Where to Begin
I always say that healthcare management is a shared responsibility between physician and patient. With regards to pain management, you must remember that if you are in pain, even if your doctor does not ask about it, do not be afraid to volunteer that you are in pain and that you would like to have it addressed.
During your consultation, be ready with the following information:
• Character of the pain.
Be able to describe the pain. Is it dull, sharp, aching, a feeling of warmth or tightness, does it feel like lightning hits your part of the body? Do you feel numbness or tingling sensation? Other terms that are commonly used to describe pain are pinching, piercing, lancinating, throbbing, stabbing, crushing. Be specific when describing because there are different types of pain and they are managed differently. Your doctor needs to determine which one it is to give you the right medication.
• Location of pain
• Intensity of pain
Patients often use vague terms to describe the intensity of pain. In the clinic, there are several ways to do this. The one I find easiest is to ask the patient to grade the intensity of pain from 0 to 10 with 0 having no pain to 10 being the worst.
• Timing of the pain
Is there a particular time of day when the pain occurs or worsens? Is the pain continuous or intermittent? How long does the pain last? How often do you experience the pain?
• Aggravating or relieving conditions
Are there movements that precipitate pain? What other situations can aggravate the pain? What do you normally do to help ease the pain?
Do you use medications for pain? If so, enumerate all those medicines and be ready to explain the dose and frequency that you have been taking them. What are the effects of the medicines on your pain? Are there side-effects of your medicine?
• How the pain has affected you
Sometimes patients do not immediately realize the impact of the pain in their lives. However upon close scrutiny, we find that it has affected many aspects such as activities of daily living, work, social functioning and relationships.
Keep in mind also that not all types of pain in patients with cancer should be attributed to cancer. There are instances when a new problem is evolving that needs to be addressed differently