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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COVID-19 Vaccine for Those Pregnant or Nursing

Here are the facts you need to know to make a good decision about whether or not to recieve the COVID-19 vaccine: 

  • During the COVID-19 pandemic we found out that pregnant women with COVID-19 disease are more likely to get a very severe infection.  According to the Society for Maternal Fetal Medicine, they are three times more likely to have to go to an intensive care unit, two to three times more likely to need advanced life support and a breathing tube, and sadly, they have a small increased risk of death due to COVID-19. They may have worse pregnancy outcomes, such as pregnancy loss, stillbirth, and preterm birth. It is difficult to know yet whether COVID infection causes these outcomes or whether they happened at the same time by chance.
  • Similarly, COVID-19 can cause chronic inflammation, which could decrease fertility in both men and women.
  • The Federal Drug Administration (FDA) has provided Emergency Use Authorization for the COVID-19 vaccine. It is recommended for everyone over the age of 16 who has not had an allergic reaction to the ingredients in the vaccine. Research has shown that the COVID-19 vaccine is 95% effective in preventing COVID-19 as soon as 28 days after the booster vaccine. These agencies directed all their effort to this work, day and night, which is how the vaccine was approved for use so quickly. No steps were skipped. 
  • It is not possible to get COVID infection from the vaccine. The virus is not in the vaccine.  It is like the flu shot, which exposes the body to something that looks like the part of the virus, so our bodies do the natural process of making antibodies to protect against disease. 
  • Many people have minor side effects, like tiredness, fever, muscle pain, headache, and pain where the shot was given. They could last a few days.  A few people feel very unwell. Having symptoms is a sign that the vaccine is working, and antibodies are being made.
  • Pregnant women were not allowed to be part of the research, which is very common for medical research trials. There were no reports of negative outcomes among the trial participants who became pregnant during the trial.
  • The vaccine does use a new technology called mRNA.  Two shots are required 3 weeks apart. Scientists believe that the mRNA can’t get into the placenta or the breast milk. The same kind of technology made vaccine against Ebola disease.  It has been given to pregnant and breastfeeding women.  No problems for mom or baby were found from this vaccine.
  • The vaccine does not cause birth defects or infertility. While the spike proteins on the virus and those found on the cells of the placenta are similar, they do not share enough amino acid sequences for the immune system to become confused.
  • The vaccine should also be offered to those who are breastfeeding/lactating. Like pregnant individuals, those who were breastfeeding were not included in the clinical trials for the vaccine. According to the Society for Maternal Fetal Medicine, the benefits of vaccination outweigh the very small safety concerns, and you do not have to stop breastfeeding because you get the vaccine.

Experts trusted by your providers recommend strongly that pregnant women be encouraged to get the vaccine.  We can’t tell you whether to get the shot, but we trust that you will make the right decision for you and your baby. Here are some points to consider as you decide:

  • How many people are getting sick with COVID-19 in your community?
  • What is your personal risk of getting COVID-19 based on your job or other exposures?
  • What is your risk of getting very sick with COVID-19, and what is the possible harm to your baby? What other medical conditions could increase this risk? Diabetes, being overweight, having lung, kidney, heart or immune illnesses or taking medicine that depresses immune function ( like chemotherapy, methotrexate, prednisone). 
  • Consider how well the vaccine is reported to work. These vaccines work exceedingly well!
  • What are the risks to other people in your household if you get sick, especially if you are living with people at risk for serious illness, like the elderly.
  • How do you feel about the lack of scientific evidence about the vaccine’s safety and effectiveness for pregnant women?
  • How do you feel you would manage the reported side effects of the vaccine?

If you do get the vaccine:

  • Pregnant women who experience fever, either as a result of COVID-19 infector or following vaccination, should take acetaminophen (Tylenol) to treat fever, since a very high fever can harm a baby. A fever is far more likely as a result of COVID-19 infection than it is from vaccination.
  • Your health professional will give you information about enrolling in the V-Safe After Vaccination Health Checker. You can provide feedback on how the vaccine experience went for up to a week following your vaccination and get help with any concerns that may arise.

If you have questions, please ask your OB/GYN.

Whatever you choose, be sure to continue with the important prevention steps like avoiding visits with those outside your household, masking and distancing when in public, and washing your hands frequently.

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