VICDOC Winter 2022 - Magazine - Page 16
Aly's story
—
Aly’s pelvic issues started
when she was 18 years old,
presenting as sporadic rectal
pains which, despite their best
efforts, doctors were unable
to explain. Twenty years
later, and following the birth
of two children, the pelvic
pain became chronic and
debilitating. A once energetic
young woman lost confidence
in her body and became afraid
of the pain that hijacked it
unpredictably, mysteriously
and mercilessly, every few
days. Aly knew what labour
was like without an epidural
and in her opinion, the chronic
pain she endured was at times
worse — pushing her beyond
her physical and mental ability
to cope. At its worst, when
experiencing the pain, she
would will herself to black out
as her teeth chattered and she
rocked herself back and forth,
emitting guttural cries and
deep breathing her way
through the worst of it.
Understandably, the pain
became the focus of her
life — as she obsessively
sought answers but there
were no straight forward
clinical explanations. Her GP
and a range of specialists
couldn’t figure out why she
was experiencing this level of
pain despite exploring many
clinical possibilities. All the
while, the pain continued
to worsen and Aly’s mental
health deteriorated into severe
anxiety and depression.
––
16
AMA VI C TO RIA
I
t is a common tale for chronic pain sufferers
and one which doctors know well. Patients
come from many backgrounds and experience
persistent pain due to a huge variety of issues but
the common thread exists: debilitating pain which,
if not properly managed, has a disabling influence
on patients and also has the potential to drastically
impair a person’s life.
Giving hope to these patients, is the focus of
A/Prof Arnold’s work at Alfred Health’s Pain
Management Clinic where she patiently and
determinedly assists people to reduce persistent
pain and its devastating impacts.
Through expert assessment, education and access
to medical, nursing and allied health treatment
and therapies, her team seeks to optimise pain
treatments, improve function and promote selfmanagement in patients. A full history of the
patient’s injury is taken to understand the patient’s
journey and all the things that have led to where
they are, how it’s affecting their functioning, their
past treatments, their mood and psycho-social
context. Individual treatment plans and programs
of education are formulated according to the patient,
their cultural background, linguistic ability and
their age.
And whilst there is no doubt first-time patients
attend the clinic wanting a cure, many come to value
what they learn. “The clinic is perhaps not what
people expect or want at first,” says A/Prof Arnold.
“They want a cure, there’s no doubt about that.
Yet our goal is to work with them to address these
expectations and help change the direction of their
endeavour and ultimately change their pain that
way. It does involve the patient putting trust in the
doctor and being open to understanding more about
their pain and why it continues. They also have to
be involved in the process. It’s important and yet,
it is resisted by many patients. Many chronic pain
sufferers feel that the pain and their experience is
not in their control but it’s crucial to actually own it
enough to make some changes or to think about it
in a different way. That’s probably our biggest goal:
to change a patient’s thinking so they can manage
their pain, then to improve the function and reduce
the pain and improve the patient’s mood, using
cognitive behavioural therapy with physical therapy
and targeted procedures.”