October 6th, 2006

Cut cuddle and be Cute

The strange in between us

To put it mildly, yesterday was a strange day.

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I do have some stuff to write about social work, because I think the concepts warrant me writing them down. I just really love this class. Every day, I go in there and come out going "that was awesome!". Obviously, this is just the first month or so, and I've got a long way to go before I prove myself in this area, but at least I like it and it's interesting.

Tummy calls, breakfast time!

Cut cuddle and be Cute

Deconstructing Chronic Pain: Informal Article Review

This post is a modification of an emailed aszsignment where I read an article about a field of social work that interested me. Since I’m going back and forth on whether to go into the field of chronic pain or blindness, I decided to research chronic pain. Here is an informal article review. It doesn’t quote, and it’s not perfect by any stretch of the imagination, but it did receive a 10/10 from the instructor in a slightly different form, so I feel comfortable sharing it here. This stuff fascinates me!

One last word of caution, don’t take any of this as medical advice! I’m fortunate to benefit from great care from several doctors, and I hope you have a similar medical team if you suffer from chronic pain. If you don’t, I encourage you to find a good physician and start finding the relief and coping skills you need.

One of the major reasons I wanted to become a social worker is that I have a strong desire to help and support people. I have been on the receiving end of services, and I feel I could bring this perspective to social work. I see so many areas where my experiences could be useful, instead of ignored. I also used to want to be a nurse, however, my health cannot support the strains of that job. Maybe with social work, I can help someone put things back together, help communities provide better services and, in general, provide a safe ear to help people figure things out.

My current goals for my professional life are to either become a medical social worker and help people who suffer from chronic pain or help people affected by any form of disability. I feel this would be the best use of my skills and experiences.

Since I wanted to learn more about current thought on social work and chronic pain, I searched for information on that topic. Most of the information I discovered was paid content or geared at a completely uninformed consumer. I did find an article from Health and Social Will, written by Judy McDonald.

Ms. McDonald's purpose is to deconstruct the current "contingency management" model of treating chronic pain and replace it with a new model that empowers chronic pain suffers. I will briefly summarize the contingency model, the contradictions in the model and how social workers fit into the new model.

The Contingency model is behavioral in nature. Ms. McDonald explains that the idea of this model is to assume that the environment is causing or reenforcing pain behaviors. This is usually a last resort after all possible treatments have been tried. While at first, the medical profession works to solve the problem causing the pain, none can be found, or, the pain seems out of proportion to the cause. This is what the medical profession refers to as idiopathic pain.

Doctors believe that the reenforcement may come in the form of attention, extra assistance, time off of work or medications. A program that addresses these environmental cues and reinforcers is administered, and the patient's pain behaviors are ignored. This isolates the person in pain even more. The second concept is that pain can be physiological in nature. But, of course, doctors don't find one for "idiopathic" pain, so the first concept of psychological becomes their primary focus. These contradictions make it challenging for a chronic pain patient to receive help. Speaking personally, it is not impossible for several doctors to miss the cause of the pain. I had this happen with my RSD and, if you looked only for conditions that can be seen on a film or with a computer, you won't see the condition I have. Doctors and professionals who dismissed my condition made it harder for me to accept the condition and ask for the help and care I needed.

Ms. McDonald then describes a holistic model, in which the patient's voice is respected and the patient uses self-determination the course of treatment. She further explains that the social work value of self-determination fits perfectly in this model. Social workers, she explains, can facilitate pain management by helping deal with the consequences of pain, teaching relaxation skills, helping find needed resources and facilitating support groups.

This model of pain management seems more likely to succeed, more respectful of clients' needs and more empowering for the client. In this model, I feel I could work well as a social worker.

I referred to the article "A Deconstruction of Chronic Pain Treatment", by Judy McDonald, from Health and Social Work. For this email and post.
Cut cuddle and be Cute

Bathroom humor

No, this won't be a post of inappropriate jokes, although I'm sure I know a few of those. I'm trying to act like a mature young woman, since this is a public blog and all.

I never thought I'd like the communal bathrooms of dorm life. It was definitely easier last year having my own bathroom and being able to take tub baths. But I'm able to handle the shower chair, and I cheat and leave my feet out of my shoes, and just put my feet on top of them, to keep them separated from the cold tile floor. It's hard, on a bad pain day to have to walk back and forth to the bathroom, but I'm getting better at it.

What I couldn't have known a month ago is how important going to the bathroom can be for increasing your social life potential. There's something about sharing a bathroom that makes it easier to say "hi" to someone. And since I can't see, people have to say hi, or risk getting bumped in places they'd prefer not be bumped. For my part, I move slowly, and listen closely most of the time. There is a lot of laughing and conversation that happens, mainly since going to the bathroom is something everyone has to do.

Sharing a bathroom also means I go out into the hall more. Last year, I had no where I needed to go, so no reason to go out in the hall. This year, on the way to the bathroom, I end up saying hi to people and laughing a lot.

I never, ever, thought I could write a blog post about going to the bathroom, other than as it refers to Julio, but there you go. Speaking of Julio, I don't take him to the bathroom, since if someone is showering, he won't go into the bathroom. I wonder if he thinks I'm going to give him a b..a...t...h?