A Chronic Pain

Firstly, I apologise for the delay in posting these blogging entries. I would like to share a clinical experience I had on my rural placement. I was told that I could participate in a programme that was being run for patients suffering from chronic pain. I was very interested in the opportunity to learn something new clinically so took the opportunity. My main role was to take the patients for a prescribed exercise class, and also partcipate in other activites carried out by other health professionals.
I learnt fairly quickly, as did the other patients and staff that there was one particular patient who was going to be a little difficult. He was very abrupt throughout the presentations that were given by the other health professionals, and would bring a large shopping bag filled with his X-rays everywhere he would go, perhaps in an effort to prove his pain was in fact real. He did little to no physical activity, and had the belief that he did not want to do any physical activity that caused him pain as he did not want to end up in a wheelchair.
I took a number of the exercise classes held for this chronic pain group over the two weeks that the programme was running. I noticed that this patient was distracting the other patients, who were highly motivated through the comments he was making and his lack of motivation. I tried my best to encourage him with his exercises, and to perform them properly, including the proper sets and reps.
One particular exercise involved walking for ten minutes. It was the second last session, and the patient in question had never before completed the ten minutes without a rest. This one time, it was around fifteen seconds before the ten minutes was up, and he had not yet had a rest. I was encouraging him to keep going, and that he had achieved much, and as I was doing this, I was standing in front of one of the chairs in the corridor that the patients could use to rest. This patient became infuriated with this unintentional gesture, and stormed inside the Physiotherapy Department to take a seat inside.
The following time I caught up with this group, the patient pulled me aside and wanted to speak with me. He had some literature that he wanted to inform me about his diabetes, and proceeded to tell me that he feels I pick on him, and that I think I know what is best for him, because I think I have much knowledge, when he doesn’t want to end up in a wheelchair because of me. I tried to explain to him that I am only trying to help him, and never meant to upset him or pick on him. This conversation went on for quite a while, and after the incident, I became quite upset by it.
The following day when I saw this patient by accident, he apologised to me about the things he had said, and that he realises that I was trying to help him, but that I have to realise that you can’t help everyone. He also wished me the best of luck.
What I learnt from this experience is to never single people out, even if it is unintentional. Also to be aware of the large significance of psychosocial issues in relation to chronic pain. Possibly the biggest lesson I learnt from the patient himself is that yes, you cannot help everyone, particularly with chronic pain, the patients need to want to help themselves. They need to want to change-we can’t do that process for them. Through all the presentations from not only Physiotherapists about the importance of physical activity, but Anaesthesiologists, Dieticians, Clinical Physchologists and the like, nothing could alter this patients view on his pain, however I did learn a valuable lesson from this experience, and really wish this patient all the best in finding a solution to his chronic pain.