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Pain Consultants of Oregon Newsletter Fall 2016
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Self-Care

Self-Care for Pain Management:
Simple, Essential Practices for a Healthy Body, Mind & Soul

 

If you’re a Pain Consultants of Oregon patient, chances are that your pain care provider has talked to you about “self-care.” Your doctor may have asked you to quit smoking, start an exercise plan to lose weight or begin practicing relaxation techniques. He may have suggested you see a psychologist, or even recommended you spend more time on a hobby.

This advice can seem strange to patients. Some feel like their doctor is saying that he feels it’s their fault they’re in pain, while others dismiss it as trivial. Often, patients know that they should be doing things to take better care of themselves, but think of these activities as something they’ll do later – when they get better.

However, self-care recommendations are made without judgment. If your pain specialist suggests you take an Ai Chi class, meditate or see a nutritionist, it’s not because he thinks you’re “lazy” or “crazy.” It’s because self-care has the potential to transform your experience of pain and improve your quality of life. Further, while it can feel daunting to start anything new when you’re in pain, good self-care is not an outcome of your doctor’s treatment – it is a crucial element of treatment.

We generally think of medical conditions as problems to be fixed, and doctors as the specialists who fix them. If you have an infected cut, for 
example, your doctor prescribes antibiotics to kill the bacteria and your infection goes away.

Chronic pain isn’t like many other medical conditions, however. Unlike acute (or short-term) conditions,there is often no identifiable cause – or cure – for chronic pain. The goal of treatment is therefore not necessarily to eliminate pain, but to improve function. Your treatment plan may include medications, injections or surgery to reduce pain, but these treatments are only part of an effective pain management plan. Equally important are self-care activities that address conditions that accompany and worsen chronic pain: sleep impairment, fatigue, changes in appetite, depression, anxiety and irritability, for example.

Consider the negative feedback cycle illustrated below. The unpleasant sensation of pain creates fear and avoidance of physical activity, which results in weakened muscles, inflammation, tension and even scar tissue. These increase pain levels, which may cause stress and sleeplessness, leading to exhaustion and irritability. Withdrawal leads to feelings of isolation and worthlessness. Depression and anxiety follow, again reducing activity and increasing pain. Soon, your pain is even worse and your physical, mental and emotional functions have declined, making life increasingly unsatisfactory.

Negative feedback cycle chart
At any point, self-care can help change the trajectory of this cycle and transform your experience of chronic pain. In fact, an ever-growing body of research consistently shows that patients who engage in self-care feel better than those who don’t, both physically and emotionally. Consider how some of the most common self-care techniques we recommend can interrupt a negative feedback cycle and have a positive impact on your quality of life.

Sleep Hygiene
Practicing good sleep hygiene can help you get a better rest, which has been proven to improve your pain threshold and give you the energy to do other healthy activities. Good sleep practices include avoiding stimulants like caffeine, nicotine and alcohol, making your bedroom a screen-free zone and establishing a relaxing bedtime routine. For more information on sleep hygiene, ask your doctor or visit sleep.org.

Exercise
Regular physical activity helps improve joint movement, reduces muscle tension and increases strength and endurance – all of which contribute to decreasing pain and enhancing function so you can take care of routine activities and take part in things you enjoy. Exercise doesn’t have to be vigorous or time-consuming to be beneficial. Start with something easy and enjoyable. Skip the morning news for a 30-minute walk outside five times each week. Or, ask your doctor or physical therapist for help finding exercises within your capacity.

Exercise

Counseling
Of all the self-care recommendations we make, counseling is the one most often met with resistance. Some patients feel their doctor is really saying, â€œYou’re crazy,” or “You’re just imagining your pain,” when nothing could be further from the truth.

In reality, a counselor is to a chronic pain patient what a coach is to an athlete: an expert who helps guide and support you so you can achieve your goals. Chronic pain often causes feelings of anger, hopelessness,sadness and anxiety, and “pain coaching” can help you constructively cope with these feelings.

Counseling and neuroplasticity training can also help you learn how to better manage stress and even alter the way your brain processes pain sensations. If you’re interested in seeing PCO’s on-staff psychologist or neuroplasticity nurse for pain coaching, ask your pain specialist for a referral.

