OT? September is Pain Awareness Month

Posted by Dr. Zachary Smith on September 11, 2009, 4:56 pm

wrote:

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urned out
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Hi Belinda,

I'm glad you weren't offended by my rant; I'm a little less tired
today if nothing else.
The above quote is interesting because it shows that we are often as
likely to dismiss our doctors as our doctors are to dismiss us. I'm
not judging whether this is good or bad - it just is.

From what little I think I know about it, (and by all means check it
out for yourself) arthritis is relatively easy to diagnose because it
shows up clearly on an X-ray. Nerve damage (or pinching) is difficult
to diagnose because it does not show up on an X-ray. Is it possible
that you had/have both? I do, and the arthritis rarely bothers me
because the other sources of pain are so much more severe.

There is a concept in pain medicine known as the "gate control
theory", which (oversimplified) says that only so much pain can be
transmitted through the nervous system at a time, and our brains
unconsciously decide for us how much of which pain gets through to the
brain and registers. Often, acute pain overrides chronic pain (though
chronic pain overrides all other symptoms), so in your case, the
pinched nerve may have overridden the arthritis.
http://en.wikipedia.org/wiki/Gate_control_theory_of_pain
(I don't cite wiki as a medical authority but rather as an
informational jumping-off point)

If what you're doing works for you and you're satisfied with the level
to which your pain is being addressed, I sure don't have any problem
with that. You're in the lucky group - statistically, more than 40%
of people with moderate to severe chronic pain cannot find relief.

Doc

Posted by teleflora on September 12, 2009, 2:17 pm

My DH is in constant pain from a back problem. This has been ongoing for 20
years. In 91, he had a laminectomy which relieved his sciatica. He could
get no relief before the surgery. He slept in a bean bag chair for a month.

After the surgery, he was relatively pain free for 10 years. Then he
started having problems again. The last 5 years have been horrible and
constant. But at least this time he can get a little relief from lying
down. Sitting in his desk chair seems to be the worst for him. Thank
goodness for cell phones and laptops. He can do his job from the bed.

Last summer, he had a spinal fusion. It didn't help at all.

Last week he had a procedure in which they went in with long needle
electrodes and cauterized the nerves on one side. A friend with the same
history as Joe had the procedure and has been pretty well pain free for a
month. We were so hopeful, but he hasn't gotten any relief yet. It's
doubtful he will.

He is on pain medication. It makes the pain tolerable but the side effects
are harsh. And he lives in constant fear that the doctor is going to cut off
the meds at some point. He takes more than he's supposed to, to get through
the work week and then lays in bed all weekend without the medication hoping
to make the prescription last.

He doesn't want the pain meds, he wants to be pain free.

Part of the problem (and he is well aware of it) is that he is like a
clenched fist most of the time. He's Italian. He gets angry easily (partly
from the pain) and he tightens up. Those tight muscles make the pain
worse. He takes a muscle relaxant to help with that. He is also on
anti-depression meds. He insisted he wasn't "sad". We convinced him that
his depression manifests as anger. Never at us, just in general.

He's pretty much given up all the outdoor sports he has always done. He is
a competitive trap and precision rifle shooter. If he spends a day at the
trap range, that means 3 days in bed.

He tries to stay upbeat, for me, but this is no way for a person to live.
His doctor is at a loss.

I don't know how much longer he can do this.

Cindy

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Posted by Dr. Zachary Smith on September 12, 2009, 2:40 pm

Hi Cindy,

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Trust me, we ALL want this.

My personal observations from taking what you say at face value:

1. Your story/situation is more common than you may think.

2. Your husband's pain is not being adequately addressed, and he needs
to speak frankly with his doctor about how the pain is affecting his
everyday life. If possible, go with him, and give the doctor your
input.

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3. All true except the Italian part. It's not that he's Italian; it's
that he's human. There is a well-documented connection and vicious
cycle of pain-insomnia-depression-stress (not necessarily that order)

4. IMO, you both need support groups. He needs one for chronic pain
patients - you need one for caregivers.

If you want/need to take this offline, you know where to find me.

Doc Smith
Oh, the pain... THE PAIN...

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Posted by onetexsun on September 13, 2009, 7:04 pm

Tell your DH he's got me pulling for him. Until you have chronic pain
you have no idea what it's like. I don't think anybody but we
"painiacs" and our spouses have a clue. Hug him and tell him I'll add
him to my prayer/good thoughts list.

And you too.

Hugs,
Sunny

Posted by teleflora on September 13, 2009, 7:58 pm

Thanks, Sunny. I think about you lots. Why did you stop writing your blog?
I still have you bookmarked and I check it now and again.

Cindy

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OT? September is Pain Awareness Month - Page 3