Guest guest Posted January 12, 2006 Report Share Posted January 12, 2006 Here are a couple of Tracie's wonderful messages on pain; I hope this is what meant. Last night there was a great program on pain on the UCTV station. The professor PhD was stating that when he teaches his medical students about pain control, he has them think of the worst pain they've ever experienced. Then he has them think that this pain level never goes away. He explained that this was the definition of "chronic pain." He went on to tell the students that he does believe in chronic pain, as compared to acute pain. He used his "gallbladder attack" as the example of acute pain. He went on to share that NO ONE in chronic, unremitting pain would "psychologically" choose to be in that pain. He stated that the idea of "psychogenic" pain was inhuman, and should be dropped from the medical doctors vocabulary! As he explained chronic pain, he explained that there has to be multiple components for pain to happen. There has to be the "physical" insult or injury, the "emotional" experience related to that insult, and the "cognitive" reaction to the pain. For example, if you burn your hand, you feel the initial pain, and you know it's going to hurt. You yank your hand away from the fire, (fight or flight response) and your brain gets the message to protect this injury. You race to the sink, put your hand under cold water, and as soon as you pull it out from the water, the burning sensation comes back. So back under the water. Then he went in to the "emotional" pain. He explained that as "grief." Either the grief we experience over lose of a loved one, or grief over the lose of function. That too triggers the "fight or flight" sequence. The same hormones are sent out to fix the problem.Now, as they were able to show in the brain-- you can have the skull cut open, and electrodes applied directly to the brain-- and NO pain is felt. None. Yet, cut or burn your hand, and your brain reacts to pain. PET scans can now show exactly where the brain is reacting. Then they gave the subject pain medication, and even if it was injected directly to the brain area that was reacting, and there was no pain relief. But inject the site of the injury, and pain was controlled. Or give the patient a pill, and the pain was controlled. Add an anti-anxiety pill and the grief was controlled.The bottom line was that pain does not happen in the brain-- it happens in the signal centers of the small and long nerve fibres. It is intercepted at a spot in the brain stem, and then transmitted as a chemical reaction to the brain itself. So that's why TENS units can help, they cut off the signal (divert it) from getting all the way to the reactor point. Also, pain meds that can be injected directly into the spine (ie. morphine pumps) don't have the side effects of constipation. That's because our guts have the same pain receptors as this critical area of the brain. What this has proven is that we can't "think" ourself into pain. We can intensify pain with our increased anxiety over the pain-- making it more intense, but pain has to be there before it can be intensified. Eliminates the idea of "psychogenic" pain. So-- and he also stated, in a chronic pain patient-- you will always have a depression/anxiety issue. That is part of why MD's are leaning towards giving us anti-depressants. He stated that if you think of pain that would never let up, it would be insane to believe that you won't become exhausted, exsaperated, angry, and scared--that there is no end to what you're feeling. That alone starts that "fight or flight" sequence. It disrupts your sleep, your activities of daily living, your ability to work, provide, financial security, your interpersonal relationships. So hell yes, you are depressed! "Who wouldn't be!" But to blow off pain-- as being psychogenic in nature, is cruel. He teaches hypnosis as a pain control-- with excellant success. This may be something we need to look at for the future. Sincerely,Tracie NS Co-owner/moderator #3 This is a copy of an email I sent earlier on pain management.Pain meds work in a couple of ways-- they give us the freedom from pain, which in turn gives us the freedom to be more mobile. There is actually certain brain chemicals that are adjusted by the pain meds. Many of the anti-depressants work in similar ways. I can't explain how that is right now-- honestly, my brain isn't pulling up the info even tho I know its in there-- but these are really good questions to ask the pharmacist. Earlier this year when I tried the Duregesic patches, I found I did have more energy to face the day. It was like all the energy I put into fighting the pain on my own, could be redirected into other things. It was heaven. (I was allergic to the adhesive on the patches, or I'd still be on them.) So, my MD has prescribed Oromorph, and because I'm imtimidated all to hell by the tablets, I have yet to take any. Too those of you who can take pain meds