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Understanding Pain for Improved Quality of Life Good pain management improves quality of life. Managing pain to live life fully is possible! It is important that the treatment of your pain is based on your diagnosis, stage of disease, response to pain and treatments, and personal likes and dislikes. Pain can be safely managed at home in a partnership between you and your medical provider. Becoming knowledgeable about your pain and learning to advocate for yourself will help you and your medical provider address your pain in a way that works for you.
Use pain medicines as prescribed
If the prescription says to take the medicine at certain times or at certain time intervals (for example, every six
hours), make sure this is done. Do not wait until the pain comes back to take the medicine. This will cause
needless suffering.
One of the important ways that pain medicine works is that it helps to prevent episodes of severe pain. In order to do this, there has to be a certain amount of medicine in the blood. This is why the medical provider prescribes taking the medicine at regular intervals - to be sure that the amount in the blood level stays high enough.
Medications for pain
There are different types of pain medications to control pain at the end of life. Your medical provider will prescribe
medication based on the type of pain you are experiencing. Pain medications include over the counter medications,
prescription pain killers, prescription antidepressants, anticonvulsants, and fi nally barbiturates. Over the counter
pain medications include aspirin, acetaminophen, ibuprofen, which can relieve mild to moderate pain.
When over the counter medications are no longer effective, your medical provider may consider an opioid, such as codeine, morphine, hydromorhone, fentanyl, or oxycodone which can be administered several ways. When combined with other medications such as antidepressants or anticonvulsants, these can be effective in treating nerve pain. Steroids such as prednisone help reduce infl ammation, and work well with opioids.
Good communication with your hospice and palliative care team about pain relief from the medication is critical, as each person’s pain and response to medications is unique. Understanding Pain for Improved Quality of Life Common side effects of pain medications
All medications have possible side effects and before taking a specifi c medication, an individual should
be aware of the possible side effects. Your hospice and palliative care team will educate you and your
family about the medications prescribed to control your pain as well as the side effects of each medication.
Examples of side effects of over-the-counter medicines
Acetaminophen may cause
(Tylenol):
Anti-infl ammatory drugs may cause (Advil, Motrin, & Aleve):
❚ Stomach upset, heartburn, and nausea (taking the medicine with food may help prevent these problems) ❚ Stomach ulcers and kidney problems (with long-term use) Examples of side effects of prescription medicines
Anticonvulsant medicine may cause:

Steroids may cause:
Because of the chance of side effects, medical providers usually try to prescribe steroid medicines only for a short time. Opiate pain relievers may cause:
❚ Constipation ❚ Drowsiness
❚ Dizziness, lightheadedness, or feeling faint Managing Emotional and Spiritual Pain
In addition to medication, there are healthy ways to deal with emotions you might have when living with
pain. Living with chronic pain can take a toll on your mood, outlook, relationships, and self-image. It may
be important to seek help from a psychiatrist, psychotherapist, social worker, or your faith community
leader. By getting additional emotional and spiritual support, you can learn new ‘life’ skills to become
more effective at managing pain, including:
❚ Ask your medical provider or loved one to connect you with a counselor, chaplain, or other professional to fi nd the resources for emotional and spiritual support.
❚ Share your feelings with friends, family members, healthcare professionals, faith leaders, and others you respect.
❚ Talk with people who are or have been in a similar situation. ❚ Write about your feelings in a journal.
❚ Explore your faith and/or spiritual beliefs through readings or discussions with family members, friends, or faith leaders.
❚ Refl ect on the role of faith and/or spirituality throughout your life and ways that you have found comfort in the past. 1,2,3 RX List Drug Index, 2013, http://www.rxlist.com/script/main/art.asp?articlekey=104699&page=2; 4 Northwestern, Spiritual Pain and Suffering, n.d., http://endofl ife.northwestern.edu/religion_spirituality/pain.cfm. For more information visit caringinfo@nhpco.org or visit www.caringinfo.org/pain
2013 Caring Connections, National Hospice and Palliative Care Organization Support provided by a grant from Purdue Pharma, LP, Stamford, CT

Source: http://www.caringinfo.org/files/public/brochures/EOL_Quality.pdf

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Themadag NVTH Werkgroep Hemostase Diagnostiek 24 Maart 2011 De jaarlijkse Themadag vond dit jaar plaats in het AMC te Amsterdam en had als thema‘Trombocyten’. Er waren 33 deelnemers afkomstig van 15 instellingen. Als gastsprekers waren aanwezig Prof. Dr. Flip de Groot (UMCU), Dr. Thomas Bergmeijer (St. Antonius Ziekenhuis Nieuwegein) en Dr. Bert Verbruggen (ECAT). Als inleiding op het onde

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