Patient Interview 2: Bernie

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Preventing Chronic Pain: A Human Systems Approach

89 classificações

University of Minnesota

Preventing Chronic Pain: A Human Systems Approach

89 classificações

Chronic pain is at epidemic levels and has become the highest-cost condition in health care. This course uses evidence-based science with creative and experiential learning to better understand chronic pain conditions and how they can be prevented through self-management in our cognitive, behavioral, physical, emotional, spiritual, social, and environmental realms. The goal of this course is to blend creative, experiential, and evidence-based teaching strategies to help participants understand chronic pain conditions and how a human systems approach can be applied to self-management strategies to reduce risk factors, enhance protective factors, and prevent chronic pain. There are four major objectives to the course; 1. Describe the prevalence, personal impact, and health care dilemma associated with chronic pain. 2. Recognize the clinical characteristics and underlying etiology of several common pain conditions and the peripheral, central, and genetic mechanisms of chronic pain 3. Based on the literature associated with risk and protective factors in the seven realms of our lives, learn specific strategies in each realm that can be employed daily to prevent chronic pain and enhance wellness. 4. Appreciate the value of a human systems approach to health care and how it can provide a basis for integrative, interdisciplinary, and individualized care to preventing pain and enhancing wellness. CONTINUING EDUCATION CREDIT OPTION Accreditation Statement: University of Minnesota, Interprofessional Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. American Medical Association (AMA) The University of Minnesota, Interprofessional Continuing Education designates this enduring material for a maximum of 24.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. American Nurses Credentialing Center (ANCC) This activity is awarded up to 24.0 ANCC contact hours. Other Health Care Professionals Other health care professionals who participate in this CE activity may submit this certificate statement of participation to their appropriate accrediting organizations or state boards for consideration of credit. The participant is responsible for determining whether this activity meets the requirements for acceptable continuing education. Registration and disclosure information is available here at http://z.umn.edu/chronicpain and pay the additional fee. Then, email your Coursera certificate statement of completion to cme@umn.edu.

Na lição

The Problem of Chronic Pain (Week 2)

1 Assessment of Pain using a Transformative Care Model 14:20

2 Characteristics of a Pain Evaluation 16:36

3 Patient Interviews 1:12

4 Assess Your Seven Realms5:25

Last Scroll: The Nightmare from The Last Scroll6:35

Patient Interview 1: Angie7:06

Patient Interview 2: Bernie7:18

Patient Interview 3: Lorrie5:21

Patient Interview 4 : Chantelle11:17

Patient Interview 5: Lydia8:41

Conheça os instrutores

Dr. James Fricton, DDS, MS
Professor and Pain Specialist
University of Minnesota, HealthPartners Institute, and Minnesota Head and Neck Pain Clinic

Today we have Bernie with us and she is a patient

that we've worked together for the last two years or so.

And she's also a tennis champion and so has some unique pain conditions.

So Bernie, tell us about your pain.

>> well, I've had several of course being an athlete.

I've competed for 40 years so I've had the

aches and pains that go along with being an athlete.

knees, ankles, elbows, shoulders, which over the years tend to still hurt.

And then more recently in the past couple years I suffered an injury

to my jaw, which has turned into kind of a chronic pain, condition.

I had reconstructive surgery, and still continue to

have pain in my shoulders, neck, and jaw area.

>> So the pain occurs on a regular basis.

Tell us how often it occurs and how intense it is.

>> It's every day, all day.

Sometimes the degree of pain varies of course, depending upon what I do.

But, for the most part, while I'm awake at any time I do have pain.

>> So, what kind of impact does it have on your life?

What does it interfere with?

>> Well, it, it tends to interfere with just about anything you do if you let it.

I find that the more I can keep myself

busy, and I teach tennis and I'm also a nanny.

So I try to keep myself occupied throughout the

day, because I find if I sit still or

find a time where I might be on a

long car ride or something the pain becomes more evident.

Because the more I just sit there and do nothing the

more I start to feel how bad the pain is bothering me.

So I find that if I can distract my mind and my

body by being busy I can help control the pain through that.

>> So does it interfere with your lifestyle

also such as your sleep or work activities?

>> It does affect sleep.

I do sense the injury to the jaw, I have had a tough time sleeping.

And I find instead of laying down to sleep for long stretches of time I grab shorter

periods of time for sleep when I've got the pain under control a little better.

I find that sometimes laying down causes more pain in the shoulder and neck,

so I try to find ways to sleep where I'm not necessarily laying down.

>> Mm-hm.

>> And that of course, I didn't grow

up sleeping that way, so that's been an adjustment.

I also find out that there are days when the pain is worse.

Where if I've had a tennis match or lesson,

something scheduled it might interfere with whether or not

I go through with it, or how will I

perform the daily task, depending upon the degree of pain.

>> So there's a lot of things that you do to keep the pain under control.

How do you self manage it?

>> Well I tend to use heat and ice, as I found out

on a particular day [COUGH] whether or not, which one is going to work.

>> Mm-hm.

>> I do stretching back, shoulders jaw.

I stretch daily, multiple times a day.

Just, just about anything you can think of to use.

Heating pads, ice packs, whatever it may be on

a particular day to try to manage the pain.

But, I find probably that stretching is the most useful.

>> Mm-hm.

Being an athlete, I'm sure you've

experienced pain during your tennis matches.

How do you know that the pain is just from overexertion or is it from an injury?

>> That's a, that's a tough question in that I think

some of that has to do with a individual's pain tolerance.

You know, as you go in and out of varying degrees

of competition, and, and working out, you're going to use muscles differently.

You're going to maybe play a long match

that's going to put more stress on the muscles.

And then you have to decide, you know, is what you're feeling pain just from

overexertion like you said or did you

injure yourself during the competition or the practice?

I think the pain that I think of as an injury may

be more related to, did I do something where I actually felt something give.

Sprain an ankle, feel a muscle tear, dislocate something.

I think at that point I would refer to that as an injury, I have had times

where maybe I have strained or pulled a muscle or partially tore a muscle.

Where because I was competing at the time, I didn't realize it was an

injury and maybe competed through it, and paid for it on the other end.

Having competed through some of that, I think even now

as I get older, I have aches and pains that are

probably related to those injuries that I probably didn't pay

attention to when I was growing up competing as a junior.

>> And do you have any recommendations for other athletes, in

particular younger athletes, in order to prevent chronic pain into the future?

>> I, I think you really have to pay attention to what you're doing.

I think if you do twist an ankle, if you pull a muscle, if you actually,

you know, see bruising in a muscle or an area that there usually isn't bruising.

You really need to be concerned, be a little cautious.

But I also think you know your body.

People heal differently.

And, I, I just think that being very aware, and I

think being a little bit selfish at times because I've had coaches

willing to ask you to push through and perform, when maybe

the smart thing to do would be to hold back a little.

And so I think, you know, if you are a competitive athlete all the

way, probably high school as it's become

more competitive through college sports and even now.

And on the national level to be willing to say, is this the right thing to do?

Should I continue on or what ramifications down

the road will I pay for pushing through this.

>> Yeah, very good.

Is there anything else you want to share with us about the pain?

>> I think that pain a lot of it can be controlled through a positive mind set.

>> Mm-hm.

>> Realizing you know, that it can become what it, what you let it become.

If it is a part of your day.

You know, try to focus on things that are a little more positive and realize

that it doesn't have to be something that is your entire focus all day, every day.

>> Okay, well thank you that's good.

Mm-hm.

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