Find Fun & Meaning
Many chronic pain patients report feeling like their lives have been swallowed up by doctor’s appointments, physical limitations, exhaustion and side effects. It can be especially upsetting if your condition has forced you to stop working or required that you give up an activity about which you were passionate, like running.

It’s okay to grieve the things you’ve lost to chronic pain, but for your emotional health it’s important to focus on finding fun and purpose in the things you can do. Finding a new hobby, or adapting an existing one to fit your physical capabilities, can restore confidence, reduce stress and provide a fun distraction.

Volunteering can also be a very powerful self-care strategy. Identifying an issue about which you are passionate and working to help others can provide a deep sense of purpose and accomplishment. There are endless ways you can help, regardless of your physical capabilities. For ideas, contact your local United Way or visit VolunteerMatch.org.

Nurture Relationships
When you hurt, socializing may seem like the last thing you want to do. But creating and nurturing relationships with people you genuinely enjoy can provide a pleasant distraction and help you avoid feeling isolated.

Reach out to people who make you happy. Ask your funny neighbor to walk with you. Bond with your new grandbaby while you ease your aches in a warm pool. Ask an old friend over for lunch.

If you don’t have a supportive social network, create one. Join a support group, volunteer or take a class. The simple pleasure of companionship can help you avoid depression and anxiety.

When you’re in pain, interrupting your personal pain feedback cycle can feel like an insurmountable task. But it can be reassuring to know that you don’t have to make multiple, big changes all at once to start feeling the benefits of self-care. We suggest starting with one easy goal and working with your doctor and support network to create and implement a plan to achieve it.
  • Be specific. Instead of saying, “I’m going to eat healthier,” choose a particular part of your diet to change: “I’m going to eliminate pasta and eat more vegetables.”
  • Choose a goal that is realistic and in tune with who you are. If you’ve never been a great cook, choosing to replace your afternoon candy bar with fruit is a better starting point than changing your entire diet.
  • Outline small, manageable steps you can take to achieve your goal. If you’d like to reduce the fat in your diet, your plan might include researching easy low-fat recipes using foods you enjoy, creating a weekly menu, listing the ingredients you need, shopping and setting aside time for preparation.
Food
 
  • Be patient and celebrate your achievements. Everyone experiences setbacks, but berating yourself is counterproductive. Even if you grabbed a less-than-ideal lunch on the go, be proud that you passed over the doughnuts in the break room.
  • Rally your friends and family around your goals. It’s easier to eat healthy if people aren’t offering you sweets, and the  encouragement of people you care about can help you stay motivated.
  • Get professional help. Starting something new can be daunting, and an experienced guide like your doctor or a nutritionist can help keep you accountable and on-track while providing additional support.
PCO’s pain specialists recommend self-care techniques because they are medically proven to reduce pain and its associated symptoms. As importantly, we have seen many patients, including people with debilitating pain and major physical barriers, break the pain cycle and make inspiring transformations in their lives by engaging in self-care.

We offer numerous services to support you in developing healthy self-care routines, including neuroplasticity training, pain coaching, nutrition counseling and stress management. If you would like to find out how these strategies can help you, call us at 541-684-9451 or ask your doctor at your next appointment. We look forward to helping you in your journey!

Group Classes


Group
Fall 2016

Living Well With Chronic Pain
Wednesdays, Oct 12-Nov 16, 11 a.m.-1:30 p.m.
Willamette Medical Center
2401 River Rd., Eugene 541-682-4103
lanelivingwell.org
FREE

Music Therapy for Pain Management
Thursdays, Oct. 6-Nov. 17, 5 p.m.
Refuge Music Therapy
1441 Oak St., Ste. 5, Eugene 541-231-7239
RefugeMusicTherapy.com
$15 drop-in; $80/7-wk series or $60 if registered by Sept. 26

Living Mindfully with Chronic Illness
Mondays, Sept. 12-Oct. 17, 4-5:30 p.m.
Bonnie Witkin-Stuart, PhD
1669 Willamette St., Eugene 541-731-7072
$350/6-wk series (most insurance accepted)

