Welcome to the current newsletter issue of
Advances in Medicine (AIM)- Take AIM against pain.
Feel free to send me an e-mail with your own thoughts
and experiences. Email: timsams@mypainreliefdoc.com.
* * *
Good morning,
Yesterday, I reviewed the results of the Personal Pain Paradigm
(PPP) Assessment with one of my office patients, Ariel.* This is
the pain assessment that I developed and is available on the
MyPainReliefDoc.com website. Ariel is a high functioning, fully
employed, single mom with severe RSD in both legs. I would expect
her to achieve generally healthy scores on most of the scales on
the PPP. In fact, she did achieve healthy scores on 20 of 31
Specific Scales but unhealthy scores on 5 of the 6 General
Scales. She was particularly surprised that she did not score
highly on the Hopefulness scale. Quite frankly, I was surprised,
too. When we reviewed this scale, item-by-item, the reason became
apparent.
Hope and acceptance sometimes conflict with each other. They
don't have to, but they are very uncomfortable dance partners,
both of whom want to lead. I define acceptance not as knowing
that "You'll just have to learn to live with it," but as
realizing that the physicians probably can't make all your pain
and limitations go away. Acceptance means you stop putting your
life on hold and get on with the business of functioning at your
new highest capacity. You make changes and organize your life to
accommodate your pain. Acceptance is the original necessary
condition for effective pain coping and reduction. You will
probably decrease your pain the most when your focus is on
strategies for functioning at your highest level, rather than
chasing temporary decreases in pain at all costs.
Ariel has completely accepted her pain and is generally
functioning well, though she doesn't socialize much outside of
work, and she engages in very little pleasurable activity. The
Hopefulness scale includes two interdependent qualities. First,
the belief that you will cope well with your pain in the future;
second, that you can or will have less pain in the future than
you do now. Ariel believes strongly that she will be able to cope
with her pain in the future as well as she is now. However, she
is not at all hopeful or confident that she will or can have less
pain in the future. She would and did characterize this lack of
hope as acceptance born of years of pain, and proceeding all the
way through the 11 step hierarchy of treatment for pain, i.e.,
she is a realist.
However, part of the essence of hope is that some aspect of life
can be better than it is right now. You can be wiser, stronger,
healthier, happier, have less pain, etc. As well as Ariel is
coping, there are still things she could do to suffer less; to
have less pain and enjoy life more. The PPP doesn't compare her
pain or your pain and suffering with an "average" person, but
with the best possible coping. The purpose of the PPP is not to
give you a grade, or to make you feel better about yourself. Its
purpose is to offer you the opportunity to achieve and maintain
less pain and better quality of life, however well you are coping
overall. It accomplishes this by comparing your post-pain
function with your pre-pain function and the best possible
function, not by comparing you to other people.
Next week, Ariel and I will begin reviewing her unhealthy
responses item-by-item and refine her Personal Pain Paradigm. She
can integrate more healthy coping behaviors into her life. As she
does that, and increases her quality of life, I will expect her
to feel more hopeful that she can give herself less pain and
better quality of life in the future. More than the jelly of the
month club, that is truly the gift that keeps on giving.
As always, your feedback is welcome as are suggestions for future
newsletter topics.
Good light,
Dr. Tim
My Pain Relief Doc
http://www.mypainreliefdoc.com
Copyright 2006. Dr. Tim Sams and My Pain Relief Doc.
All rights reserved. http://www.mypainreliefdoc.com
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You may freely distribute a copy of this newsletter or
use it on your web site or RSS feed, as long as you
include the entire article, along with the web links
and copyright information. Thanks, Dr. Tim
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*Not her real name