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  • Advice from Pain Management Team

    I just wanted to share some of the advice that is being given to patients and parents as part of a pain management study being conducted at Children's Mercy Hospital, KC, of adolescent posterior spinal fusion patients.

    The mother of one such patient (who shared this with me), and her daughter, received some pain management counseling which mom feels has "truly been key in her excellent recovery."

    A pain management doctor, nurse and also psychologist met with the patient and told her what to expect, what drugs would be used to help and also what she could do to help herself. They taught her some guided imagery techniques ("imagine a happy place and how you feel when you are there"), some breathing she could do, etc.

    The psychologist also met with the parents, separately and told them how they could help . . . reminding her to do the guided imagery, etc., and to NOT say things like "you poor thing, the pain must be really bad, it isn't fair you have to do this." Mom said that she found the whole thing pretty fascinating and that she "definitely worked hard to not say stuff like that".

    I'm not sure who or what to credit for it, but this particular patient is running 3-5 miles per day just a little over two months since fusion surgery.

    I hope this is helpful to someone
    mariaf305@yahoo.com
    Mom to David, age 17, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

    https://www.facebook.com/groups/ScoliosisTethering/

    http://pediatricspinefoundation.org/

  • #2
    Maybe my son was just contradictory (), but he was more likely to push past his pain if I *was* sympathetic. Something like "Oh mom, it's no big deal."

    OTOH, if I ignored his pain, he played it up a bit more to be sure that I "got" that it hurt.

    I find that I react the same way. I just want to be sure that I'm heard. Once I'm heard, I can move on.

    Different folks, different strokes is the *only* thing I've ever been certain of in psychology

    Comment


    • #3
      Focusing on the unfair nature of things helps me personally because it emphasizes that there is no reason some people suffer and others don't. There is no personal failing underlying it so you don't feel persecuted or punished. It's a key concept for me.

      I'm very sure I said it was unfair to both my kids at some point in the hospital and they seemed to have good recoveries. I guess there is more than one right answer here.
      Sharon, mother of identical twin girls with scoliosis

      No island of sanity.

      Question: What do you call alternative medicine that works?
      Answer: Medicine


      "We are all African."

      Comment


      • #4
        Yes, Sharon I agree there is definitely no right answer.

        And just to clarify, I was in NO WAY saying one way is wrong and one way is right. It's just that the mom who shared this felt strongly that the approach had been so helpful for them, that I wanted to share it with others in case it may help someone. They PM team also likened it to a child falling down, not getting upset initially....until mom ran over and looked upset. I guess this is what they found is the case 'generally' speaking.

        I definitely agree with hdugger as well regarding 'different strokes for different folks'
        Last edited by mariaf; 09-07-2010, 08:05 AM.
        mariaf305@yahoo.com
        Mom to David, age 17, braced June 2000 to March 2004
        Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

        https://www.facebook.com/groups/ScoliosisTethering/

        http://pediatricspinefoundation.org/

        Comment


        • #5
          I think it's great that this hospital has a pain management team to meet with the patient and family prior to surgery! I would have really liked to have had the pain meds explained to me in advance. Let's hope that more hospitals move in this direction.
          Kathy
          46 yrs at surgery, now 50
          71 degree thoracolumbar curve corrected to 34 degrees
          8/2/2010 surgery with Dr. Lenke

          posterior T9 to sacrum with pelvic fixation

          4 osteotomies and 1 cage
          http://s1066.photobucket.com/albums/...athK_08022010/

          Comment


          • #6
            maria,
            My son saw pain management for his other conditions & they helped to with the focusing and with me to try and not say those things. My son is a momma's boy and the minute I go awwwwweeeee he loses it and his pain is 10 times worse. He had the nurses at his school wrapped around his little finger too.. I explained to them about if they checked him out and gave him his meds to be more assertive with him that he will be ok, It actually helped and saved me from having to go pick him up from school so much... Im sure there were times when he was in hospital I slipped up from feeling so bad for him but he did recover ok too.
            Kelly
            mom of Cameren 12 yrs. old
            Chiari,retroflex odontoid,syringomyelia,scoliosis
            Chiari decompressions 6/2005,5/2006
            Syringopleural shunt 6/2009
            Boston Braced off & on 6.5yrs
            scoliosis surgery- 9/15/10 T4-L4 Dr. Bridwell
            Fell & broke finger,surgery 3/2011

            Comment


            • #7
              Originally posted by mariaf View Post
              Yes, Sharon I agree there is definitely no right answer.

              And just to clarify, I was in NO WAY saying one way is wrong and one way is right. It's just that the mom who shared this felt strongly that the approach had been so helpful for them, that I wanted to share it with others in case it may help someone. They PM team also likened it to a child falling down, not getting upset initially....until mom ran over and looked upset. I guess this is what they found is the case 'generally' speaking.

              I definitely agree with hdugger as well regarding 'different strokes for different folks'
              Maria I definitely knew you weren't saying there is only one right way. This approach you posted likely helps plenty of folks.

              Without explicitly downplaying the mind-body connection, I think if the subject was studied, my guess after seeing just two kids recover and reading plenty of testimonials would suggest the following correlates:

              - length of fusion
              - amount of blood loss
              - individual reaction to the drugs
              - incidence of complications (avoidable like abdominal bloating and uavoidable like a misplaced screw)

              Somewhere down the list would be attitude which of course is important but there must be limits set by the above criteria.
              Sharon, mother of identical twin girls with scoliosis

              No island of sanity.

