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Creating a Resource Page and Understanding Health Anxiety: Applying SURG0139 Learning to My Work

In our first lecture; for the module Managing Pain in the Community, Jill Whibley highlighted the importance of signposting. I have been meaning to create a resource page on my website for years and this was the push I needed. Here it is. I’ve already directed half a dozen people to it for various sources. On it is included two web resources that Johanna Theron showed us that are brilliant. These are Project TWENTY21 and live well with pain I have also included the free mental health resources CALM and The NHS Talking Therapies, with an awareness - after Jamie Kirkham’s lecture, that people living with chronic pain are 50% more likely to have depression.

Jill Whibley’s lecture on frequent service users was useful to me a few weeks ago. I coordinate a walking group for our local community and I was chatting with a woman who explained her health anxiety to me. Her story illustrated the way that doctors interactions with her fuelled her anxiety further. Thanks to our lecture I was able to advise her to contact her GP and the urgent care centre, asking them to note her health anxiety on her file. We chatted about how useful that would be for her in an anxiety flare up. Seeing a medic who held the opinion of “better safe than sorry” would not be the right approach for her. I also checked that she was seeing a therapist for help with this issue. Prior to our lecture I would have had the same attitude that she did. The more medical tests that she had, the better. Though on the surface these tests provide reassurance, they are expensive, they take time and positively reinforce a person’s health anxiety.

In our second lecture Ethel Carboni Jardim pointed out that a high proportion of people with chronic pain are also autistic. She let us know that autistic people don’t necessarily respond well to pain metaphors. This worried me as I use metaphors and imagery in my work all the time. I took three metaphors that I use often and asked my neuro-divergent contacts on social media for feedback. The adults who responded were fine with these metaphors. The teenager (who I approached directly) is a very visual person. She understood the metaphor when it was paired with an image. This was an important wake up call for me that I will need to check on people’s understanding of my descriptions. I may even need to customise them for the person that I am speaking with.

In her lecture on complementary therapies Johanna Theron spoke to us about the benefits of TENs machines. I had always thought that they had more of a placebo effect than anything but she had good data to support their effectiveness. I bought this TENs machine from amazon and my husband and I used it for an hour each day for a week. My niggly knee pain has pretty much gone. I’m very happy and have recommended this unit to four friends so far.

The lecture and course notes on non pharmacological therapies highlights the difficulties in obtaining appropriate evidence. This is very relevant to my work as I am in the process of developing a personalised imagery intervention for chronic pain sufferers. Placebo, non specific effects and the complexities of the person must all be factored into my process. The lecture for this topic stressed the importance of focusing on goal achievement and on outcome measures that are not linked to the person’s pain. This has also motivated me to find good note keeping templates, Manuela Mishke’s Somatic Therapy Toolbox has over 100 worksheets that could be easily modified.

The exercise section in our course notes recommends collaborative working between physiotherapists and exercise professionals. This piqued my interest and I thought of approaching my local private hospital for a chat about the possibility of starting a program. However, when Johanna Theron listed the considerations required in developing an exercise class for chronic pain I rethought this idea. A pilot trial would require sourcing equipment; finding a space; competency documents; risk assessments; legal, CPD and professional body requirements; patient inclusion and exclusion criteria; patient referral; consent forms; administration of the booking process; PARQ’s; safety checklist; and more. I think it would be easier to approach a community organisation like the YMCA and to develop something through them.

Throughout this module the overarching message has been that data speaks. Measurement of successful outcomes is a necessary tool when working with chronic pain patients. Though elimination of pain is unlikely, achieving an important personal goal is very possible.

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