Why Goals Matter
Imagine a day in your life if your pain were under good control. What would it look like? Who would you be with? What would you be doing? How would you feel? Answering these questions is not just wishful thinking. Setting specific goals for your pain is a really important step toward better pain management.
Pain affects us far beyond the physical discomfort. Pain can change the way we think about ourselves: about who we are, our purpose, what we are capable of, and how we matter to others. When pain takes too much control over these thoughts, it changes our day-to-day choices about what to do and how to spend our time. After a while, some people find that they stop doing many of the things that they love, and that help make them who they are. This adds to feelings of sadness, loneliness, and discouragement – which only make pain worse.
Staying involved in what matters
Pain causes real limitations in our lives. But pain cannot change the core of who we are. So - it becomes really important to pick goals that are important to you and choose to stay engaged with those activities that bring you meaning and joy. Your involvement will probably look different than it did in the past. But that’s okay. What is important is to move toward goals that line up with who you are and what you care about.
Picking a goal
How do you pick the right goal for yourself? Start by thinking of something that is important to you, something that motivates you and brings your life meaning or happiness. Examples could be spending more time with friends or family, walking, reading, going out to dinner, attending religious services, working, or spending time outside.
Getting specific with your goal
Once you’ve thought of the goal, try to get more specific about it. If you want to be spending more quality time with family, the goal should be spending time with family for a few hours at a time and not spending all weekend with your family (because this will likely be very overwhelming and not give you time to rest).
Here are some questions to ask yourself to make it more specific:
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Why is it important to you?
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When can you do it?
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How often do you want to do it?
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For how long will you do it?
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How will you know if you've reached your goal?
Being realistic with your goal
Setting goals can be hard because we tend to compare ourselves what we used to be able to do. This is a recipe for discouragement. It can be hard to accept that that things are different now. For some, it feels much easier to just avoid meaningful activities all together. There is a better way. Try to focus on what you can do right now to stay engaged in things you care about, even if it is very different than what you used to do.
It can be hard but helpful to accept that your involvement in the activity may look different than it did before. For example – if you loved playing baseball, your goal now may be to watch some games with a friend or to spend time throwing a baseball outside. If you love family gatherings but don’t have the energy for them now, your goal may be shorter visits with a few relatives.
Here are some specific tips to adjusting your goals to make them more realistic and achievable:
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Always follow the instructions on your prescription bottle.Never take a higher dose of your opioids, or take them more often than prescribed. Instructions on medicine bottles can be confusing. Short-acting opioids are often prescribed with a range of doses you can take. For example: “Take 1-2 tablets every 3 hours as needed for pain.” This means it’s OK to take up to 2 tablets within a 3-hour time window. You can also choose to take less than this, or not take it at all (if your pain is controlled). Take them with a sip of water, with or without food.
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Take them when you have pain and need quick relief.These take about 30 minutes to start working and 1 ½ hour to get the most relief, so take them early on when you feel your pain creeping up.
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If you don’t have pain, don’t take them.If your pain is manageable and you don’t expect it to get worse, you shouldn’t take this medicine. It should be used “as needed” when you have pain.
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Take them before your pain gets severe.Try to “stay ahead” of your pain by taking your short-acting opioid early on when you notice your pain getting worse. If you wait until your pain is severe, it often takes more medication and a longer time to get your pain under control. Pay attention to your body as you learn about your pain and how you react to opioids. Most people start recognizing their body’s signals about when they need to take their short-acting opioid for breakthrough pain.
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Choose the dose that matches your pain level.Most short-acting opioid prescriptions have a range of doses you can choose to take within a given time-period. A common example is take 1-2 tablets every 3 hours as needed. If your pain is severe, start with the higher dose (for example: 2 tablets). If your pain is less severe, you can start with the lower dose (for example: 1 tablet). If your pain isn’t significantly better after 30 minutes to an hour, you can take the rest of the dose.
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Take them about 30 minutes before painful activities.Some people know they will have pain with certain activities, like walking or taking a long car ride. Think of activities that usually worsen your pain. To help you be more active, you may want to take your short-acting opioid 30 minutes beforehand.
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If your short-acting opioid is not working well, talk to your care team.Every person is different and it can take some time to find the right medicines and right doses for you. Your care team might decide to increase the dose of your opioid or change to a different medication. The important thing is to let them know how you are doing.
Examples of specific goals:
I would like to take a 15-minute walk on the beach, on Tuesdays around 10am (at a specific day and time, once a week).
I would like to spend 1 hour at lunch with my friend once a week (specific length of time, and how often you could engage in this activity)
I would like to attend my grandson’s sports event for 1 hour every Wednesday night.
I would like to cook dinner (45-minute task) twice a week, around 5pm.
I would like to go fishing, once every other week for 2 hours. I will go with a friend to help me set up.
I would like to be able to shower on my own 3 times per week, in the mornings when my energy is higher.
In summary
Goals matter for your life and for your pain control
Pick a goal for yourself, one that is meaningful and matters to you
Goals help you stay engaged and feel less helpless
Make the goal specific
Be realistic about your goal
Take it slow
Try not to overdo it