‘The pain, the pain’
Hospitals are not a place for the faint of heart or the emotionally irresolute. It takes a certain resolve to operate in an environment where you are consistently bombarded with reminders of illness and morbid states. Augmenting that, is sometimes the unfortunate event of a patient that has a particular condition you know is untreatable, but you desperately want to do something. This article lies with an older woman who may have single-handedly determined the direction of my future in the field.
In the developed world, the increasingly ageing population brings about its own unique set of challenges. People are living longer, so they are living with disease for longer. They are also experiencing things like non-communicable diseases (preventable diseases), which are nasty conditions such as diabetes, stroke, asthma and COPD. These all deteriorate an individual as they age and make for poor quality of living. One of the manifestations of people living longer, is chronic pain.
Now just imagine as a young person with all your wits about you, you use improper lifting technique causing a slipped disc in your back. That slipped disc is unbelievably painful and this pain will be with you for life. It may not always be there, but when it comes you sure as hell no it’s back. My story lies exactly here, when I encountered an elderly woman with right hip pain.
This woman had been readmitted to the hospital due to the worsening of her pain over the last 3 months. Her condition however, had nothing to do with a spinal disc problem as her MRI results cleared her of that. This made things even more challenging and at the time when the team were discussing her conditon, they mentioned their frustration at seeing this woman in the state she was, but still being unable to do much else except for getting pain specialists assess her. For now treating the symptom would have to do, but even that was weaning.
Her tolerance for the pain relief drugs was building, meaning the dosage would have to increase. However, this in itself highlights a current controversial area in medicine and that is, assessing between patient addiciton to the medication and giving relief to the individual. The solution may seem simple, but just like most things there is more that lies beyond the surface. Addiction to the medication has no limits due to continuous tolerance build up. It may in-fact worsen her outcomes in the long term due to the potential psycho-social issues it can lead to, resulting in more triggers for her pain, as you can see it becomes a vicious cycle.
Nonetheless, leaving her in her current plight is not sufficient. There are current methods of dealing with such chronic pain, but the hunt is still on for the ‘penicillin’ of this area. Her prescribed treatment involves something by the way of monthly injections and prescribed exercises for what could be a manifestation of Osteoarthritis.
I didn’t mention this lady from the outset to demonstrate her as a medical case, but rather to remind us of the struggles that may plague many in our society and to humanise them. Appreciating her constant cries of ‘the pain, the pain’ will live with her probably for the rest of her life. Understanding that this is a reality for many, even if we may not experience it ourselves because we’ve been blessed with health. In fact, she may have single-handedly motivated me to pursue a sustainable, quality of life improving treatment for those enduring a life of chronic pain.