Global Day Against Pain

[TruthSeeker]

There is a live webcast on Oct 11 featuring some of the world's leading pain researchers. The main theme is the relief of pain as a human right. The panel discussions will cover many topics and some questions are being accepted via email.

This is open to everyone and I thought might be of interest to some of the members here.

for more info

 

[Dragonrock]

So, is this a masocist convention?

please be informed that anyone insterested in pain can log on an watch the Global webcast

My wife is a nurse and is a big advocate for patient's rights. One thing she will rush to do is give a patient their pain medication on time. She feels that since she wouldn't want to lie there in pain, her patients shouldn't have to either.

 

[TruthSeeker]

Your wife is absolutely right! If only we could figure out how to get all health care workers to adopt the same attitude.

How is she feeling, BTW? Better, I hope.

And, no, we are not all masochists...about half are sadists. (bad, bad, stupid joke)

 

[Dragonrock]

Your wife is absolutely right! If only we could figure out how to get all health care workers to adopt the same attitude.

How is she feeling, BTW? Better, I hope.

And, no, we are not all masochists...about half are sadists. (bad, bad, stupid joke)

Thank you for asking. She's been running a fever up and down and her cough is now productive (which sounds QUITE lovely I must say). Today is day two of the antibiotics which means she should quit getting worse.

As far as the pain conference goes, I think many people underestimate the problems that even moderately low level pain can cause and how it can slow the healing process. Improving pain management would have far reaching affects throughout the medical industry.

 

[TruthSeeker]

Poor thing. I do hope she's feeling better soon.

I agree with your thoughts on pain. Not only does acute pain slow healing, but chronic pain is associated with depression, anxiety, sleep disturbance, relationship distress etc. Not surprising really when you imagine what it would be like to be in pain every day.

 

[exarch]

Originally posted by TruthSeeker
I agree with your thoughts on pain. Not only does acute pain slow healing, but chronic pain is associated with depression, anxiety, sleep disturbance, relationship distress etc. Not surprising really when you imagine what it would be like to be in pain every day.

Normally I'm someone who avoids taking meds at all cost, but one of the best decisions I've made in a long time was buying that box of Nurofen (Ibuprofen) on Wednesday. The fact that I could barely keep my head up before I left for work, and the fact that I could hardly even feel my neck pain any more a few hours later if I sat down for a while, is just amazing.

I think I would have spent the past three days crying in agony if it hadn't been for the painkillers. And the doctor also said that the Nurofen will actually help the healing process. Probably because the reduced pain ensures that I don't (involuntarily or not) tense up the surrounding muscles to keep the sore one from causing me pain.

Sometimes I hate being right though. The only thing that still hurts right now is having shelled out another 20 bucks to have the doctor tell me that yes, it's probably just a strained muscle, maybe a tiny tear, and to just keep doing what I'd already been doing so far (i.e. popping painkillers to keep the pain at a comfortable level and being generally careful and avoid activity). And she said to call back on Monday if it still hadn't improved.

There's only one downside though. Pain-meds mask the pain, so it kind of hinders when you're trying to determine what's wrong.
- Does it hurt when I push here?
- Uhm, ... no, not really.
- How about here?
- Uhm, ... no.
- What if I turn your head like this?
- Well, yes, maybe a little bit.
etc...
Well, if I hadn't taken them before going to the doctor, I don't think I would have survived the drive over there. I think I took the speed-bumpiest and pot-holest route imaginable
Also, parallel parking when you can't turn your head back is, ... interesting, to say the least. Hey, at least I still parked better than some people I know

 

[TruthSeeker]

You raise a couple of good points:

1) acute pain is a communication. It tells us when something is wrong and enforces rest or changes in function that support healing. While analgesics can certainly "mask" the pain, a good assessment incorporates this information. For instance, knowing that ibuoprofen helped tells me something about the nature of your pain. I would also ask you to use words to describe the pain before and after the pain killer. That can be very informative as well

2) I wish people would not hesitate to use pain meds. I understand the fears about addiction. However, drugs like ibuprofen, acetaminophen and aspirin are not addictive and addiction following the use of opioid drugs for pain is rare in people without a history of substance abuse issues. Rather, using these drugs is associated with improved healing as you mentioned and there is some evidence that reducing the initial acute pain reduces the chances of developing chronic pain.

One of the objectives of the Global Day on Pain is to spread some of the knowledge we have on pain. One of the key points is that pain needs to be managed. Please, please do not suffer needlessly.

Ok, that's my lecture for today.

