Strumming one’s pain

My patient shyly handed me a piece of art. It was a multicolored gummy candy that was perfectly shaped like a gecko. Clutching it to my chest, I thanked her and told her she must be feeling a lot better. In reply, she gave me her beautiful smile that we have been missing lately. Remembering the last visit and how we stood by her bedside watching her bravely struggle through waves of pain, it was such a relief to see her comfortable. Discussing the cocktail of medications with her mom in attendance, I couldn’t help but tease her about being on some serious analgesics. Being the smart and sensitive teenager that she is, she shared that the current regimen just made her sleepy and the unfortunate side effects she experienced must have been caused by a previous medication.

Stepping out of the hospital room, I couldn’t help but be reminded of how we as doctors act when the roles are reversed and we become the patients. Most of the time, we fail to heed the pieces of advice that we freely give. Remembering the months that I stubbornly refused to take anything to address the arthralgia and arthritic pain brought on by chikungunya, how I chose to hop like a rabbit to avoid the torment experienced from landing on one’s feet, and resorting to moving like a 2-year-old taking the stairs one step at a time, has now become a memory to derive amusement from. Life then could have been relatively pain-free if I wasn’t so proud.

“You might have to consider letting her undergo an operation if the pain becomes worse.” This was the kind advice a cousin had given a neurosurgeon upon seeing the spinal MRI findings of my beloved 92-year-old mother close to two years ago. We had come for consult as she could hardly sit or walk and was unresponsive to the analgesics that were prescribed. Broaching the subject to her, she hastily agreed as the pain was intolerable. Upon hearing her say this, we sat down as a family and discussed the benefits versus the risks. With her consent, we all agreed to maximize both pharmacologic and non-pharmacologic means available. Today, though she can no longer run a marathon or do her uninterrupted 2.2-kilometer walk around the Oval, she is mobile enough to move around the house on her own and thankful for that kind of independence. Her dream team included the following: a rehabilitation expert, a pain specialist, an acupuncturist, and a physical therapist who conscientiously still comes to visit twice a week. We attribute this success story to her determination to adhere to the program planned, her deep unwavering faith in the Almighty, and our Carmelite sisters who constantly keep her and the family in their prayers.

Lessons learned. In one’s lifetime, it is a near impossibility to be exempt from experiencing acute or chronic physical pain, as it is inevitable when one deals with an injury, surgery, an illness, a chronic health condition, or simply as part of the aging process. Physical pain is to be acknowledged and should never ever be dismissed, no matter how minor, as severity may sometimes be a matter of perception. While some types may be alleviated as part of the healing process, some will unfortunately persist. Admittedly, pain management was something that was not consciously a part of my medical armament in the early years of practice, but having seen its immeasurable benefits has become integral. It pays to be aware that there are subspecialties and numerous interventions that may assist in improving one’s quality of life. While there is no such thing as a one-size-fits-all program, there are options that will help you better manage your pain and ultimately give you better control of your life.

Pain that is unrelenting, steadily worsens, or interferes with your daily activities entails a visit to your trusted health-care provider. As in any ailment, the cause should be identified to provide targeted solutions. For severe and chronic pain, there is no straight-line approach and in most cases may involve a complicated combination of oral or intravenous medications, injections, transdermal patches, involvement of equipment such as those that provide electrical stimulation, home remedies, and exercise to include lifestyle changes. Never ever attempt to self-medicate with over-the-counter drugs as there may be unforeseen and untold consequences from improper use that may even be debilitating or worse cause end organ damage. Seek expert and professional advice.

An octogenarian friend always tells me that she is thankful for each day that she wakes up pain-free. This is one of her greatest blessings and definitely one thing that money cannot ever buy.

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