Skills for Everyday Mindfulness
Mondays, Nov. 7-Dec. 12, 5-6 p.m.
David Lechnyr, LCSW, ACSW
1598 Pearl St., Ste. 2, Eugene 541-344-2256
eugene-counselor.com/group-therapy
$189/6-wk series (some insurance accepted)

NEUROPLASTICITY CORNER
In this issue: Focus On thePositive

NeuroplasticityIn our last issue, we talked about taking  advantage of the brain’s ever-changing structure – its neuroplasticity – to retrain your brain to focus on the positive. We talked about why neuroplasticity works, and got you started with the concept. 

Research has shown that when you deliberately refocus your mind on a positive experience and hold that thought for at least 20 seconds, your brain will gradually become sensitized to the positive and desensitized to the negative.

Most people, most days, have frequent opportunities to experience a mild, good experience. For example, you pass a coworker in the hall who says,“You look really nice today!” You might smile briefly and say thank you, but quickly forget the compliment – or even downplay it by thinking, “Oh, she says that to everyone.” Instead, let the pleasure of the compliment really sink in. Focus on how nice it felt and let the experience fill you, without qualifiers.Your goal should be to be able to remember pleasant experiences and how they made you feel.

Retraining your brain can take as little as three minutes a day. Six times a day – every few hours – pause for 30 seconds to think of something positive or do something enjoyable. A pleasurable experience doesn’t have to be big or perfect — on a zero to 10 scale, positive experiences can register as quietly pleasing as a “one,” “two” or “three” rating and still train your brain to focus on the positive.

Patients at Pain Consultants of Oregon find success through creating art, focusing on photos of family, stroking a worry stone or other token, stepping outside to breathe deeply or listening intently to a favorite song.

Taking in the good involves three steps:

   1. Have (or create) a positive experience.
   2. Extend it in time — let it become more intense, help it fill your body.
   3. Absorb the experience. Again and again and again.


Begin each day with this practice. When you wake up, before getting out of bed, take a few moments to establish a basic sense of peace. Feel calm. Find gratitude. Notice that you are alright, right now.

If you need help getting started with this practice, it can be useful to create a list of ideas ahead of time to which you can refer. Or, use a daily meditation resource such as Rhythm of Peace which posts on Facebook each day to help you focus on a theme related to cultivating peace in your life.

Complete your days with a bit of reflection, too. Ask yourself, “How many times did I take in the good today?” If you didn’t make it to the recommended six, don’t be too hard on yourself. Instead, pause to absorb the comforts that await you as you rest for the next day.

Stay tuned for more guidance about how to use neuroplasticity to help combat chronic pain and retrain your brain. In the next issue we’ll focus on some of the common obstacles that patients encounter, and how to overcome them.

Jennifer Wagner, LPN, BS, will resume her neuroplasticity practice at PCO in September. Ask your doctor for a referral or call us at (541) 684-9451.
Cooking

Cooking with the Koseks:
Use-Up-My-Squash Soup (Please!)

Stumped by what to do with all your squash? This simple but delicious soup is rich, warm and gorged with gourds! Enjoy with a tomato salad and crusty bread for a healthy autumn meal.

Ingredients
2 lbs. yellow summer squash
2 tbsp. olive oil
2 medium shallots, chopped
1 cob of corn, kernels removed (or 1 can)
Salt and pepper, to taste
1 qt. vegetable stock
1 carrot, sliced
¼ onion, cut in chunks
1 stick celery, chopped
1 small herb bunch (parsley, thyme, oregano, etc.)
1 tbsp. olive oil
1 bay leaf

Cooking Instructions
  1. Prepare stock. In medium pan, heat oil and sauté onions, carrot and celery for 5-10 min. Add 6 cups water, the herbs, bay leaf, salt and pepper. Bring to a low boil for 30 minutes, then strain.
  2. Chop squash into 1-inch cubes and sauté with shallots in olive oil on medium heat for 5 minutes, until lightly browned.
  3. Add vegetable stock and bring to a light boil for 10 minutes.
  4. Remove and purée a portion of soup, then return it to stove.
  5. Add corn, salt and pepper to taste. Heat for 3-5 minutes until corn is just softened.

fall leavesHoliday Closures


Pain Consultants of Oregon will be closed the following days:
  • Labor Day, September 5
  • Thanksgiving, November 24 & 25
To ensure that your holidays are comfortable, please request refills and pick-up prescription medications from your pharmacy as needed prior to these dates. Enjoy the bounty of autumn!
 

