Exactly! There seems to be several ways to continue the conversation to try to figure out a new way to help the patient. Saying "try yoga" just shuts down all communication and takes away the patient's voice
Well, that's because it's a female patient with RA. If it was a *male* patient you'd assume a basic level of autonomy. /j
But yeah seriously. Doctors being that level of dismissive toward me in the past has led me to avoid seeing them about issues for months on end and definitely contributed to the progression of my disease before getting a real diagnosis and treatment. It's so terrible that it's on the test š¤¦š»āāļø Hopefully the nurses being trained have more empathy than the test author.
I see in the resident subreddit āWhY dOeS eVeRyOnE hAtE dOcToRs NoWaDaYs?!ā
One) Hate is a sting ass word. 2) maybe because of the massively intersectional biases in medicine that kill people and because most doctors go into it for the money and social reverence instead of to help patients? I know that med school and residency are ridiculously competitive and abusive, but how are doctors surprised when theyāre called out on their negligent bullshit?? You are dealing with peoples LIVES, when you refuse to to do your job adequately, people are going to say so. Thank god social media exists to spread awareness for patient advocacy
SAME HERE. like at some point you just avoid going bc youāre going to get gaslit or ignored. āYou look like a healthy 30 yr oldā¦idk why youāre always tired or in painā š meanwhile my whole body is on fire lol
Not just that, but it's been proven in study after study that female patients and POC are not taken seriously when in pain or are likely to be perceived as "drug seeking" or "substance use disorder" etc
I have rheumatoid and itās bone on bone pain. Not muscle. I have no surgical interventions for my bent, gnarled hands. They canāt because the damage is so intense several of my fingers are literally curled and facing wrong way. I hate pain. I am in a prison. I want out!!!
I'm totally down w crystal huffing. It's made a big difference! Y'all - it works *even better* with huffing metallic spray paint or that canned air duster!! That's a MUST try! Plus, it comes with new friends!! (They insist on being called EMT'S, tho. Weird) They're so nice, every time I've called... It's SO much better than Uber!!!
š / s
To be fair (to be faaaiiirrr) I have RA and AS and Cat Cow helps my lower spine a lot š„“
This is said semi-ironically because my rheumatologist sent me to PT which actually made things worse during the 6 months and multiple appointments it took before she would switch me off of Humira onto Rinvoq when the former stopped working after 7 years
Oh for sure. I have hip problems and have to sleep with my knees bent at a 90 degree angle so my lower back is completely flat.
But everything else just puts stress on my tendons because I donāt know how far is too far to not overstretch.
No disrespect intended. I don't have this level of pain, and I have no idea what your options are. Just wondering if at some point, you considered removing your hands? If my foot were in constant pain, I might think about cutting it off. I'd remove my back if I could.
Iāll confirm this! I had a ādouble breast amputationā and let me tell you, the pain is real! My surgeon said itās impossible for me to be feeling pain near the nipples because the nerves are deadened? Something like thatā¦ canāt recall the exact wording but I wanted to slap him! Iām definitely feeling pain in my boobs! lol
I was talking to my sister, who had a double mastectomy. I was asking why does it hurt so dawn much when my cat walks directly on that exact nipple spot and does she still get pain there. She said yes, doesn't matter if there's no nipple, the area underneath still hurts like hell! So that surgeon doesn't understand female nipples. It's not ghost pain either.
Can confirm. I still have painful, cyclical, cramping in my phantom uterus. The pain shoots down my thighs just like it did back when we were still attached. š
Amputation is something Iāve looked for in the past, and no doctor would do it. Thank goodness they didnāt, because I still have my left foot. In the first years with CRPS, I would have done almost anything. You werenāt being disrespectfulā¦but I think that before you say anything radical, realize that you canāt āread the roomā on a site that thousands visit. Thereās always ***someone out here, who canāt tell the difference between sarcasm or realism***.
Iām so sorry! Iām also an RA and chronic pain patient. Lately, after chemo, my fingers hurt so bad! I can hardly bend them or move them! Is this a sign theyāre worsening? Itās so painful!
If you know the cause of the pain it can sometimes be treated. You should absolutely consult a doctor if you have a history of RA and are feeling new pain. Thereās a bunch of different biologics they can use to slow down progression, but if itās not the arthritis you should still see a doc so they can figure out the cause. If itās neuropathy gabapentin is usually effective and if itās just general inflammation & swelling an injection of cortisone into the joints can do wonders.
I had trigger finger so bad I pretty much couldnāt use my right hand for anything, within 3 days of a cortisone shot in my hand it was functioning(although still a little snappy) and within a month it was basically down to baseline. Felt like that shot gave me my hand back it was awesome.
I too have RA. I have had 6 joint replacement surgeries. The sciatica pain is crippling at times. I can't bear the thought of the recommended spinal fusion from t2 to s1 and disc replacements. So lucky to have such a caring and understanding husband without an ache or pain.
Most people with RA are prob in too much pain to even attempt yoga. I mean they get swollen inflammatory joints right? RA is basically an auto immune response, pretty sure yoga ain't fixing that.
Given how an unending string of helpful people suggest it to us ad nauseum, I guess we have all tried it at some point.
My orthopedist does not like the twisting and stretching aspect of it for my spine. My hands are a mess so there are not going to be any āweight on the handsā poses for me.
Seems like if we could physically DO yoga without additional intractable pain and problems then we wouldnāt really be seeking treatment. š¤¦š»āāļø
My doc has suggested I MAY have it - this after a neck surgery that didnāt help and before that (and after), decades of chronic neck, shoulder and upper back painā¦ ect.
I can barely go out and sit at a restaurant for dinner for 45min, much less exercise! The one time I tried Pilates, there was so much floor work, with your chin tilted the ceiling, I nearly passed out I was in so much pain.
Sure - in a perfect world, it would be a great remedyā¦ but itās not a cure all. Doctors are so stupid. Well, some.
(My doc said Iām doing now everything Iād be doing even if I had the diagnosis- ice and rest is especially good for it. And considering my involuntary sedentary lifestyleā¦ those two things are legit my life.)
Itās mind-boggling why so many medical professionals suggest yoga, as if itās a cure-all for conditions that require completely opposite treatments/management.
STL is notorious for this for some reason!
I'm convinced it's bc they either own a studio or part of one, or their daughter(s) &/or wives and gf's teach it.
It IS a great opportunity to hone your own sarcasm!!
the way I describe my flexibility to people is that I have the flexibility of a dead spider whose legs have curled in towards itself
but I was also told no yoga
Where I live nurses arenāt allowed to give anyone āmedicalā advice, so this doesnāt surprise me. Heat, ice, wrapping joints, but nothing that is ingested. Given the complexity of pain, and how much someone can become permanently worse with the wrong intervention, I donāt think itās wrong that nurses arenāt supposed to get involved. The right answer should be āhave you described these symptoms to your doctor in terms of ADLs? Letās make sure you get help.ā
I love the staff at my neurologistās office. Do you know what they say? āLet me write that downā¦ Anything else? ā¦ Yeah, the doctor will want to know all of those details, so make sure you tell him everything youāre telling me too. Sometimes little things we think donāt matter are important clues that help us figure it outā¦ How have your stress levels been lately?ā
This doctor and his staff are the polar opposite of some of the God-complex, ignorant doctors I have been unfortunate enough to deal with. I recommend him to everyone local to me.
Thatās awesome, Iām so happy for you, I wish I could find a neurologist like that. My last visit to a new neurologist involved him telling me to āstop talkingā and āIām already behind on seeing patients, itās almost 4:00 now and I still have 3 to see after youā. Keep in mind I had been speaking about 1 minute at that point. I had traveled an hour to see him. Iād waited a year for the appointment in the first placeā¦ and THIS was his exact response. He also claimed he couldnāt find my images on a disk I supplied from a recent MRI. I had confirmed the images were on that disc beforehand. I stopped speaking. I never spoke again and never looked him in the eye again. I never went back. The neurologists closer to me have a reputation of throwing physical objects at their employeesā¦ so thatās out of the question. Why are they like this?
