Pain Archives - Danny van Leeuwen Health Hats

It’s not so simple – making treatment choices

By | Advocate, Caregiver, Clinician, ePatient | No Comments

We (patients and clinicians) need all the help we can get making informed health care decisions. We need the right information to the right person, in the right format, through the right channel, at the right time in our life flow and workflow – The five rights. Let’s take managing acute pain as an example. Clearly, we need to make some decisions together. I (the patient) am in pain for whatever reason – hurt my back, migraines, colitis, sickle cell, a million reasons. I (the clinician) need to help my patient manage that pain with the least long-term risk possible, e.g. relief with maximum function without addiction, constipation, confusion, whatever. This pain could be new – never had it before, or familiar – chronic (we have experience with what works and what doesn’t). Clinical decision support can help us to structure and inform a routine to make choices based on research and clinical and life experience. What has worked for groups of people (those with acute back pain, migraines, colitis, sickle cell) and what has worked for the individual (me or my patient)? We can welcome this decision support when symptoms first occur, when the patient and clinician first communicate, when they first meet about the symptoms, or as we try treatments until the pain goes away or is manageable – anytime from first pain to living with pain to no pain. Read More

People with Chronic Illness Get Sick Too

By | Clinician, ePatient | No Comments

When I watch the camera scan a crowd (sports event, political rally) or I’m on the T (subway) I pick someone out and wonder,  What’s their backstories? Where do they live? Do they like being where they are right now? What ailments do they suffer from? Are they chronically ill? I’m either curious or nosey, maybe both.

A common theme in chronic illness social media is the frequent invisibility of chronic illness. You don’t look sick! When I see someone with a visible disability, I wonder if they have a cold, a stomach ache, or recently stubbed their toe?  People with chronic illnesses get sick, too. As my Primary Care doc says, your specialists help you manage your multiple sclerosis, I help you manage the rest of you. You’re still a 65-year old white man with high cholesterol, a prostate, a heartburn. You can get sick just like anyone else. Read More

Fibro Mama – Book Review

By | Caregiver, ePatient, Family man | One Comment

Fibro Mama: Pregnancy and Fibromyalgia by Melissa Reynolds

Odd, isn’t it? A book review about pregnancy and pain by a guy! Well, I’m a dad, an Opa (grandpa), registered nurse, and a patient activist.  I have Multiple Sclerosis and I know chronic illness and pain management. We had home births with a midwife at one and no midwife at another. Enough about me. I’m reviewing the book because Melissa asked me to.  Thanks, Melissa.

Look, no one knows someone else’s experience, it belongs to them. As Melissa says in her introduction, “I can give you tips about what worked for me. … However, in the end, it’s you putting one foot in front of the other.  That’s how we live, right?”

Lived experience and a dollar fifty will buy you a Pepsi. Lived experience + self-awareness  + systems thinking + good storytelling is golden. Add brevity and it’s priceless. Melissa’s book is priceless. Took me half an hour to read it through once. I marked it up and spent a couple of hours reading it again. Here are the best parts (for me, a guy, who will never be pregnant):

  1. 16 natural pain relief suggestions – I use many of these myself for muscle tension and cramping. Great list. I never tried oils. I may.
  2. The sections about the three trimesters, immediately post-delivery, and the first 6 weeks all include sleep, exercise, meditation, and a pain management plan.  They’re basic and vital. She lays it out for you.
  3. I can’t evaluate the extensive section on nursing except to say that it’s comprehensive and empowering. I always love the response, “there is no wrong choice”.
  4. Using help is big, really big. Melissa has a great care partner. She says to insist that s/he/they be allowed to be with you 24/7 whenever you’re a guest in an institution. Absolutely. Pregnant or not pregnant, fibromyalgia or no fibromyalgia, this is true.
  5. Last, but so not least – Tips to Cope with a Fussy Baby When You’re Sore. She’s buying minutes for you. Dad’s too.

Thanks for the opportunity to review this fine book. You can get it here.


See also:

How Many Words for Pain?

Managing Pain

A Caregiver is [Not] a Caregiver, is [Not] a Caregiver

Health Partners

Managing Pain

By | Caregiver, Clinician, Consumer, ePatient, Family man | No Comments
Several blog posts these past weeks on pain management. Read one here from Engage the Patient.  Everyone has pain.  Some are called stoic, some sensitive. I remember when my son, Mike, had a lung tumor removed.  Curled up in a fetal position, hardly able to breathe, he told a nurse that his pain was a 6!! A six?! How could that be? I was talking to someone this week, recently diagnosed with pancreatic cancer, about a new sensation in her abdomen – a pressure. As we explored the new sensation, she said, it’s not pain. It’s a pressure in the morning. It travels, one day here, the next day there in my abdomen. It doesn’t affect my life. It’s annoyingly noticeable. Gets better as the day progresses. I’ve found for myself, that becoming one with unpleasant, unwelcome, strange sensations helps me manage and not freak out too much. For me its neuropathy – electric, radiating tingles or zaps often in my hands and legs, sometimes elsewhere, lasting moments.  Seriously annoying, but doesn’t affect my life. Nowhere near as bad as a toothache. Acupuncture keeps it at bay, reducing intensity and frequency. It’s good to be intimately knowledgeable about pain and share that with your health team. What’s it like? How has it changed? What works to decrease it? What doesn’t? Some people welcome help understanding their pain better. Shouldn’t pain sensation, what helps and what doesn’t be core health information – included with medications, health team members, diagnoses, and procedures? I have found that people at the center of care get this, most health professionals and information technologists don’t. I’m sure they or their loved ones have pain too. What’s missing here?

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