Meet the Staff:
Danny Urness, Medical Scribe


Danny Urness, Medical Scribe
Danny Urness is a vital part of Pain Consultants of Oregon, where he works as a medical scribe. He came to us almost a year ago after working at PeaceHealth Labs and the emergency department at RiverBend. After studying at Oregon State for a year, Danny transferred to Linfield College where he graduated with a bachelor’s degree in biochemistry.

Danny finds his clinical experience at PCO valuable professionally and personally. “The most rewarding part of my day is hearing thankful patients telling our doctors and staff that they feel encouraged, supported or just altogether better.”

Danny is an avid sports fan who loves golfing and fishing. A Eugene native, he enjoys living close to his parents and siblings. Danny and his girlfriend Keana, who is a Hawaiian native, enjoy spending time outdoors and visiting family in Maui.

Support Groups

Support
Fall 2016

CFID Syndrome & Fibromyalgia
Fourth Saturdays, 3:30-5 p.m.
Eugene Public Library
100 W. 10th Ave., Eugene
541-341-1355

Chronic Pain
First Tuesdays, 2-4 p.m.
Second Tuesdays, 6-8 p.m.
Willamette Medical Center
2401 River Rd., Eugene
FibroSupp11@yahoo.com

Depression & Bipolar
Second Mondays, 7-8:30 p.m.
First United Methodist Church
1376 Olive St., Eugene

Living With Cancer
Second & Fourth Tuesdays, 4:30-6 p.m.
Willamette Valley Cancer Institute
520 Country Club Rd., Eugene
541-683-5001

Multiple Sclerosis
Fourth Thursdays, 7-9 p.m.
Willamalane Adult Activity Center
215 W. C St., Springfield
541-736-4444

Spinal Cord Injury
Fourth Thursdays, 4-5:30 p.m.
Sacred Heart Medical Center
1255 Hilyard St., Eugene
541-686-7300

 

Ask the Triage Nurse:
Acute vs. Chronic Pain - What's the Difference?

Pain can serve an important purpose by warning your brain when something is wrong. For example, if you sprain your ankle, the pain warns you not to put too much pressure on it so your body can heal. This “normal” kind of pain is called acute: it can be mild or intense, but it is short-lived and goes away when the injury has healed.

Chronic pain is different. In general, pain is considered “chronic” if it lasts longer than 12 weeks. It may be the result of an initial injury, such as a back sprain, or an ongoing condition like arthritis. However, chronic pain sometimes continues even after an initial injury has healed, or it may have no identifiable cause. While chronic pain cannot always be cured, it can generally be managed.

If you are prescribed medication for chronic pain, you should not self-medicate by using these medications to treat acute (new) pain – this is a violation of your pain medication agreement with PCO, and will cause you to run out of your medication early.

Because acute (new) pain may be a symptom of something else going on, it is important to seek education and treatment from an appropriate medical practitioner. Evaluation by your primary care physician, dentist or surgeon will help you address the underlying injury or illness in addition to helping you determine how to manage the pain.

Many patients are concerned that taking medication prescribed by another office for their acute (new) pain will put them in violation of their medication agreements with PCO. However, as long as you do not get medication for your chronic pain from another office, you will not violate your agreement with us by taking medication prescribed elsewhere for an acute condition. We simply ask that you do the following:

 
  • Tell the medical provider treating your acute (new) pain about your chronic pain condition, and provide a full and accurate list of your current medications, including those taken for chronic pain.
  • If another doctor prescribes medication for acute (new) pain, please inform us what was prescribed and why at your next visit.
  • If you’re not sure if you need to see another doctor for acute (new) pain, or have questions about whether it’s okay to take medications another office has prescribed, call the triage line at (541) 684-9451 for help. We can help you get the treatment you need without compromising your chronic pain care.

