Coping with Pain
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/ Categories: WELLNESS, 2022

Coping with Pain

The Journal of the International Association for the Study of Pain estimates as many as 18 million Americans suffer from chronic pain on most days. It can be caused by headache, surgery, cancer, trauma, arthritis, nerve damage, and neck or back injury. Sometimes the cause is unknown or continues long after the initial cause of the pain has healed. The pain can go on for months or years and can lead to anxiety, depression, fatigue, insomnia, mood swings, irritability, and other difficult psychological conditions.

Once you have worked with your primary care provider and specialists to identify and treat the cause of the pain, you can try these options for coping with the pain in any order that makes the best sense to you and your provider.

Medical Approaches

Each of the many medications used to help with pain come with side effects. 

  • Acetaminophen can harm the liver if used excessively or improperly.
  • Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) can cause kidney damage in certain patients.
  • Muscle relaxers can provide relief in some cases, but they may cause drowsiness, dizziness, headache, and other side effects.
  • It’s best to develop a system that includes these medications when needed.
  • Antidepressants are being prescribed for those with chronic pain. Often, the benefits outweigh the side effects.

SPECIAL NOTE:

A few of the drugs often turned to for pain come with major concerns and should only be used with careful supervision from a medical provider.

  • Opioids come with a great risk of addiction, tolerance, dependence, and a paradoxical increase in pain. This factor alone makes them undesirable for many patients, even for short-term use.
  • Cannabis is not approved by the Food and Drug Administration. It is associated with acute adverse effects including anxiety, nausea, panic, disorientation, impaired attention, short-term memory, and driving performance.

Physical and occupational therapy can be a great drug-free way to cope with chronic pain. Movement can help restore strength and confidence. Often, the symptoms of chronic pain are reduced. Therapy is a safe, even fun, way to navigate pain.

Similarly, mental health counseling can help patients think more positively, process past events, and implement helpful changes. Through talk therapy people often come to understand how unconscious forces contribute to their pain.

Pain Management Programs combine imaging and anesthesiology technologies to target the source of pain and relieve it.  Services offered include joint injections, nerve blocks, spinal cord stimulation, and others.

Do-it-Yourself Ideas

Many people find that concentrating on improving their overall health is a great way to make progress against chronic pain.

Many people find it beneficial to focus on relaxation.

  • Don’t try to do too much. Create a daily schedule that includes a few priorities and time for rest and self-care.
  • Create the conditions for good sleep.
  • Learn stress management techniques that work for you, including deep breathing, yoga, meditation, listening to music, walking in nature, playing with kids or pets, and others.
  • Getting interested in a new hobby can also be beneficial. More than a distraction, hobbies and interests get us thinking positively about the future.
  • Strong relationships help us cope with pain too. Meet up with friends and family or join a pain management support group.

Complementary Medicine

Complementary medicine can be as simple as treating the site of your pain with heat or cold or enjoying a cup of restorative tea. If you are receptive, you can also try massage, reiki, acupuncture, biofeedback, guided imagery, or hypnosis. Each has been shown to be an all-natural method for achieving pain relief.

It is unlikely that any one of the tips above will resolve your pain entirely. A personalized system of pain-management habits you do on a routine basis will be most powerful in helping you live a healthy and fulfilling life.

Joshua Tobe, MD, is an anesthesiologist and interventional pain management specialist at SVMC Anesthesiology, part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care in Bennington.

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Emergency Department: Open, Ready, Safe. 

The last 3 months have been a uniquely challenging experience in the SVMC Emergency Department (ED) and emergency departments and hospitals all over the country and the world. I am very proud of all our staff has done and continues to do to ensure safe care for patients during this era of COVID-19. We are grateful that cases of COVID-19 in our area have been the lowest in the U.S. and have decreased even further over the past several weeks. We are also heartened to see that patients who had been avoiding the ED are now confident to return to get the care they need.

It may be surprising to hear that over the past few months, the sickest patients we have seen in the ER have not had COVID-19. Many people have refrained from seeking care for serious medical problems due to the fear of being exposed to the virus, assuming that the hospital was not a safe place to be and not recognizing the seriousness of their symptoms. The most challenging moments of the past several months have involved critically ill patients who tried to stay away for far too long due to fear of being exposed to COVID-19. We have had many sad moments trying to care for those who waited until it was too late for us to help with conditions that could have been easily treated if presented sooner.

One might expect that the greatest challenges related to the pandemic were those needed to adapt our facilities and procedures and the work of caring for sick COVID-19 patients. SVMC is fortunate to have built a strong foundation of safety and infection-prevention methods over many years, which made this transition much easier. Still, when it became apparent that we were going to see COVID-19 cases coming through our doors, we implemented many COVID-specific changes very quickly.

From day one our staff have all been fully trained to use protective equipment effectively, to focus on cleaning and disinfecting, and to move patients safely through the new areas created to keep them safe. We also spaced the waiting room chairs to allow for plenty of distance and initiated drive-by testing to keep potentially contagious people outside and away from other patients.

We immediately increased our standard of protective equipment we use. For example, all staff who relate with patients now wear both a mask and protective shield, which is a proven and effective strategy to prevent transmission. Those staff who work with patients with respiratory or other contagious symptoms also wear a gown and advanced respirators developed in cooperation with Mack Molding in Arlington. They look strange, but they help us deliver care safely.

We also quickly built special spaces and units in the hospital to treat and segregate patients with respiratory symptoms who might be contagious from those with other routine medical problems. Outpatients with symptoms that could be related to COVID-19 are directed to a spacious area called the Respiratory Evaluation Center. There they can be taken to a safe treatment space called a negative-pressure room without encountering any patients who are using the ED for other reasons or any staff who are not fully equipped with protective gear. There are similar, safe, negative-pressure units for those who require treatment in the ED or hospital.

Our hard work paid off. We have treated a number of COVID-19 patients in our ED and, as far as we know, not a single staff member was sickened in relation to their work here, and no patients have contracted COVID-19 while under our care. With our current procedures and drastically declining COVID numbers, we are confident that we can continue that trend. Furthermore, SVMC recently received a perfect score on a rigorous survey specifically designed to judge our ability to prevent transmission of COVID-19. At this time our ED is safer than just about any other public place you could go.

My goal in writing today is to communicate that SVMC’s Emergency Department is open, ready, and safe. If you need emergency care, we are here and we can care for you safely. Please do not defer emergency care until it is too late for us to help. While many symptoms can represent a serious medical problem, the most concerning are chest pain, difficulty breathing, fast heart rate, confusion, high fever, intense headache, drooping face, dehydration, or weakness. Of course, with any other symptom you feel indicates a serious problem, come in right away or call 9-1-1.

For us, spending time with patients and connecting on a personal level is the best part of our jobs. We take pride in our life-saving role in our communities and the work we have been able to do during the pandemic, but we cannot help if you do not come in. Please don’t hesitate to get the care you need when you need it.

Adam Cohen, MD, is a board-certified emergency medicine physician at Southwestern Vermont Medical Center. He also serves as the chair of the Department of Emergency Medicine and the medical director of SVMC’s Emergency Department.

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