31.05.07
Oh do shut up!
Not another Caameron post though.
Just had a patient who’s been in an RTA about 6 months ago. Cue “everything hurts everywhere all the time. Pain level 10 out of 10 all the time but gets worse when I do stuff.” etc..
Moving terribly slowly and oohing and ahhing to every little tiny movement. Muscles spasmed up horribly. Basic increased pain behaviour.
I’ve had a coupl’o sessions being relentlessly positive and chatty and motivating but today she made me angry.
Me:”How are you then?”
Pt:”Terrible. Everything I do hurts”.
Me:”So what have you been doing?”
Pt:”Nothing, it all hurts too much.”
M:”So what hurts?”
P:”Everything”.
M: “OK I can’t treat everything which bit hurts most?”
P:”I can’t say, it’s all bad”.
NB I should point out that the face is contorted and the voice is quiet and there are huffs and puffs and groans coming out all the time and hand grabbing various bits at various times to give them a rub.
M:”OK then let’s talk about pain.”
etc etc etc for a bit where I explain carefully and fully that specific area pain would be a red herring and I’d be forever chasing pains around her body if I tried to pick specific “bits”.
Then I talk more about motivation and chronic pain and activity and avoiding pain behaviour etc.
Pt:”But my knee really hurts here (points at knee)”.
Me:”No I’m not going to look at specific bits remember. Where else hurts?”
Pt:”Everywhere.”
Me:”OK….”
Pt:grabs thigh, “My hip hurts and all the way down to the foot on this side.”
Me:”Remember we’re not doing “bits”".
Pt:”What about my neck?” (puts hand to neck)
Me:”No.”
This conversation went on for ages. Basically all she needs is to crack on with life again and “get with the programme”. As hard as that is to tell someone it’s sadly true. Shame she’ll not “get” it for ages (if at all). No-one is going to make her right until she understands this.
I’ve discharged her now as she’s no way going to “get” it. I’ll ask the GP to refer to the pain management team who’ll basically do the same stuff; but with more resources behind them.
I do feel a little sorry for this woman but I really wasn’t in the mood this morning.
Have more fun than her.