosis The Inside Story.
>-----------------------------------------------------------
>http://www.endometriosis.org/html/video.html
>
>Please leave this intact when sharing with other sufferers.
>*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*
>United We Stand ----~^j^~^j^~----- Divided we Fall

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