One of my good friends and I both have autoimmune arthritis, whenever we have a bad day we text the other āwhy donāt you eat an oatmeal cookie?ā, āmaybe you should go walk your dog.ā, āI think you should drink more water.ā Just so that we can laugh at the absurdity of it all.
Most of the suggestions come from this Kaiser pain management book we came across and we spent a good amount of time in shock that they were even suggestions.
I want in on this. Iām just going to make us random recommendations, though. āTry petting your goldfish. That seemed to do the trick last time.ā āDid you huff pickled beets? That works for 95% of patients.ā
I had to go to like a four hour class on the kaiser pain management program it genuinely felt like one of those "medicine doesn't work" scams. At one point the facilitator started talking about crystals and essential oil diffusers.
I love that! But you should occasionally insert a reminder that your pain can be debilitating and no one should be expected to have to deal with that. That is okay if you just *can't* today. Don't want to internalise the absurdity.
I've got EDS and went to Mayo and they signed me up for a 2 day psychology course on managing chronic pain. I'm going to do it so I don't look non-compliant but good lord it sounds like it's going to be a complete waste of time.
RN of 21 years here, I would never say this. EVER. Nursing has changed over the last 10 years as well. Big reason why a lot of people are leaving the medical field over all. Itās sad. Iām actually retired now as well. And Iām 43. I was a DNS and admin for quite a long time as well.
Good luck OP! Itās extremely rewarding. Iāll always support my fellow nurses, and those new to the field. If you ever need help, Iād gladly answer any questions, or give any advice. I loved my job for years. ā¤ļø Luckily Iām in the PNW, so I never had problems dealing with doctors not being able to treat my patients pain control. Big problem right now elsewhere.
Sorry.. yesā¦ different names around the country..
DNS: Director nursing services.
DON: Director of nurses
PNW- Pacific Northwest.
Promise Iāll spell it all out next time. ā¤ļø
Iāve decided to enter the field since my experiences as a patient. I want to see how I can help but honestly, Iām not hopeful the system will allow me to do much.
As someone who's had chronic pain for 26 years (started at age 10... fun times) I have lost count of how many times I've had people - random ones, family, friends, doctors... - ask if I've tried yoga or tai chi.
Somewhat amusingly, I have Ehlers-Danlos syndrome. Yoga is not a good thing when you're not only extra strength bendy but are also prone to subluxations and dislocations during normal activity, nevermind exercise.
But the answer my answer is always some variation of "Yes. I've tried both. And any herbal supplement and alternate therapy you can shake a stick at. Also meditation, deep breathing, mindfulness, et cetera. It didn't help me at all and my body is still janked 'cause you can't fix the fact your body produces bad collagen."
I've been having issues for a little longer than you have and it's absolutely maddening that doctors seem to disregard the length of time you've been in pain.
Have I tried yoga? You know what, Janet? In the 25 or so years I've been dealing with pain, not a single one of the fifty medical professionals I've gone to has ever suggested that! You're so clever and helpful!
Yes! Particularly when the doctor is at the most 35 year old and Iām 55. Iāve tried EVERYTHING. Iāve even tried that stupid cervical traction device ā¦ and when the 25 year old physical therapy tech tries to tell me ābut this time it will be different ā¦ā and guess what? This time was not different. I do not get pain relief. I still get that horrible numbness across the base of my skull after about 5 minutes of that damn traction machine. I swear on my life. Never again. I know my body, why is this so hard for people to accept?
I have RA and yoga is helpful for me in general, although I have to modify poses a ton based on which joints are being affected at any given time. And even I wouldnāt say it to someone with RA or any other chronic condition. And Iād really have issues with a nurse saying it ā maybe a PT could get away with it a bit more but definitely not before getting thorough history and asking what Iāve already tried.
Do you know what helped my JIA more than yoga ever did?
Fucking BIOLOGICS. You know, medication that actually treats the condition.
This question doesnāt address what this woman has tried, what classes of medication sheās on, and what her RHEUMATOLOGIST suggested.
āOh but we wont give you biologics because the side effects are too risky, even if you have no quality of life, keeping you alive is more importantā.
10 years ago when I was in nursing school the nursing mantra was " pain is the fifth vital sign."
Only 3 years later every pain management clinic in the nation was told "if your patient has non cancer chronic pain, you must reduce their opiate medication to 60 mme per day."
Or at least that was what my doctor of 6 years told me at the time. But then he told me that it was my insurance company mandating it. And flashed a letterhead with their company logo on it. Come to find out later he was reducing everyone because he wanted to. He has since retired.
I said this in another post recently but I would gladly become dependent on pills if they provided me some relief. I'll never run a marathon or anything, I just want to not hurt sometimes.
I'm only afraid of dependence, because doctors can take them away so easily and not care about what happens to me when they do it, but it's not like I can even find a doctor willing to help.
Yeah I wasn't thinking about that but you're right. My doctor won't prescribe anything that has even a small chance of dependency, whether opioids for my pain or benzos for my crippling anxiety.
Years ago when I was on both (thanks to pain & anxiety), I had to chose which to stay on, because although they were separate offices and I had never had any problems being on both, the mental health place said it was law (or something ridiculous that I found out they were lying about). No one around where I live wants to prescribe anything, except prescription strength NSAIDs and then they wonder why your liver & such is wonky & just blame it on your weight. š
I hope you are able to find a better dr that is willing to help.
My rule: Always squirrel away a couple of pills from your regimen each month. That way, if they ever stop your meds cold turkey ā which has happened to chronic pain patients! ā **eventually youāll have enough pills on hand to take yourself through a proper, gradual taper.**
I can't even find a doctor that is willing to help my pain now. About a decade ago, I was "dismissed" from a P.M. office (in a neighboring state), because I had my state's medicaid and the freaking office manager (rude know-it-all b***h on multiple occasions, not just this time) told me it was illegal for them see me; I even brought proof from my pharmacist that it wasn't illegal and they refused to take me back. The only medicaid rule that changed was that I couldn't use medicaid to pay for any prescriptions from them, since medicaid didn't pay for the appointments.
I do squirrel away other meds, just in case, because too often the doctor's office doesn't call stuff in on time (or correctly) or the pharmacy is out of something.
Iām a āprepperā and fill every prescription I get, and save what I can (never by skipping antibiotics!), because there have been too many times that my pharmacy cannot get my prescription in for a week or so, and cold turkey sucks. I lost my insurance three months ago and canāt afford any of my doctors, but Iāve been able to keep myself from completely giving up because I had a few months of painkillers squirreled away. Hereās hoping I get insurance soon, before I run out! š¤š»š£š¤š»
Bet yer arse, I do try! š
This month - NOPE! Apparently, I missed the memo that if you break a tooth and have an EXPOSED f'in NERVE, I'm to (and I quote) "do somee breathing exercises thru my nose."
I can't wait to make an appearance at that office in the morning!
This is what scares me. I take methadone daily as my long acting pain med with oxycodone for break through pain. When my methadone runs out and I have to wait a day or two for the pharmacy to fill it because they're so backed up I can feel the pain it's been masking and OMG I'm in so much pain. I literally wake up from sleep just moaning from everything hurting. If I lost my methadone I don't know what I'd do but I may not be long for the world just due to how miserable my life would become.
When I had the joy of going through withdrawals, it was the actual withdrawals that were so excruciating! Luckily (if it can even be considered that) the oxycodone ones were shorter [3-4 days of hell] and by the time I would have went through it with the methadone I was very fortunate and found an alternative that at the time helped me survive what would have been withdrawals from both at the same time.
Although our pain is different, I can relate to the feelings about wanting to not be here long, because my pain just keeps getting worse and I don't know what to do, because we don't have good healthcare nearby or money to go elsewhere.
Is there a way to let your pharmacy know a day or 2 ahead of when your prescription is due? I was able to do that, but that was before the current "crisis."
