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“Before I learned to live with pain, several weeks passed (…) I focus only on activities that may temporarily improve my health and reduce pain” – said Tomasz Gollob in the first interview since the accident. After the death of Anna Przybylska, her doctor said that he saw her almost howling in pain. Is it the Polish medicine of the XNUMXst century that cannot cope with pain, or are doctors anesthetized to it, because it does not concern them, but patients? Why is the consumption of the strongest relieving drugs in our country less than in other European countries. The health ministry has just promised that this will change.
65 percent of people with rheumatic diseases experience pain constantly. 80 percent of cancer patients suffer horribly because their ailments are not relieved properly. Every fifth Pole goes to sleep and wakes up painfully.
Jerzy Sthur, when he became the ambassador of the action “Cancer free from pain”, began to speak out loud about how important measures to relieve suffering were for him. – I know from my own experience how cancer can hurt. In this disease it is so important to mobilize the body to fight, but this mobilization is possible when it does not hurt – he emphasized.
In Poland, not only cancer patients struggle with pain. Many patients after surgery and chronically ill suffer. Pain isolates them from the world, takes away their dignity and makes them no longer want to live.
She stayed home for three years
– There is a girl in our association who was unable to walk because of the pain. And because she lives on the third floor in a building without an elevator, she did not leave the house for three years while waiting for the operation – says Monika Zientek, the head of the association of people with rheumatic diseases, “Let’s get together”. Due to improper treatment, 3 percent of people with rheumatic diseases experience pain continuously or for several hours a day. It is so strong that it prevents you from moving or sleeping. And the painkillers prescribed by the rheumatologist are not able to eliminate it. It lowers self-esteem, prevents interpersonal contacts and, as a result, causes depression.
He lost the will to live
She attacked ankylosing spondylitis during her studies.
– Before, I was the life of the party. I was always the last to leave meetings. It has changed – he says. – I am a believer. However, sickness and pain caused a crisis of faith. I was wondering what I deserved it, what I did wrong. Fatalistic thinking caught up with me. Even when the pain stopped, I was devastated because I thought: he’ll be back soon – she recalls.
Jakub fell ill with the same disease already in high school. When he began his studies, the pain worsened. – I remember when at the university I tried to walk down the corridor to the bathroom without crying out in pain. I was lying on the floor in the toilet, unable to move. My girlfriend, using superhuman strength, tried to get me out of there, and I simply didn’t want to live anymore – she says.
A handful of pills is not a solution
About 20 percent. society suffers from chronic pain lasting more than three months. 5 percent due to acute pain – after surgery or trauma. Meanwhile, prolonged acute pain threatens your health. According to the researchers, there is a direct relationship between persistent untreated acute pain after surgery and complications such as pneumonia or thromboembolic events.
After surgery for Mark’s umbilical hernia, happiness was bursting. He wanted to go home as soon as possible. On the day of his discharge, when the nurse asked how he was feeling, he replied that he was fine, the postoperative wound only hurt a bit. However, on leaving the hospital, he almost fainted from the pain because he hadn’t been given any medications to relieve him. He crawled over to the hospital pharmacy and bought them himself. He swallowed handfuls for relief. This is not how pain management should be.
Pain relief measures taken by the ministry
A few years ago, desperate Polish patients formed the Coalition for Fighting Pain. As a result of her actions, amendments to the Act on Patients’ Rights were adopted earlier this year, which were to enable effective pain treatment not only – as it was the case until now – in terminally ill patients. Everyone was entitled to relief from suffering. However, in order for the record not to remain dead, implementing regulations were needed. For over half a year, the patients waited for their project. November 29 this year. the health ministry boasted that it was ready. Deputy Minister Marek Tombarkiewicz announced that the regulation is to be signed at the end of February 2018. Then all hospitals and clinics will have 6 months to adapt to the new regulations.
Why does it hurt more in Poland?
One-fifth of adult Poles get up in the morning and go to bed with pain, and over 80% cancer patients suffer because their ailments are not always adequately relieved. Why is this happening? – Pain in Poland is treated with the most common over-the-counter painkillers. And although these drugs – unlike opioids – are considered safe, more people die from their use than are killed in car accidents. In addition, they are not useful in certain types of pain – says Dr. Jarosław Woroń from the Polish Society for the Study of Pain. Such drugs are suitable for the treatment of pain with severity on a scale of 0 to 10 at level 4. If it is more severe, they are ineffective. In addition, when abused, they cause many severe side effects. Monika Zientek, president of the “Let’s get together” association, which has been suffering from rheumatoid arthritis for over 3 years, says that rheumatologists, apart from such drugs, have nothing to offer to pain sufferers. – Patients exchange tablets with each other, check what is helping them, and then ask the doctor to prescribe the drug for them – he says.
Ignorance hurts
Patients often say that they heard from their doctor that he must hurt. In Poland, many doctors still do not realize that reducing pain strengthens the effects of treatment. This is true not only of cancer but also of other diseases, incl. asthma, RA, allergies and diabetes. Also, when a patient’s test results improve but he still feels pain, he stops trusting his doctor and seeks help in paramedics. The panic fear of opium and marijuana-based drugs, i.e. opioidophobia and cannabinoidophobia, is also a big obstacle on the way to effective pain treatment. WHO experts have long stressed the need to avoid the use of erroneous “narcotic” terminology that misleads patients and doctors when it comes to these drugs. – If a medical or pharmacy student uses the phrase narcotic painkillers in the exam, I am sending you a correction – says Dr. Jarosław Woroń. – As a doctor, I am ashamed of my colleagues who do not prescribe opioids for completely unreasonable reasons. He cannot explain it by fear of an approved, very safe drug. The only sad explanation is ignorance, says Deputy Minister Tombarkiewicz.
What will change?
According to the new regulations, the so-called Pain Assessment Card. The doctor will obligatorily, through an interview with the patient, determine the intensity of pain on a numerical scale and note it down in the documentation. He will also be obliged to treat pain with drugs appropriate to its intensity and type. The effects of therapy will have to be monitored, which will also have to be noted. – The doctor will have a clear and legible, very simple guide on how to locate, diagnose pain, assess its intensity and properly supply the patient with medications – says Szymon Chrostowski, president of the Coalition for Fighting Pain “Let’s win with pain”. This will apply not only to doctors in hospitals, but also family doctors and specialists in outpatient clinics, as well as paramedics.