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OFF THE CHARTS

My name is Allison and I am a registered nurse. I am going to be writing a weekly blog called “Off The Charts.” This will be a nursing based blog that covers all aspects of the healthcare system. I have the education, knowledge, experience and expertise to write this blog.

After graduating from High School, I received my Bachelor’s s of Science in Business Administration with a Major in Marketing and a Minor in Communications.

I began my career in the business world, selling medical services to nursing homes as well as business services to companies. I realized that sales weren’t fulfilling my desire to help people or making a difference in their lives. I decided to take a leap of faith and make a change in my career.
In 2009 I graduated from Nursing School. I began working in the Pediatric Intensive Care Unit at Children’s Hospital.

After working for many years in the Pediatric Intensive Care Unit, I began to have my own health problems. I had 8 surgeries, spent 6 months confined to a hospital bed and the next 3 years unable to walk. I have the ability to speak not only as an ICU Registered Nurse, but also as a patient.

I also have an enormous amount of experience in substance abuse. This is so prevalent in today’s society. Does the exposure to medication given in the health care system set people up for misuse of prescription medications and other chemical substances?

I welcome any topics, questions, or comments. Thank you for allowing me to share my experiences w you.

  If I asked you to name the 10 most common reasons individuals seek medical care or treatment, do you think you could identify all 10?  

According to a study done by the Mayo Clinic, the top 10 reasons people in the United States go to their doctor are depicted below. 


Skin Disorders

Joint Pain & Osteoarthritis 

Back Pain

Anxiety, Depression, & Bipolar Disorders

Chronic Neurology Disorders 

Head aches and Migraines 

Upper Respiratory Problems (not including Asthma)

High Blood Pressure 

Diabetes 

Cholesterol Problems


What fascinates me when I look at the list above, at least half of the most common reasons individuals seek medical care and/or treatment involves some type of pain: 


Physical Pain or Mental Pain


That number is even higher if these conditions in the above chart go untreated. 


I decided to make this blog about pain because it’s something that almost all of us have dealt with personally or know someone who experiences pain in their everyday lives. According to the the National Pain Advocacy Center, “one out of six people wake up in pain daily. 40 million Americans have severe pain, and nearly 20 million Americans have pain so often that it regularly prevents life and work activity”.


Pain is subjective which means even if two people have the same injury, diagnosis, or even the same surgery, the pain they experience is unique to them. For example two patients have a hip replacement. Both patients have pain after the surgery and one patient reports the pain to be a three out of ten and the other patient reports the pain to be an eight out of ten. Neither patient is wrong in regards to their pain rating.


Every person handles pain differently which makes pain also individualized


In this example the patients reporting their pain to be a three out of ten have a higher pain tolerance than the patients reporting their pain to be an eight out of ten.


A higher pain tolerance is not necessarily a good thing


This could mean that some patients have had more painful experiences throughout their lives. If a patient says that he or she is experiencing any type of pain, then the responsibility of that person's doctor is to diagnose a reason for the pain and then to treat the pain, even if the doctor doesn’t believe the patient has pain. 


The definition of pain is-a signal in our nervous system that something may be wrong. It is an unpleasant feeling such as a prick, burn, or ache. Pain may be sharp or dull, it may come and go, or it may be constant. Pain may reside in one area of your body like your hip, or abdomen, or you may feel pain all over your body. 


The scientific explanation of pain is the result of complex brain processes which are influenced by, overlapping physical (nociceptive and neuropathic) physiological and environmental factors. 


There are two types of Physical Pain. These are Nociceptive Pain & Neuropathic Pain

.

  • Nociceptive Pain-nociceptive is caused by damage to body tissue. This type of pain feels sharp, achy, & throbbing. This type of pain is an external injury like stubbing your toe, spraining an ankle, or having a sports injury. 
  • Neuropathic Pain-is referred to as nerve pain. This pain is usually from a health condition that affects the nerves that carry sensations of pain to your brain, or the brain itself. Nerve pain can affect any nerve in your body and it feels different than other types of pain. This usually feels like a shooting, stabbing or burning sensation.


          Most people believe pain is the result from physical injury or disease,

but

psychological factors play a huge role in pain perception.


Pain is tied to brain functions that govern behavior and decision making.

When looking into the psychological aspect of pain, factors such as a reward, punishment, fear, stress, & mood alter perceived pain and intensity and affect our choices.


Why is pain so important in our lives? 

Pain is like our built in alarm system that something is wrong in our bodies. Pain is essential for survival because it also protects us from doing something to harm ourselves. For example if you come across a hot stove top, you feel the sensation of heat, and our brain knows if we touch that hot stove, pain will follow. 


Where does pain come from? 

There are specific pain receptors in our bodies which are called  nerve endings. These nerve endings are  present in most body tissue and only respond to damaging or potentially damaging  stimuli. Next, the pain messages are transmitted by specific identified nerves to the spinal cord. After the pain messages reach the spinal cord then the spinal cord relays that pain message thru pathways to higher centers in the brain, including the brain stem, thalamus, somatosensory cortex and limbic system. It is thought that the processes underlying pain perception involve primarily the thalamus and the cortex. 


How do we feel pain?

A pain message is transmitted to the brain, by specialized nerve cells called nociceptors or pain receptors. When pain receptors are stimulated by temperature, pressure, or chemicals they release neurotransmitters within the cell. Neurotransmitters are chemical messengers in the nervous system that facilitates communication between nerve cells. Once the pain reaches the thalamus (which is located in the brain),the thalamus transmits the pain signal to other parts of the brain to be processed. 


When the brain has received and interpreted the pain message, it coordinates an appropriate response. The brain will then send a signal back to the spinal cord and nerves to increase or decrease the severity of the pain.


Research has shown that people possess differing numbers of neurotransmitters possibly explaining why some people experience pain more intensely than others. 


This blog is about pain. Pain is such a small word, but if we look closely at the term(pain),we realize the complexity of this word. Pain is so prevalent in the medical field. It is hard to diagnose and even harder to treat. Since the pandemic there are so many people that are suffering mental pain or in physical pain on a daily basis. If you experience pain daily you have what’s called chronic pain. My next blog will focus on chronic pain, what chronic pain does to our bodies , and how pain was managed and treated 10 to 15 years ago versus how pain is treated now.