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Pain's impact on families and patients

We sat with Dr Amaury Salavert, an authority in pediatric pain management, for a fascinating talk on pain ranging from assessment to treatments and the contributions Alternative and Complementary medicines can make.

This is part 5 of 6, where we discuss the impact of pain treatments on families and patients. For an overview of the various type of pains and how to address them, see part 1. For an overview of the various treatments available, see part 2. For an overview of benefits and risks, see part 3. For on overview of integrative treatments and new trends see part 4.


What advice do you have for parents when their child is in pain?

Always trust your child. When it comes to helping a child manage chronic pain, it is important for parents to trust their child. Pain is physical, social, cultural and so much more. What might not seem painful to you might be painful to him/her. It is essential for parents to talk to their child and to understand how he/she is feeling. If a child says he/she is in pain, trust him/her. Children, except in very rare occasions, don't lie.

What do you think are the most important things parents can do to help their child manage pain?

It's important for parents to have open conversations with each other about how they are feeling and how they are responding to their child's pain. It is important for parents to be mindful of their own emotions and stress levels, as these can have an impact on the child's pain. Children are like sponge. If parents want to help, they should start by not adding their own anxiety to the mix.

How do you work with parents to make sure their child is comfortable with the treatment itself?

First of all I strive to answer any questions. Usually they are about potential side effects or whether the treatment should be taken during holidays. Additionally, I emphasize the importance of parental involvement in the process, as a child is unlikely to take the medication without their support. As I already mentioned, I also work to ensure that parents are not overly oppressive in their questioning, as this can be detrimental to the child's wellbeing.

Would you say it's easier to impliment non-pharmaceutical treatments since they are less likely to generate side effects?

Depending on the situation yes, I may suggest non-pharmaceutical treatments, as these can be easier to work with parents due to the lack of concerns about addiction. However, I recognize that these treatments may require more effort and time from the family, which can be difficult to accept.

How do you educate parents or caregivers on the fact that alternative treatments take time to be effective?

You have to be open about it, emphasize that it takes time for these treatments to be effective. Repeating this message and allowing parents and patients to take the lead in the treatment plan can help to ensure that they understand the importance of patience. If the patient is not seeing the desired results, it is important to listen to his/her concerns and explore other options that may be more effective. For example, if a treatment is causing sleepiness, it may be beneficial to try a different treatment that has the same effect but without the same side effects. Ultimately, it is important for me, parents and caregivers to listen to the patient and work together to find the best treatment plan.

Since we're talking about patients too, can we zoom in on fear and anxiety associated with pain? How do you address them?

When it comes to helping children cope with fear and anxiety associated with pain, it can be difficult to differentiate between the two. In the emergency room, painkillers may be used to treat acute pain, while anxiety treatments such as hypnosis, meditation, or other methods may be used to treat chronic pain. It is important to recognize that it is normal to feel depressed about chronic pain, and integrative care is essential to ensure that children receive the psychological and emotional support they need. Additionally, teenagers may not recognize their own stress and anxiety, so it is important to provide them with resources to help them understand their emotions. One thing I do for instance is recommend watching a Disney animation called Inside Out. It does a great job at teaching children about accepting their fear and anxiety.

What are the most difficult cases to handle with patients and their families?

Cases where we're running out of options. These might require hospitalization in order to separate the child from their family. This is especially true when the individual is suffering from emotional pain due to trauma experienced during childhood that has not been addressed. In these cases, separation is best to provide the best care. These cases are the most difficult.

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