PAIN INFO

my pain my brain204x170

My Pain My Brain
by Melanie Thernstrom

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Time the secret killer

Pain in adolescence

A time of vulnerabilty and Opportunity. Susan M Lord and Elizabeth A Kepreotes

"Pain in adolescence and youth can interrupt learning, social outcomes and work roles with life-long effects. GPs can help young people to reduce their pain and disability, and can co-ordinate care if allied health or specialist advice is needed. A focused approach in adolescence may restore wellbeing and prevent persisting pain in adulthood". Download the article here

Pain in children

According to Lulu Matthews "Pain is one of the most misunderstood, under diagnosed, and under treated/untreated medical problems, particularly in children. One of the most challenging roles of medical providers serving children is to appropriately assess and treat their pain. New JCAHO regulations regard pain as “the fifth vital sign” and require caregivers to regularly assess and address pain. Pain being a personal experience, many different terms are used to describe different sensations. Assessment of pain in children is linked to their level of development. Children of the same age vary widely in their perception and tolerance of pain". Read the full article here

TJ aged 12 said "I feel like my foot is on fire and I cannot walk on it. Nothing helps, no one knows why, no one believes me".

TJ rolled her ankle playing netball. Although it was strapped and she rested as recommended, contrary to expectation her ankle pain worsened. She had a normal X-ray and MRI scan but her foot changed colour and went cold. She could not sleep, concentrate or go to school. Her Mum was forced to take time off to attend multiple appointments and look after her. After 12 weeks, TJ was diagnosed with complex regional pain syndrome of her foot. It was only after the hard work and support from a dedicated pain management team, including a physiotherapist, occupational therapist, psychologist and pain specialist, that TJ learnt to manage her pain. She recovered to play netball with her friends again.

Read the whole article here

Bayly lives with Juvenile Idiopathic Arthritis

Jo is the mother of Bayley, who lives with a very painful condition which has a huge impact on his and his family's daily life.

  

There is a blog site worth exploring on this topic at

http://blog.oup.com/2013/12/why-is-pain-in-children-ignored/

Here is a sample of that blog by Patrick McGrath who says:

"It is hard to believe that in the mid 1980s it was standard care, even in many academic health centres, for infants to have open heart surgery with no anaesthesia but just a drug to keep the infant still.

This practice was blown out of the water by a courageous mother, Jill Lawson, who against great resistance, pushed to publicize the lack of anaesthesia during open heart surgery that her son, Jeffrey Lawson, had undergone at DC children’s hospital. After dozens of letters and requests for a review of the policy and many condescending rebuffs, the Washington Post published her story. All hell broke loose. There were dozens of news stories because every mother knew that babies feel pain. How could health professionals be so stupid?

Careful research by Dr. Kanwaljeet J. S. Anand on the same procedure for his Rhodes scholarship at Oxford had demonstrated the under medication of children following surgery and the massive stress response that infants experience when undergoing surgery without anesthesia. Anand was feted and given a prize by the British Paediatric Society. But his research was also attacked by a group of British MPs because they claimed he was experimentally torturing babies"

Resources for kids who live with chronic pain

ACI Pain Bytes website has resources for kids who live with chronic pain. You can find these resources here

 pmn

y Patrick McGrath


It is hard to believe that in the mid 1980s it was standard care, even in many academic health centres, for infants to have open heart surgery with no anaesthesia but just a drug to keep the infant still.

This practice was blown out of the water by a courageous mother, Jill Lawson, who against great resistance, pushed to publicize the lack of anaesthesia during open heart surgery that her son, Jeffrey Lawson, had undergone at DC children’s hospital. After dozens of letters and requests for a review of the policy and many condescending rebuffs, the Washington Post published her story. All hell broke loose. There were dozens of news stories because every mother knew that babies feel pain. How could health professionals be so stupid?

Careful research by Dr. Kanwaljeet J. S. Anand on the same procedure for his Rhodes scholarship at Oxford had demonstrated the under medication of children following surgery and the massive stress response that infants experience when undergoing surgery without anesthesia. Anand was feted and given a prize by the British Paediatric Society. But his research was also attacked by a group of British MPs because they claimed he was experimentally torturing babies.

- See more at: http://blog.oup.com/2013/12/why-is-pain-in-children-ignored/#sthash.aqf3DdaP.dpuf

Non english speaking people - is there any assistance?

For people who do not speak English, there are translations of resources available on the ACI website here 

Pain in older people

Pain is not a normal part of ageing; its high prevalence in older people is usually associated with a condition such as arthritis or other diseases. As such many older people do not report their pain and often it goes untreated or undertreated. Many older people do not mention pain as they believe it is simply a part of growing older. This has a huge effect on quality of life for many.