     Triage Nurse Cyndi
    If you believe you need to take your medications at a different dose to control new pain, you will need to be seen by your PCO clinician to develop a mutually agreed upon treatment plan.
Cyndi, Triage Nurse

Congrats!

We hope you will join us in congratulating Whitney, Dr. Kosek’s medical office assistant, on the birth of her daughter!

Baby Saige was born healthy and happy on March 16, weighing 7lbs.3 oz. and measuring 21” long. We are very excited for the family, and look forward to welcoming Whitney back from maternity leave this September!

Patient Seminars:
Free Series Offers Wellness Advice to Keep You Healthy


Begining this September, PCO will be hosting a series of patient seminars during the fall and spring. Expert presenters will cover a wide variety of topics and offer realistic self-care tips to help you more successfully manage your pain. Space is limited, so please call our office at (541) 684-9451 or click here to register online to reserve your seat. Learn more at pain-consultants.com/pain-resources.

Chris & SierraDiet & Inflammation
Friday, Sept. 23, 2-3:30 p.m.
Sierra Hovdey, RN and Chris Green

Thought to negatively affect chronic pain, inflammation can be reduced – or worsened – by certain foods. Join Chris and Sierra, the nutrition enthusiasts in PCO’s research department, to learn about low-inflammation food choices and eating practices that can help you feel your best.

Got Sleep?
Friday, Oct. 21, 2-3:30 p.m.
Jude Kehoe, LPN, HTCP

Sleep loss is common for people with chronic pain, and the effects can be far-reaching. Health educator Jude Kehoe will help you better understand the mechanics of sleep and pain, and teach you healthy self-care techniques to help you develop good sleep hygiene for a better night’s rest.

Stress Management with MeditationJude
Friday, Nov. 18, 2-3:30 p.m.
Jude Kehoe, LPN, HTCP

Research shows that stress increases pain – and pain increases stress. Guest speaker Jude Kehoe will demonstrate stress management techniques to help you break the cycle and effectively induce the relaxation response.

PCO Watercooler:
New Staff Members, Anniversaries & Promotions


With neStaffw providers Steven Surrett, MD and Debra Blaker, FNP, we’re thrilled to be expanding our clinical and support staff, as well. Please join us in welcoming Diane, procedure nurse at Middle Fork Surgery Center; Bryn and Mona, front desk receptionists; Chris, radiology technician; and Kim, Tara and Erin, medical office assistants. We’re excited to have so much new energy in the clinic!

We extend our heartfelt thanks to Beth as we recognize her 13th year of service at PCO. Our bookkeeper and human resources coordinator, Beth keeps us running and we are lucky to have her.

Last, we are proud to announce that Angela, previously Dr. Haber’s medical office assistant, has been promoted to director of clinical services. Congratulations, Angela!

Activities Calendar


Calendar






Fall 2016

Ai Chi Aquatic Exercise Class
Saturdays, 3-4 p.m. (ongoing)
Tamarack Wellness Center
3575 Donald St., Eugene 541-686-9290
Please ask your pain specialist if this opportunity is appropriate for you. No registration required. Bring a swimsuit and towel. Tell the receptionist you are a patient at Pain Consultants of Oregon.
FREE for PCO patients.

Free Yoga
Wednesdays, 8:45-10 a.m.
First Christian Church, with Ginny Heer
1166 Oak St., Eugene
All ages and abilities welcome.
v.wildwood@gmail.com
FREE

Walk ‘n Talk
Fridays, 9-10:30 a.m.
Walks begin at the Campbell Center
155 High St., Eugene
Ages 50+, 3-5 miles, quick pace.
FREE

Small Dog Walkers
Tuesdays, 10 a.m.- Noon
Campbell Community Center
155 High St.,Eugene
Ages 50+ (no dog necessary).
FREE

Bike Riding
Wednesdays, May-Sept.: 9:30 a.m.;
Oct.-Apr.: 10:30 a.m.
Campbell Community Center
155 High St., Eugene
Ages 50+, Rain or shine; helmets required.
FREE

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