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The collective aches and discomforts of people everywhere were brought to the fore Saturday as the city celebrated, if such can be said, Ottawa Pain Day, kicking off Sunday’s start to National Pain Awareness Week.
At the conjoined Agora and Adriatic rooms at the Centurion Conference and Event Center, in the industrial park that is Colonnade Road, about 60 family physicians, pain management specialists, nurses and other similarly-minded medicos gathered for the third annual one-day conference on the topic, hosted by the Ottawa Pain Physician Network and this year given the auspicious title “Managing Pain, Selecting the Right Patient for the Right Treatment.”
To the non-medically trained outsider, the day’s presentations on such issues as “Understanding Pain in Cancer Patients” and “Tips & Strategies to Simplify Management of Patients with Complex Chronic Pain,” as well as the post-lunch debate over the pros and cons of opioid treatment for pain, each mixed easily understandable facts and argument with such specialized terminology, electron microscopy and PowerPoint slides outlining, for example, “Increased frequency of atypical mitochondria in oxaliplatin-treated saphenous nerve: C-fibers & A-fibers (but not Schwann cells),” that even professionals in the crowd admitted that some of the information presented sailed over their heads.
But information was the point, as organizers tried to disseminate current knowledge on chronic pain management to those interested. It’s a growing problem, as an aging population enjoys less sleep, a poorer diet with unnatural imbalances of calcium and magnesium, and greater exposure to such water-borne chemicals as those that mimic estrogen. Adding in such factors as car accidents and work-related accidents, doctors have seen a spike in chronic pain in recent decades, as it’s estimated that some 30 per cent of Canadians suffer chronic pain, a condition that often affects every aspect of their lives.
“They’re living lives that have been made difficult by the fact that maybe they can’t work, their home lives have changed, they can’t do family things, they don’t sleep well and often have co-existing depression,” said attendee Dr. Mary Redmond, who since 2002 has been dealing exclusively with patients with chronic pain at her west-end practice.
“But getting the message across that chronic pain is something that needs to be respected and treated has been hard,” she added, citing as an example the length of time before fibromyalgia, once dubbed “the yuppie flu,” was taken seriously.
“And there are still a number of physicians who don’t accept that it exists.”
Meanwhile, few doctors have more than a cursory training in chronic pain treatment, while the consequences can be dire.
Kingston-area family doctor Bernard Tobia said he had no instruction in pain treatment when he attended med school. “But we’re doctors and we’re there to lessen suffering and feel an obligation to help patients, but at the same time try to do it in a way that we’re not actually causing problems.”
Tobia tells his patients that the process of prescribing pain medication might bring them some short-term relief, but that they might in the end have a bigger problem than the one they started with.
Dr. Cuong Ngo-Minh, a 40-year-old family doctor, says he sees chronic pain every day in his practice at Somerset West Community Health Centre on Eccles Street, yet admits, like Tobia, to having received precious little instruction on the subject. “In my training, I learned a little bit about acute pain, but not much about chronic pain — maybe one hour.”
Ngo-Minh added that the issue of an aging population is exacerbated by the greater demands on their doctors by that demographic — the baby boomers. “They expect more.”
Dr. Ellen N. Thompson, a pain-management specialist, anesthesiologist and former family physician, as well as co-organizer of Saturday’s event, said that she, too, received scant instruction when she attended med school at Newcastle upon Tyne in the U.K.
“They taught us wonderfully about everything except pain,” she recalled, “and so when I started in family practice I had no knowledge to treat people with chronic pain.
“A 2007 study showed that veterinarian students are taught about five times as much about chronic pain as are medical students,” she added. “And that explains why we have such a problem.”
Indeed, as Vancouver’s Dr. Pam Squire gave her presentation on “Tips & Strategies… (etc.),” few in the room seemed all that eager to answer questions she posed, lest they appeared uninformed.
The afternoon debate between Thompson and Kingston’s Dr. Richard Henry, meanwhile, produced no rancour, nor winner or loser, as each argued two sides of the same coin: Thompson citing various successes at treating pain with opioids, and Henry raising such issues as addiction (10 per cent of the population is at risk of addiction when using opioids), overdose (the 3rd-most common type of death in Ontario, he claimed), sleep and motor-skills deprivation, and cardiac concerns.
