Pain Management in Healthcare
Pain management is a difficult topic in the healthcare profession since only the customer understands the complexities of the situation. Furthermore, people frequently exaggerate the degree of their pain in order to obtain heavier pain medicine for reasons other than treatment. To assess the true extent of pain, healthcare practitioners must rely on a variety of factors such as the patient's mental, emotional, and psychological analyses (Stahl & Ball, 2009).
Case Study: A 43-Year-Old Man with Hip Ailment
The current case study features a 43-year-old man who has had a hip ailment for seven years. The client complains of significant discomfort that has previously been misdiagnosed by other doctors. According to the current analysis, the patient suffers from complex regional pain disorder; therefore, a combination of several medication including Savella and Amitroptyline will be used in the management of the pain, and other psychological issues associated with the condition (Stahl, 2014).
Importance of Comprehensive Approach
Of importance is the client to note that medication therapy alone cannot completely manage the problem; further therapies such as massage and counseling therapy might be required to achieve a better control of the situation.
Medication and Treatment
The first choice of treatment included savella 12.5 mg taken orally on the first day, followed by 12.5 mg BID on the second day and day three. Another medication to be used Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg. and neurontin 300 mg po bedtime (Stahl, 2014). The medication was chosen to help in the management of psychological trauma that the patient goes through because of the uncontrolled ache and to id in the management of the chronic pain (Kaye & Urman, 2011).
Role of Medications
Amitroptyline acts as an antidepressant and it helps people with psychological problems to achieve normalcy within the shortest time possible (Pasero & McCaffery, 2011). The Savella drug helps in the management of chronic pain by affecting the neurotransmitters in the brain. The drug also helps in relieving emotional tension that builds up when dealing with unmanageable conditions such as the one that the complex regional pain disorder affecting the client.
Results and Ethical Considerations
The physician hopped to achieve a considerable reduction of pain experienced by the patient by the use of the stated medication (Acton, 2012). Further, the decision was meant to help the client have better rested nights and enable him to operate as effectively as possible regardless of the condition. The result of the decision was as good as expected. The client did indicate a significant reduction of pain and the ability t walk without the crutches. However, the client indicated the feeling of anxiety, high blood pressure, and abnormal sweating. The negative reactions are side effects of the drugs and are manageable situations. At this stage, the only ethical consideration that influenced the decision of care was based on the previous doctor's assessment of the patient (Schatman, 2007). The report indicated that the patient was using the pain to get narcotics for non-medical use. However, the first stage of treatment does not indicate that the client is faking the pain or the problems.
Adjusting Medication Dosage
The second decision was to use the same combination of the medication but at a lower dosage since the pain was already at a manageable level. Further, the use of a reduced level of medication would still offer the intended results but with less severe side effects. Amitriptyline and Savella medication should not be used for a long time at high doses (Pasero & McCaffery, 2011). A continuous use of the drugs at a higher dosage can lead to drug dependence thus reducing the effect of the medication to the body. The results of the second decision of care were not very good. The patient indicated increased levels of pain and disrupted nights. Further, the client indicated dissatisfaction with the re-occurrence of pain. The reasons for the discrepancy between the results and the expectation of the physician could be due to the lowered doses and the lack of a second set of treatment. The disorder is both physical and psychological; therefore, the patient should not only rely on medication for the complete elimination of the problem (Otis, 2007).
Alternative Approach for Pain Management
The third decision is to discontinue the use of Savella and replace it with 50 mg tramadol, which is to be taken orally at six hours intervals. The client is allowed to increase the dosage to 100mg if the pain persists but should not exceed that quantity. Further, the client will have to meet with a counselor every week, schedule a heat, and massage therapy every Friday. The purpose of the third decision is to help the patient understand that pharmacotherapy might not offer the best solution to his condition. The results at this stage indicated positive results. The pain level was reduced to 3/10, and the patient was able to function normally without crutches on most days. Further, the patient did not have trouble sleeping, and most of the drug's side effects were not mentioned during the review. The results at this stage were favorable because the patient understood his condition better, and he was willing to use different methods of care to achieve effective pain management (Otis, 2007).
References
Acton, Q. (2012). Complex regional pain syndromes: new insights for the healthcare professional : 2011 edition : scholarlypaper. Atlanta, Georgia: ScholarlyEditions.
Kaye, A. & Urman, R. (2011). Understanding pain: what you need to know to take control. Santa Barbara, Calif: Praeger/ABC-CLIO.
Otis, J. (2007). Managing chronic pain. a cognitive-behavioral therapy approach. Oxford: Oxford University Press.
Pasero, C. & McCaffery, M. (2011). Pain assessment and pharmacologic management. St. Louis, Mo: Elsevier/Mosby.
Schatman, M. (2007). Ethical issues in chronic pain management. New York: Informa Healthcare.
Stahl, S. M. (2014). The prescriber’s guide. New York, NY: Cambridge University Press.
Stahl, S. M., & Ball, S. (2009). Stahl’s illustrated chronic pain and fibromyalgia. New York, NY: Cambridge University Press.
