Pain Behavior: What My Pain Treatment Got Wrong

BY JONATHAN D. MAYER

ngd-this is the best explanation of all the things wrong with pain treatment I’ve run across…

Pain is frequently frustrating for both the patient and the clinician. For the patient, it can be difficult to bear, and for the clinician, difficult to treat. Clinicians wish to help patients but fail to understand the nature of pain because of continuing inadequate education about pain at each step of medical training. Particularly with chronic pain, frustration can grow for all, including patients’ family and friends. There are no quick fixes for chronic pain, defined by the International Association for the study of Pain as pain that lasts longer than either three months or past the normal healing time for damaged tissue.

What made me angry was not the adverse surgical outcome. There is always the risk of damage from medical care, and that is the purpose of informed consent. Patients need to learn that adverse outcomes are not the same as negligence or malpractice. What shook me profoundly, though, was the indifference to and ignorance of pain by the service at the hospital in which I had the surgery. Ironically, undertreatment of pain was an issue that was frequently discussed in the community of pain experts that hospital.

I was told that I could not possibly be experiencing the pain that I was reporting. Yet I was. Being told that what I was experiencing “could not possibly be” was an assault on my sense of reality. Thus, my pain went ignored and untreated. The underlying cause, I believe, is ignorance about pain.

(By the way, it is not true that nobody dies from pain. I have been told by clinical colleagues that extreme pain can cause tremendous stress on the cardiovascular system, and a patient with coronary heart disease might have a cardiac event because of this. Nausea and vomiting, along with the anorexia that can accompany severe pain, also can disturb the electrolytes in a diabetic patient and could dysregulate the delicate dance of insulin regulation and glucose.)

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