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Old 13-07-2016, 02:32 PM   #1
Bas Asselbergs
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Default pain education for kids

Thanks to a post by Josh in https://www.somasimple.com/forums/sh...861#post220861 , my brain went off on a tangent.

Having treated quite a few young people (7-14) lately, mostly figure skaters from a world-class training centre nearby, I found their grasp of "pain as an output" to be rather quick.
They really get the concept of the brain making their experiences rather than their senses alone! The examples of visual and other illusions seem to sink in very well.
They love stories, especially when they illustrate how incredibly complex their brain really is, and how their reality is just a representation, a version, of the world.
They get it.

I have a dream.
That good pain education is provided at a young age in every school.

Yeah, it is a dream. A pipe-dream, most will say....

But, I think I will approach the principal (a patient) of a nearby school and see what may develop.
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Last edited by Bas Asselbergs; 13-07-2016 at 04:22 PM.
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Old 13-07-2016, 04:05 PM   #2
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It's my understanding that Adriann Louw has started looking into this
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Old 13-07-2016, 04:12 PM   #3
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Agreed - children make for poor dualists without adult intervention.

3 nights ago my son fell off his swing in the backyard and hurt his 5th finger. It swelled instantly and - while he was trying to put on a brave face - it was clear that he was hurting and worried when he re-entered the home.

I explained that he has all of these little feelers in his finger that send messages to the brain all day long. I asked him to concentrate for a moment and tell me what he could hear in the room (it was a nice distraction and refocused his attention away from the throbbing finger) - he could hear the fridge running. He recognized that his ears didn't just start working to hear the fridge, but that his attention had become more pointed. I told him that the "feelers" in his finger worked all day and he usually ignored them (like the fridge) unless something caught his attention...banging his finger on the ground was sudden and alarming for those feelers, just like a loud thunder clap in his ear.

[forgive the homuncular falacy]The feelers, I told him, provide info to the brain like gauges on the dashboard of a stock car ... often, the driver is too busy driving to pay attention to what the gauges say unless the crew chief asks him to look (just like the fridge running). But, occasionally, the gauge will start to flash colors to get the driver's attention (like a thunder clap, or putting a lot of weight suddenly on your finger).[/falacy] Sometimes the driver needs to worry about it ("Oh no, I have to get inside!"), sometimes not ("Phew, glad I am not outside, I'd be getting soaked.") - but it will always get their attention. The pain in his finger was simply his body's way of getting his attention to figure out if something else needed to be done. Toward the end of race, a driver doesn't care if his car is over-heating and he needn't slow down. Sometimes he needs to ask his crew chief for advice when the gauges are confusing or he doesn't know what to do. When his fingers hurts, it is confusing, so he needs to ask his crew chief (me) what is going on and what he needs to do.

He was able to understand that that he has feelers everywhere in his finger - I showed him a picture of nerves in the hand and explained that each has their own feelers who inform the rest of his body/brain what is going on down there. He appreciated that if noises are too loud, he feels compelled to place his hands over his ears to protect them - the feelers don't tell him to cover his ears, he simply tries to find a way to reduce the noise.

I explained how he may have just startled the feelers ("jamming the finger") and that the best thing he can do for it is to protect (splint) it initially, but occasionally to move it to tolerance - after all, the first clap of thunder can be scary, but if it is a long storm, we get accustomed to the sound of thunder and then the storm passes.

I explained how the straps that hold his bones close together can become strained and that the feelers in the straps might be sending signals that there is need for repair - if you patch and re-seal a driveway, you can't drive a car on it for a few days. right? But you can walk on it without doing any harm. Again, the best thing he can do for it is to protect (splint) it initially, but occasionally to move it to tolerance.

I even explained how bones can fracture, but the same process is true for bones and ligaments (straps) - the best thing he can do for it is to protect (splint) it initially, but occasionally to move it to tolerance.

