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The Direct Correlation Between Pain and Increased Vitals



  • Motor1MMotor1 Pittsburgh, PaPosts: 606
    When I worked in Hospice, we were taught that elevated vitals is definitely a sign of being in pain. A lot of my patients were not able to vocalize their pain. We were taught to look for the signs like, elevated vitals, moaning, restlessness & crying. 
    When I started seeing my new pain doctor, he was very concerned about my vitals. Normally my blood pressure is low, but it was very high that day & so was my heart rate. After he questioned whether that was normal for me, he questioned my pain level at that moment. 

  • jpouljjpoul Portland,Or.Posts: 9
    edited 07/20/2016 - 1:17 AM
    Motor1-I can so relate to this. I've always had low blood pressure myself as well as a lower heart rate.

    In spite of living with chronic pain of severe disk and very painful spine degenerative changes, my vitals have always been indicative of not signaling anything out of the ordinary when my pain was previously well managed, however recently, my vitals have been high, signaling inadequately controlled pain with my heart rate staying in and around 130 bpm, and my blood pressure in hypertension rage even though tests have ruled out heart disease or high blood pressure, but unfortunately for me, my current pain clinic isn't paying attention to the high vitals, and they're the ones responsible for my pain mgmt.

    Like another member has mentioned; In light of the country's opiate epidemic, doctors are having to adhere to stricter prescribing practices in the wake of new guidelines, and sure it's common sense that if you make things less available, there's going to be less of a problem, but what we are seeing in the chronic pain community is resulting in needless suffering. There are many of us who aren't addicts and don't abuse our medications, and need them as an integral part of treatment in easing our pain, but I'm reading stories everyday of people with chronic pain that are now being neglected by their doctors who disregard their physical symptoms of uncontrolled pain like vitals. There are some that have ended becoming unfortunate statistics. If we are creating more problems aimed at fixing one problem, then I think it's about time to go back to the drawing board.
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  • Like another member has mentioned; In light of the country's opiate epidemic, doctors are having to adhere to stricter prescribing practices in the wake of new guidelines, and sure it's common sense that if you make things less available, there's going to be less of a problem, but what we are seeing in the chronic pain community is resulting in needless suffering.

    Amen--however, making these drugs less available isn't going to necessarily make it less of a problem.  I actually see it in reverse.  It's going to become MORE of a problem, in my humble opinion. Those who are addicted to these medications have, and will continue to find a way to get these types of drugs.  The danger zone developing with this that I've thought about is those people who are in absolute physical need of these medications for chronic pain to the point of desperation, who for whatever reason, do not have access to the medications they need, or are undermedicated for their conditions.  As the old adage goes, "Desperate times call for desperate measures."  As it is often seen with individuals who are addicted, it is both sad and dumbfounding to those without addiction issues the lengths to which these people will go to acquire their drug of choice.  It is no mystery that desperate people will sometimes behave in ways that would normally be completely against their personal moral and ethical standards.  Add chronic, unmanaged pain to the equation, and I could absolutely see desperation winning out over morality/ethics.  As addiction saddens me to see, my heart is also heavy for chronic pain sufferers who may decide that resorting to obtaining these drugs via illegal means will become a more viable option because their attempts to go about getting their pain controlled legitimately (i.e. through their primary care physicians, pain management, etc.) are failing (or have failed). 

    I do understand that taking illegal and alternative avenues to obtain medications is a choice.  I also understand, however, that certain combinations like pain plus desperation minus adequate pain management can exert more power over an individual than common sense, logic, and even their ethical and moral belief systems--hence leaving these individuals with the perception that they are out of choices.

    There are some instances where guidelines can create, rather than control, criminality (Prohibition, anyone?).  Beyond the deleterious effects unmanaged pain on the body, I'm also concerned about the long-term effects these guidelines may have on society as a whole.  I'd personally rather see some guidelines for the medical community in terms of how pain is assessed.  I think it might be interesting for prospective pain management patients to wear a cardio-tachometer for two days--with one of those days being without any type of medicinal pain management.  The more empirical evidence that we can use to prove pain, the better, as patient self-reports leave too much room for interpretation and/or deception. 

