Category Archives for Pain Clinic

Pain Clinic #8: Time For Acupuncture

I’ve been waiting for space to open in the pain clinic’s treatment rooms to start receiving acupuncture since the end of October and I was starting to think they had forgotten about me. The wait for an appointment was worrying my friends and family too, and some suggested that I should seek out an independent acupuncturist or naturopath to receive the treatments. Thankfully, I don’t have to go that route because I received a call yesterday from my pain specialist’s assistant with dates for a series of appointments that start in two weeks. I have four 60-minute treatment sessions booked with my pain specialist who is also a trained acupuncturist. Having her treat me with acupuncture, makes me feel more confident that the treatments will be successful because she knows my history with pain, knows exactly where in my body the pain originated and where it spread to, she has immediate access to all my medical records, and she can adjust my medications if necessary.

The breadth of my pain specialist’s knowledge and openness to alternative treatments for chronic pain, make me feel less anxious about trying something new. Years ago, I went to a naturopathic clinic as advised by a close friend to try something new for terrible migraines. The something new then was acupuncture. The naturopath who treated me would place needles under my skin in three or four areas of my body. After the first pinch of each needle faded, it was almost impossible to feel where they stood. With the needle placement completed, the naturopath would then dim the lights and leave me alone to rest for about 30 minutes. When she returned to remove the needles, I would feel as if I had rested for hours. Unfortunately, acupuncture didn’t rid me of migraines but that rested feeling would stay with me for a few days after a treatment; and the treatments did reduce the frequency and severity of my migraine episodes, which was a big improvement in my life.

The memory of the pain relief I gained because of those acupuncture needles is still with me. And I also remember that those fine, silver needles didn’t only target my migraines; they calmed my entire body, somehow quieted my mind, and even helped me sleep better. I am hoping for similar results from these upcoming acupuncture sessions because my entire nervous system needs calming. The way my doctors explain it to me, my nervous system is now like a hyperactive child who has eaten a bowl of sugar. It has run at that level for almost three years in response to the pain from a benign growth that no longer sits in my pelvis. This overdrive needs to stop, and acupuncture – I say this with fingers crossed – should help to slow it down.

 

David Bowie – Absolute Beginners

Pain Clinic #7: Trying Alternative Pain Treatments

I had my third appointment at the pain clinic since having surgery in August. Each appointment I have makes me aware of how fortunate I am to have access to such an incredible resource. My pain may not be gone, but I have specialists working to support me and trying to find the root cause – and hopefully the cure – of my pain. My primary doctor at the pain clinic is a wonderfully compassionate woman who is open to exploring as many alternative treatments as possible to treat my pain.

During this appointment, we reviewed my pain medications. I’m still taking a considerably higher dose of the opioid pain medications than I was before surgery, but I’ve been trying to decrease the doses over the past few months. I’m keeping a daily log detailing how much I take throughout each day. My pain specialist encouraged me to continue keeping this log because it’s helping to identify trends in my pain. I can pinpoint when I have a pain flare up and what activities may cause it, and whether I need to increase the doses of my pain medications. To support these trends she wrote me prescriptions for each of my pain medications with quantities large enough for me to increase or decrease my doses as my pain dictates.

Acupuncture was the next thing we discussed. My pain specialist is a trained acupuncturist. By all accounts, she’s highly skilled. Knowing that as a medical doctor – she’s an anesthesiologist – she has a holistic approach to treating pain makes me feel encouraged. One of my next appointments with her will be in the treatment centre of the pain clinic – where I had my nerve block  – for acupuncture. Her hope is that acupuncture treatments will help to reduce my pain and my need for such high doses of pain medications. My hope is that the treatments will deliver those results, and much more.

We also talked about the Mindfulness-Based Chronic Pain Management (MBCPMTM) program offered at the same hospital as the pain clinic. The program teaches patients “how to manage their chronic pain and illness through Mindfulness and meditation practice, and better lifestyle skills.” It’s based on the Mindfulness-Based Stress Reduction Program (MBSR) originated by Jon Kabat-Zinn. My pain specialist is referring me to the program to give me another option for managing my pain. The idea for me to try this program originated with my therapist because our therapy sessions include mindfulness practices. My pain specialist believes this program will be a beneficial addition to the practices I’m already including in my life to cope with my pain. I believe, whatever the outcomes, I have an incredible support system that keeps working to find solutions to get me pain-free.

