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pahavit
Date: 7-16-2009 12:12 AM
Subject: Pain Management Class #9
Security: Public
Tags:disability/medical, me/cfs, pain management class, stanford pain management center
Pain Management Class #9

In today's pain management class, after a review of all the previous topics we've covered over the course of the classes, we looked at how to handle a pain flare.

Pain flares are inevitable. Even if we diligently practice the deep breathing relaxation response, pace ourselves perfectly, observe excellent sleep habits, stop ourselves from getting caught up in cognitive distortions about our circumstances, set and maintain healthy boundaries and clearly communicate our needs and wishes, we are still going to have pain flares from time to time. There is no way to avoid them. So we need to formulate a strategy ahead of time for how to handle them, before we are in the middle of one and getting overwhelmed.

The goals for a pain flare coping plan are to decrease the intensity of the flare, to decrease the duration of the flare, and to increase the time between flares. This is best achieved by using a combination of the deep breathing relaxation exercises, cognitive restructuring and physical conditioning. Often the basic plan will need to be modified in some fashion, to account for different kinds of flares or different circumstances surrounding any particular flare.

The plan needs to be in writing, to help us remember the details of it in the heat of the moment when we are distracted by the pain and the accompanying emotions. And it needs to be specific, the way a building's fire exit plan is specific. You never see a building's fire exit plan signs say just "In Case Of Fire, Get Out." Instead, they have a map of the premises and specific instructions of how to get out. And our pain flare coping plan needs to be just as specific to be useful.

Our plan needs to include being aware of our thought process, including any negative thoughts -- they need to be addressed head-on in order to employ any necessary cognitive restructuring to get through the flare. It needs to include deep breathing, to help the relaxation response kick in and start reducing the pain. It needs to include a pacing strategy to figure out how to accommodate for the flare. It needs to include any physical therapy exercises or stretches that might help mitigate the pain.

There should be multiple hard copies of our plan, to be sure of having a copy at hand wherever we may be when a flare might strike -- at work, in purse or wallet, on the fridge, in the nightstand, etc. Significant others and family members should have copies as well.

This was the final session of the pain management program. I learned a lot from it. Probably the most useful thing for me will turn out to be the deep breathing exercises, because almost everything else we covered in the classes built upon that foundation. And the deep breathing is simple and easy to do, but it can achieve some pretty impressive results all on its own, without any drugs or special equipment or anything else. So even if I might forget the formula for how to make an "I statement" or all 10 sleep hygiene recommendations, I won't forget how to breathe in, count for 5, hold for 1, breathe out for 5, hold for 1, etc., etc. *takes long, deep breath* *feels more relaxed already*

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