responsibly, I say use them. For me, I know that my being in constant pain is an issue that not only effects me, but effects everyone around me. Now, to explain addiction vs dependency-- addiction again is when you use the meds to create a euphoric state, and has the added component of using more meds than prescribed-- not because you're keeping the pain under control, but because you just don't give a shit about anything else. You find yourself self-medicating just because you want to-- not because you're in pain.Dependency happens when you are taking pain meds, and your body and brain become dependent or resistant to the dosage. You find yourself having to self-medicate between regular doses because your pain isn't under control. This is a sign that your body has become tolerant to the dose your on. This isn't a bad thing, it just means you really need to talk to your MD and get something stronger or a different drug to control your pain. Pain is the most misunderstood symptom that all of us have. The "old school" MD's and staff come from the background that if you can't make the script last, you're abusing. Fortunately, that tide(al) wave is changing. The new info on pain control clearly explains that when pain isn't under control, patients will find a way to control it. It's called survival. Don't beat yourself up over using pain meds, or having a positive response like getting up to do something-- that is what should be happening. You don't have to be in excruitating pain before you take your meds, in fact- you shouldn't be in excruitating pain first. Thats why it's called Pain Control.Hugs,Tracie Here is a site that explains neuropathic pain. http://www.medscape.com/viewprogram/2361_pntHope this helps! Ramblin' Rose Moderator With MSN Spaces email straight to your blog. 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Guest guest Posted January 12, 2006 Report Share Posted January 12, 2006 I have to add a little to this; I used to work for a rheumatologist who specialized in fibromyalgia. Sometimes as is fibro - you pain filter is broken. Your pain is amplified and this even shows up on PET scans; though try getting one...you can usually only get one if you are suffering from cancer. When your pain filter is broken, you might pinch your finger and feel extreme pain rather than a pinch. He was the type that did treat your pain. Pain may be subjective but it is real. He uses different combos of meds, electrostimulation, moist heat, antidepressants etc. Well, I don't know where I was going to go from there, my brain lost the train...of thought. I guess what I am trying to say, is if you are not being treated sufficiently for your pain, find a pain treatment doctor/center. They are out there and as well all know sarcoid can be extremely painful and you deserve relief. Take care. Terri G. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 12, 2006 Report Share Posted January 12, 2006 I have to add a little to this; I used to work for a rheumatologist who specialized in fibromyalgia. Sometimes as is fibro - you pain filter is broken. Your pain is amplified and this even shows up on PET scans; though try getting one...you can usually only get one if you are suffering from cancer. When your pain filter is broken, you might pinch your finger and feel extreme pain rather than a pinch. He was the type that did treat your pain. Pain may be subjective but it is real. He uses different combos of meds, electrostimulation, moist heat, antidepressants etc. Well, I don't know where I was going to go from there, my brain lost the train...of thought. I guess what I am trying to say, is if you are not being treated sufficiently for your pain, find a pain treatment doctor/center. They are out there and as well all know sarcoid can be extremely painful and you deserve relief. Take care. Terri G. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 12, 2006 Report Share Posted January 12, 2006 I have to add a little to this; I used to work for a rheumatologist who specialized in fibromyalgia. Sometimes as is fibro - you pain filter is broken. Your pain is amplified and this even shows up on PET scans; though try getting one...you can usually only get one if you are suffering from cancer. When your pain filter is broken, you might pinch your finger and feel extreme pain rather than a pinch. He was the type that did treat your pain. Pain may be subjective but it is real. He uses different combos of meds, electrostimulation, moist heat, antidepressants etc. Well, I don't know where I was going to go from there, my brain lost the train...of thought. I guess what I am trying to say, is if you are not being treated sufficiently for your pain, find a pain treatment doctor/center. They are out there and as well all know sarcoid can be extremely painful and you deserve relief. Take care. Terri G. Quote Link to comment Share on other sites More sharing options...
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