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Pain Management

Menlo Park Surgical Hospital (MPSH) is committed to an interdisciplinary approach to pain management. MPSH health care providers plan, support and coordinate activities and resources to assure that pain in any patient is recognized, believed and addressed appropriately.

What is Pain?
Patients Rights and Responsibilities
Treatment Goals
Pain Control: What are the Options?
Pain Control Methods: After Surgery
What To Do After Surgery
Slow Rhythmic Breathing for Relaxation
Describing Your Pain

What is Pain?

Pain is an uncomfortable feeling that tells you something may be wrong in your body. It is your body's way of sending a warning to your brain. Your spinal cord and nerves provide the pathway for messages to travel to and from your brain and the other parts of your body. Receptor nerve cells in and beneath your skin sense heat, cold, light, touch, pressure and pain. You have thousands of these receptor cells. Most sense pain, while fewest sense cold. When there is an injury to your body – in this case surgery – these tiny cells send messages into your spinal cord and up to your brain. Pain medicine blocks these messages or reduces their effect on your brain.

Sometimes pain may just be a nuisance, like a mild headache. At other times pain can be a sign of a problem or complication. After your operation, your nurses and doctors will ask you about your pain because they want you to be comfortable, but also because they want to know if something is wrong. Be sure to tell your doctors and nurses when you have pain.

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Patients Rights and Responsibilities

As a patient of MPSH, you can expect:

To receive information about pain and pain relief measures
Treatment by concerned staff committed to pain prevention
A quick response to your reports of pain
Your reports of pain will be believed
State-of-the-art pain management
To receive appropriate assessment and management of pain

As a patient in this hospital, you are responsible for the actions listed below.

Ask your health care providers what to expect regarding pain and its management.
Discuss pain relief options with health care providers.
Work with your health care providers to develop pain management plans.
Report pain when it first begins.
Help your health care providers measure your pain at all stages of your care.
Tell your health care providers if pain is not relieved.

Treatment Goals

People used to think that severe pain after surgery was something they had to accept. But with current treatments, that's no longer true. Today, you can work with your nurses and doctors before and after surgery to prevent or relieve pain.

Pain control can help you:

Enjoy greater comfort while you heal
Get well faster
- With less pain, you can start walking, do your breathing exercises and get your strength back more quickly. You may even leave the hospital sooner.

Improve your results
People whose pain is well-controlled seem to do better after surgery. They may avoid some problems (such as pneumonia and blood clots) that affect others.

Pain Control: What are the Options?

Both drug and non-drug treatments can be successful in helping to prevent and control pain. The most common methods of pain control are described below. You and your health care providers will decide which ones are right for you. Many people combine two or more methods for greater relief.
Most patients don't need to worry about becoming addicted to pain medications. Studies show that this is very rare – unless you already have a problem with drug abuse.

Pain Control Methods: After Surgery

Drug treatment:

Pain medicine can be given as a pill, shot or suppository, or through a tube in your vein or back.
Medications may consist of narcotics, such as morphine or Vicodin®, or non-narcotics, such as Toradol® or Motrin®.
Medications may be regularly scheduled, or given as needed.
Patient controlled analgesia (PCA) may be available to you. With PCA, you control when you receive the pain medication. When you feel pain, you activate the machine to inject the pain medication through an IV tube.
Your anesthesiologist may offer you an epidural or a regional anesthetic to give you continuous pain relief.

Non-drug treatment:

Massage, positioning, hot or cold packs, relaxation, music or other pastimes can be used to distract you, as well as positive thinking and nerve stimulation (TENS™).

What To Do After Surgery

Take (or ask for) pain relief drugs when pain first begins.

Take action as soon as the pain starts.
Your pain will worsen when you start walking or doing breathing exercises, therefore take pain medicine first. It is harder to ease pain once it has taken hold. This is a key step in effective pain control.

Help the doctors and nurses measure your pain.

They may ask you to rate your pain on a scale of one to 10. Or you may choose a word from a list that best describes the pain.
You may also set a pain control goal (such as having no pain that is worse than two on the scale).
Reporting your pain as a number helps the doctors and nurses know how well your treatment is working and whether to make any changes.

Tell the doctor or nurse about any pain that does not go away.

Extensive pain can be a symptom of a problem or complication with your operation.
Your health care providers want and need to know about your pain.

Stick with your pain control plan if it is working. Your doctors and nurses can change the plan if your pain is not under control. You need to tell the nurses and doctors about your pain and how the pain control plan is working.

The general rule of pain management is to treat pain when it is still at a mild level (0-3), before it becomes worse.
More medication may be needed to bring pain down from a severe level (7-10), than is needed to keep pain at a mild level.
Consider using several different available pain relief methods in combination.

For example:

cold pack + elevation + morphine

pillows + Motrin® + heating pad

Vicodin® + Motrin® + elevation + ice pack

Slow Rhythmic Breathing for Relaxation

Breathe in slowly and deeply.
As you breathe out slowly, feel yourself beginning to relax; feel the tension leaving your body.
Now breathe in and out slowly and regularly, at whatever rate is comfortable for you. You may wish to try abdominal breathing. If you do not know how to do abdominal breathing, ask your nurse for help.
To help you focus on your breathing and breathe slowly and rhythmically:

Breathe in as you say silently to yourself, "in, two, three." Breathe out as you say silently to yourself, "out, two, three."

Or

Each time you breathe out, say silently to yourself a word such as peace or relax.
You may imagine that you are doing this in a place that is very calming and relaxing for you, such as lying in the sun at the beach.
Do steps 1 through 4 only once or repeat steps 3 and 4 for up to 20 minutes.
End with a slow deep breath. As you breathe out say to yourself, "I feel alert and relaxed."

NOTE: If you intend to do this for more than a few seconds, try to get in a comfortable position in a quiet place. You may close your eyes or focus on an object. This breathing exercise may be used for only a few seconds or for up to 20 minutes.

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Describing Your Pain

Besides a 0 – 10 rating, your nurse may ask you to describe the pain. Words commonly used to describe pain include:

Sharp
Dull
Annoying
Aching
Cramping
Throbbing
Shooting
Stinging
Burning
Stabbing
Hot
Tender
Squeezing