    For those of you who may say I'm full of dooky on this...that you would NEVER do anything illegal or immoral no matter HOW much pain you were in--please just do me a favor and do an internet search for moral/ethical dilemmas.  You might just surprise yourself with what you might choose to do in certain situations...             
    Kimmy72, Spine-health Moderator
    Firm believer in PMA!
  • jpouljjpoul Portland,Or.Posts: 9
    edited 07/20/2016 - 11:22 PM
    Kimmy72, I cant' agree more. There's been much said in  response to the new guidelines both supporting and opposing them, however I find it interesting that the ones in favor of advocating them are the ones who aren't on the side of the spectrum being directly impacted in a negative sense including the "experts" stating that they know what's best for society in curtailing our nation wide epidemic, but who aren't having to live the full impact of which these guidelines are having on individuals, mainly those in the chronic pain population. It would be a much nicer world if lawmakers and legislators would make decisions rooted in morals and ethics, but alas we are seeing less and less of these qualities. They seemed to have gone out the window.

    You are absolutely right, making these prescription drugs less available isn't going to get rid of the problem or make it less of a  problem. Those who are addicts and dealers will always find a away around to obtain what they need, just like criminals will always find ways to continue in illegal activity. Interestingly is that whenever there's extreme restrictions affecting a portion of society; There's always opportunities in the black market to hop on board, taking advantage of people who now don't  have or limited access to their medication, like the illicit fentynal that was leading the epidemic, and now there's a trend of designer topical pain creams being used for chronic pain, made and marketed by specialty pharmacies that contain Ketamine, an animal tranquilizer and potent anesthesia drug. There have already been reports of adverse health effects and deaths. This is also becoming a standard for physicians to recommend and suggest these creams even sending patients info. to these pharmacies who then mail it to them, and is a way of having to prescribe less opiates. I've been in this position. It's true that the use of Ketamine is helpful in some cases of severe neurogenic pain and depression, but it's always done in a clinical setting under the supervision of medical staff who are trained, if that patient becomes unconscious. But I myself would be very leery of using these creams at home in which I'm unfamiliar, and encounter adverse health effects.

    I was more or less being sarcastic in my previous message. It's ridiculous to not think that chronic pain patients who have been safely maintaining their medications and have been monitored regularly to assure that the medications are being taken as prescribed without the need to escalate dose and strength, wouldn't be affected by these guidelines. Fixing the opiate endemic by restricting access to the medications that chronic pain patients need who aren't part of the problem, in my opinion is going to compound the problem. I agree with you there because previously responsible patients out of desperation are going to resort to obtaining illicit drugs or worse, putting an end to their suffering. I'm seeing that these things are already happening. Three suicides have hit close to home with the numbers rising. Portland, Oregon is almost three times the national average.  Anyone that  lives with severe chronic pain will do anything to find relief. We aren't designed for immense suffering, and it's only human to have improved quality and function of life- You aren't full of dooky!

    I'm very familiar with the recommendations, and here I agree with you as well; Rather than restricting access, affecting those who need them the most and are most vulnerable in society resulting in pain clinics shutting down, doctors not accepting new patients or no longer prescribing out of fear of repercussions also reducing  their current patients to an ineffective amount, we should focus on screening processes that will help physicians determine who's abusing and who isn't. There are leading health organizations who utilize these processes. It does boil down to choice and responsibility. Our care should not be dictated by those who aren't involved in it.

    When we start to see chronic pain patients go from previously stable to unstable, myself included, and seeing our vitals go through the roof, and sadder still, the fact that physicians in focusing on what they now have to adhere, disregarding the obvious physical signs of under treated pain; It's a sign that something isn't working in the way of how we're going about our societal problem. I just hope that it doesn't get to a level of a new epidemic before we decide to redefine our scope and put the emphasize once again on the value of life.
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