BTP or Breakthrough Pain has always been associated with Cancer patients. Pain specialists are now applying the term with pain patients that have the same type of sudden severe pain flares. In a recent study published by the Journal of Opioid Management, they found that non-cancer patients suffered from breakthrough pain more than those with cancer. The trouble with breakthrough pain is that nothing helps. The prescribed pain medication does not work, hence the term: “Break-through” as the pain breaks through the barrier level of medication.Whether you call them flares, flare-ups or BTP, the pain is often severe and debilitating. It can come on suddenly or when doing certain tasks. Breakthrough pain will usually reach its peak intensity after a few minutes and lasts anywhere from 30 to 60 minutes. The Breakthrough Pain may also cycle off and on for several hours, causing sleep disturbances and quality of life issues not to mention financial hardships. My understanding is that this is different from the pain felt with “end-of-dose failure”. End of dose failure tends to happen when you are on a long acting opioid and it should last for 12 hours, but in some persons tends to last 8 to 10 hours. As an individual, you have reached your end of dose cycle.
I started keeping mental notes of when I have a flare up. I have since changed some of my work and everyday habits. In order to maintain a quality of life, I have made my work associates aware of what I can and cannot do. I ask for assistance in doing certain tasks that involve lifting or moving of awkward items. When met with resistance I ask them if they would want me to be to work tomorrow or off for a week due to pain. That usually gets me the needed help. Mind you, this tactic doesn’t always work, but it does help on occasion. I am not so inflexible that I refuse to do something (unless it’s way out of my ability). The key is to remain flexible in situations. There are times when you will have to do things that bother your Fibromyalgia. Life is that way. By working with the fibro and your limitations, you will garner respect from your fellow associates and your boss. Even though you may not want to share your limitations with others, it may be best to do so. Speak with your Human Resources Dept., this is one of the reasons they exist.
Home may be a different situation altogether. You may not have the luxury to “not do” certain things. Sometimes you have to be your own caregiver. On fibro days that I have Breakthrough Pain and it affects my shoulders and arms, I cannot fold laundry nor do the dishes. Pacing oneself and getting plenty of rest is all you can do sometimes. This will always affect your relationship with family members. It will affect your quality of life. It will increase your medical expenses. You don’t have to like it, but you do have to accept this. Another thing that must be accepted is that BTP can just happen.
According to the American Pain Foundation; people can experience severe flares an average of twice a day. Their researchers also estimate that more than 80% of people taking long-acting medications for chronic pain experience breakthrough pain.
I had several flare ups this week. I did miss one day of work. The nice thing is my boss understands I can no longer do the things I used to do. Fortunately I have proven to be a valued employee as I am sure most bosses would have found a way to get rid of me by now. I continue to take my prescribed medication. If I did not, I am afraid I would not be able to function as well as I do. I would hate to think what BTP would feel like if I were not on pain medication.
Tell your doctor if you are experiencing Breakthrough Pain. Rate your pain and try to keep track of it. You can help your doctors’ treatment of your Fibromyalgia better by understanding your body better. Communicate with your doctor, your family, friends, co-workers. Don’t become a whiner, do become a better communicator.