 

Third Eye Blind – Semi-Charmed Life

 

Pain Clinic #6: Acute Pain Service

I’m steadily working my way through my pre-surgery appointments. My next appointment at the pain clinic was supposed to happen in August, but because of my upcoming surgery, they moved it up to this past Tuesday. I met with a doctor who recently started his one-year Fellowship in Anesthesiology and Pain Management at the hospital’s pain clinic – there is an annual program rotation that starts at the beginning of every July. I had to catch him up on what’s been happening since I had my nerve block.

I told him that I had dutifully kept my pain log every two hours for 48 hours after the nerve block and sent the log back to the pain clinic as instructed. I also expressed my disappointment that the nerve block didn’t last longer than two weeks, but I tempered that by letting him know that it was still nice to have had a little pain relief even if it was for such a short time. He asked if the nerve block had made it possible for me to reduce my pain medications. Unfortunately, the answer to that question is “no.” I wasn’t able to reduce my pain medications but I believe that during that short period I felt some benefit from them for the first time in a long time. They enabled me to do a bit more than just the basic daily functioning of moving around. For instance, I was able to go out with a friend to a local market where I picked out fruit, vegetables, spices, and cheeses for myself from different shops; and the relief was enough to make it possible for me to cook myself a complete Sunday dinner. It was good to get out of the house and walk through the market for the first time since becoming ill and it was even better to use produce I selected – instead of some anonymous person from my online grocer – to make myself a tasty meal.

After talking about the nerve block, we moved on to my surgical pain management plan. I will have an Anesthetic Clinic consultation during my pre-admission appointment. During that consultation, an anesthesiologist will review my current pain medications, the pain management plan designed for me a few months ago by the pain clinic, and factor in the results of my nerve block to determine the level of pain medications I will need during surgery. My pain specialist believes that the suggested epidural should remain a part of the pain management plan so that I can receive a constant flow of pain medication during surgery and for up to two days after because my surgeon is going to use a vertical abdominal incision, which is of course the more painful technique. Following surgery, I may also have a patient controlled analgesia (PCA) pump so I can control the frequency of the doses of narcotic/opioid pain medications I receive immediately after surgery.

In addition to having my body flooded with pain medications through these invasive methods, I will be closely monitored for the length of my hospitalization by the Acute Pain Service (APS). The job of the APS is to “to ensure patients with pain have individualised, safe and effective therapy” and “to provide safe and effective pain management to patients undergoing surgery…from admission to discharge”. An anesthesiologist will lead the APS team. The team will see me daily to assess my pain management needs, make adjustments as required, and measure my rate of recovery from my surgical pain and chronic pain. The team will also make recommendations about the type and amount of pain medication I’ll need when I’m recovered enough to be discharged from the hospital. Before this conversation, I had no idea that such a service existed and that I would receive this level of pain management care after surgery.

Surprisingly, I left that appointment feeling buoyed with confidence. A few days ago, I didn’t feel that. I instead felt overwhelmed by anxiety and fear. I think the anxiety is starting to shift because as I go from appointment to appointment and make phone call after phone call from the many points on my to-do-list, I’m realizing there is a supportive network of healthcare professionals around me who feel invested in getting me better. To meet that goal they are openly communicating and sharing information with each other and me so all I have to do is show up. I just have to show up and let them worry about the surgery and the post-operative care. Let them worry about the sharpness of the blades of the scalpels; the amount of pressure in surgical suction pumps; the number of stitches and staples needed to close my incision, and when they will reintroduce solids to my diet. I’ll let them worry about those things and the piles of other things rolling around in my head and in the meantime, I’ll work on trying to sleep more, laugh more, and take in the love and support of the many friends and family who want to carry the rest of my worries for me.

Now on to doing the work of making this positive perspective my reality…

 

Bob Marley – Three Little Birds