 

[Zombified]

2) I wish people would not hesitate to use pain meds. I understand the fears about addiction. However, drugs like ibuprofen, acetaminophen and aspirin are not addictive and addiction following the use of opioid drugs for pain is rare in people without a history of substance abuse issues.

I'm not sure if migraines count for this event, but that's my thing, so...

This business of using the medications available was something I had to learn when I figured out I was getting migraines as well as the usual tension headaches... because medication works best when taken early in the process. I was one of those people that wouldn't take anything until I absolutely had to. I don't think its was really an addiction fear, I think it was a combination of being afraid of building up a tolerance and having the stuff stop working, and just a general "I ought to be able to handle it" attitude. Secular puritanism, sort of.

This year I've had a lot fewer migraines than I did a couple years earlier. I didn't really realize just how debilitating it was. It's very hard to perform well in your career when you are useless a day or two every week. I'd show up for work, and then the migraine would set in, and I'd feel too sick to drive home, I'd just sit in my office all day with the lights off and the blinds closed hoping I'd get better. Late afternoon I'd start feeling better. Annoyingly, some of my friends at work were a bit suspicious these about "9-5 headaches" but apparently its not uncommon to be on a schedule like that.

Migraines seem to be one of the favorite targets of "alternative" medical practitioners. I think this is because historically migraines have been difficult to treat, and because people don't know how to distinguish between different types of headache pain and get the right treatment for them. It's my understanding there are a lot of developments in this area recently, and I think people's beliefs about what treatment is possible lags the state of the art, as well.

 

[TruthSeeker]

Hi Zombified,

Yes, migraines definitely count as a type of chronic pain.

Your pain stoicism is not uncommon. But we don't do this with other medications or diseases "I won't take my thryoid/diabetes/disease of choice meds because I should be able to handle it" I think pain is in a class of its own because we still don't think of it as a legitimate target of treatment in its own right and second we feel we should have control over it. I think this is a fundamental misunderstanding that comes from the whole "grin and bear it" approach to lesser types of pain.

I also agree that alternative medicines often target people with chronic pain. Some of this is related to the point above. People with pain are looking for a way to have control outside of pain meds. Another reason is that many have met with negative attitudes from more traditional health care workers and so are thrilled to find more accepting practitioners. A third reason is the subjective and fluctuating nature of pain. This makes it highly vulnerable to placebo effects. I'm sure there are other reasons too.

BTW, have you seen a doctor about getting a migraine prophylactic drug? They work wonders for some people.

Be well,
TS

 

[Zombified]

BTW, have you seen a doctor about getting a migraine prophylactic drug? They work wonders for some people.

Yes, I have been prescribed Axert which works wonders for me. This is what I meant by learning to take one's medication early: in my inexpert understanding, it interrupts whatever biochemical process causes the migraine and therefore is much more effective taken as soon as possible.

I have been singing the praises of this drug ever since, but it is not for everyone: there is another poster on this forum that cannot take this class of drug because she has a bad reaction to them. Which, not to put too fine a point on it, really sucks. I sincerely hope research into migraines (and how these drugs work) will identify other ways of treating migraines so she'll be able to get the kind of relief I have.

As far as the stoicism goes, I think, especially for men, we're taught that we're supposed to bear acute pain without complaining about it - you take a hit on the football field or hit your thumb with a hammer and it sucks but you don't whine about it. This attitude carries over into chronic pain. Especially for an episodic problem like migraines, where its a chronic condition, but each episode seems like one acute event.

 

[exarch]

Originally posted by TruthSeeker
1) acute pain is a communication. It tells us when something is wrong and enforces rest or changes in function that support healing. While analgesics can certainly "mask" the pain, a good assessment incorporates this information. For instance, knowing that ibuoprofen helped tells me something about the nature of your pain. I would also ask you to use words to describe the pain before and after the pain killer. That can be very informative as well

It's remarkable how I can almost tell when the pain killer is kicking in, and when it's starting to wear off.

According to the description, it should work between 4 and 6 hours, and I feel the most effect about 3 hours after I've taken it, and it starts to wear off after about 6 to 8 hours. I also notice it takes about an hour before it really starts to have an effect. So I assume it's a bit like a bell curve, it's taking a while before it starts working (it's a pill, so I think it needs to be digested). The positive side is that it also takes a while before it stops working, so it gradually wears out for about two hours.
And even though it may not be apparent, the pain I have in my neck after waking up in the morning (when the painkiller from last night has completely worn off), is much less severe than it was last week.