Good communication is essential to getting continuous relief for any pain you may experience due to breast cancer or its treatment. It can take some trial and error to find the right pain medications and other therapies — and get them working well for you. The nature of your pain can change over time, and this may require a change in your treatment.
The following tips and reminders may be helpful for communicating with your doctors and nurses about pain:
- Talking about your pain is not complaining, nor does it mean you are a "bad patient." Don’t hesitate to talk about your pain because you're afraid of bothering the doctor or seeming like a "whiner." Also, reporting your pain will not lead your doctor to think that you cannot handle rigorous treatment. In fact, getting help for your pain is likely to make cancer treatments more tolerable — and help you stick with your treatment plan.
- Bring your pain diary with you to appointments, and put pain on the list of topics you wish to discuss. It is easy to forget to discuss pain when you and your doctor are so focused on the details of your treatment and recovery. And you may not feel any pain while you are in the doctor's office. Written reminders will help you bring up any concerns you have about pain before the appointment ends.
- Talk about which side effects you are willing to tolerate and which ones you find unacceptable. For example, the medications known as opioids initially can cause drowsiness, although many people adjust to the medication and feel fine within a few days. If the drowsiness persists, you may find this keeps you from activities you need or want to do — and this may be unacceptable to you. On the other hand, you may feel that complete relief from your pain is more important, and you would rather take the opioids and scale back on activities as needed. Preferences range from individual to individual, so you and your doctor need to come up with the pain control plan that is right for you.
- Ask for ways to prevent or treat any side effects of your pain medication — and which side effects might warrant a call to your doctor. For example, constipation is a common side effect of opioid medications, so it's generally recommended that people take regular doses of a laxative to prevent this. For whatever medication(s) your doctor prescribes, just be sure to ask about the most common side effects and strategies for lessening or relieving them. Also ask whether there are any side effects that you should report to your doctor right away. For example, if you suddenly develop trouble breathing, a rash, or itching, these could be signs of a serious allergic reaction to a medication.
- Speak up if your pain control plan is not working. Tell your doctor if your pain isn't getting better or going away, or if your pain medicine does not work as quickly or as long as your doctor said it would. Other signs that your plan may need adjustment include: experiencing breakthrough pain; having troublesome side effects that do not go away; having pain that interferes with activities such as eating, sleeping, or working; or difficulty taking medication in a certain form or on the prescribed schedule. All of these are possible reasons for making a change.
- Ask about what to do if you experience pain in between appointments. Sometimes a pain medication may stop working as well as it once did. This does not mean that you are addicted to the medication or becoming immune to it, just that your body is growing more tolerant to its effects. Or, in other cases, pain may suddenly appear or worsen when it was not a problem before. Ask your doctor what you should do if you need an adjustment in your pain control plan — such as a new medication or higher dose — in between appointments.
- Bring a trusted family member or friend with you to appointments. Just as a relative or friend can help you remember the details of your diagnosis and treatment, he or she can help with understanding your pain control plan. A relative or close friend also can support your descriptions of any pain you may be experiencing. Their observations about your pain may be helpful to the doctor.
Questions to ask your doctor
The American Cancer Society suggests several questions you may want to ask your doctor or nurse about pain medicine:
- How much medicine should I take? How often can I take it?
- If my pain is not relieved, can I take more? If so, how much more?
- Should I call you before increasing the dose?
- What if I forget to take it or take it too late?
- Should I take my medicine with food?
- How much liquid should I drink with the medicine?
- How long does it take the medicine to start working?
- Is it safe to drink alcohol, drive, or operate machinery after I have taken pain medicine?
- What other medicines can I take with the pain medicine?
- What medicines should I stop taking or avoid while I'm taking the pain medicine?
- What side effects from the medicine are possible, how can I prevent them, and what should I do if I have them?
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