Re: the need to be pain free...

May 5, 1999

In a message dated 5/5/99 12:27:37 PM Eastern Daylight Time,

byteme@... writes:

> To arrive at this utopia, they need to know how much pain there really is

and to do

> that, you must be as med. free as possible when they do the tests.

Please forgive me, in advance, for what I am about to say, if it accidentally

offends you. I have to disagree with idea that for a doctor to determine

whether or not a person needs pain medicine, the person has to be medicine

free. When I went to the hospital with what turned out to be impacted bowel,

I was literally screaming with pain. The doctor did not want to give me any

pain medicine for the very reason you quoted. I responded with, " This is not

the 1500s and we are past the point where torture is a normal part of

doctoring. Just give me enough pain medicine to keep me from screaming. You

will still be able to locate the pain. There is no need for me to be in

torture while you figure out what is going on. " A few minutes later a nurse

came in with a shot of something that took the edge off. They still found

the cause of the pain, and I was able to stop screaming........

The point is it is archaic to think that a patient must feel the full extent

of pain to qualify for pain medicine. I am not advocating narcotics for all

occasions, just a realistic acceptance that pain is there and needs to be

treated with increasing doses until it is manageable. I do not take anything

unless I need it... I am always in some kind of pain, however, if I need it,

I want it and do not want to be neglected because of such thinking.

I hope this has been taken in the light it was sent...not to cause an

argument, but to perhaps, stir some re-evaluation of this process by the

medical profession.

As far as the patient doing things him or herself to improve own life, this

should be a given. If someone is able to handle the pain and do what ever is

needed to build personal health, this should be done. I don't see how

accepting pain medicine is contrary to this process. Why is pain treatment

any different then treatment for say Diabetes.... With Diabetes 2, the

patient is expected to watch his or her diet, and exercise. They are also

given Glucatrol and or Glucophage... one process does not exclude the other.

I am stopping now...I think I am beginning to beat a dead horse..

Mad

May 5, 1999

In a message dated 5/5/99 8:01:33 PM Eastern Daylight Time, byteme@...

writes:

> I stand by my statement. The naked truth may be ugly but at least it's the

> truth. See? I'm not upset, just bull headed! As far as beating the dead

> horse thing, I don't know enough about veterinary medicine to comment!

ROFL!!!!!

Mad.

May 5, 1999

In a message dated 5/5/99 8:30:06 PM Eastern Daylight Time,

kturbin@... writes:

> That is their

> objective in the first place, and not necessarily ours at all.

So true, so true...

Mad.

May 5, 1999

That's relative and specific to the sort of pain we are talking about. I did

state that these were my views based on my experience. What I should have

said was that in a case like mine where there is back injury causing pain,

it is important to be medicine free for these kinds of tests. I never would

have received proper treatment had I undergone the tests while drugged.

In fact, to go one better, at around the same time, still in denial and

believing I could beat this if I fought hard enough, I got myself completely

sauced up and submitted to a physical to work as an underground mechanic in

a mine up in Northern Canada. I did all the bending, the touch your toes,

the wrap your legs around your head and cartwheel stuff and passed with

flying colours ! The examination team (there was more than one doctor) found

me to be one of the best physically qualified applicant !

I'll grant you it's pushing things a bit too far (or a lot too far) but it

works. And that is my point. Under normal amounts of medication, I could

never have passed. I wanted to prove I could do it and I did (pass the

medical that is). I was offered the job and I did tell them that I had a

history of previous back injury and I thanked them but passed. $90,000 a

year back in 1982 was no small change believe me.

The fact remains that the pain killers passed the test, not me. To get back

to the actual subject at hand, it is my personal opinion that there is no

way in God's green earth that you can honestly judge the amount of pain you

would have unless you remove the medication. It is easy to say that on bad

days I need 2 canes and walls all around me to walk a straight line because

of the pain and that at best I can only walk 15 or 20 feet. Words are cheap.

Saying it and feeling it are 2 different things and unless I can accurately

demonstrate this to a therapist so that they have a measuring stick to go by

in establishing a proper treatment, geared to my pain and my strength to

endure such treatment, I am wasting both their time and mine.

In the context described by Jeff, we are talking about individualized

service. We are not talking about everyone following the same treatment

regardless of pain. The first step in assessing an individual is to

determine at what level, on a pre-established general scale, proper

treatment can be started at and administered. In a Lasegue test, I have less

than 10% mobility. Assuming a " normal " individual has 100 % then my

treatment should start at the 10 % level and work up. If my neighbour has

50% why should he start at my level and waste time, resources, money and so

on starting at my level. Would he not get better quicker starting at the 50%

level ? How can I allow a professional to correctly gauge this if the pain

killers allow me to live at a 60/70% level which is my case ? I don't see

how I can.

You mention an impacted bowel. Not to minimize the ordeal in any way, this

would also cover a toothache, an automobile accident, even a gall bladder

attack. What these all have in common is that they are NOT chronic pain

situations. Further down in your message, you mention the treatment of

Diabetes and different pain treatments. There is a difference. Pain per se

is temporary in the examples I mention above. Diabetes is a chronic

condition I believe and therefore subject to the same form or level of

treatment as any chronic pain patient. I really don't know what I'm talking

about as far as Diabetes goes but I suspect that a well informed diabetic

would have a way to regulate his/her blood sugar levels approaching the

standard of a non diabetic. Applying the same logic as the pain clinic

tests, wouldn't that defeat the purpose of the test required to establish

the amount of insulin required ? What benefit could you possibly get from

making things artificially better for the purpose of the test ?

I stand by my statement. The naked truth may be ugly but at least it's the

truth. See ? I'm not upset, just bull headed ! As far as beating the dead

horse thing, I don't know enough about veterinary medicine to comment !

