When pain just won’t go away
When clients tell Betty Downey they have pain, she accepts them at their word.
“If a patient says it hurts, it hurts. We don’t live in their body.”
Chronic pain is an area that has intrigued this registered nurse for many years, partly because she lives with someone who suffers from it and partly because she has encountered so many people with chronic pain since she first became a nurse in 1973.
When she took her Bachelor of Science in Nursing in 1985, she developed a pain management course for patients. In 2005, she challenged the American Nursing Credential Centre’s exam on pain management and became a board-certified Pain Nurse.
Her extensive knowledge on pain management has resulted in a growing number of referrals from all over the mountainous British Columbia region of East Kootenay and sometimes beyond. Tucked away in the small community of Sparwood, she needed to find the most effective way to reach the highest number of patients seeking assistance in managing their pain.
“We knew there were people out there who needed help,” she explains.
Telehealth was the obvious answer and now she meets with distance patients every second Friday. They go to their local health centre and she sees them via a television monitor from the Sparwood Wellness Centre. During the rest of the week, she sees pain clients in her office and also works as a Diabetes Nurse Educator.
“I do a lot of listening. If a person says they have pain, I accept they have pain. Chronic pain is, and of itself, a disease. It is the reason for the most frequent trip to the doctor’s office,” she says.
She counsels on best approaches, including appropriate medication. For example, neuropathic pain doesn’t improve well with narcotics and quality of life isn’t going to improve with the wrong medication.
Betty also uses biofeedback as a modality of treatment. Biofeedback is a therapy that trains the patient to be aware of their body and how it functions. The patient then learns to change those patterns to reduce their symptoms. The patient can learn to control body function that most people don’t usually think of as within their control. Among these are muscle tension, sweat response, skin surface temperature and pulse rate.
“If you are relaxed, you hurt less,” explains Betty in her low soothing voice, which likely contributes to her success in pain management.
The solutions for improving chronic pain are wide and varied. The patient may need to see their GP for medication; an anesthetist for procedures that involve nerve blocking, thus blocking the pain; a physiotherapist for directed exercises; or attending a mental health program such as ‘Changeways’. Any one or all may assist the person dealing with chronic pain.
“The emotional stress of pain will increase symptoms, which is why mental therapy can be important. Pain circles used to think depression causes pain. We now know they exist together but should be treated separately through different treatments and specialists.”
Betty works closely with physicians who refer patients to her. She sends the family physician her suggestions for treatment after she sees the patient and she also follows up with patients or their caregivers by telephone at least once and often two to three times.
After working in pain management, Betty knows the complexities associated with chronic pain. It can occur in many areas of the body. It can have many different causes or it can seemingly have no cause at all.
Migraines, neuropathies, low-back, rheumatoid arthritis, fibromyalgia and traumatic events are only a few causes of chronic pain. Untreated each one can seriously detract from a person’s quality of life.
“The sooner we can intervene with someone who has chronic pain, the sooner they can seek the appropriate treatment so they do not enter into the unsuccessful revolving door of repeated visits to their family physicians or the nearest hospital emergency department.”
Visit www.canadianpaincoalition.ca/index.php/en/help-centre/conquering-pain for more information on chronic pain and treatment strategies.