Perhaps one of the most troublesome worries is the fear of unrelieved pain at the end of life. Many of us have heard stories of someone who died in pain. Unrelieved pain is a crisis in healthcare. The truth is, most pain can be relieved or greatly reduced. The knowledge necessary for proper pain management exists today, but most doctors and nurses have not been adequately trained in pain management techniques.

Does there need to be pain?
No! Pain serves a purpose in our bodies. It tells us when there is something wrong and we usually take steps to correct that problem. Often, for instance, in those persons with cancer, arthritis or other chronic problems, the unending pain is no longer needed. Unrelieved pain causes sleep disturbances, fatigue, depression, hopelessness, disruption in social activities and relationships with those we love.

Are there treatments available?
Yes! And finding the right pain treatment for each person can take a lot of work. Treatments may include:
· Taking pain pills on a regular schedule
· Taking other medicines, such as anti-depressants to specifically help treat the pain
· Having radiation or chemotherapy to shrink a tumor that may be causing pain
· Blocking the nerve that transmits the pain signals
· Taking pain medicine intravenously around the clock

Most people with pain at the end of life can achieve good pain management by taking pain pills around the clock, under the supervision of their doctor or hospice team.

What about addiction?
There is very little risk for addiction to the pain medicine when it is used correctly. The addiction that most people think of, that is taking a drug to "get high" and escape the reality of life simply does not occur in proper pain management. Instead of trying to escape from life, people with pain take the medicines to re-enter life. Good pain relief offers better rest and more energy to be with family.

The body does develop a physical dependence to certain pain medicines. "Opioids" like morphine or other strong pain medicines, may causes "withdrawal" symptoms if stopped suddenly. This is not a sign of addiction! This problem is easily avoided if the medicines are stopped over a period of time.

What do I tell my doctor or nurse?
Your doctor or nurse should become partners with you in your pain management. It is important that you be as specific as possible about the pain you are experiencing. Keep notes about your pain to help you remember.
· When is it worse?
· What makes it better?
· What is the strength of the pain (on a 0-10 scale)?
· What does it feel like (aching, stabbing, shooting, throbbing, etc.)?
· Where does it hurt?
· How does it affect your life?

Above all tell your doctor or nurse that you expect them to be committed to work with you to relieve the pain. There are pain management specialists and teams on the islands. Hospice doctors and nurses are specially trained in pain management and can be a resource for your doctor.

For more information, go to the American Pain Foundation website and click on the Pain Action Guide.
http://www.painfoundation.org/