Pain Assessment

Discussion in 'Chit Chat' started by JLH, Apr 30, 2007.

  1. JLH

    JLH New Member

    Health care providers use the word assessment to describe questions they ask to learn more about you and your pain.

    Expect your doctor or nurse to ask about your pain and pain relief at each visit: If they do not ask, and you are experiencing pain, tell them. Describe any changes since your last visit. The better you describe the pain, how it affects your life and activities, and what works to relieve it, the easier it will be for others to help.

    Write down information about your pain and what helps to relieve it, and bring this written information with you to your doctor or clinic appointments.

    * Where does it hurt? Does the pain move from one place to another?

    Tell exactly how the pain feels. Does it feel like it's on the inside of your body? Or does it seem like it is on the outside? Point to the places that hurt. Show where the pain moves if it travels from one place to another. Use a drawing of the outline of a body to show the places where it hurts. Be sure to show all of the places that hurt, not just the spot that hurts the most.

    * Do you have more than one spot where it hurts?

    You may have more than one kind of pain - some caused by the disease or disorder, some by the treatments, and some unrelated - a stress headache, for instance. It is important to describe each kind of pain in detail.

    * When does the pain happen? How long does it last? Does the pain come and go? Or is it there all the time? Is this pain new? Have you ever had this pain before? When does it begin? When does it end?

    Describing pain this way helps others know more about the pain.

    * Does the pain keep you from doing all you want to do?

    Pain may stop people from moving, walking, climbing stairs, bathing, working, playing, or getting around. Sometimes pain interferes with thinking and concentration. Pain can interfere with being close to other people. Describing how pain limits your life will help your doctor or nurse set goals with you for dealing with your pain.

    * Does pain interrupt your sleep? Does it change your mood? Affect your appetite?

    When pain interferes with sleep, mood, or appetite, it can affect all parts of life. A first goal for treatment is to insure a good night's sleep. When you are well rested, you have more energy to try to get well, to talk with others, to enjoy life, and to do the things that are important to you. Pain can also cause you to feel grumpy or sad, especially when it lasts a long time. Pain can change the way you eat and cause you to gain or lose weight. Pain that won't go away can change the way you feel about yourself and others. Explaining how pain affects you can help others understand more about your pain and how to make it better.

    * What do you think causes the pain?

    Many people with cancer fear that pain means the cancer is spreading or has returned. This is not always true. Pain may be caused by constipation, not moving around as much as usual, or other reasons not related to your cancer. New pains can cause worry and concern. Your doctor and nurse need to know what you think is happening. Doctors and nurses will look for the cause of the pain. But even if the cause is not found, pain can be treated.

    * What makes the pain better? What makes it worse?

    People try things to relieve pain. Some work well; others may not work at all. Sometimes pain occurs when you move a certain way. Sometimes staying in one position eases the pain. Telling your doctor or nurse about these things can help them control your pain more quickly.

    * What have you tried to relieve the pain?

    Different kinds of pain respond to different treatment. You may already have found things that work well to relieve the pain. You may have tried relaxation, meditation, heat, cold, or mild exercise. These may all relieve some kinds of pain. If so, your doctor or nurse will want to include these actions in your treatment plan.

    You also might have tried things, such as certain medicines, that did not relieve the pain. Your doctor or nurse needs to know this to avoid delays in finding just the right treatment for you.

    Your doctor or nurse also needs to know all of the over-the-counter medications you take and what medicines have been prescribed for you by another doctor or nurse practitioner. Some medicines can't be taken together. Some medicines with different names contain the same chemicals and could be harmful if too much is taken.

    * What medicines are you taking for pain right now?

    Describe all the medicines you have tried for pain in the last two or three days. Be prepared to list all other medicines as well. List the name, amount of medicine, time the medicine was taken, amount of relief, and any side effects.

    * How are you currently taking medications to relieve pain?

    Sometimes medications that have not worked before might be effective if they were taken in a different way. Describe exactly how and when you are taking medicines now. Your doctor or nurse needs to know if the way you are taking medicine is different from the instructions on the bottle.

    Describe how long the medicine takes to work. How long does pain relief last? Does all of the pain go away after you take the medicine? Does the pain return before the next dose is due?

    Answers to these questions make it easier to come up with a plan that works for your pain.

    * Do you have any side effects from medicines you are taking? Do you have any allergies?

    Medicines for severe pain cause constipation. Dealing with constipation is an important part of the pain control. Expect to be asked about bowel movements at each visit. Two days is too long to go without a bowel movement when taking most medications for severe pain. Also talk about other side effects that cause problems; most are easy to treat.

    Discuss your allergies to medicines and other things. Describe how the allergy showed itself and when you first noticed it.

    * Do you have any worries about taking medicines for pain relief?

    Many people worry about taking medicines, especially narcotics or opiates, for pain relief. They worry about addiction and other side effects. Addiction rarely occurs in people taking medicines for the relief of cancer pain, yet many people do not take medicines or take less than they need because of this fear. Your doctor or nurse needs to know how you feel about this. They should explain that it is not a problem. Ask questions about other worries you may have.

    * How much relief would allow you to get around better? What is your goal for pain relief?

    You may be asked to set a goal for pain relief. The goal may be based on the ratings scale (for example, 2 on a scale of 0 to 10). Or, your goal may focus on activities you would like to carry out (walking without pain, being able to work). The aim of the treatment plan is to meet the goals you set for pain relief.

    * Some Words Used to Describe Pain

    Pins and needles
    On the surface


  2. Mini4Me

    Mini4Me New Member

    I'm printing it off to keep those great adjectives handy to describe my pain before my doc visits.