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Don’t Wait in My Waiting Room, Come into My Office, Too!

January 11th, 2007 · No Comments

Pain conditions affect not only patients, but family, friends, co-workers, etc. I’ve co-written a handout to provide information for family members and to help them with what they’re going through. You’re invited to copy these posts and discuss them with your loved ones.  Please see all the links below for topics.

Family Issues #1

What is chronic pain?

Chronic pain is pain which persists beyond the time usually required for the healing of an injury or illness. Some definitions set a specific time period, for example, pain which lasts longer than three months or longer than six months.

How is it different from acute pain?

Acute pain is what most of us are familiar with. It’s what happens when you twist your ankle or burn your fingers on the stove. It’s a signal that tissue damage is happening. While it may be severe, it’s time limited and responds to appropriate treatment.

Chronic pain is different. It may occur without ongoing tissue damage. It’s what happens many times when nerves get injured (known as neuropathic pain). Examples include shingles (postherpetic neuralgia), diabetic neuropathy, and Complex Regional Pain Syndrome (CRPS, also known as Reflex Sympathetic Dystrophy, RSD).

It’s difficult (or impossible) to imagine that someone can be in severe pain continually if one hasn’t experienced it. It’s normal for family members not to understand it if you haven’t lived through it. It may also be hard to stand by and accept that your loved one’s pain can’t be fixed or cured (although it may be eased and the suffering associated with it may be reduced). It may also be hard to accept that you can’t make it better.

How am I affected by their pain?

If you’re in a close relationship (spouse, significant other, parent, child, sibling or even close friend) with someone with chronic pain, you’re likely to develop a variety of negative feelings as a result. For example, you may feel guilty at times for not being able to help them more. You may feel angry at them if they’re irritable or withdrawn. You may resent having to take over tasks they previously performed. You may feel depressed as a result of a withdrawal of affection or a decline in your sex life. You may get anxious about financial problems which result from your loved one’s disability. You may feel stressed by the reactions of others. For example, relatives or neighbors may say “He (she) doesn’t look that disabled to me” or “Should she (he) be taking that addictive pain medication?” In fact, both you and the family member in pain are victims of the pain problem, as are those others who are part of the family (and this applies to close friends too).

You may experience significant lifestyle changes. You may have to live on a reduced income or have to work harder to stay afloat financially. You may have to spend time getting your family member to medical and to other appointments if he or she can’t drive. You may end up doing most or all household chores and childrearing activities. You may have less time for friends and experience reduced social support.

You may experience intrusions into your life from outside agencies. For example, some insurance companies (primarily workers compensation) may follow or film your family member. You may be stressed also by lawsuits, disability evaluations, or independent medical examinations (IMEs).

You may also experience some positive outcomes, although this is less common. For example, if your spouse was controlling, you may actually have more freedom. If you have very strong needs to help others, you may feel good about needing to help your loved one so much. If you were experiencing intimacy with your loved one (including sex) as unwanted, a decrease in intimacy may feel positive. You may get additional support or sympathy from other family members. These positive outcomes can lead one (not always intentionally) to try to keep the situation as it is. These have been referred to as “tertiary gains.” Being aware of these can help you identify more effective ways of dealing with problems in your relationship.

If you’re the spouse of a patient with pain and you have children, you may worry about the effect of the pain on them. Children may blame themselves for their parent’s pain. It’s important to let the children know it’s not their fault. They may also get depressed about the loss of attention and affection from the parent in pain or from the loss of activities due to financial limitations.

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Family Issues #2:  Is the pain just “in her head”? Is he just faking this?

Family Issues #3:  Family members need to take care of themselves too

Family Issues #4:  Tips for talking to a person in pain

Family Issues #5:  Medications for Pain

Family Issues #6:  What helps besides medication?

Family Issues #7:  How to tell how my loved one is doing

Family Issues #8:  10 things those of us in pain would like you to know

How to help your family cope

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