Pain Management in Cancer Treatment or Other Long-Term Illness
By award-winning author and stress-relief expert Susie Mantell
Q: Dear Susie, My wife is in treatment for cancer, following major surgery. We've learned that some residual pain may remain indefinitely. Can you please offer some suggestions that might help relieve the stress that accompanies chronic, debilitating pain?
A: Safe and effective management of chronic pain has long been a matter of great controversy. As a society that has battled the ravages of narcotics addiction for centuries, some physicians and institutions may be reluctant to administer sufficient medication to manage debilitating chronic pain for fear of creating dependency or encouraging abuse. Any responsible physician must assess such potential risks and monitor use closely over time, remaining mindful of the risk of under-medicating as well. It is a delicate balance, and one always hopes to manage pain without unnecessarily hampering cognitive function.
As you know, acute and chronic pain are discouraging and frustrating, and often depressing to the patient as well as to loved ones and caregivers. Pain may be episodic in nature, diffuse and migratory, or intense and unrelenting. One frustration is that while there are many drug-free techniques and practices for palliative care, while a particular technique may be highly beneficial one day, on another it is not as effective. We therefore need an assortment of techniques and strategies from which to choose. In addition to prescription medications which may be necessary and extremely effective, a wide variety of mind-body stress-relief techniques including multi-sensory imagery, are now used in even the most "traditional" of hospitals.
While I am not a medical professional, I've had considerable experience facilitating pain management over the years, so I will share a number of non-medical observations and hope that some of these might be helpful. If your doctor feels it is advisable to try any of the following, some may ease symptoms, boost the spirits and enhance quality of life.
16 Tips: Ask Your Doctor Which of the Following Might be Safe and Beneficial for You
1. Physiatrists (aka rehabilitative physicians) are medical doctors with specialized expertise in the diagnosis and treatment of pain. A skilled physiatrist will evaluate the patient from multiple perspectives, offering non-surgical solutions wherever possible, with the goal of restoring maximum function.
(See http://www.aapmr.org/condtreat/what.htm )
2. Eliminate sugar, caffeine and alcohol entirely, or reduce as much as possible. Each can exacerbate stress in some people. If you use a lot of caffeine, taper gradually. Drink 6- 8 glasses of filtered water daily.
3. Clear out unhealthy thoughts, behaviors and people. Reduce stress in every way you can. Replace those things with dreams, plans, activities and people who nourish your spirit.
4. Breathe mindfully, inhaling as slowly and deeply as is comfortable and pleasurable. Focus on the in-breath ...then the out-breath. Inhale Comfort and Peace...exhaling Tension and Pain. Mindful breathing to support wellbeing can be a powerful release for pain, as well as stress.
5. Listen to your body. Rest as soon as you begin to fatigue. Your body will tell you. ( Then, it may also say, "Okay, get up again now and do just one thing. Then, rest again.") Being productive, even in small ways, often lifts our spirits. People in bed can be called upon to toss the salad or sort socks, thereby feeling more a part of household activities.
6. Get deep, restful sleep. While we sleep, growth hormone is secreted and microscopic muscle tears repaired, etc.
7. If you're able to get around, exercise gently with supervision if your doctors feel that is advisable. Movement helps to release endorphins to counter physical and emotional pain. Stretch gently, daily as possible, and in a heated pool if you can. Exercise requires a delicate balance. Too much can lead to a pain flare, but too little allows stiffness and aches to set in. Moderation is key.
8. Digestive upset can exacerbate seemingly unrelated pain. For example, some experience back pain after eating a large meal, or foods that do not digest easily for them. If you have no dietary restrictions, eat enough fiber, fruits and vegetables to keep bowels moving regularly. Read about "Leaky Gut Syndrome" vis-a-vis joint pain. See if anything about the concept resonates for you. Interestingly, doctors of oriental medicine often draw a relationship between healthy digestion and the respiratory system.
9. Many benefit from gentle massage. If the torso is tender, try reflexology. Soothing music in the background can help to distract the body-mind from pain, while refocusing attention on pleasure and deep relaxation.
10. See a licensed health care professional who understands chronic pain to ask about potential nutritional supplements and medications that may be beneficial.
11. Try some counseling with a licensed psychotherapist you genuinely like, trust, and who "gets it." There are extraordinary oncology social workers and others out there who can offer local resources and support.
12. Look into working with a physical therapist using myofascial release, ultrasound or electrical stimulation. Ask if perhaps a small TENS unit for home is an option. Do you know about Kinesiotape? Used in the Olympics, it has been amazingly helpful to many. It must be applied by a skilled professional so ask your PT, DC, DO or MD about professionals certified to apply Kinesiotape, if it's indicated for your problem.
13. Share with close, trusted friends how you are really doing, so they can support you, distract you, and remind you of all the wonderful things you are -- besides a person in pain.
14. As able, pursue interests that are fun and completely unrelated to your health. Explore movement as you are able, painting, music, yoga, body work, meditative practices, art, etc.
15. Daily meditation can gentle, provide powerful, drug-free relief.. Guided imagery meditation, like my own deeply soothing, "Your Present: A Half-Hour of Peace" CD, requires no prior training, and is used in many oncology departments, burn units, VA hospitals, rehabs, and at home by people living with long-term illness, as well as by their caregivers.
16. Think positive, and hang around with others who do. Many who have known the misery of chronic pain later find simple, manageable ways to prevent and reduce pain, moving beyond difficult times to days that are once again filled with joy and comfort and enhanced well-being!
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Award-winning stress-relief expert Susie Mantell ...is the author of the deeply soothing relaxation CD, "Your Present: A Half-Hour of Peace,” clinically approved for symptoms associated with stress and sleeplessness, depression and grief, anxiety, P.T.S.D., Fibromyalgia, caregiver stress, cancer, pain, divorce and addiction recovery. Featured in The Los Angeles Times, NBC, ABC, CBS-TV, Town & Country, The American Pain Society, Hazelden and The Susan G. Komen Breast Cancer Foundation, listeners include The Mayo Clinic, Memorial Sloan-Kettering, The Betty Ford Center, V.A. Hospitals,and Canyon Ranch (#1 Spa.) Customizing stress-reduction for Fortune 500 companies, distinguished hospitals and spas, Mantell has facilitated thousands in relieving health-related, work-related, chronic or traumatic stress. Her multi-sensory, mind-body techniques appear in national media, medical and corporate publications. Susie Mantell's Stress-Relief & Wellness Tips are intended as an adjunct to, not a substitute for, professional health care. Order “Your Present: A Half-Hour of Peace” and find more of Mantell’s stress-relief tips at www.relaxintuit.com