Cooperating in our health care

Funny thing pain, if you’ve never had a severe pain then the suggestion of taking simple analgesia and resting the affected area all seems quite reasonable. I was reminded of this when I read recently of a doctor’s advice to someone who was suffering from sciatica. Having personally experienced sciatica, it’s a condition I would not recommend to anyone who wishes to walk, sit, laugh, sleep, or to just simply pull up your trousers. It’s a bit like a dentist drilling your teeth without an anaesthetic, but it affects your whole leg. In other words the pain is consuming, exhausting and without respite. Clinical studies do show that in the majority of cases the pain will eventually subside and surgery may not be necessary, but in the meantime the patient has to deal with the pain or deal with the medication required to dull the pain. Remember, pain-killers are not selective to the area affected. They affect the whole of the nervous system and elsewhere so there may be significant side-effects from these medications.

Dealing with severe pain can be a complex issue, but I suggest that you have to treat this sort of pain fairly aggressively as acute severe pain is relatively easier to treat than chronic severe pain. In the early stages of an injury or insult to an area of the body, most of the pathological processes are happening at the site of the injury or insult. Throughout time the brain begins to modulate this pain and so no only do you have the injured area to deal with, but you also have complex neural pathways within the brain to deal with as well. This often means a far more complex management plan and a far more protracted recovery time. Specialists are very skilled at dealing with these issues but they do rely heavily on the stories their patients give them. That means being honest in answering their questions and not being heroic with a grin and bear it grimace! Often the use of a pain scale is helpful with zero being no pain at all and a 10 being the worse pain you have ever experienced.

Another health issue we commonly down play is influenza. Over the years I have frequently heard people say that they would not have the flu vaccine because either they never get the flu or that they had it last week for a couple of days and then it was all over! Influenza is a serious debilitating disease that will usually last from 10 days to two weeks and often leave you flat on your back exhausted. It’s not a happy 10 days either as patients do not have the energy to read a magazine or even watch a DVD. You will literally feel ancient with every movement being a real challenge and that doesn’t include the aching all over or the fevers and sleepless nights. The influenza virus is also extremely contagious and most people are unaware that if you spread it to someone who is more frail than yourself that you may actually be putting their life at risk.
With the 'flu the big challenge is to vaccinate as many people in the community as possible, including children, those employed and unemployed, the elderly and the infirm, to reduce the chance of an epidemic occurring. Recent research has also showed that vaccinating pregnant women in the last trimester of their pregnancy will help protect their new born infants born during the 'flu season.

Medicine has evolved over the last 40 years, but the change has been fairly slow with doctors by nature being very cautious and conservative people. But we can't leave the doctors to take all the initiatives. As patients we need to be good listeners in our approach to health by heeding all the great health messages that keep being given to us about vaccinations, smoking, alcohol, exercise and healthy eating. We also need to be good communicators and tell our doctors how we are feeling with conditions such as pain. If the team treating you doesn’t have the best information then it may be that you will not end up getting the best treatment!

HBF Health Funds, the largest health insurance provider in Western Australia.