An institution-wide program at Parrish Medical Center ensures that patients who have pain are identified and treated appropriately and effectively. From the moment you are admitted to PMC, your health care team will work with you to ensure successful pain control.

• the right to have your pain assessed
• the right to appropriate pain management
• the right to request, question or refuse treatment for pain

It is essential for your well being that you and your health care team work together to choose methods that will make you feel comfortable. To better understand your situation and help you, your health care team will ask you to describe your pain. Patients will be asked to rate their pain on a scale of zero - 10, where zero = no pain, 5 = moderate pain and 10 = the worst pain possible. Other patients, such as young children, those who do not speak English and those who are cognitively impaired may use the "faces" scale to describe their level of pain.

You may be asked to describe your pain in terms such as dull, sharp, stabbing, etc. Tell your health care team where the pain is, exactly how it feels, what makes it better or worse, and what you are using to treat your pain. Medications for pain and response to pain will vary from person to person. Discuss your pain with your doctor and agree on a treatment plan that works for you.

There are many reasons for which patients may not choose to discuss pain with their health care team.

1. Fear of addiction: Some patients worry about addiction to pain medication. This rarely occurs when it is used properly and under medical supervision.
   
   
2. Fear of interrupting the health care provider.
   
   
3. Fear of being labeled a complainer.
   
   
4. Difficulty communicating: Patients who are in pain and have difficulty communicating their needs may show the following symptoms: inability to sleep, loss of appetite, fatigue, irritability and fear.
   
   
5. Side effects: Any medication may produce side effects. Common side effects include constipation, nausea or vomiting, and sleepiness. If you experience any of these please report them to your health care provider.
   
   
6. Religious or cultural reasons: If you do not want to report pain for any reason, please talk to your health care team about why you feel this way. Together we can seel to solve the problem.
   
   

Be sure to ask for your pain medication before the pain becomes severe. Stopping pain early will make you more comfortable, increase activity and strength, and help you feel better. However, after taking the first dose of any pain medication, please ask for help before getting out of bed.

Let your health care team know if a particular pain medication or treatment has worked for you in the past. Be sure to report if you have had a bad reaction to any medication.

Always notify your physician before taking these medications if you may be pregnant or are breast-feeding.

NSAIDS (non-steroidal anti-inflammatory medications): These medications are for mild to moderate pain.

Opiods: These medications are for mild to moderate to severe pain. Morphine is an example of an opiod.

Adjuvant: Medications that are not primarily used for pain management, but have some benefits in this area, i.e., steroids and anti-seizure medications.

• Oral (by mouth): Useful for all patients. Provides continual pain relief for longer periods of time.
  
  
• Injectables: usually provides faster relief than by mouth. Requires a needle stick to administer. These methods include:
  
  
  • Subcutaneous (SQ): Given under the skin.
    
    
  • Intramuscular (IM): Given into the muscle.
    
    
  • Intravenous (IV): Given into a vein. Provides relief. Most commonly used after surgery.
    
    
• Patient Controlled Analgesia (PCA): Requires a needle stick to start an IV. A pump located at the patients' bedside can be programmed for patient control of pain medication. This method requires patient education. This is available to adults and children above seven years of age.
  
  
• Epidural PCA: Pain medication is given through an epidural catheter into the spinal column. Effective for some major surgeries as well as for the birth of a baby. A pump at the patient's bedside can be programmed for patient control of pain medication. This method requires patient education.
  
  
• Transdermal: Pain medication is applied to the skin and is absorbed into the system.