“The bottom line,” said Thompson, “is we need to prevent acute pain from becoming chronic. This is not being done.”
查看原文...
At the conjoined Agora and Adriatic rooms at the Centurion Conference and Event Center, in the industrial park that is Colonnade Road, about 60 family physicians, pain management specialists, nurses and other similarly-minded medicos gathered for the third annual one-day conference on the topic, hosted by the Ottawa Pain Physician Network and this year given the auspicious title “Managing Pain, Selecting the Right Patient for the Right Treatment.”
To the non-medically trained outsider, the day’s presentations on such issues as “Understanding Pain in Cancer Patients” and “Tips & Strategies to Simplify Management of Patients with Complex Chronic Pain,” as well as the post-lunch debate over the pros and cons of opioid treatment for pain, each mixed easily understandable facts and argument with such specialized terminology, electron microscopy and PowerPoint slides outlining, for example, “Increased frequency of atypical mitochondria in oxaliplatin-treated saphenous nerve: C-fibers & A-fibers (but not Schwann cells),” that even professionals in the crowd admitted that some of the information presented sailed over their heads.
But information was the point, as organizers tried to disseminate current knowledge on chronic pain management to those interested. It’s a growing problem, as an aging population enjoys less sleep, a poorer diet with unnatural imbalances of calcium and magnesium, and greater exposure to such water-borne chemicals as those that mimic estrogen. Adding in such factors as car accidents and work-related accidents, doctors have seen a spike in chronic pain in recent decades, as it’s estimated that some 30 per cent of Canadians suffer chronic pain, a condition that often affects every aspect of their lives.
“They’re living lives that have been made difficult by the fact that maybe they can’t work, their home lives have changed, they can’t do family things, they don’t sleep well and often have co-existing depression,” said attendee Dr. Mary Redmond, who since 2002 has been dealing exclusively with patients with chronic pain at her west-end practice.
“But getting the message across that chronic pain is something that needs to be respected and treated has been hard,” she added, citing as an example the length of time before fibromyalgia, once dubbed “the yuppie flu,” was taken seriously.
“And there are still a number of physicians who don’t accept that it exists.”
Meanwhile, few doctors have more than a cursory training in chronic pain treatment, while the consequences can be dire.
Kingston-area family doctor Bernard Tobia said he had no instruction in pain treatment when he attended med school. “But we’re doctors and we’re there to lessen suffering and feel an obligation to help patients, but at the same time try to do it in a way that we’re not actually causing problems.”
Tobia tells his patients that the process of prescribing pain medication might bring them some short-term relief, but that they might in the end have a bigger problem than the one they started with.
Dr. Cuong Ngo-Minh, a 40-year-old family doctor, says he sees chronic pain every day in his practice at Somerset West Community Health Centre on Eccles Street, yet admits, like Tobia, to having received precious little instruction on the subject. “In my training, I learned a little bit about acute pain, but not much about chronic pain — maybe one hour.”
Ngo-Minh added that the issue of an aging population is exacerbated by the greater demands on their doctors by that demographic — the baby boomers. “They expect more.”
Dr. Ellen N. Thompson, a pain-management specialist, anesthesiologist and former family physician, as well as co-organizer of Saturday’s event, said that she, too, received scant instruction when she attended med school at Newcastle upon Tyne in the U.K.
“They taught us wonderfully about everything except pain,” she recalled, “and so when I started in family practice I had no knowledge to treat people with chronic pain.
“A 2007 study showed that veterinarian students are taught about five times as much about chronic pain as are medical students,” she added. “And that explains why we have such a problem.”
Indeed, as Vancouver’s Dr. Pam Squire gave her presentation on “Tips & Strategies… (etc.),” few in the room seemed all that eager to answer questions she posed, lest they appeared uninformed.
The afternoon debate between Thompson and Kingston’s Dr. Richard Henry, meanwhile, produced no rancour, nor winner or loser, as each argued two sides of the same coin: Thompson citing various successes at treating pain with opioids, and Henry raising such issues as addiction (10 per cent of the population is at risk of addiction when using opioids), overdose (the 3rd-most common type of death in Ontario, he claimed), sleep and motor-skills deprivation, and cardiac concerns.
“The bottom line,” said Thompson, “is we need to prevent acute pain from becoming chronic. This is not being done.”
查看原文...