Mike

mailto:byteme@...

homepage: http://members.home.net/mcourteau

ICQ# is 19431463

" Free Tibet ! 50 years of Chinese occupation is long enough ! "

--------------------------------------------

Re: the need to be pain free...

> From: MadMad4JC@...

>

> In a message dated 5/5/99 12:27:37 PM Eastern Daylight Time,

> byteme@... writes:

>

> > To arrive at this utopia, they need to know how much pain there really

is

> and to do

> > that, you must be as med. free as possible when they do the tests.

>

> Please forgive me, in advance, for what I am about to say, if it

accidentally

> offends you. I have to disagree with idea that for a doctor to determine

> whether or not a person needs pain medicine, the person has to be medicine

> free. When I went to the hospital with what turned out to be impacted

bowel,

> I was literally screaming with pain. The doctor did not want to give me

any

> pain medicine for the very reason you quoted. I responded with, " This is

not

> the 1500s and we are past the point where torture is a normal part of

> doctoring. Just give me enough pain medicine to keep me from screaming.

You

> will still be able to locate the pain. There is no need for me to be in

> torture while you figure out what is going on. " A few minutes later a

nurse

> came in with a shot of something that took the edge off. They still found

> the cause of the pain, and I was able to stop screaming........

>

> The point is it is archaic to think that a patient must feel the full

extent

> of pain to qualify for pain medicine. I am not advocating narcotics for

all

> occasions, just a realistic acceptance that pain is there and needs to be

> treated with increasing doses until it is manageable. I do not take

anything

> unless I need it... I am always in some kind of pain, however, if I need

it,

> I want it and do not want to be neglected because of such thinking.

>

> I hope this has been taken in the light it was sent...not to cause an

> argument, but to perhaps, stir some re-evaluation of this process by the

> medical profession.

>

> As far as the patient doing things him or herself to improve own life,

this

> should be a given. If someone is able to handle the pain and do what ever

is

> needed to build personal health, this should be done. I don't see how

> accepting pain medicine is contrary to this process. Why is pain

treatment

> any different then treatment for say Diabetes.... With Diabetes 2, the

> patient is expected to watch his or her diet, and exercise. They are also

> given Glucatrol and or Glucophage... one process does not exclude the

other.

>

> I am stopping now...I think I am beginning to beat a dead horse..

> Mad

>

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May 5, 1999

Hi MAd,

At 07:11 PM 5/5/99 -0400, you wrote:

>it is archaic to think that a patient must feel the full extent

>of pain to qualify for pain medicine. I am not advocating narcotics for all

>occasions, just a realistic acceptance that pain is there and needs to be

>treated with increasing doses until it is manageable.

I tend to agree with you, with the exception that there are some

medical procedures that need to be done with little or local anesthesia. I

think that it is possible different medical specialties have different

viewpoints too. I assume that an anesthesiologists could probably tell

differences in pain levels if he/she knew what meds you have taken, more so

than , say an internist. When I went for neurosurgery, nothing was ever

discussed about needing to be off meds for any exam. I was a bit surprised.

I was not referred by any of my doctors, I was a walk-in! My neurosurgeon

appeared to take for granted the levels of pain I experienced, and was more

interested in the sources. He might have called my other doctors, or gotten

reports from them.

Also, in the probably 5 years of treatment at a respected pain

clinic, there was never any need to go off pain medication. And the clinic

was quite professional & effective. Interestingly, the head & founder of

the program did write about advisability of going off meds & using meds

sparingly in a book which was very popular (don't recall the name). I think

the opinions he expressed publicly were more to protect the practice than

what he might do face-to-face. Suspect that most medical practitioners

would probably recognize that part of his writing as " medical code words. "

Thinking about it, I am sure that there must have been some docs

who took him at his word. That would cause problems. Much of this double

standard has been created by control drug measures & poor & uneven

application of these measures, or fear about it. Doctors also would be

concerned about drug abuse in general, but I really wonder why with an

established chronic pain patient. We know that large-scale medical research

has found little proneness toward drug abuse by chronic pain patients.

I suppose the only way new patients could be cautiously treated

to prevent handing drugs to masqueraders would be actually seeing their

pain. But from my experience with addicts, I would say they know what to

say & do to get control drugs a lot better than we do. That is their

objective in the first place, and not necessarily ours at all.

Ken

May 5, 1999

Mad: The letter that I posted to the list was from the Pain Control Clinic

at the Hospital where they want me to go for a further eveluation.

I'm also not too thrilled about the drive over 1 1/2 hour

and then go through a day of torture, and then 1 1/2drive home, I will not

be a pleasant person to be around.

What I do not understand is that the key as i ahve ben told is to break the

pain cycle, and not just keep it to a tolerable level.

If they break the cycle then the need for increasingly stronger meds will be

avoided.

I'm still not totally convinced that I will go through with this, as I do

not totally agree that this is the best solution for my condition.

Thanks very much for the letter, it is great to see someone who is out

spoken as I am.

Jeff

jkeith@...

& The Hounds of Hooterville

May 6, 1999

ditto on all you said....

shadow

May 6, 1999

ditto on all you said....

shadow

May 6, 1999

here...

When performing nerve blocks and some other dx testing....it is a pre test

requisite not to take pain meds as they cannot identify the nerves that

provoke a feeling of exquisite agony.......hence...the test is a

bust...........most docs recommend that you run steps or limp them...so that

you may raise your pain level so the test will be as extensive and accurate

as possible.....everyone always says.. I am in so much pain........the acid

test of a pain med is how bad you hurt without them.........I know the kind

of hell I would be in.....if I had to do without them.........

Hugs..

May 6, 1999