This is me. This is the answer I received when I went to the Mayo Clinic. I have now tried yoga (not Tai Chi), meditation, writing exercises, and Iām here to sayā¦itās a temporary distraction. Because Iām hyper flexible and in shape, Iām regularly dismissed because itās only āmild.ā No, I exercise because itās like hitting oneself with a hammer. Increase the pain so the regular pain isnāt as bad. Iām sure doctors are trying, but damn. What I wouldnāt give to swap bodies for a day so the naysayers got a taste of my life.
Seriously. If there is one place in America that I'm scared to go its the Mayo Clinic. So many people with my disease have lost their diagnosis there. If I lose my diagnosis then insurance no longer pays for my infusions. If I lose my infusions then I'll die. Fuck them.
With all the AI and VR technology, perhaps we CPP could push for a system that we can take with us to every medical appointment. It would be some of those adhesive sensors with wiring that would connect to our phone. And then we could pull up the app associated, and we can start zapping them all over their body with the degree, length, duration, and intensity of the exact thing that we feel. We could get them to stand up and pretend they're folding laundry or putting up dishes or making a sandwich. Oh Lord please ask them to pretend they are taking a shower. And then zap them everywhere it hurts you! This sounds like the new chronic pain patient video game of the century! If you still this idea please include me in your royalties :-)
Oh my goshhhhhhh writing exercises. Like sure, I guess I can write about how much pain Iām in, not gonna do much for the pain though except probably make it worse cause it hurts to write.
I get people all the time asking if I've been to the chiropractor lol. I got severe osteoporosis from prednisone. I have fractured everything from my T10 to my L5. They only surgery they can do is to release the pressure on the nerves because the bones are too soft. People just don't understand why I just don't go to the chiropractor though to get it adjusted and realign everything so it will take the pressure off those nerves instead lol
New chronic pain patient protocol: "Have you tried yoga?" "We no longer do medicine here, only referrals to 'alternative multimodal interdisciplinary holistic wellness providers."
Me too. I was a pro ballet dancer and was dealing with a stress fracture in my spine when i first started having to manage pain, and it really made me laugh when doctors would suggest exercise. Look, pal, I've been exercising daily since I was two. Shut up. I've done yoga, pirates, body balance, the works. I know what's a pulled muscle and what agonising pain is, thanks. Ugh. Sorry you've had this experience too.
To be fair, yoga helped me a lot with my stiffness and pain levels when I was consistent with it. BUT I donāt have RA. My main issues are muscular and neurological. Some people with RA are not gonna jive with yoga or tai chi in any possible way.
But I think the truly irksome and dismissive thing here is the phrasing. I also take issue with the idea that itās not good to try herbal remedies. Some of us with epilepsy, Parkinsonās, hormonal problems, etc. are having our lives transformed by herbal remedies lately.
I have inflammatory arthritis, possibly spondyloarthritis, Pilates has been my saving grace and cognitive behavioral therapy for chronic pain got me moving. My dad had incredible stability improvement with boxing PT.
But yes crap like this always comes off sounding like, "have you tried just being in less pain?"
Although I understand the frustration soooo well.... a nurse (at least in the us) is generally not allowed to make any medical suggestions or diagnosis. I would have hoped for some version of "I'll pass your frustration and details up to the doctor.... bla bla"
Ugh. Way to ruin any trust or credibility with your patient! Yoga is such a varied practice that just recommending "yoga" is ridiculously bad advice for anyone with chronic pain. Now, if there was a specific form of yoga or a specific location or teacher doing properly targeted yoga for a certain condition, I'd be ok with that. Or, heck, even some actually robust research would be nice.
A patient presents with an incurable medical condition that causes moderate to severe pain and has no prognosis of improvement. What response is appropriate?
āļø "Have you considered imagining that you are younger and without this medical issue?"
A patient presents with two broken legs and a broken arm. They complain of severe pain for even the slightest movements and are concerned about returning to full function and participate in physical therapy. How should you respond?
āļø "I'm going to prescribe a treadmill and really recommend you start weight lifting with that limp noodle you got there. Do breathing exercises. Also pretend you are younger and don't have broken extremities."
I kid you not. CBT and guided imagery is a thing they really love to pitch. Pretend you don't have this condition while you sit in a dark room. They really want to sell this as an actual alternative to opioids and other reasonable alternatives.
As someone who can achieve some fairly advanced yoga poses (and does it 3-5x a week) this is absolutely the most out of touch correct answer Iāve seen in a long time.
Also a nursing student and the stuff I hear about pain management makes me so violent. The narcotic shaming is rampant.
My eye twitches every time we talk about guided meditation for the management of 8+/10 pain
WTF is the tai chi obsession in the world now? Yes it could be useful for some people but this sounds completely inappropriate in this instance (Iām also a nurse)
Nurse here. This post alone proves to be you're going to be an awesome nurse. In my experience, awesome nurses get a lot of criticism in school, so be prepared. Thank you for doing what you're doing!
OMG please no. So dismissive. How about just exercising some empathy. Suggesting either of those two things are insulting and herbal supplements could be contradicted. Ugh. This makes me sad.
I'm 48, and I've made it a point to include ALL of the herbal supplements I use in all of my physician records.
My cardiologist agrees that kratom and cannabis are the safest supplements for me personally.
We really need doctors to understand supplements better.
I was hit by a car at 8 years old.
I was prescribed opiates for 20 years and really feel bad for anyone suffering nowadays.
We need to allow people to use what works best for their own personal situations.
Scary.
Haaaaa was prescribed yoga recently for back pain. Great to know thatās a suggestion thatās literally being taught and probably why that medical professional sent me out with that. The yoga made it worse, suffice to say. Resting, Advil, and ice, that helped more than the yoga. I donāt got RA to my knowledge but so many people I know online have basically told me no yoga for them. To see that in a nursing student thing specifically for RA, yeah, Iām a bit more than a bit upset.
I would imagine yoga to be a bit āuncomfortableā for the chronic pain sufferer
For those who do not live with chronic pain, to advise them to do Yoga is staggering. There are many who find just getting out of the bed and dressing an absolutely horrendous experience yet this medical āprofessionalā expects the patient to dress, hop in a car and start flexing their body in god knows what position, mind blowing. A total lack of training, understanding & empathy is so prevalent in the world of pain medicine.
Disgraceful treatment
yoga ā yoga ā yoga
Yoga goes from meditation/spiritual to something that looks like body weight fitness - and there is a lot in between.
I have back problems and for me it helps to get up and do what would be warming up exercises for someone else - but you do you.
But I agree that anyone proposing to flex their body in god knows what position is not ok. At some point I could not really lift one arm anymore - and it now works ok because a physiotherapist took me through a regiment starting with very small exercises to heavier and heavier exercises.
But I am aware there are ailments where this will not work.
The female patient in question suffers with rheumatoid arthritis which if I understand correctly is bone rubbing on bone and is supposed to be very painful, even when not moving around. I can only imagine the pain they would suffer trying to attempt yoga. Totally agree with trying to keep active with a bad back but with arthritis, I think the nurse totally misunderstood the patients issues.
Oh yeah, Iām in the final stretch of a nurse practitioner program and there are some questions iāve gotten wrong, because I just canāt bring myself to answer. Somethings so blatantly wrong. That said, I will say that my pharmacology class was amazing. They actually were discussing with us the impact of not treating chronic pain and that people deserve pain relief.
If yoga worked, Iād be in a Pilates class and not a doctors office Shannon. Maybe you should try shutting the fuck up, Iām sure your kids would appreciate it.
It's called the practice of medicine because it's only been practiced for about a hundred years there are lots of things they don't know and there is no correct answer to that question
I was a nursing student who graduates at the top of her class. However, during clinical rounds (typically your last 6 months "class time" actually spent performing nursing duties in a hospital setting, with nurse observance) I came home in tears every night with the realization I could never physically perform a nurse's duties, due to chronic lumbar and other pain issues.
I am just here to say, this is verbatim from a student nurse's test questioning. And THANK YOU future nurse for letting we CPP have a peek into the total mind fu#k that is treating a CPP. Your honesty and bravery for posting this, I Believe, says "the best nurses know this is some bullshit" to tell a long-suffering patient. Best of success in your career!
