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No pain IS a Gain: helping clients work through medical decisions while staying in my lane


dinos and comics

As a movement teacher and an educator, advising on anything medical is beyond my scope of practice. However, since starting my course, I now have tools to help my clients advocate for themselves. Where once I would be sympathetic to a client’s sense of being dismissed and having to fight to be treated - or being unable to get past “gate keeper” receptionists to even be seen. Now I have the confidence to inform them that pain is the fifth vital sign and that it is a human right that they be treated.

Many of my clients have pain stories that follow recurring themes. After cascades of medical interventions they are living with more pain than the initial discomfort they felt to start with. They have been seen by multiple doctors for multiple conditions who all provide conflicting advice. They are given unhelpful and false statements by doctors such as “bone on bone.” On top of this we have all heard stories of surgeries that have been retrospectively harmful, be they for breast implants, metal hip replacements or vaginal mesh. This means that the prospect of surgery, or any medical procedure can be very worrying for them.

A useful framework that they can talk through with their doctor is the B.R.A.I.N informed decision making tool. I came across this tool in my essay research around medical ethics, I now use it all the time.

“B” stands for benefits and asks what good will come from this procedure? When compared with sham/placebo surgery how has this one fared?

“R” stands for risks and requires a conversation about present and hypothetical risks as well as side effects and long term safety.

“A” asks about alternatives and complementary therapies that they can follow alongside a treatment regime.

“I” asks what one’s intuition tells them and asks what decision feels right to them.

“N” asks what will happen if I do nothing? What if we take a pause on this course of treatment?

Initially the benefits to a course of action may seem