PAIN MANAGEMENT AT UM/SYLVESTER

PAIN MANAGEMENT AT UM/SYLVESTER

W HAT IS THE PURPOSE OF THIS BROCHURE? We created this brochure for patients receiving care from the University of Miami Sylvester Comprehensive Cancer Center and their families and friends. This brochure provides information about pain management at UM/Sylvester to address and treat chronic pain. 1

WHAT IS PAIN? Pain from a minor cut or bruise is often short-lived and easy to ignore. But severe pain or pain that lasts months and longer is a serious concern. Most pain is a result of nerve or tissue damage. Nerves carry pain signals up the spinal cord to the brain, and we feel different degrees of discomfort. Those who have unresolved pain find that the pain greatly affects their quality of life. Whether it is acute or chronic, pain is no small matter. In fact, pain is the nation s number one public health concern according to the American Academy of Pain Management. Pain affects more Americans than diabetes, heart disease, and cancer combined. And, if left untreated, pain can linger and even worsen. More than 40 percent of those who report pain have suffered with it for longer than a year, according to the American Pain Foundation. HOW CAN PAIN AFFECT YOUR LIFE? You cannot ignore chronic pain. Yet many people do not realize there is help for their pain. Chronic pain, which lasts months or longer, can be dull, sharp or cause other discomfort. There are many sources of chronic pain, including injuries, arthritis, back and neck problems, shingles, diabetes, ulcers, cancer, and other conditions. The pain can occur anywhere on the body and at any age. Pain s effects can range from a nagging discomfort to a debilitating and life-altering experience. Severe pain significantly stresses the body and mind. Long-lasting pain can lead to decreased muscle strength and endurance; it can interrupt sleeping and eating patterns. It can keep you from working and engaging in simple daily life activities, and it can change your mood (leading to depression). Pain can keep you from being able to concentrate, and even rob you of the joys of personal relationships. 2

When pain accompanies disease, such as diabetes or cancer, it can greatly affect quality of life and disease outcome. It is estimated that 70 percent of cancer patients have significant pain during their illnesses, but fewer than half receive adequate treatment for their pain, according to the American Pain Society. WHAT CAN YOU DO TO MANAGE YOUR PAIN? The first step in managing your pain is to acknowledge it. You may find it helpful to keep a pain journal to identify patterns. To help improve your general health which may lessen the pain, you should stay active, eat the right foods, and learn to reduce stress. It is important for you to speak with your health care providers about your pain. If you re not getting adequate pain relief, seek the help of trained pain management specialists who work with your current oncology team to alleviate your pain. IS PAIN ASSOCIATED WITH CANCER? Having cancer does not always mean having pain. But when the cancer itself, treatments or unknown causes result in pain, there are many proven and safe treatment options to relieve pain and restore quality of life. Since pain is your body s way of telling you something, communicate with your health care provider when you experience pain or any changes to existing pain. It is also essential that you let your physician know whether pain treatments are working, in case adjustments in dosages or medication are needed. Controlling pain is a goal of comprehensive treatment. 3

WHAT ARE COMMON MYTHS ABOUT PAIN? Many people are reluctant to seek care for their pain because they believe any of a number of myths which are not true. These myths should not prevent you from seeking pain relief. Myth: If I ignore the pain, it will eventually go away. Truth: Some pain does not go away and can, in fact, intensify. Remember, the sooner pain is treated, the better the chances of pain relief. Myth: Pain medication is addictive or a sign of weakness. Truth: Taken correctly and under the supervision of a medical pain management specialist, pain medications are safe and will not result in addiction. Some medications have side effects, such as drowsiness or constipation, but even these can be addressed. Toughing out severe pain because you believe that taking pain medications is a sign of weakness is not only unnecessary but can be unhealthy. Myth: Pain medication must be taken for the rest of one s life. Truth: Pain medication plays an important role in relieving pain, but it is only a part of a comprehensive pain management program. Patients generally discontinue medications as their pain subsides. Myth: Pain medication alone is all that s needed to relieve pain. Truth: Medication is only part of a successful pain relief program. Other elements of optimal pain management and relief are procedures, therapy, and lifestyle improvements such as stress management. Myth: Some pain, such as cancer pain, cannot be relieved. Truth: Cancer and other pain can almost always be relieved safely with today s treatment options. 4