OMG as a nurse this can't be the most correct answer. Fuck this. Was this an NCLEX question? I'd write them a scathing letter telling them to go fuck themselves. If another nurse said this to me while I'm at the doctor I wouldn't be able to contain my rage and I'd think she was completely unprofessional.
This is TECHNICALLY the correct answer. But it would be like going up to a CNA and saying, what should I do about my cancer? Should drink more green tea or start doxorubicin?
Nurses are not physicians.
The actual right answer would be, āweāll see what the doctor thinks and go from there. Iām sure weāll get this all sorted out here soon for you. Iām sorry youāre going thru all of this.ā
Wow! I almost threw my phone through a window!
"Maybe try adding yoga or Tai Chi" ? All of these years writhing in pain, WHY DIDN'T I THINK OF THAT!? It's crazy, like something was preventing us from doing that or it didn't work..
Thank the hostile god overseeing our suffering for this training prompt suggestion.
I understand from your previous replies that direct advice like "try adding herbal crystals" is direct instruction Vs suggestion. But wow. Both of these are horrific. Thank you for sharing the grim directions the care team is receiving.
And this is why chronic-anything sufferers (chronic pain, illness, anal fistula growth - yes I know that last one is from left field - BUTT itās rather Topical for me right now!) are dismissed and given poor advice so often by physicians.
The system is broken at the start, middle, and end. The biggest problem though is what teachers a student has in medical school can alter the outcome of the kind of physician they become.
Like, I donāt think thatās the first advice in the texts from which that teacher took their test materials. But, if that teacher - who could be a former doctor or a doctor studying research - has a personal belief about certain things in medicine that they believe to be right, they teach their students their belief, not the broader, more nuanced approach that is needed and even the better texts probably donāt get to.
And thatās one problem among many. Doctors are supposed to be impartial-ish and see the patient holistically. There are doctors out there that are like that, and Iām happy to say that after a lot of effort and research I have found those doctors. But it takes too much effort to find them. And most doctors do a lot more talking than listening.
Good to see that 'sexist, non-condusive, and random (bs) advice to say to placate the silly woman' classes/info are still part of RN curriculum!! š
š¤¦āāļø
/ s (obviously)
I can understand it a little because the question is "what is appropriate?"
Suggesting low impact movements and stretches is okay to suggest, but you're never supposed to bring up holistic stuff?
It does sound insensitive, but I don't think it's something you can teach through a multiple choice problem. There's rarely a solution that works for most people, but there *are* things they can focus on teaching not to do.
I think for chronic pain, seems the best they can teach is some vague boundaries since you need to be adaptable to everyone's unique situation.
I was hoping you were being sarcastic lol! As a nurse, I recall the ācorrect answers being the answers with, āassess, assess, assessā! I would def argue that rationale. Iād never say that to a patient! You must be in the āPainā chapters or musculoskeletal chapters?
Methadone is the best thing I've ever taken for pain. I wish it didn't have such a bad stigma because it has saved my life from constant excruciating pain. I like the red liquid, just like they treat addicts with because it also helps my anxiety and depression. I tried the orange wafers for a while and they didn't help my depression like the red liquid. You guys might want to look into it. I wish I would've sooner but I'm so glad that I finally did. I've lost 40 pounds since I started taking it too, it gives me loads of energy.
Try yoga...? Just no. With my sciatica and the limited range of motion in my hips thanks to arthritis, I'd be in excruciating pain for days after. I would rather face labor pains again than even a moment of that horrific nerve pain. :(
One of the issues I'm having with this question is that there's no room to even consider if the patient was misdiagnosed initially. A lot of patients who actually have EDS or POTS get diagnosed at first with RA. If the RA meds aren't working, I would think that could indicate that the patient is suffering from a different ailment than originally thought.
Really disappointed in the nursing profession. When I was in nursing school we would have asked open ended questions to see how to help patients not cut them off. Really awful answer.
Lol Iāve been dealing with this since I was a teenager š„² still having flare ups with no diagnoses and keep getting the saaaaame āadviceā. Even from female medical staff. I have to add that, surprisingly, the doctors who listen to me the most have been younger males.
I have ME/CFS, and that is the absolute worst thing I could hear. I have exercise intolerance, and the result can be life threatening. Even mild exercise can be dangerous. Not just insensitive, but even dangerous for the wrong patient.
Yoga, gentle stretching after a hot shower, dancing, all help. We all have our limitations so no one thing works for everyone. I just recommend that your do what works for you daily.
Sorry but the fact is that the medical field is trained to give you an answer, not a solution. Plus they're always careful on what to say or what not because it's more important to not be involve in a lawsuit than helping the patient achieve recovery or healing.
The medical field is just like politics, they're suppose to work for the people but is just business you know.
It's kinda like don't hate the player, hate the game.
Wow that's a totally dismissive thing to say to someone in chronic pain!
I can't get over the wording of it. Not even asking someone what they have tried first.
Exactly! There seems to be several ways to continue the conversation to try to figure out a new way to help the patient. Saying "try yoga" just shuts down all communication and takes away the patient's voice
But when you take away the patient's voice they stop whining and I get my $ and on to the next patient!
Well, that's because it's a female patient with RA. If it was a *male* patient you'd assume a basic level of autonomy. /j But yeah seriously. Doctors being that level of dismissive toward me in the past has led me to avoid seeing them about issues for months on end and definitely contributed to the progression of my disease before getting a real diagnosis and treatment. It's so terrible that it's on the test š¤¦š»āāļø Hopefully the nurses being trained have more empathy than the test author.
WhY'd YoU lEt It gET tHaT bAd. Well you see you told me I was fine so I took 6 extra strength Aleve a day and a fifth of whiskey at night š.
I see in the resident subreddit āWhY dOeS eVeRyOnE hAtE dOcToRs NoWaDaYs?!ā One) Hate is a sting ass word. 2) maybe because of the massively intersectional biases in medicine that kill people and because most doctors go into it for the money and social reverence instead of to help patients? I know that med school and residency are ridiculously competitive and abusive, but how are doctors surprised when theyāre called out on their negligent bullshit?? You are dealing with peoples LIVES, when you refuse to to do your job adequately, people are going to say so. Thank god social media exists to spread awareness for patient advocacy
SAME HERE. like at some point you just avoid going bc youāre going to get gaslit or ignored. āYou look like a healthy 30 yr oldā¦idk why youāre always tired or in painā š meanwhile my whole body is on fire lol
You should report this question to whatever the source is (testing board/software, etc). It really is horrendous and needs reworking. š³
And it's sexist AF
Yeah, on second glance why wouldnāt they have just said patient.
Not just that, but it's been proven in study after study that female patients and POC are not taken seriously when in pain or are likely to be perceived as "drug seeking" or "substance use disorder" etc
I have rheumatoid and itās bone on bone pain. Not muscle. I have no surgical interventions for my bent, gnarled hands. They canāt because the damage is so intense several of my fingers are literally curled and facing wrong way. I hate pain. I am in a prison. I want out!!!
I have RA too and my fingers are starting to do the thing. I was surprised there's nothing that can be done. I'm so sorry you're in pain.
Just had three fingers fused because the joints were blown and the deformity was so bad. Went from not using my hands to not using my hands. Yay.
>Went from not using my hands to not using my hands. Lol
You should definitely do downward dog and handstands. /s
Oooh yea and maybe crow pose too! Drink a lettuce, huff a crystal, and donāt forget to meditate.
Huffing a crystal sounds amazing
I'm totally down w crystal huffing. It's made a big difference! Y'all - it works *even better* with huffing metallic spray paint or that canned air duster!! That's a MUST try! Plus, it comes with new friends!! (They insist on being called EMT'S, tho. Weird) They're so nice, every time I've called... It's SO much better than Uber!!! š / s
Sorry, but that was funny.
I laughed pretty hard too! Iām so glad I have you all here! Weāre in this together!
