Most palliative care patients with chronic pain have been prescribed around-the-clock pain medication.  Reason tells us that if the patient is taking something around-the-clock then they should also be prescribed something for breakthrough pain - just in-case.   Breakthrough pain is the pain that "breaks through" regularly schedules doses of pain medication.  Unfortunately, medication isn't always prescribed for breakthrough pain and patients don't always take as much as they are allowed.

Breakthrough pain is almost always treatable and shouldn't be ignored or accepted as and "inevitable" part of illness.  Learn how to recognize breakthrough pain, what could be causing it, and how you can help treat it.

Managing Breakthrough Pain

Shhhhh.....don't breathe a word of this but I'm giving a couple lucky friends the book Moments With Baxter this year for Christmas.  I've enjoyed the book about Baxter, the therapy dog, so much it has a permanent place on my coffee table.  I know my lucky friends will enjoy it too.

I've read other great books that would make excellent holiday gifts as well.  Here's a small list of my recommended books for the people in your life.

For the hospice/palliative care patient:

• The Handbook for Mortals
• Dying Well
• The Four Things that Matter Most

For the Caregiver:

• The End-of-Life Handbook
• Guide to Caregiving in the Final Months of Life
• Final Gifts

For the Grieving:

• Final Gifts
• The Gifts of Grief (a film)

For Everyone:

• Moments With Baxter

Grief has a way of showing up for the Holidays like an unwelcome in-law.  Whether someone you love has recently died, passed away long ago, or is nearing death now, the sorrow and loss you feel is magnified by Holiday perceptions of joy and togetherness.  Perhaps one of the greatest gifts you can give yourself this Holiday season is to allow yourself to grieve.  I don't mean you should find a dark corner to curl up in and wait this season out, but if you are able to recognize, acknowledge, and embrace grief, you'll be better equipped to cope with it.

I was contacted recently by an Episcopalian Reverend who had this to say about grief:

"Real grief stays with you. In fact, not only can one not expect grief to go away completely, we also shouldn't want it to. For as the person you loved is not returned to you, how can you stop grieving? The loss remains, and so does the sorrow. But grief can and does change. We pray not for an end to the grief, but for an unbearable sense of loss to be replaced by a sorrow we can bear."--Frank Logue

Even if you think your loss has become bearable, the Holiday season can swell your sorrow until waves of grief come crashing down on you.  It's absolutely normal and perfectly okay to feel this way.  This year, why don't you try welcoming your grief in for the Holidays - just be sure to set some boundaries so he doesn't kick up his shoes on your coffee table and overstay his welcome.  Some things to remember:

• Allow yourself to feel sad and lonely but don't skip the office Holiday party or the neighborhood potluck.
• Honor old traditions you shared with your loved one but don't neglect to create new ones as well.
• You're not obligated to hang outdoor lights, blow up the 10 foot Santa, or even put up a Christmas Tree but you can make an effort to put up at least one treasured decoration.

Keep in mind that your grief will change over time.  You may never spend another Holiday season without grief as an unwelcome visitor but one year you'll find that you can look him in the eye, shake hands, and move on.

Coping With Grief During the Holidays

Few stories are as inspiring and affecting and Baxter's.  The "golden chow" rescue dog turned hospice hero spent the last seven years of his life volunteering at San Diego Hospice.  He brought comfort and calm to patients facing death, he brought solace and a smile to grieving loved ones, he graced hospice staff and volunteers with his gentle soul.  He was a beautiful dog, inside and out.  His teddy bear looks and loving nature touched everyone he met.  His story is inspiring and deserves to be heard and shared.

Melissa Joseph, Baxter's owner, wrote a book about Baxter's work.  <i>Moments With Baxter</i> is a collection of 36 stories of how Baxter impacted the lives of those he touched.  I received my copy in the mail a couple of days ago and I've already read 25 of the stories.  I made the mistake of taking the book to my daughter's gymnastics class and ended up crying in the lobby because I was so moved!  Baxter has an international fan club and the book is a top seller.  Baxter even has his own stuffed animal replica complete with a pet therapy vest.  Shhh....my daughters are each going to get one for Christmas!

Read Baxter's story to learn more about this amazing dog.

Don't miss my Q&A with Melissa Joseph, Baxter's owner and author of <i>Moments With Baxter</i>

Learn more about pet therapy volunteers and how to get your pet certified.