Pain - A physio's friend

This week has been rather quiet and so I will reflect on a patient who had some pain issues. He is a 30 yo male who underwent heart surgery for an aortic valve replacement. He had a congenital bicuspid valve instead of a tricuspid valve. The surgery was uncomplicated and on initial Ax following the operation the pt reported 8/10 pain at rest. The patient was young and understood the role we have as physios to assist with their recovery and although he was anxious to move because of the pain he was happy to attempt to SOOB. My supervisor however looked through the med charts and noticed that he had come off morphine and not had adequate pain cover since then. She said that we could use this to our advantage and get the patient on our side especially because younger patients report higher pain scores and would be an issue throughout his recovery.

So we informed the patient that we would discuss pain relief with the doctors and then return later to SOOB. The patient was happy with this decision too. The doctors prescribed further paim meds and 45 mins later his pain was 4/10 and he SOOB and completed all DB ex's nand supported cough with good pain control.

We could have attempted Rx initially but the Rx would have been ineffective due to the pain and it also would have turned the patient against us as he would percieve pain and physio related. This was a good move by the supervisor as we now had a very compliant patient who was more comfortable during our Rx and the Rx was more effective as we got more out of the patient. So the small things can make a difference and we can also use pain to win over pt respect and trust.