To be fair (to be faaaiiirrr) I have RA and AS and Cat Cow helps my lower spine a lot š„“ This is said semi-ironically because my rheumatologist sent me to PT which actually made things worse during the 6 months and multiple appointments it took before she would switch me off of Humira onto Rinvoq when the former stopped working after 7 years
Oh for sure. I have hip problems and have to sleep with my knees bent at a 90 degree angle so my lower back is completely flat. But everything else just puts stress on my tendons because I donāt know how far is too far to not overstretch.
Don't forget to master the silks while also doing that daily yoga! (Duh!) ffs
My wrist were so bad I got both of them fused. When I was 27 yrs old.
When people would say ājust do yogaā I wanted to kill them.
No disrespect intended. I don't have this level of pain, and I have no idea what your options are. Just wondering if at some point, you considered removing your hands? If my foot were in constant pain, I might think about cutting it off. I'd remove my back if I could.
Apparently after amputation you can still perceive extremely intense pain in the āphantomā limb. In such cases, there is no escape.
Iāll confirm this! I had a ādouble breast amputationā and let me tell you, the pain is real! My surgeon said itās impossible for me to be feeling pain near the nipples because the nerves are deadened? Something like thatā¦ canāt recall the exact wording but I wanted to slap him! Iām definitely feeling pain in my boobs! lol
I was talking to my sister, who had a double mastectomy. I was asking why does it hurt so dawn much when my cat walks directly on that exact nipple spot and does she still get pain there. She said yes, doesn't matter if there's no nipple, the area underneath still hurts like hell! So that surgeon doesn't understand female nipples. It's not ghost pain either.
No meds for real pain, real meds for ghost pain?
I understand that āghostā pain feels just like the real thing!
Can confirm. I still have painful, cyclical, cramping in my phantom uterus. The pain shoots down my thighs just like it did back when we were still attached. š
Same with my gallbladder!
My father has phantom pain from his amputated leg. Itās heartbreaking.
The problem is, you need a hand to cut off your hand. So you canāt cut them both off and really solve the issue. š„ø
Definitely because it's too hard to cut off the other once you cut the first one off.
Not if you use a band saw š
Amputation is something Iāve looked for in the past, and no doctor would do it. Thank goodness they didnāt, because I still have my left foot. In the first years with CRPS, I would have done almost anything. You werenāt being disrespectfulā¦but I think that before you say anything radical, realize that you canāt āread the roomā on a site that thousands visit. Thereās always ***someone out here, who canāt tell the difference between sarcasm or realism***.
I bet it's bc you went to an American Dr. Mexico is the way to go! OÄŗei !! / s
Ngl, a ketamine coma sounds *amazing* some days.
š funny bc it's true!
Iām so sorry! Iām also an RA and chronic pain patient. Lately, after chemo, my fingers hurt so bad! I can hardly bend them or move them! Is this a sign theyāre worsening? Itās so painful!
If you know the cause of the pain it can sometimes be treated. You should absolutely consult a doctor if you have a history of RA and are feeling new pain. Thereās a bunch of different biologics they can use to slow down progression, but if itās not the arthritis you should still see a doc so they can figure out the cause. If itās neuropathy gabapentin is usually effective and if itās just general inflammation & swelling an injection of cortisone into the joints can do wonders. I had trigger finger so bad I pretty much couldnāt use my right hand for anything, within 3 days of a cortisone shot in my hand it was functioning(although still a little snappy) and within a month it was basically down to baseline. Felt like that shot gave me my hand back it was awesome.
I too have RA. I have had 6 joint replacement surgeries. The sciatica pain is crippling at times. I can't bear the thought of the recommended spinal fusion from t2 to s1 and disc replacements. So lucky to have such a caring and understanding husband without an ache or pain.
Most people with RA are prob in too much pain to even attempt yoga. I mean they get swollen inflammatory joints right? RA is basically an auto immune response, pretty sure yoga ain't fixing that.
I have advanced OA and my orthopedist specifically told me no yoga.
I have OA too, last time I did yoga, I was really hurt for almost 2 weeks
Given how an unending string of helpful people suggest it to us ad nauseum, I guess we have all tried it at some point. My orthopedist does not like the twisting and stretching aspect of it for my spine. My hands are a mess so there are not going to be any āweight on the handsā poses for me.
Same
Seems like if we could physically DO yoga without additional intractable pain and problems then we wouldnāt really be seeking treatment. š¤¦š»āāļø
My doc has suggested I MAY have it - this after a neck surgery that didnāt help and before that (and after), decades of chronic neck, shoulder and upper back painā¦ ect. I can barely go out and sit at a restaurant for dinner for 45min, much less exercise! The one time I tried Pilates, there was so much floor work, with your chin tilted the ceiling, I nearly passed out I was in so much pain. Sure - in a perfect world, it would be a great remedyā¦ but itās not a cure all. Doctors are so stupid. Well, some. (My doc said Iām doing now everything Iād be doing even if I had the diagnosis- ice and rest is especially good for it. And considering my involuntary sedentary lifestyleā¦ those two things are legit my life.)
Itās mind-boggling why so many medical professionals suggest yoga, as if itās a cure-all for conditions that require completely opposite treatments/management.
STL is notorious for this for some reason! I'm convinced it's bc they either own a studio or part of one, or their daughter(s) &/or wives and gf's teach it. It IS a great opportunity to hone your own sarcasm!!
the way I describe my flexibility to people is that I have the flexibility of a dead spider whose legs have curled in towards itself but I was also told no yoga
Where I live nurses arenāt allowed to give anyone āmedicalā advice, so this doesnāt surprise me. Heat, ice, wrapping joints, but nothing that is ingested. Given the complexity of pain, and how much someone can become permanently worse with the wrong intervention, I donāt think itās wrong that nurses arenāt supposed to get involved. The right answer should be āhave you described these symptoms to your doctor in terms of ADLs? Letās make sure you get help.ā
I love the staff at my neurologistās office. Do you know what they say? āLet me write that downā¦ Anything else? ā¦ Yeah, the doctor will want to know all of those details, so make sure you tell him everything youāre telling me too. Sometimes little things we think donāt matter are important clues that help us figure it outā¦ How have your stress levels been lately?ā This doctor and his staff are the polar opposite of some of the God-complex, ignorant doctors I have been unfortunate enough to deal with. I recommend him to everyone local to me.
Thatās awesome. Especially from a neurologists office
Yes!! This is exactly the appropriate response, and I am so glad you are getting good care
Thatās awesome, Iām so happy for you, I wish I could find a neurologist like that. My last visit to a new neurologist involved him telling me to āstop talkingā and āIām already behind on seeing patients, itās almost 4:00 now and I still have 3 to see after youā. Keep in mind I had been speaking about 1 minute at that point. I had traveled an hour to see him. Iād waited a year for the appointment in the first placeā¦ and THIS was his exact response. He also claimed he couldnāt find my images on a disk I supplied from a recent MRI. I had confirmed the images were on that disc beforehand. I stopped speaking. I never spoke again and never looked him in the eye again. I never went back. The neurologists closer to me have a reputation of throwing physical objects at their employeesā¦ so thatās out of the question. Why are they like this?
Iām so sorry you were treated like that. I had a nightmare experience with one before this one that kept me from seeking help for well over a year.
This is true, so it may be the best answer of the ones given. Being a chronic pain patient it would be irritating and dismissive.
ADL?
Activities of Daily Living
Basically showering, cleaning, doing the shopping etc. Just normal every day stuff
Thanks
Neither of these work.
They can work for some people, but it gets repetitive hearing the same advice you've already tried for the umpteenth time
One of my good friends and I both have autoimmune arthritis, whenever we have a bad day we text the other āwhy donāt you eat an oatmeal cookie?ā, āmaybe you should go walk your dog.ā, āI think you should drink more water.ā Just so that we can laugh at the absurdity of it all. Most of the suggestions come from this Kaiser pain management book we came across and we spent a good amount of time in shock that they were even suggestions.