An older person often benefits from a thorough review by a geriatrician who will ask the right questions and be able to treat the older person for their pain. This is not always with drugs. A team of health professionals including physiotherapist, occupational therapists can be really helpful for older people living with pain. 

In 2006 there was a focus on pain in older people during the Global Day Against Pain Older Adults September 12, 2006. This was an initiative of the International Association for the Study of Pain. You can read Addressing the Issue of Pain in Older Adults here

Inevitably we all get older. Pain is a particular issue for many older people although pain does not have to be a feature of ageing. It is common to hear the phrase "Pain is part of getting older" and consequently many people just put up with it. They feel that their doctor really isn't interested in hearing about it  "he's too busy" is often heard. However it does not have to be that way at all.

Here is an article published in the Australian Ageing Agenda. It is an interview during National Pain Week by Dr Coralie Wales in 2011 with Yasmin Noone.

"Almost two million older Australians who live with excruciating levels of chronic pain are not receiving treatment for their condition, and as a result are suffering unnecessarily in silence each and every day.

Chronic Pain Australia (CPA) estimates that, throughout the country, there are around eight million “forgotten” people who live with extreme pain each day and around 80 per cent of this figure is currently missing out on treatment.

Yet according to the Pfizer Health Report on Chronic Pain, released in 2011, almost 30 per cent of Australia’s chronic pain sufferers are adults aged over 66 years (click on the icon below to read the report).

Pfizer Health reportSmallPresident of CPA, Dr Coralie Wales, warned that chronic pain is now "endemic” in Australia. Unfortuently however, the medical profession and the community is yet to fully grasp the true extent of the issue and realise the “heartrending consequences it can have on people’s lives”.

“Pain is not a symptom but a condition in its own right, one that doctors have only come to recognise," Dr Wales said.

"Acute pain is definitely a symptom but once you get chronic pain and the original disease has resolved, you have to say that pain exists in its own right. ...Although few people die of pain, many people die in pain and even more live in pain."

The under-treatment of chronic pain in residential aged care, according to Dr Wales, presents a very “scary” situation.

She said this is partly because aged care residents with dementia, who experience communication difficulties, are less likely to articulate how they feel and are therefore less likely to receive treatment.

What’s more, she said, aged care staff often use psychotropic medicine as a “behaviour management tool” because they do not think to check to see whether chronic pain is actually the cause of the resident’s bad behaviour.

“I have it on good academic and research authority that what happens with people living in aged care is that, if the resident is difficult then the first line of treatment [or action] is psychotropic medicines.

“[Psychotropic drugs] calms people down because it zombies them.

“Yet, addressing a resident’s pain could be done simply by putting an opiate patch on their shoulder.”

Of course, she said, this tragic situation is not the fault of facility staff.

“Aged care staff mean well,” Dr Wales said. "But, what you have care assistants and other aged care staff who are expected to treat people who are in pain, “who are not necessarily trained to manage pain. And if you don’t have the training or resources to deal with chronic pain, you become overwhelmed with the problem.

“…To be blunt, [the problem] has to do with the numbers of registered nurses. Quite often, aged care facilities don’t have enough trained health professionals available to the number of residents to identify that there is a pain problem.”

Chronic Pain Australia states that chronic pain costs the Australian economy more than $34 billion each year and that it is the nation’s third most costly health issue.

“If we don’t do something about chronic pain now, the problem will become so huge and the cost of dealing with this sort of thing will become phenomenal.

“We are fuelling more problems by not dealing with the issue.

“…We need systemic change. The research is out there. Now we just need to enlarge the research and do something with the results.”

National Pain Week, the country’s national campaign to address the health problem, was launched in 2011 in an effort to reach out to the millions of Australians living each day with pain.

“The community’s understanding of and response to chronic pain is similar to where depression and other mental health conditions were 20 years ago," she said.

“People who live with pain carry an extra burden. They are often stigmatised, isolated, suffer depression and feel others don’t understand their condition.

“National Pain Week is about breaking the silence. We want people to feel they are not alone, there is help, and importantly someone who will listen.”

Dr Wales said the National Pain Week campaign aims to target three main groups: government, health and aged care staff, and people in the broader community living with chronic pain.

“To the government – Chronic Pain Australia is here and we are happy to talk about [solutions] and engage in a conversation.

“…To health professionals – the more you know about pain, the more creative the solution you can find to deal with the pain…If you [try to] find out about the person behind the pain, the easier your work will be even if it does take a bit of time to do so in the beginning.

“To the community – by connecting with other people around you who care about you, you can actually reduce the chemistry of pain.

“Connecting with others makes a huge difference. It reduces that isolation and could keep you out of trouble.

“And [if you need help], contact us. We are here for people in pain, no matter what age or where you are.”

 

 

 

 

 

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