Expert Tip:
◆ Describe your real pain to your doctor in detail.
◆The control of cancer pain needs your own confidence and participation.
◆Most cancer pain can be controlled through standardized three-step pain relief therapy.
◆WHO recommends strong opioid DD preferred for severe cancer pain is morphine (morphine is safe for cancer pain and there are almost no addicts. Guo Quan, Department of Oncology, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine
Cancer pain is a big problem. Many advanced patients do not think about eating and drinking and cannot sleep because of having cancer pain, which can be described as painful and inexplicable. Of course, having cancer pain does not mean that it is already advanced; some early stage cancer patients can also have pain symptoms. There are many misconceptions and perceptions around the issue of cancer pain, we will set aside the fog and answer them one by one.
II. Cancer pain assessment, based on me
⒈ Tell your doctor you feel pain
Two kinds of statements are often heard. One is that ××× is really good, forbearing severe pain and continuing to work ……; the other is that ××× is really soft-boned, too delicate, taking time off for the slightest problem ……. I wonder which one you are? Generally we respect the former kind of people, to their spirit to inspire us to strive for improvement, since childhood we are also this kind of education, Jiao Yulu, Kong Fan Sen, etc. are our role models. But now, we have to sing the opposite from the medical point of view.
Take Jiao Yulu for example, he died because of liver cancer, he had abdominal pain symptoms very early in life, he kept insisting and insisting and refused to see a doctor properly, and eventually died young. In the long run, in fact, his early death brought losses far greater than he insisted on working for the benefit of the country and the people.
So whether it’s for ourselves or for someone else, we should inform our doctors of our pain condition early and seek their help.
⒉Detailed description of your pain
As mentioned earlier, pain your self-feeling. In order for the doctor who sees you to understand exactly how you feel, you have to make an effort to give them a clear description. Be aware that a thorough pain history is a key to pain control.
Because an adequate evaluation of pain is the basis and prerequisite for determining your treatment plan, it is important to make a thorough and comprehensive assessment of cancer pain before cancer pain treatment. Of course, this needs to be done with the help of your doctor. It must be clear: cancer pain assessment is an extremely important first step in cancer pain treatment.
Self-judgment of pain
The assessment of cancer pain should include your pain history, the degree of pain, the nature of pain, the location of pain and whether it is transmitted to other locations, whether the pain is continuous or intermittent, whether there are any flare-ups and aggravations, and the factors related to the increase or decrease of pain. In addition, one’s physical and psychological condition and other concomitant symptoms associated with pain – motor weakness, sensory impairment, decreased mobility, etc. – also need to be taken into account.
For readers of this book, the pain characteristics of esophageal cancer are worth presenting to illustrate. Esophageal cancer is often characterized by a pinprick-like pain behind the sternum when swallowing food or a pulling pain when swallowing food; if there is significant pain behind the sternum even without eating, this indicates that the disease is localized and may have invaded other organs and nerves outside the esophagus.
Singing how much pain I have
So how much pain do I have? Everyone knows the difference between mild, moderate and severe pain, but how do I know? Simply put, it can be classified by whether or not your sleep is disturbed. If you have pain that is tolerable and does not interfere with your sleep and you can live a normal life, you can be considered to have mild pain; if you have significant pain that is not tolerable and your sleep is disturbed, you can be considered to have moderate pain; if you have severe pain that is not tolerable and your sleep is severely disturbed, you need pain medication, and you may suffer from vegetative dysfunction or passive posture, you can be considered to have severe pain.
Be careful with the standard practice of experts
As shown in the chart below: use the numbers 0 to 10 to represent different levels of pain, with 0 being no pain and 10 being the most severe pain, that is, the most severe pain you have ever felt, or imagined.
You circle one of these numbers that best represents the level of pain and tell your doctor.
0 1 2 3 4 5 6 7 8 9 10
No pain Most severe pain
Of course, this pain grading method can also be used with cross-reference to the previous one.
How do I tell my doctor about my pain?
As already emphasized, it is “my pain is my choice”. Now I would like to say that it is important to be aware of how to do this. You may ask, “If I am in pain, the doctor should solve it for me, if I say how much it hurts, how can I talk about the way?” In fact not, there is a lot to be said for it.
First of all, I would like to criticize again those who are good at enduring, their approach will only bring trouble to themselves and the doctor, and will not really help. If you do not talk about your illness, it is not necessary to say that you suffer, the doctor may also underestimate your condition and make a wrong judgment, so in the end it is you who suffers. Therefore, we strongly encourage you to actively report your pain symptoms to your doctor. The second point is that although it is good to be proactive, it is important not to exaggerate. We cannot rule out the possibility that some people may worry that their doctors will not pay enough attention to them, so they may exaggerate their condition to get their doctors’ attention.
How do I feel about my loved one’s pain if I am a family member?
Pain can lead to some psycho-spiritual changes. Pain is always a bad psychological feeling and will often bring us some negative effects. The incidence of depression, anxiety and delirium all increase with the increase of physical debilitation and the degree of pain. As family members, on the one hand, we should try to comfort patients and give them maximum psychological support; on the other hand, we should communicate with doctors in a timely manner and truthfully reflect the changes of our loved ones’ symptoms, prompting them to give appropriate treatment in a timely manner.
How to understand the abnormal psychological and mental state of patients with cancer pain
Once a patient with cancer pain is found to have some mental symptoms, it should first be regarded as a possible result of uncontrolled pain and emotional and psychological disorders due to uncontrolled pain. While the relief of pain can make the obvious mental disorder disappear, it should be accurate to evaluate the patient’s mental psychological state again after the pain is controlled.
Counter-effect of µ abnormal psychology on cancer pain
Conversely, the vast majority of cancer pain patients have different degrees of psychological disorders such as fear, anger, depression, anxiety, loneliness, etc. These psychological disorders have a great impact on the degree of cancer pain and its treatment, and patients should cooperate with doctors to eliminate psychological disorders while taking painkillers in order to achieve good pain relief.