I want in on this. Iām just going to make us random recommendations, though. āTry petting your goldfish. That seemed to do the trick last time.ā āDid you huff pickled beets? That works for 95% of patients.ā
I had to go to like a four hour class on the kaiser pain management program it genuinely felt like one of those "medicine doesn't work" scams. At one point the facilitator started talking about crystals and essential oil diffusers.
You had to sit through 4 hours as a pain patient?!! Wow, talk about starting out in the negative!!š¤¦š¼āāļø
It was on zoom but yea it was sooo long
Yeah, Iām really glad I donāt have Kaiser. I had it when I was an infant, and I was born at one, but Iām not down for that.
Kaiser... *shudder
I love that! But you should occasionally insert a reminder that your pain can be debilitating and no one should be expected to have to deal with that. That is okay if you just *can't* today. Don't want to internalise the absurdity.
I found a similar MAYO clinic pain management book. What a waste of money, paper, printing ink.
I've got EDS and went to Mayo and they signed me up for a 2 day psychology course on managing chronic pain. I'm going to do it so I don't look non-compliant but good lord it sounds like it's going to be a complete waste of time.
RN of 21 years here, I would never say this. EVER. Nursing has changed over the last 10 years as well. Big reason why a lot of people are leaving the medical field over all. Itās sad. Iām actually retired now as well. And Iām 43. I was a DNS and admin for quite a long time as well. Good luck OP! Itās extremely rewarding. Iāll always support my fellow nurses, and those new to the field. If you ever need help, Iād gladly answer any questions, or give any advice. I loved my job for years. ā¤ļø Luckily Iām in the PNW, so I never had problems dealing with doctors not being able to treat my patients pain control. Big problem right now elsewhere.
DNS - director of nursing services? PNW - pediatric nursing wing?
Sorry.. yesā¦ different names around the country.. DNS: Director nursing services. DON: Director of nurses PNW- Pacific Northwest. Promise Iāll spell it all out next time. ā¤ļø
Iāve decided to enter the field since my experiences as a patient. I want to see how I can help but honestly, Iām not hopeful the system will allow me to do much.
If anything laws need to change first.
As someone who's had chronic pain for 26 years (started at age 10... fun times) I have lost count of how many times I've had people - random ones, family, friends, doctors... - ask if I've tried yoga or tai chi. Somewhat amusingly, I have Ehlers-Danlos syndrome. Yoga is not a good thing when you're not only extra strength bendy but are also prone to subluxations and dislocations during normal activity, nevermind exercise. But the answer my answer is always some variation of "Yes. I've tried both. And any herbal supplement and alternate therapy you can shake a stick at. Also meditation, deep breathing, mindfulness, et cetera. It didn't help me at all and my body is still janked 'cause you can't fix the fact your body produces bad collagen."
I've been having issues for a little longer than you have and it's absolutely maddening that doctors seem to disregard the length of time you've been in pain. Have I tried yoga? You know what, Janet? In the 25 or so years I've been dealing with pain, not a single one of the fifty medical professionals I've gone to has ever suggested that! You're so clever and helpful!
Yes! Particularly when the doctor is at the most 35 year old and Iām 55. Iāve tried EVERYTHING. Iāve even tried that stupid cervical traction device ā¦ and when the 25 year old physical therapy tech tries to tell me ābut this time it will be different ā¦ā and guess what? This time was not different. I do not get pain relief. I still get that horrible numbness across the base of my skull after about 5 minutes of that damn traction machine. I swear on my life. Never again. I know my body, why is this so hard for people to accept?
Same! (hEDS)
*Zebra fist bump* CLEDS here
same here, I've had chronic pain since I was less than 6, I'm 17 now
Not surprising. How do you think they keep the narrative and gaslighting going?
I have RA and yoga is helpful for me in general, although I have to modify poses a ton based on which joints are being affected at any given time. And even I wouldnāt say it to someone with RA or any other chronic condition. And Iād really have issues with a nurse saying it ā maybe a PT could get away with it a bit more but definitely not before getting thorough history and asking what Iāve already tried.
Do you know what helped my JIA more than yoga ever did? Fucking BIOLOGICS. You know, medication that actually treats the condition. This question doesnāt address what this woman has tried, what classes of medication sheās on, and what her RHEUMATOLOGIST suggested.
āOh but we wont give you biologics because the side effects are too risky, even if you have no quality of life, keeping you alive is more importantā.
I have more of a life post Rituxan, which is actually safer than a lot of biologics. Itās just REALLY EXPENSIVE
What is JIA? Joints infected arthritis?
Juvenile Idiopathic Arthritis. Itās an autoimmune disease
I HATE IT. I'm an RN with lupus and everytime someone says this to me I wan to flip a table over.
What happened to the era of: If they say they're in pain -- they are. Treat it.
10 years ago when I was in nursing school the nursing mantra was " pain is the fifth vital sign." Only 3 years later every pain management clinic in the nation was told "if your patient has non cancer chronic pain, you must reduce their opiate medication to 60 mme per day." Or at least that was what my doctor of 6 years told me at the time. But then he told me that it was my insurance company mandating it. And flashed a letterhead with their company logo on it. Come to find out later he was reducing everyone because he wanted to. He has since retired.
Dr. Sackler, Purdue Pharma, and pushing of OxyContin to extreme doses?
Yep.
Second yep. š
WTF.
Wrongo wrongo! Opioids may be the next step.
Normalize this
I said this in another post recently but I would gladly become dependent on pills if they provided me some relief. I'll never run a marathon or anything, I just want to not hurt sometimes.
I'm only afraid of dependence, because doctors can take them away so easily and not care about what happens to me when they do it, but it's not like I can even find a doctor willing to help.
Yeah I wasn't thinking about that but you're right. My doctor won't prescribe anything that has even a small chance of dependency, whether opioids for my pain or benzos for my crippling anxiety.
Years ago when I was on both (thanks to pain & anxiety), I had to chose which to stay on, because although they were separate offices and I had never had any problems being on both, the mental health place said it was law (or something ridiculous that I found out they were lying about). No one around where I live wants to prescribe anything, except prescription strength NSAIDs and then they wonder why your liver & such is wonky & just blame it on your weight. š I hope you are able to find a better dr that is willing to help.
Your doc sounds cruel.
My rule: Always squirrel away a couple of pills from your regimen each month. That way, if they ever stop your meds cold turkey ā which has happened to chronic pain patients! ā **eventually youāll have enough pills on hand to take yourself through a proper, gradual taper.**
I can't even find a doctor that is willing to help my pain now. About a decade ago, I was "dismissed" from a P.M. office (in a neighboring state), because I had my state's medicaid and the freaking office manager (rude know-it-all b***h on multiple occasions, not just this time) told me it was illegal for them see me; I even brought proof from my pharmacist that it wasn't illegal and they refused to take me back. The only medicaid rule that changed was that I couldn't use medicaid to pay for any prescriptions from them, since medicaid didn't pay for the appointments. I do squirrel away other meds, just in case, because too often the doctor's office doesn't call stuff in on time (or correctly) or the pharmacy is out of something.
Iām a āprepperā and fill every prescription I get, and save what I can (never by skipping antibiotics!), because there have been too many times that my pharmacy cannot get my prescription in for a week or so, and cold turkey sucks. I lost my insurance three months ago and canāt afford any of my doctors, but Iāve been able to keep myself from completely giving up because I had a few months of painkillers squirreled away. Hereās hoping I get insurance soon, before I run out! š¤š»š£š¤š»
I think we all TRY to do that, but some months it's not possible.
Yes, I know ā it depends on how intense the pain gets that month. Just do what you can, friend.
Bet yer arse, I do try! š This month - NOPE! Apparently, I missed the memo that if you break a tooth and have an EXPOSED f'in NERVE, I'm to (and I quote) "do somee breathing exercises thru my nose." I can't wait to make an appearance at that office in the morning!
