Commitment to Comfort Program

 For many people, the worst part of being sick is the pain that often with an illness or surgery.  This is especially true for children who often can’t describe their pain to us or don’t realize that something can be done to help as well as for their parents who feel the pain as or more deeply than their child.  Pain has many negative consequences In addition to the suffering it imposes.   It may slow healing from surgery or injury and limit your child’s participation in activities that may speed recovery.  Pain that lasts for months can be devastating – it may diminish concentration and promote school absence, limit participation in sports and in social activities, alter sleep and appetite, and significantly impact on your child’s mood and your family’s quality of life.  

Although eliminating all pain is impossible, the staff at Boston Children’s Hospital is committed to minimizing the pain that your child experiences.   Our “Commitment to Comfort” , is our pledge to you that addressing your child’s pain is one of the highest priorities at our hospital.  Our pain service is the oldest and largest in the U.S. and has pioneered many advances in the field.  It has been designated as a Center of Excellence within Boston Children’s and has received recognition by the American Pain Society as….  It is not only our pain service, however, but our entire staff from the administration to all physicians, nurses, and our entire clinical staff that is committed to keeping your child as comfortable as we can whether you are seen in the hospital or in one of our outpatient facilities.  In fact, we are the first hospital to receive designation as “A Childkind Hospital” which is awarded to hospitals that have made an institutional commitment to reducing pain. 

Pain can be divided into a number of categories: 

1. Acute pain- Acute Pain is the pain that is caused by disease, injury, inflammation, or surgery and usually lasts until the tissue heals.  At BCH, we have many ways of addressing acute pain.  Much of acute pain can be handled by your hospital team.  However, for most surgeries and other severe pain problems, we have an Acute Pain Service composed of expert anesthesiologists and nurse practitioners who use the most up to date techniques to control pain.  There is always someone from the acute pain service in the hospital 24 hours a day, 7 days a week.  Additionally, our child life practitioners can provide needed distraction and other techniques to reduce acute pain.

2. Chronic Pain – Chronic is pain that persists beyond the time we would expect healing from an injury or infection (usually over 3 months), pain that results from a life limiting condition, or pain that has occurred spontaneously such as headaches, abdominal pain, or widespread muscle or joint pain without an obvious cause.

While the treatment for acute pain often relies heavily on drugs, the treatment for chronic pain is always multidisciplinary. That is, at BCH, we are fortunate to have many teams that address chronic pain.  Which team is best for you depends on location of your child's pain, how much intervention it requires, and what type of strategies are desired.   For severe headache pain, we have a headache program staffed by a neurologist, psychologist, and nurse practitioner. For abdominal pain, we offer our MAP Program (Multidisciplinary Abdominal Pain) staffed by a gastroenterologist, a pain doctor, a psychologist, a dietician, and a nurse practitioner. For children with multiple pain problems or ones that are largely orthopedic, we have a Chronic Pain Clinic composed of a pain doctor, a psychologist, and a physical therapist. We also have a program for children who have experienced pain for a very long time and have not responded well to the different strategies that have been attempted.  In that program (the Mayo Family Pediatric Pain Rehabilitation Center), child receive very intensive physical, occupational, recreational, and psychological therapy as well as medication where appropriate.  We have many other important programs here that help children and families in pain – the Acupuncture Clinicthe Comfortability Workshop where our psychologists help a group of children and their families understand chronic pain and teach a number of psychological strategies proving to reduce it; the Get Living Program which offers a combined physical therapy/cognitive behavior therapy to children whose fear of pain has limited their lives, as well as are interventional pain program where we offer injections and infusions that might help selected children.  As you can see, we have many ideas about how to treat chronic pain.  The important point is that all of these programs treat the whole child and not just the pain. 

3. Pain from medical interventions- Frequently, to adequately diagnose or treat a medical problem, we must test blood or other body fluids or tissues.  Sometimes, accessing those samples may be uncomfortable and require needles or other skin breaking procedures.   

Other times, needles are used for injections (shots) to give medicine such as immunizations, or  to place an intravenous catheter to give medicine. We know this can be both uncomfortable and scary for children. At BCH, it is our policy that whenever possible every patient in the hospital who has a needle procedure use a numbing medicine on the skin, or to reduce the pain of the procedure. Sucrose (sugar water)) can also be given to infants  along with numbing medicine or breast feeding during certain needle procedures. We also encourage the use of a variety of behavioral and psychological techniques that might further reduce the pain that your child might experience from needle procedures. 

We are united in our desire to make your child’s experience in our hospital as comfortable as we can and we have the expertise, resources and commitment to just that.