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The Importance of Pain Control
Unrelieved pain can affect every area of your life, including eating, sleeping, activity, mood, concentration and even your immune system. If you experience cancer-related pain, it should be acknowledged and treated so you can focus on more important things—like healing.
At CTCA at Southwestern Regional Medical Center (Southwestern), we understand that pain control is an essential component of the cancer treatment process. We offer a separate Pain Management Program to address this common and often underestimated problem for cancer patients. Our goal is to not only bring you relief from pain, but also to help improve your overall sense of well-being and quality of life.
Southwestern's Pain Management Department
Our physician-led, patient-centered Pain Management Program aims to empower you to make judgments and decisions free from the distraction of pain. The goal is to get your pain under control and to improve your quality of life. It is about fulfilling not what our doctors want, but what you need.
Southwestern’s pain management team is comprised of pain management physicians, nationally board-certified pain management nurses, and a supporting staff.
The pain management team takes care of all of the perioperative in-patient and out-patient pain management needs at the hospital.
“As the vast majority of our patients live outside of the Tulsa area, we are uniquely positioned and experienced to be able to care for their needs even while they are away from our institution,” says Dr. Mark Axness, Medical Director of Pain Management and Anesthesiology Services at Southwestern.
According to Dr. Axness, most of his patients, who had already been treated at other institutions prior to arriving here, state that their pain had not been adequately controlled or addressed. Dr. Axness believes cancer patients in many other hospitals do not receive adequate or appropriate attention to pain because there is often only one person available to address their pain management issues—their medical oncologist. Yet, most traditional oncologists do not specialize in the field of pain management.
Our pain management team specializes in treating pain. “Having dedicated pain management physicians facilitates appropriate and rapid management of patients’ pain,” says Dr. Axness.
Your Pain Assessment and Plan
Upon your arrival at Southwestern, you will have an initial evaluation by the pain management team. You will be given an extensive pre-treatment history and physical exam, including appropriate lab and radiology studies. Part of this evaluation will involve an assessment of your pain.
This comprehensive assessment includes information about the following dimensions of your pain:
- Factors influencing its occurrence (i.e., what makes it better or worse)
- Observed behaviors during pain
- Psychosocial variables (e.g., attitudes, situational factors)
- Effects of therapy and patterns of coping
In addition, Southwestern's pain management team uses the Wong-Baker Faces Scale (also knows as a “Comfort Scale”) to determine the intensity of your pain. Facial expressions arranged on a scale from zero (no pain) to 10 (worst possible pain) help you rate your pain level.
Once the pain management team determines your pain level, we can determine the nature of your pain, where the pain is, how long you have had pain, and what makes it better or worse. Since each person experiences cancer differently (i.e., patients vary in diagnosis, stage of disease and responses to treatments), we manage your pain on an individual basis.
We also understand that it may be difficult for you to talk about your pain. To help you describe your pain, we encourage you to keep a record or a journal of your pain experience. This may include information about the location of your pain, how it feels, if it has changed, which pain treatments help relieve it, etc. By tracking your pain, the pain management team will be better able to determine the pain control methods that will work best for you.
The pain management team will work closely with you, and the rest of your Patient Empowered Care® team, to develop a personal pain management plan tailored to your needs. This treatment plan will be initiated immediately and will be altered as frequently as is needed. This plan will include appropriate pain management techniques to help control your cancer pain and discomfort and/or alter your perception of it.
You may receive conventional pain-reduction treatments, such as medication, and/or more advanced procedures. In addition, your plan management plan may include complementary treatments, such as acupuncture, acupressure, and mind-body techniques, to help relieve your pain.
Throughout your treatment, the pain management team will follow up with you as often as necessary to treat your pain aggressively. Our goal is to provide you with integrated and consistent care and support. We also provide educational information about pain management, including how pain affects your well-being, how to adequately treat your pain and fears about pain treatment.
A Team Approach to Pain Management
Since our cancer experts are housed under one roof, the pain management team is able to consult regularly with other Southwestern departments to balance pain medicine with supportive options.
“We are totally integrated with the rest of the medical staff, including internal medicine, surgery, medical oncology, radiation therapy and radiology. There is a seamless flow of patient care from one specialty to the next,” says Dr. Axness. This team approach ensures that you get uninterrupted, comprehensive cancer care.
The following are examples of how the pain management team interacts with the other Southwestern departments:
The pain management team works with our medical oncologists to understand your oncology treatment plan, so we can better tailor your pain management plan around your needs.
“As most of our patients live away from the Tulsa area [and come and go from home to Southwestern], it is absolutely vital that we are in frequent touch with the oncologists so we know what the ongoing plans are. This is a very unique challenge and one in which we excel,” says Dr. Axness.
Hospitalists (in-patient physicians):
The pain management team works with our hospitalists to understand the in-patient treatment plan of our hospitalized patients, so that we can change our therapy as needed. In-patient treatment plans for pain management can change a number of times per day. Therefore, we are in constant communication with the hospitalists to address these needs.
The pain management team works with our surgical oncologists to handle all the perioperative pain management needs of our surgical patients.
The pain management team frequently assesses patients who have metastatic disease that is causing pain. After an appropriate assessment (involving history and physical, as well as appropriate laboratory and radiology studies), we will refer patients for consultation and treatment with a radiation oncologist.
The pain management team's dependence on the Imaging Services Department is critical. Our team frequently requires sophisticated imaging to determine sources of pain, and appropriateness of our treatment plan to resolve the discomfort. Also, we commonly use imaging modalities during interventional procedures to verify correct placement of medications or devices.
Pain Management Techniques
The Pain Management Department at Southwestern offers a full complement of traditional medical, interventional and allied therapies. We use several therapeutic approaches to pain management aimed at helping you resume activities you enjoy and improve your overall enjoyment of life.
Pharmacological pain relief
Many of our patients have excellent pain control using medication therapy. Pharmacological pain control involves the use of analgesic drugs (or painkillers) and other medications that intensify the analgesics' effects or modify your mood or pain perception.
Non-pharmacological pain relief
Non-pharmacological pain control attempts to promote your comfort. The pain management team consults with other Southwestern departments, such as surgical oncology and radiation oncology, to provide methods such as:
- Radiation therapy - Aims to reduce pain by shrinking the tumor
- Surgery - When a tumor is pressing on nerves or other body parts, surgery to remove all or
- part of the tumor can relieve pain
- Nerve injections, implanted pain pumps, or nerve stimulation devices
Additional Pain Relief Methods
The pain management team also works with other Southwestern departments, such as oncology rehabilitation, mind-body medicine and pastoral care, to provide additional methods for managing cancer pain, including:
- Relaxation therapy, guided imagery, visualization
- Exercise, physical therapy
- Transcutaneous Electric Nerve Stimulation (TENS)
- Massage, skin stimulation
- Cold or heat applications
- Emotional support and counseling
- Chiropractic care
- Spiritual help
Because of the complex nature of cancer-related pain, successful pain management usually involves a combination of techniques.
The best way to control pain is to prevent it from starting or to address it right away, before it becomes more severe. Pain may get worse if you wait, and it may take longer or require larger doses of medication to get relief. Our pain management team is accessible and approachable so you feel comfortable coming to us as soon as you experience pain.
For helpful tips on understanding and managing cancer pain, read our April 2007 newsletter, featuring the role of pain management in cancer care.