04/09/2023
I was crying by the end of first paragraph. I know it's going to hurt me too much to read right now. Because I know every word this patient will say already. Imagine, believe when I tell you, there's no better healthcare in the world than here. Yet this still happens. Pain. Unmanaged poorly assessed inadequately treated unbelieved misunderstood- healthcare workers fear pain, I mean, a lot of them. Obviously there are professionals like myself who are more capable of recognizing pain and not fearing it's management but having spent 14 years beside patients gravely suffering pain... I do wish there was a way that I could empower nurses to approach pain competently.
I suffered severe 10/10 chronic pain for 15 years. I was finally cured at age 28! A neurosurgery an emergency physician finally ordered saved my life - that's how I've always felt about it. When I awoke from surgery I cried. They asked me why and I told them , I had no pain. I had not felt that way since I was 10 years old. From my experience I can say my biggest complaint is that nurses would not recognize the difference between me being sedated on intravenous opiates in the ER and being in agony. The meds for me didn't touch my pain a single bit yet they sedated me so much I hallucinated and was unconscious unable to speak and ask for help. I remember hearing a nurse say "she's sleeping don't wake her" when it was time for pain assessment. Somehow, out of the dark ages we arose in the Intensive Care Units and by the time I was leaving the ICU for Primary Care NP work, a Fentanyl First approach was being adopted by most ICUs. Because before, propofol would be used to sedate and they wouldn't be given pain medicine. Now many patients sedated for life support are done so with Fentanyl first.. and then propofol is added on. Movements like this in how conventional medicine is practised are very meaningful. Sucrose on infants tongues is used in Canada prior to painful procedures, but it was not, in the largest Neonatal Intensive Care Unit I've ever worked in, which was in Saudi Arabia. In fact, due to drug laws, pain medicine is often impossible to obtain and hospitals turn to the black market to buy narcotic analgesia.
I'm pretty confident that the first rule for anyone helping someone in pain, is to believe them, and ask them how you can help them.
When I first met my oncologist, he told me that he had three sides: the optimist, the pessimist and the realist. They all work together in equilibrium, having to be able to understand each other but not rely too heavily on one perspective over the other. At first, I saw the optimist. He was hopeful....