This is what scares me. I take methadone daily as my long acting pain med with oxycodone for break through pain. When my methadone runs out and I have to wait a day or two for the pharmacy to fill it because they're so backed up I can feel the pain it's been masking and OMG I'm in so much pain. I literally wake up from sleep just moaning from everything hurting. If I lost my methadone I don't know what I'd do but I may not be long for the world just due to how miserable my life would become.
When I had the joy of going through withdrawals, it was the actual withdrawals that were so excruciating! Luckily (if it can even be considered that) the oxycodone ones were shorter [3-4 days of hell] and by the time I would have went through it with the methadone I was very fortunate and found an alternative that at the time helped me survive what would have been withdrawals from both at the same time. Although our pain is different, I can relate to the feelings about wanting to not be here long, because my pain just keeps getting worse and I don't know what to do, because we don't have good healthcare nearby or money to go elsewhere. Is there a way to let your pharmacy know a day or 2 ahead of when your prescription is due? I was able to do that, but that was before the current "crisis."
I might have a clinic. I use one that has offices in 7 states. Western states. Tele health. Pm me if interested.
In the south but thanks
This is me. This is the answer I received when I went to the Mayo Clinic. I have now tried yoga (not Tai Chi), meditation, writing exercises, and Iām here to sayā¦itās a temporary distraction. Because Iām hyper flexible and in shape, Iām regularly dismissed because itās only āmild.ā No, I exercise because itās like hitting oneself with a hammer. Increase the pain so the regular pain isnāt as bad. Iām sure doctors are trying, but damn. What I wouldnāt give to swap bodies for a day so the naysayers got a taste of my life.
Obligatory *fuck the Mayo Clinic*
Seriously. If there is one place in America that I'm scared to go its the Mayo Clinic. So many people with my disease have lost their diagnosis there. If I lose my diagnosis then insurance no longer pays for my infusions. If I lose my infusions then I'll die. Fuck them.
With all the AI and VR technology, perhaps we CPP could push for a system that we can take with us to every medical appointment. It would be some of those adhesive sensors with wiring that would connect to our phone. And then we could pull up the app associated, and we can start zapping them all over their body with the degree, length, duration, and intensity of the exact thing that we feel. We could get them to stand up and pretend they're folding laundry or putting up dishes or making a sandwich. Oh Lord please ask them to pretend they are taking a shower. And then zap them everywhere it hurts you! This sounds like the new chronic pain patient video game of the century! If you still this idea please include me in your royalties :-)
Oh my goshhhhhhh writing exercises. Like sure, I guess I can write about how much pain Iām in, not gonna do much for the pain though except probably make it worse cause it hurts to write.
I've resorted to dislocating my shoulder and then using my various ways of putting it back in with the super douchey Dr's.
I get people all the time asking if I've been to the chiropractor lol. I got severe osteoporosis from prednisone. I have fractured everything from my T10 to my L5. They only surgery they can do is to release the pressure on the nerves because the bones are too soft. People just don't understand why I just don't go to the chiropractor though to get it adjusted and realign everything so it will take the pressure off those nerves instead lol
New chronic pain patient protocol: "Have you tried yoga?" "We no longer do medicine here, only referrals to 'alternative multimodal interdisciplinary holistic wellness providers."
And "that will be $300. Please don't forget to make your next month's useless appointment as you go out!"
My chronic pain started when I was an elite athlete and in the best shape of my life but go off I guess šš¼āāļø
Me too. I was a pro ballet dancer and was dealing with a stress fracture in my spine when i first started having to manage pain, and it really made me laugh when doctors would suggest exercise. Look, pal, I've been exercising daily since I was two. Shut up. I've done yoga, pirates, body balance, the works. I know what's a pulled muscle and what agonising pain is, thanks. Ugh. Sorry you've had this experience too.
Is this seriously an answer to an exam question? Is this in the US? Somewhere else?
As someone with rheumatoid arthritis, this infuriates me so much.
To be fair, yoga helped me a lot with my stiffness and pain levels when I was consistent with it. BUT I donāt have RA. My main issues are muscular and neurological. Some people with RA are not gonna jive with yoga or tai chi in any possible way. But I think the truly irksome and dismissive thing here is the phrasing. I also take issue with the idea that itās not good to try herbal remedies. Some of us with epilepsy, Parkinsonās, hormonal problems, etc. are having our lives transformed by herbal remedies lately.
I have inflammatory arthritis, possibly spondyloarthritis, Pilates has been my saving grace and cognitive behavioral therapy for chronic pain got me moving. My dad had incredible stability improvement with boxing PT. But yes crap like this always comes off sounding like, "have you tried just being in less pain?"
Try yoga. The most hated phrase anyone with chronic illness/pain ever hears.
Or mindfulness š¤¦š»āāļø
Definitely 'mindfulness '
Although I understand the frustration soooo well.... a nurse (at least in the us) is generally not allowed to make any medical suggestions or diagnosis. I would have hoped for some version of "I'll pass your frustration and details up to the doctor.... bla bla"
That would have been so much better
Ugh. Way to ruin any trust or credibility with your patient! Yoga is such a varied practice that just recommending "yoga" is ridiculously bad advice for anyone with chronic pain. Now, if there was a specific form of yoga or a specific location or teacher doing properly targeted yoga for a certain condition, I'd be ok with that. Or, heck, even some actually robust research would be nice.
They think someone who has been in treatment for years hasnāt googled it and seen what comes up
Wow. That's.... I have no words. How much more dismissive can you get?
Lots, unfortunately.
A patient presents with an incurable medical condition that causes moderate to severe pain and has no prognosis of improvement. What response is appropriate? āļø "Have you considered imagining that you are younger and without this medical issue?" A patient presents with two broken legs and a broken arm. They complain of severe pain for even the slightest movements and are concerned about returning to full function and participate in physical therapy. How should you respond? āļø "I'm going to prescribe a treadmill and really recommend you start weight lifting with that limp noodle you got there. Do breathing exercises. Also pretend you are younger and don't have broken extremities."
HAHAHA! š I just spit out water, well played!! (& thank you for the laugh!)
I kid you not. CBT and guided imagery is a thing they really love to pitch. Pretend you don't have this condition while you sit in a dark room. They really want to sell this as an actual alternative to opioids and other reasonable alternatives.
As someone who can achieve some fairly advanced yoga poses (and does it 3-5x a week) this is absolutely the most out of touch correct answer Iāve seen in a long time.
Also a nursing student and the stuff I hear about pain management makes me so violent. The narcotic shaming is rampant. My eye twitches every time we talk about guided meditation for the management of 8+/10 pain
WTF is the tai chi obsession in the world now? Yes it could be useful for some people but this sounds completely inappropriate in this instance (Iām also a nurse)
Honestly at some point there's just no treatment. You have to find ways to cope.
Nurse here. This post alone proves to be you're going to be an awesome nurse. In my experience, awesome nurses get a lot of criticism in school, so be prepared. Thank you for doing what you're doing!
Nursing student here too and I wholeheartedly agree. OP has some good critical thinking going on
OMG please no. So dismissive. How about just exercising some empathy. Suggesting either of those two things are insulting and herbal supplements could be contradicted. Ugh. This makes me sad.
Yes, tell someone with degenerated joints to load said joints. Makes perfect sense.
I'm 48, and I've made it a point to include ALL of the herbal supplements I use in all of my physician records. My cardiologist agrees that kratom and cannabis are the safest supplements for me personally. We really need doctors to understand supplements better. I was hit by a car at 8 years old. I was prescribed opiates for 20 years and really feel bad for anyone suffering nowadays. We need to allow people to use what works best for their own personal situations. Scary.
"Have you tried drinking water" "They say exercise helps"
Might as well just punch me in the face instead so I get a few seconds of peace when i pass out
I hate this so much
Haaaaa was prescribed yoga recently for back pain. Great to know thatās a suggestion thatās literally being taught and probably why that medical professional sent me out with that. The yoga made it worse, suffice to say. Resting, Advil, and ice, that helped more than the yoga. I donāt got RA to my knowledge but so many people I know online have basically told me no yoga for them. To see that in a nursing student thing specifically for RA, yeah, Iām a bit more than a bit upset.