              Question: What do you call alternative medicine that works?
              Answer: Medicine


              "We are all African."

              Comment


              • #8
                Originally posted by hdugger View Post
                Maybe my son was just contradictory (), but he was more likely to push past his pain if I *was* sympathetic. Something like "Oh mom, it's no big deal."

                OTOH, if I ignored his pain, he played it up a bit more to be sure that I "got" that it hurt.

                I find that I react the same way. I just want to be sure that I'm heard. Once I'm heard, I can move on.

                Different folks, different strokes is the *only* thing I've ever been certain of in psychology

                How funny hdugger, somehow I thought you were a guy!

                Now need to change my mental image...

                Comment


                • #9
                  Originally posted by Pooka1 View Post
                  Maria I definitely knew you weren't saying there is only one right way. This approach you posted likely helps plenty of folks.

                  Without explicitly downplaying the mind-body connection, I think if the subject was studied, my guess after seeing just two kids recover and reading plenty of testimonials would suggest the following correlates:

                  - length of fusion
                  - amount of blood loss
                  - individual reaction to the drugs
                  - incidence of complications (avoidable like abdominal bloating and uavoidable like a misplaced screw)

                  Somewhere down the list would be attitude which of course is important but there must be limits set by the above criteria.
                  Well said, Sharon. I think attitude is just one of many factors that comes into play, certainly not the only factor. The other factors you listed make perfect sense and likely play a significant role in one's recovery. For example 'individual reaction to drugs' I'm sure plays a huge role, etc.
                  mariaf305@yahoo.com
                  Mom to David, age 17, braced June 2000 to March 2004
                  Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

                  https://www.facebook.com/groups/ScoliosisTethering/

                  http://pediatricspinefoundation.org/

                  Comment


                  • #10
                    Originally posted by Ballet Mom View Post
                    How funny hdugger, somehow I thought you were a guy!

                    Now need to change my mental image...
                    Yeah, I get that alot online. Out here, people seem a little clearer on my gender

                    If you need a mental image, I offer you this one - http://www.flickr.com/photos/4570184...n/photostream/ - of my dog. That way, if I say something stupid, you can think to yourself "well, it's actually pretty clever, for a talking dog."

                    Comment


                    • #11
                      Hi everyone:

                      My daughter is the one who is participating in this pain management study - when it is published I will be sure and share the info.

                      I just wanted to clarify that I certainly don't believe we shouldn't empathize with someone going through a recovery this intense, just that it could be helpful to find the right words with which to do so.

                      I think what was probably most helpful for my daughter out of all of this was the pain counseling before surgery. She met with a psychologist, a pain management physician and a pain management nurse. She learned a lot about what to expect and was able to prepare for it, mentally. She also knew exactly what the professionals were going to do to help her through the pain, and that she would not be going it alone. Finally, they taught her some excellent coping/pain management skills (guided imagery, etc.).

                      Those mechanisms also helped us (her parents) because when she would have a particularly bad episode of muscle spasm we could say "can you think about your best place" or "can you try some breathing" (while we waited for the valium to kick in, of course!)

                      I completely agree that many things come to play in how well people do after a major surgery, but I think this pain management aspect could be really helpful for adolescents, especially, because we all know how much psychology goes into childrearing in general, and certainly in the day to day dealings with teenagers!
                      Jill, mom to 14-year-old daughter who had spinal fusion surgery (T3 to L1) June 21, 2010. (Pre-op curves 52T and 30L.)

                      Comment


                      • #12
                        Originally posted by mariaf View Post
                        Well said, Sharon. I think attitude is just one of many factors that comes into play, certainly not the only factor. The other factors you listed make perfect sense and likely play a significant role in one's recovery. For example 'individual reaction to drugs' I'm sure plays a huge role, etc.
                        I have come to have a healthy respect for individual reaction to drugs as being one of the key differences affecting how my two daughters coped in recovery. You either are physically able to log roll yourself out of bed after a scant few days (Kid 2) or you still can't do it by yourself several days later (Kid 1).

                        And they are of course identical twins with identical surgeries in terms of both length of fusion and length under anesthaesia.

                        On the other hand, Fingers Crossed makes a good point about preparing kids for what is coming. Kid 2 had the huge benefit of hearing directly from Kid 1 what to expect. Kid 2 was cool as a cucumber going in and coming out. Because she was fully debriefed, I can't rule out attitude and confidence as helping her though my money is still on differential drug reactions.
                        Sharon, mother of identical twin girls with scoliosis

                        No island of sanity.

                        Question: What do you call alternative medicine that works?
                        Answer: Medicine


                        "We are all African."

                        Comment


                        • #13
                          Originally posted by hdugger View Post
                          Yeah, I get that alot online. Out here, people seem a little clearer on my gender

                          If you need a mental image, I offer you this one - http://www.flickr.com/photos/4570184...n/photostream/ - of my dog. That way, if I say something stupid, you can think to yourself "well, it's actually pretty clever, for a talking dog."
                          LOL! Cute poochie! That's quite a different image than the balding one I held previously in my mind.


                          Oh, and if anything works for anybody to help them personally with pain, that's a good thing.

                          Comment

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