heart attack pain

everyone experiences pain, but only a few have experiencedthe intense pain of sickle cell disease, a pain more intense than childbirth,an open bone fracture, or a hammer on the thumb. for the sickle cell patient,

heart attack pain, this intense pain occurs in unpredictableepisodes throughout their lives. this intense pain can cause themto miss out on important life events. imagine missing yourchild's big events repeatedly, because of your pain.

imagine trying to study or start a careerwhile living with sickle cell pain. sickle cell patients spenda lot of their time in the hospital because of their pain. many patients arein pain 50% of their days, even when they do not go to the hospital. the pain of sickle cell disease is very real. sickle cell vaso-occlusive pain is more severe thanmost other pain conditions encountered in the emergency department.

however, it is very important to know that the facialexpression of a sickle cell patient is not a reliable indicator of pain. their reflection of painis like the tip of an ice berg; the full extent of their painis hidden underneath the surface. they often train themselves to hide the outward painand keep control of emotions, in order to live withmany days and years of pain. just because it cannot be seen,

it is sometimes nottreated with the same urgency. poor blood flow leadsto acute tissue ischemia and produces vaso-occlusive pain, which is much like heart attack pain, however all over the body. sickle cell disease leads to bloodflow abnormalities in at least 3 ways: rigid cells causinglog-jam and high viscosity, sticky cells, and constricted blood vessels.

these physiological changescan be aggravated by emotional stress. sickle cell paincan start from tissue damage. also, sickle cell disease can lead to damage to peripheral nerves or plasticity in the central nervous system. this results in neuropathic pain. sickle cell pain often gets worse with movement or emotional stress, so patients learn notto thrash around or scream in pain. for example a grimacetakes energy the patient does not have

and you may see a lack of expression. children often have evenmore difficulty explaining their pain. they may display a flat affect. clinicians' behaviors can helpthe pain medications work better by reducing the patient's fearand increasing their trust. stressful situations suchas loud or cold environments, impatient healthcare providers,and long wait times, can increase the pain and reducethe effectiveness of the pain medication. thus, it is important for the clinician

to be courteous,patient, gentle and caring. patients can become frustrated if they sense that their reportsof pain are not being taken seriously. patients can also become frustrated if their individualizedpain management plan that was developed by their physician is not being usedin the emergency department. anxiety can also occur when a patient experiences delaysand mishaps in pain management,

often aggravating the pain. the pathophysiologyof sickle cell does mean that emotional stress can worsenthe blood flow and increase pain. i am used to having my medicationsgiven to me a certain way. my doctor has alsomade protocols for me, but the other doctors and nursing staff will not respectmy pain regiments and protocols. this behavior sends meinto a bigger crisis and it takes much longer for me to get well.

whereas in the end, they end up doing things my wayand my doctor's protocol way, and it's a waste of time and energy. it leaves me hurting and stresses me out. please remember sickle cell patients often respond differentlyto drugs than other patients. for example, many sickle cell patients eliminate opioids up to 10 times fasterthan people without sickle cell disease. since pain medication

may be more rapidly eliminatedfrom a sickle cell patient's body, the amount remaining in their system is much less than someonewithout sickle cell disease who was giventhe same dose at the same time. this is just one of the many reasons why some sickle cell patientsrequire more pain medication than those without sickle cell disease. with adequate management,patients with sickle cell disease can live productive, successful lives

despite their chronic pain.