I have noticed that I’ve devoted an extraordinary amount of my life to the process of adaptation. When I take the time to think about it, I guess we have all done so. As we age and develop, our lives demand it of us. Adapt: “to make suitable especially by changing,” “to change so as to see fit,” “to adjust oneself to new circumstances.” Yes, life requires it of us. Health care staff who treat patients daily find themselves confronted with the need to refine their abilities to counsel and guide their clients through the situations they face. One confrontation we so often meet is the pain the patients must endure throughout their maladies. We have yet to develop a reliable method of measuring the intensity of pain they experience. In 2009, the Joint Commission for Accreditation of Healthcare Organization (JCAHO) began requiring that all professionals working with patients must assess these patients throughout the patient’s hospital stay. Staff use different measuring tools, but the more commonly used is to ask the patient: “On a scale of 1 to 10, where is your pain right now?” Another tool which has shown to be even more reliable is the visual analog scale where the patient is shown a picture of a straight line on a continuation from 1 to 10; another is a continuation from a happy to a sad face, often used with children. Often we find the patient’s responses are exaggerated; they may say “It’s 9/10!” yet they show no other pain behavior. Pain is such a subjective thing resulting from the unique feelings of the person. Patients often expect that the therapist will try to minimize their pain and try to force them into unrealistic activities beyond their ability to tolerate. For years, a common cliché could be heard throughout therapy clinics, “No pain, no gain!” Well, we no longer follow this outmoded belief. Our goals must be to eliminate and avoid, or at least reduce their pain rather than extending it. Physical therapists and occupational therapists have a vast tool kit of pain management and reducing techniques. Body-based include: exercise, range of motion, muscle conditioning, hydrotherapy, massage, mobilization and manipulation; physical agent modalities include use of TENS units, electrical stimulation, ultrasound, superficial heat and cold; and cognitive-behavioral modification includes imagery, visualization, distraction, and progressive muscle relaxation. Some therapists have expanded their modalities by adding Tai Chi, Yoga, Acupuncture and biofeedback as well as others. We need to learn how to talk to patients about their pain. I have heard far too many times the relative say to the wife who has just lost her husband, “I know how you must be feeling!” No, you do not know; you can’t possibly know!
Acute pain is often relieved rather quickly, but chronic pain demands of us adaptation, adjustment and new learning.
Christine Harness has worked in the field of Occupational Therapy throughout her adult life, both in and outside of the Kern River Valley. She has helped countless individuals to maintain or regain their independence. Christine believes that enjoying and taking satisfaction in one’s day-to-day activities is the key to a meaningful life.