Myth: Pain is an unavoidable result of aging or the disease process. Truth: Regardless of your age or health status, you should not accept pain as normal and untreatable. WHAT PAIN MANAGEMENT SERVICES ARE OFFERED AT UM/SYLVESTER? You do not have to live with your pain. Today s most effective pain treatments delivered by pain specialists is available right here in your community. UM/Sylvester is dedicated to treating patients suffering from all types of pain including: Cancer pain Motor vehicle accident and pain from other types of injuries Head and facial (dental) pain Neck and shoulder pain Joint (including arthritic) pain Low back pain Pelvic pain Postsurgical pain Post back surgery pain syndrome Reflex sympathetic dystrophy Myofascial pain and other pain syndromes The multidisciplinary program addresses all aspects of pain management, from diagnosis and assessment to treatment with noninvasive and invasive traditional therapies, as well as complementary therapies such as stress management and acupuncture. Our pain management team, led by the board-certified professor of Anesthesiology and chief of Pain Management, Salahadin Abdi, M.D., Ph.D., includes physician members expertly trained and highly experienced in pain management medicine. Pain management is a team effort, involving the expertise of different health care disciplines. UM/Sylvester is home to physicians who are board-certified in pain management. We work closely with physical therapists, occupational therapists, and other health care professionals who specialize in pain management. 5

HOW IS PAIN TREATED? Depending on one s pain level, pain management professionals use a variety of treatment options to resolve it. Among the major categories of pain treatment today: medications (given in many different forms, including pills, patches, suppositories and injections); minimally invasive pain treatment procedures; acupuncture, relaxation and meditation; biofeedback; and cognitive or behavioral therapy. The first step in successful pain management is correctly diagnosing one s pain. The staff conducts an extensive assessment, performs a thorough physical examination, and asks the patient important questions. Communication between the patient and pain management team is vital for properly diagnosing the source and level of pain, and how the pain is affecting his/her life. Pain management team members can then target pain therapy to aggressively and safely provide short- and long-term pain relief. Pain management often calls for use of multiple approaches. Medication therapy with drugs aimed at reducing inflammation, relaxing muscles or dulling pain, is one level of treatment. Medications for pain can range from over-the-counter drugs to control mild pain, to mild and strong opioids in combination with antidepressants and anticonvulsants to relieve moderate and severe pain. Taking medications under the supervision of our pain management team ensures that patients will achieve optimum pain relief, without side effects, the threat of addiction, and potentially dangerous drug-to-drug interactions. Various types of therapy, including physical and occupational therapies, can help patients gain movement, flexibility, and strength to ward off pain in the long-term and get back to being able to perform not only work and activities of daily life, but also enjoying sports and hobbies. 6

There are other state-of-the-art pain management treatment options available at UM/Sylvester which include minimally invasive interventional procedures, such as epidural steroid injections and diagnostic nerve blocks as well as diagnostic discography and minimally invasive intradiscal procedures (e.g. nucleoplasty and intradiscal electrothermal therapy). UM/Sylvester also offers radiofrequency treatments, which are outpatient procedures to help alleviate back pain. Some patients also benefit from devices that help to thwart pain signals or deliver needed pain medication to a targeted area of the body. Examples include spinal cord stimulation, where physicians implant devices that emit low level electrical signals to block the brain from perceiving pain, and intrathecal pumps, which deliver constant and variable amounts of medication to control chronic pain. In addition to other minimally invasive pain treatments, UM/Sylvester offers radiological and surgical procedures aimed at blocking pain signals or removing the sources of pain, such as tumors. WHAT ARE MY RIGHTS AND RESPONSIBILITIES AS A PATIENT SEEKING PAIN RELIEF? People who are in pain have the right to: Have their pain taken seriously by doctors, nurses, pharmacists and other providers Have their pain assessed and treated by providers with experience in treating and managing pain Be informed about the causes of their pain and the benefits and drawbacks of pain treatment Have their questions answered and approve or disapprove treatments recommended by their providers People in pain are responsible for: Acknowledging that their pain needs attention Communicating clearly with their medical providers about their pain, how it makes them feel, how it affects their lives, and their fears about the pain and potential treatments 7

Being a member of the pain management team who is willing to discuss treatment options Accepting a pain management plan that they will comply with taking necessary medications and therapies when they are prescribed Giving the pain management team honest feedback about how different therapies may or may not be working Reporting side effects and problems with treatments or therapy For more information about the services described in this brochure or for an appointment with a member of our pain management team, call 305-243-8500 or 1-888-4UM-NOPAIN. To learn more about UM/Sylvester, call the information line at 1-800-545-2292 or 305-243-1000, or visit www.sylvester.org. UM/Sylvester Comprehensive Cancer Center 1475 N.W. 12th Avenue Miami, Florida 33136 305-243-1000 1-800-545-2292 UM/Sylvester at Deerfield Beach 1192 East Newport Center Drive Suite 100 Deerfield Beach, Florida 33442 1-800-545-2292 www.sylvester.org 8