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.
Patient Interview 5: Lydia
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From the course by University of Minnesota
Preventing Chronic Pain: A Human Systems Approach
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From the lesson
The Problem of Chronic Pain (Week 2)
Meet the Instructors
Dr. James Fricton, DDS, MSProfessor and Pain Specialist
University of Minnesota, HealthPartners Institute, and Minnesota Head and Neck Pain Clinic
Hi, it's a pleasure to have Lydia here today.
Thank you for coming.
>> Of course.
>> So tell us a little bit about your pain condition.
Where does it occur and how often does it occur?
>> So with with me the pain that I
was really, truly experiencing was intense, like a migraine pain.
It was kind of in the front of like, my eyes.
And, just a constant sharp, dull headache almost every
day for the last two to three years, constantly.
And then what I didn't realize was eventually I noticed that it was tightness
in the back of my neck, and then also, you know, tightness within my jaw.
But because and having it for so long all I thought was it's a migraine.
And I just need to take some Tylenol and, and go to bed.
And it happened let's see, this was last year.
I actually had to take a leave of absence
from, from my place of employment because I was
constantly experiencing, you know weeklong straight migraines with you
know, intense nausea and sometimes, you know, becoming physically ill.
And my life was completely put on hold.
I couldn't interact with my husband.
I couldn't interact at work.
And so, I took a leave of absence, was going through
all these different treatments, seeing all
these different doctors, neurologist after neurologist.
And finally, someone had suggested to me that maybe it was my jaw, or my teeth, and
I, through my contacts, found out about your clinic and what you do here.
And when I came here, like I remember the
first time you were talking about the trigger point injections,
and like actually showing me where the tension in
the back of my neck was causing my eye problems.
And I originally, I thought, I thought my
eyes, there was like something wrong with my eyes,
like, and so it was definitely something where I
was like going to see, get my eyes checked.
Like, what's wrong with my eyes?
And no, it actually was the tension in the back of my neck.
>> So how did it start originally?
What factors brought it on?
>> You know, I think, because it was such a constant problem for so long, I
think, it probably started, you know, as tightness
in like, just my upper shoulders, you know.
Definitely scrunching over, everybody did, we're
always working on the computers, scrunched over.
Carrying heavy bags on my, on my shoulders.
And it was always just really tight up in here.
And I thought okay, I'm just, that's just how I am.
I just need to like, relax, get a massage or something.
And then what, through the treatment with you, I realized
that the tightness in here was causing problems with my jaw.
And that I was clenching and that, that was causing my triggers for
my migraines and why it was, why the pain was happening, you know.
All the time, I was, you know, in
meetings, like, having a meeting, like, no one
could see my face, because I was, like,
constantly, like, trying to, like, relieve my pain.
And I mean, it was probably, you know, three years,
I would say was, was kind of when it started.
>> So, how does it interfere with your life,
and what things has it stopped you from doing?
>> I would say it had a tremendous impact on my life.
I, I had to take a leave of absence, extended leave of absence from my job.
And there are times where I,
because I would be, you know, just trying to cope,
where I would be sleeping all day and that's not a life for anybody.
It had impacts on my relationships with my co-workers where
you know, I couldn't, didn't really feel like I could
be engaged in the work because I wasn't ever there,
because every other day I was out with a migraine.
And then also, it really impacted my relationship with my husband.
for, you know, the longest time.
Like, he didn't know what to do, and so he was kind of looking
to me to be, tell him, like, what do you need me to do?
How, you know, and I was, like, well, I'm so desperate.
I can't make myself feel better.
I don't know what to tell you what I need.
And I think that that has definitely has been a learning process, just kind of
like a growing process for my personal as well as my, our, my relationship with him.
So.
>> So what do you do now to manage the pain?
What are the self-management strategies you've learned?
>> I definitely make sure that I take time out not only to do
the, the stretches and the physical therapy
that I've, I've learned within your clinic.
But also the trigger point injections, which have been huge.
I mean, now I'm so a, much more aware of where the
pain is coming from because I've been doing, you know, the stretches.
Doing the trigger point injections, making sure that I'm getting in to do those.
But then also just doing a self-check, and
make sure how's my posture when I'm at work?
Not spending too much time leaning over, forward and crunched up
against the computer and making sure I'm getting exercise, getting out.
If I can't get out that day, like just get out and take the dog for a walk.
I mean, simple things like that, you don't realize,
you say, oh I don't have, I don't have
the time for a 30 minute walk, but, you feel so much better if you don't do it.
Or when you do do it, then it's like you, I mean there's
no way that you can't just take that time, and just spend that time.
And you just need that mental time too.
And then also working with, with the physical
therapist here, and making sure I'm doing the
stretches, and the posture checks, and just being
more self-aware of, how I'm, like if I'm clenching.
Now I can tell when I'm clenching, like I can feel it instantly.
So I just like, relax, especially when I'm driving, because that's stressful, so.
>> Yeah, now you have a little device here too.
Tell me a little bit about how you use that.
>> [LAUGH] Yeah, so one of the things that you have
brought to my attention is this little, it's called The Nobble.
Nobble II.
And what I would find is, I would spend so much time trying to self-massage
the back of my head with my fingers, that my fingers will, like, get so tired.
So then you brought this to me and it's basically you just
use it as a massage tool, and sometimes I will just sit
in the car and I will massage my temple, or I will
massage the back of my head and it just helps me relax too.
When I find that I am like, so tensed up and stressed, and it's just
like one of those things that, it's so simple and it's such a little thing but.
It's nice to just have that, it's like
almost like a little pacifier sometimes, just like
I can use my Nobble, and I'm working and using it, so that's one of the things.
And then for sure just making sure that, I'm taking the, the breaks where
I feel like I'm anxious, then I take the you know, doing the breathing exercises.
You know, the other day I felt like okay, I'm a little overwhelmed, talking about it
with you and the officers like okay, make
sure you do, you're doing your breathing exercises.
>> So, what advice do you have for other people to help them prevent chronic pain?
>> Take care of yourself.
Make yourself a priority.
Don't let it get out of control.
I let it get out of control.
I didn't make myself a priority.
I let everything else kind of become my main concern.
And it got to the point where I couldn't even go to
work, I couldn't, I couldn't even
function, I would sleep throughout the day.
Make yourself a priority, number one.
Number two, just be aware of how you're feeling,
like in your gut, you kind of know what's good for you and what isn't.
If you're saying to yourself that oh, I, you know, I really need to just kind
of like, take some time out to just do some stretches, like, go do the stretches.
You're going to be so much better off afterwards.
>> That's true.
>> And you're not going to make the
other people around you as miserable if you're grumpy.
So but just make yourself a priority, number one.
And don't let it get out of hand, like.
>> Yeah.
>> Address it.
Take the time.
And everyone says like oh, I don't have time, you know,
I got to, I can't take time for this doctor's appointment.
Well, make time because it's not worth living in such agony and such pain so.
[BLANK_AUDIO]
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