[Verse 1]
Chronic pain management, it ain't a set-it-and-forget-it game
Every follow-up visit gotta document the change
Pull up the chart, we running through the five A's today
Analgesia first — how much that pain been washed away
Activities of daily life, can they function, can they move
Or are they frozen like before, we need to see improvement
Adverse effects lurking — constipation, sedation, nausea too
You prescribing harm alongside help, that math is on you
Aberrant behaviors — watch for early warning signs
Requesting early refills, multiple pharmacies combined
And affect, the fifth A, mental health inside the equation
Depression riding shotgun on a chronic pain vacation
[Chorus]
Five A's, monitor over time
Analgesia, Activities, keep the Adverse in mind
Aberrant behavior, then Affect — run the line
Document benefit versus harm every single time
Reassess acute in days, chronic every three months or so
When the risk outweighs the remedy, you gotta let it go
Informed consent ain't paperwork, it's a covenant you sign
Five A's, monitor, refine
[Verse 2]
Treatment agreements, some folks call 'em pain contracts, yeah
Informed consent means laying out the facts exact
Risks of dependence, overdose, hyperalgesia too —
That's where the opioids paradoxically amplify what they're supposed to subdue
Aberrancy thresholds, define 'em before you ever prescribe
So when behavior shifts, you ain't surprised, you got receipts alive
Urine tox screens, pill counts, prescription drug monitoring boards
These are the instruments of vigilance, sharper than any sword
Acute therapy reassessed in days, not weeks, not months
Reassessment intervals matter — don't let the urgency run blunt
[Chorus]
Five A's, monitor over time
Analgesia, Activities, keep the Adverse in mind
Aberrant behavior, then Affect — run the line
Document benefit versus harm every single time
Reassess acute in days, chronic every three months or so
When the risk outweighs the remedy, you gotta let it go
Informed consent ain't paperwork, it's a covenant you sign
Five A's, monitor, refine
[Bridge]
Here's a rare word for your lexicon — iatrogenic
Harm caused by the healer's hand, that's the meaning, be specific
When the cure creates the wound, documentation is your shield
Every note you write becomes the record of a battlefield
Define your stopping rules before the therapy begins
Dose escalating, function flat — that's where the harm wins
Benefit gotta outpace burden, that's the calculus of care
If the scale tips toward damage, you documenting why you're still in there