Re: To Debs - your questions

[Guest guest]

Hi Debs,

I just read this post and I am going to think about the things that

you are asking me about. I will email you in the next day or so

about them.....as far as the questions to ask when you meet with

him.

I can explain about the trigger point injections now though but I

am not sure if this will help explain what happened to you with

this doctor's diagnostic procedures. But basically this is what

my pain doctor told me last spring. When the pancreas gets

irritated and inflamed the large abdominal muscles, both

superficial and deep ones start to spasm. This spasming

causes the muscle cells and the nerves that connect to them to

become irritated and sore which causes pain. In addition this

spasming can spread along the whole length of the muscle,

somewhat like the effects of pulling on a rubber band - the

stress that is applied on one part of the rubber band affects the

whole length of it. So in her opinion (and it does make sense

from a holistic point of view), when you have chronic pain with

pancreatitis (or biliary problems like SOD) you cannot say that

the patient is only experiencing visceral, neuropathic or muscular

pain. It is most likely the whole gamut with certain aspects being

more or less painful but all of them interacting and enhancing

the sensations of each mechanism. That is why, in my case,

she was treating the components. I had the trigger point

injections which is suppose to cause the muscles to relax by

paralyzing the cramping; in addition, she gave me smooth

muscle relaxant medication. Then I had myofascial massage by

a Physical Therapist who was also able to teach me to do this

myself (again, to relax the muscles). According to a fellow who

was doing his rotation through that clinic (and is knowledgeable

about chronic pancreatitis), there are characteristic locations in

the abdomen and back muscluloclature that are suspected to be

a direct result of the protection mechanism that the body induces

when the pancreas is angry. In my case, the trigger points did

help to reduce the pain but unfortunately, my insurance company

denied approval to continue. The massage was helpful too but in

a subtle way...nothing too dramatic in pain reduction. The

medicine may have helped, but the side effects were intoleable

to me.

Now to address the neuropathic pain that in my case was also

induced by my surgery....we tried the TENs unit (to me it seemed

to make things worse) and neurontin (which I use at very low

levels because I have big problems with my eyes when I take it).

But I think this works to some degree.

So basically.........because there are many aspects of a body's

response to chronic pain, I do not think your doctor will be able to

give you a definite cause of your pain. But, if he is good and

sensitive to your needs...he should be able to tell you what

medicines, procedures or therapies will have the best chance to

address each aspect of the systems that are causing the pain.

That is what I am hoping he will be willing and able to do for you.

If he is blunt and concise and dismisses something outright

(that is, if he says that the pancreas is not the source at all) then I

think he is not doing the job that pain management doctors are

there to do.....at least from my point of view.

A good plan should offer you narcotics for the visceral pain,

therapy (medical or otherwise) for the neuropathic pain, and a

plan to address the muscle pain. In addition, other adjuvants like

low dose anti-depressants to work on pain sensations caused

by the effects on our biochemical makeup is also helpful

Hope this helps a little for now.

Laurie

[Guest guest]

Hi Laurie

thanks very this.

The

> medicine may have helped, but the side effects were intoleable

> to me.

what were these medicine?

triggers....how do they work out where to put your trigger point

injections, where did you have them?

Your explanation is awesome of SOD and the pain

great below I will look for this

> A good plan should offer you narcotics for the visceral pain,

> therapy (medical or otherwise) for the neuropathic pain, and a

> plan to address the muscle pain. In addition, other adjuvants like

> low dose anti-depressants to work on pain sensations caused

> by the effects on our biochemical makeup is also helpful

>

> Thanks for your time that you have taken to help me

I really appreciate it

Debs