So you have already been prescribed the suitable pain medicines. Here are some guidelines that you need to know.
1. It is generally better to take your medicine on a fixed schedule instead of taking them on an as needed basis only.
This is true especially for patients who are already having mild to moderate pain. For patients who are in pain, very few of them have mild pain on whom we can recommend taking the medicines on an as needed basis only. The reason why we recommend taking the medicine on a fixed schedule is because we want to maintain a constant level of drug in the blood. This prevents the patient from having episodes of severe pain and when they eventually occur, the intensity is not as severe as when the patient is not taking the medicines regularly. Cancer pain is sprinkled with intermittent spikes in pain intensity. Taking the medicines intermittently instead of round the clock exposes the patient to more intense episodes of pain.
2. Breakthrough pain
There are instances when even despite good compliance with the prescribed pain medicines, the patient still experiences “flares of pain” or “Breakthrough Pain”. This is a normal phenomenon in cancer pain. The patient need not worry that the medicines are no longer effective.
Breakthrough pain is managed by giving additional doses of medicine. Patients should not necessarily be concerned that the disease is getting worse.
3. Be alert on the timing of worst pain as well as those things that aggravate the pain
There may be certain times of the day when the pain becomes severe or movements or activities that may aggravate the pain. I advise patients to keep a diary of their observations of their pain as well as the effect of the medicines. It allows us to see the pattern of the pain and know when we need to take precautionary doses. Discuss with your doctor if you can take additional pain medication before engaging in an activity that you have noticed to precipitate the pain.
4. Remember that all medical interventions have potential side-effects.
Some patients encounter side effects while on their medicines. This should not be a reason to stop them. I always make it a point to discuss these things with the patient and give them pre-emptive medicines to avoid experiencing the trauma of surprise from a nasty side effect. It becomes difficult to convince patients that those medicines will help them when they were surprised by the side-effects. However, when they understand that these unwanted effects may happen and that they can be managed, I find that they are willing to cooperate and go through these slight difficulties with some ease and a lot of patience. Most of the side effects, especially of opioids will wane over time.