Well folks, the more things change, the more they remain the same.
This "journey" covers 40 or more years of observation, reading anything
(relating to pain) in books, magazines and newspapers.

My "pain journey" began watching my mother's pain, while growing up.
Her pains continued, untreated and eventually blended into ag-related
conditions/pains and then (unbeknownst to us) cancer related pain, until
she was (late) diagnosed with lung cancer.

My "pain journey" was observational, until I was made aware, through
mother's letters that she was receiving medications, from nurses/RN
friends, she'd met after parents moved to a new location. I was appalled
(that she had to go outside the medical system) and (I was) relieved she
had pain relief.

Along the way, I had acquired articles from a well-known physician in a
large city in Ontario, about how he was often called, by loved ones or
patients complaning that they were in awful pain and nobody would stick
their neck out to sufficiently and/or promptly help their pain relief.  I
still remember when I was there, some 20 years ago, our meeting being
interrupted by a call from a desperate loved one, trying to get pain
relief for a patient.

Along the way, I also read that cancer pain was "well looked after".  That
reassured me.
It was for my mother _because she was in hospital, at diagnosis_ and
remained there until death, 3 or 4 weeks later; but what about cancer
patients today?  The more things change, the more they remain the same.

I was just searching for cancer pain (in various parts of Canada). There's
lots of talk and studies, and claimed experts, but no official Canadian
policy or instructions or plan (that I could find) that ensures that a
cancer patient will get prompt pain relief.

What brought this "rant" on?  Penny's journey, since being a non-cancer
patient.  (ie no longer being actively treated for cancer) and her winding
her way through "home care", palliative care experts, only to find, that
every twist and turn, when pain relief was needed "now", there were delays
and suffering, until the "right"person was found to provide the pain
relief.   And if you read her blog, the same thing happened over these
past 5 or 6 days. For cripes sake. She had to go to ER to get pain
relief.  Where are all these people who were supposed to be available to
her?  She had to then call her GP, who exaimed her in their vehicle who
then provided a prescription for morphine.

[from her blog]
"After 7 hours in emergency and finding out that I don't fall anywhere,
there is nothing in the system that shows me as "belonging" to any care.
Palliative Care shows me as being discharged from their system, the Pain
Clinic would not accept me as their responsibility, the emergency room had
to let me go. Nothing more they could do. Gave me one more shot of
morphine and sent us on our way to find out where I belonged. I have to
say, the doctor's there were very kind and caring and every there did
their upmost to try to find out how this all happened. In the end they had
no answers for me except that we had to get to see a doctor that would get
me back into palliative care. That usually takes 3 days.

From the emergency room, at 11 am Monday morning, we drove to my GP's
office (still in my nightgown). My GP came out to see me in my car, got me
going on morphine as it was obvious that the oxycodone was not cutting it.
Michael made some calls to home care and to the pain clinic while the
doctor spent time with me in the car.  I must of been a sight, sitting in
the parking lot of the shopping centre being examined by my doctor!

It now looks like I'm done at the Pain Clinic, for whatever reason, we
aren't sure why, they have given up on me and turned me over to my GP and
Palliative Home Care. Home Care, btw, doesn't know why I wasn't showing up
in the system from the emergency room and that is still a mystery. They do
have me registered as being under their care." [from her blog]

Note: I rather doubt that ER's have registration of cancer paitents in
their system, unless a cancer patient has been there previously and/or
someone (Palliative Home Care?) failed to register her at the
hospital...Unknown if that's their responsibility.

And why wasn't morphine prescribed before?  I don't know and/or Canada is
"backward" as to pain relief, and/or the system's a mess.  One "Peter"
from UK's wife had morphine from the trme of cancer treatment (2 years
ago) and continues on it, after treatment and still clear of cancer.

So what is so backward about the Canadian system?  And/or Canadians,
please plan ahead and talk with your GP (if you have one), make sure plans
are in place for pain relief, if needed. There's the other possible
problem; many Canaduabs don't have GPs and walkin clinics may be reluctant
to dispense appropriate pain meds (since they do not have the cancer
patient's file).  So what would happen?  Told to go to ER.  (just like
what just happened to Penny).

Back to the doctor in the big city...I suspect his phone is still ringing
off the hook. I can still picture him, shaking his head, in disbelief...

As a side note: I've found the following.
http://www.cancer-pain.org/about/mission.html
Mission Statement
A majority of cancer patients experience pain and are generally less
satisfied with their pain treatment than doctors think they are. Although
adequate relief can be achieved with available therapies, studies show
that cancer pain remains underreported and undertreated. This is due
primarily to lack of education about pain assessment and control; myths
about addiction to medication; and a general reluctance on the part of
patients and physicians to initiate discussions about this important
aspect of cancer treatment.

Cancer-pain.org has been developed by ACOR (Association of Cancer Online
Resources) with input and advice from patients, caregivers and an Advisory
Board of health care professionals dedicated to providing the most
advanced cancer pain relief. Our aim is to help cancer patients receive
the pain treatment they deserve.

The site offers in-depth information to assist in pain management
decision-making and interactive discussion groups to help patients
determine what will work for them. We will stay abreast of the latest
developments and communicate this information to our users. All content on
the site is developed in consultation with our Editorial & Medical
Advisory Board and pages are updated regularly. We welcome your feedback
and input. So bookmark our site and check back with us frequently. <end
quoted text>

All sounds good, but how does talk, referrals, website and/or advisory
board help a patient such as Penny (in Canada) or a patient in Missouri,
or a cancer patient in UK.  Advice (or referrals) is useless in such
situations.  The cancer patient needs pain relief...NOW !

J