No matter the circumstance, the plan would be the same and he would likely feel a little better after splinting it with a popsicle stick. 3 days later, it is still swollen and a bit black/blue, but he is moving it more freely, going to camp, and playing with his new (unpredictable) puppy. He is not going to taekwondo tonight; he can't yet make a fist, but he feeling better. The coolest thing about it all was watching the anxiety fade in 5-10 minutes of conversation. I don't think the pain changed, but his sympathetic nervous system certainly calmed - his breathing quieted and deepened, he slouched in his chair, and he even grinned a bit.

Kids get this stuff - it is intuitive when you are young, it just needs to be framed appropriately.

I wish you luck in your efforts, Bas. They are merited.

Respectfully,
Keith
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Last edited by Keith; 13-07-2016 at 04:25 PM.
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Old 13-07-2016, 04:21 PM   #4
Bas Asselbergs
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Thanks Keith, also for that story!
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We don't see things as they are, we see things as WE are - Anais Nin

I suppose it's easier to believe something than it is to understand it.
Cmdr. Chris Hadfield on rise of poor / pseudo science

Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

We don't need a body to feel a body. Ronald Melzack
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Old 13-07-2016, 09:04 PM   #5
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Hi Bas!

Quote:
I have a dream.
That good pain education is provided at a young age in every school.
I just responded in a different thread on why I believe SomaSimplers writing for Freelap might be a very good idea. A large segment of the coaching community I deal with are involved in both health and physical education.

Getting to them may be the first step in fulfilling your dream. At least it might be a start not as fraught with the kinds of controversy we see in therapist-to-therapist discussions.
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Old 14-07-2016, 04:06 AM   #6
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Default Pediatric Pain Letter

Please see this link to "Pediatric Pain Letter" if it has not already been posted on SS:
http://childpain.org/ppl/issues/v15n...n1_coakley.pdf

Commentary
Chronic pain is like…
The clinical use of analogy and metaphor in
the treatment of chronic pain in children
"Metaphors may be as necessary to illness as they are to literature,
as comforting as a bathrobe and slippers." (Broyard, 1992)
Rachael Coakley and Neil Schechter
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Old 14-07-2016, 02:24 PM   #7
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Bas,
This is a great idea. I wish you well. I have pretty easy access to our local schools too, I will see if I can make this go in my area too.
Pain education in elementary school.....the vaccine for chronic pain
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Old 14-07-2016, 02:47 PM   #8
Diane
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Quote:
Originally Posted by Bas Asselbergs View Post
Thanks to a post by Josh in https://www.somasimple.com/forums/sh...861#post220861 , my brain went off on a tangent.

Having treated quite a few young people (7-14) lately, mostly figure skaters from a world-class training centre nearby, I found their grasp of "pain as an output" to be rather quick.
They really get the concept of the brain making their experiences rather than their senses alone! The examples of visual and other illusions seem to sink in very well.
They love stories, especially when they illustrate how incredibly complex their brain really is, and how their reality is just a representation, a version, of the world.
They get it.

I have a dream.
That good pain education is provided at a young age in every school.

Yeah, it is a dream. A pipe-dream, most will say....

But, I think I will approach the principal (a patient) of a nearby school and see what may develop.
The ultimate - combining a previous career with a current career.
Bas, if you succeed in this little dream, and it takes off, you'll save the Canadian health care system untold $$.

I just saw this, posted by Sigurd Mikkelsen:
Quote:
"The doctor (or therapist) who refrains from operating on a back, instead giving it a chance to heal itself, will not be rewarded and judged as favorably as the doctor who makes the surgery look indispensable, then brings relief to the patient while exposing him to operating risks, while accruing great financial rewards to himself. The latter will be driving the pink Rolls-Royce. The corporate manager who avoids a loss will not often be rewarded.
The true hero in the Black Swan world is someone who prevents a calamity and, naturally, because the calamity did not take place, does not get recognition—or a bonus—for it."
(Nassim Nicholas Taleb)
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Old 14-07-2016, 02:51 PM   #9
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What of the medieval thinking taught in most schools? What of tradition? Post hoc ergo propter hoc?

I agree that science should be taught, but something has anticipated that.
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