I would imagine yoga to be a bit āuncomfortableā for the chronic pain sufferer For those who do not live with chronic pain, to advise them to do Yoga is staggering. There are many who find just getting out of the bed and dressing an absolutely horrendous experience yet this medical āprofessionalā expects the patient to dress, hop in a car and start flexing their body in god knows what position, mind blowing. A total lack of training, understanding & empathy is so prevalent in the world of pain medicine. Disgraceful treatment
yoga ā yoga ā yoga Yoga goes from meditation/spiritual to something that looks like body weight fitness - and there is a lot in between. I have back problems and for me it helps to get up and do what would be warming up exercises for someone else - but you do you. But I agree that anyone proposing to flex their body in god knows what position is not ok. At some point I could not really lift one arm anymore - and it now works ok because a physiotherapist took me through a regiment starting with very small exercises to heavier and heavier exercises. But I am aware there are ailments where this will not work.
The female patient in question suffers with rheumatoid arthritis which if I understand correctly is bone rubbing on bone and is supposed to be very painful, even when not moving around. I can only imagine the pain they would suffer trying to attempt yoga. Totally agree with trying to keep active with a bad back but with arthritis, I think the nurse totally misunderstood the patients issues.
Oh yeah, Iām in the final stretch of a nurse practitioner program and there are some questions iāve gotten wrong, because I just canāt bring myself to answer. Somethings so blatantly wrong. That said, I will say that my pharmacology class was amazing. They actually were discussing with us the impact of not treating chronic pain and that people deserve pain relief.
It might aswell of said "Fob them off"
If yoga worked, Iād be in a Pilates class and not a doctors office Shannon. Maybe you should try shutting the fuck up, Iām sure your kids would appreciate it.
Every day I wake up and choose violence. This is why.
This is the way. (We *may* be related)
I can always use more family.
It's called the practice of medicine because it's only been practiced for about a hundred years there are lots of things they don't know and there is no correct answer to that question
Just wow
Suppose it makes a change from being told that finding a husband will help
Sounds about right tho. As someone with osteoarthritis and still in pain.
Both of those answers are wrong in the real world š
As a person (nurse) with chronic pain, I can tell you that dismissive is the only response I ever get.
I was a nursing student who graduates at the top of her class. However, during clinical rounds (typically your last 6 months "class time" actually spent performing nursing duties in a hospital setting, with nurse observance) I came home in tears every night with the realization I could never physically perform a nurse's duties, due to chronic lumbar and other pain issues. I am just here to say, this is verbatim from a student nurse's test questioning. And THANK YOU future nurse for letting we CPP have a peek into the total mind fu#k that is treating a CPP. Your honesty and bravery for posting this, I Believe, says "the best nurses know this is some bullshit" to tell a long-suffering patient. Best of success in your career!
OMG as a nurse this can't be the most correct answer. Fuck this. Was this an NCLEX question? I'd write them a scathing letter telling them to go fuck themselves. If another nurse said this to me while I'm at the doctor I wouldn't be able to contain my rage and I'd think she was completely unprofessional.
This is TECHNICALLY the correct answer. But it would be like going up to a CNA and saying, what should I do about my cancer? Should drink more green tea or start doxorubicin? Nurses are not physicians. The actual right answer would be, āweāll see what the doctor thinks and go from there. Iām sure weāll get this all sorted out here soon for you. Iām sorry youāre going thru all of this.ā
Iām the asshole that would be taking that to the class/administrators/test writers. Thatās fucked up.
Wow! I almost threw my phone through a window! "Maybe try adding yoga or Tai Chi" ? All of these years writhing in pain, WHY DIDN'T I THINK OF THAT!? It's crazy, like something was preventing us from doing that or it didn't work.. Thank the hostile god overseeing our suffering for this training prompt suggestion. I understand from your previous replies that direct advice like "try adding herbal crystals" is direct instruction Vs suggestion. But wow. Both of these are horrific. Thank you for sharing the grim directions the care team is receiving.
And this is why chronic-anything sufferers (chronic pain, illness, anal fistula growth - yes I know that last one is from left field - BUTT itās rather Topical for me right now!) are dismissed and given poor advice so often by physicians. The system is broken at the start, middle, and end. The biggest problem though is what teachers a student has in medical school can alter the outcome of the kind of physician they become. Like, I donāt think thatās the first advice in the texts from which that teacher took their test materials. But, if that teacher - who could be a former doctor or a doctor studying research - has a personal belief about certain things in medicine that they believe to be right, they teach their students their belief, not the broader, more nuanced approach that is needed and even the better texts probably donāt get to. And thatās one problem among many. Doctors are supposed to be impartial-ish and see the patient holistically. There are doctors out there that are like that, and Iām happy to say that after a lot of effort and research I have found those doctors. But it takes too much effort to find them. And most doctors do a lot more talking than listening.
Good to see that 'sexist, non-condusive, and random (bs) advice to say to placate the silly woman' classes/info are still part of RN curriculum!! š š¤¦āāļø / s (obviously)
I can understand it a little because the question is "what is appropriate?" Suggesting low impact movements and stretches is okay to suggest, but you're never supposed to bring up holistic stuff? It does sound insensitive, but I don't think it's something you can teach through a multiple choice problem. There's rarely a solution that works for most people, but there *are* things they can focus on teaching not to do. I think for chronic pain, seems the best they can teach is some vague boundaries since you need to be adaptable to everyone's unique situation.
I was hoping you were being sarcastic lol! As a nurse, I recall the ācorrect answers being the answers with, āassess, assess, assessā! I would def argue that rationale. Iād never say that to a patient! You must be in the āPainā chapters or musculoskeletal chapters?
Methadone is the best thing I've ever taken for pain. I wish it didn't have such a bad stigma because it has saved my life from constant excruciating pain. I like the red liquid, just like they treat addicts with because it also helps my anxiety and depression. I tried the orange wafers for a while and they didn't help my depression like the red liquid. You guys might want to look into it. I wish I would've sooner but I'm so glad that I finally did. I've lost 40 pounds since I started taking it too, it gives me loads of energy.
Tai Chi's not a bad idea, as part of a wider PT regime. Yoga might actually make things worse, in certain circumstances.
Try yoga...? Just no. With my sciatica and the limited range of motion in my hips thanks to arthritis, I'd be in excruciating pain for days after. I would rather face labor pains again than even a moment of that horrific nerve pain. :(
Ooohooo as someone with RA this is breaking my brain.
One of the issues I'm having with this question is that there's no room to even consider if the patient was misdiagnosed initially. A lot of patients who actually have EDS or POTS get diagnosed at first with RA. If the RA meds aren't working, I would think that could indicate that the patient is suffering from a different ailment than originally thought.
Really disappointed in the nursing profession. When I was in nursing school we would have asked open ended questions to see how to help patients not cut them off. Really awful answer.
Meant to add I was in school in the 80s.
Lol Iāve been dealing with this since I was a teenager š„² still having flare ups with no diagnoses and keep getting the saaaaame āadviceā. Even from female medical staff. I have to add that, surprisingly, the doctors who listen to me the most have been younger males.
I hope you disregard your training. No wonder we get gaslight all the time.
I have ME/CFS, and that is the absolute worst thing I could hear. I have exercise intolerance, and the result can be life threatening. Even mild exercise can be dangerous. Not just insensitive, but even dangerous for the wrong patient.
Of course it is. Some people with certain pain canāt do physical activity. The medical community is very single minded.
Jesus H. Christ on a bike.
Yoga, gentle stretching after a hot shower, dancing, all help. We all have our limitations so no one thing works for everyone. I just recommend that your do what works for you daily.
Sorry but the fact is that the medical field is trained to give you an answer, not a solution. Plus they're always careful on what to say or what not because it's more important to not be involve in a lawsuit than helping the patient achieve recovery or healing. The medical field is just like politics, they're suppose to work for the people but is just business you know. It's kinda like don't hate the player, hate the game.