Questions on pain relief

September 15, 2003

Hello everyone.

I hope you are all having a good day. My questions are about pain

relief. I am 57 and have chronic, hereditary pancreatitis, only

diagnosed in April this year. I don't think I've ever had an acute

attack because I've never been hospitalised but my attacks of upper-

abdominal pain, which used to be very well spaced out in childhood

and up to my 30's, and reasonably spaced out even a few months ago,

are now running into one another. For the first time ever I'm at

home off work and this really depresses me. When the pain only came

occasionally, even a day a week, I could put up with it and carry

on. But pain nearly every day is too much. I used to take codeine

(8mgs) and paracetamol tablets when the pain came but they have

stopped relieving it significantly when it's at its worst. My GP

prescribed new ones with 30 mgs codeine the other day. I had a bad

pain yesterday and they certainly shifted it. My questions are

(at last!): are there many of you who take pain relief all the time

to avoid daily pain coming on at all? Do some of you work while

taking this daily medication or using patches? Am I unusual in

having pain so frequently? I take Creon, which definitely helps with

the bowels, and I follow the correct diet. Within the next month

I'll be seeing my specialist again; he has recommended a total

pancreatectomy as there are particular complications which can occur

with long-standing hereditary pancreatitis. (I have atrophy and

extensive calcifications throughout the pancreas.) In the meantime

or while waiting for the surgery, I'm desperate to get back to work!

I feel it's better for me psychologically as it takes my mind off my

health worries. But I'd have to manage the pain better! I still have

times when I have no pain at all or only mild pain. I know there are

others who have suffered a lot more than me so I hope you'll excuse

my questions.

Thanks for any responses and thanks to everyone who has helped me so

far.

Best wishes. Sorry for long message! Fliss (Felicity Brown)

September 15, 2003

Dear Fliss,

I'm on the duragesic patch, so in that sense, you could say that

I'm on daily pain medication, whether I have pain or not. I have

noticed that those days when I have forgotten to change to a new

patch, that my pain levels increase, so it appears the patch is

doing it's job.

While on the patch, I have tried to work, and sometimes I'm able

to put in an hour or two before the pain starts to take over. I have

found it too painful to maintain the sitting position I need to be in,

at a minimum for several hours at a stretch.....preferably all day

long. Additionally, the patches do cause me drowsiness and

when that happens, it's impossible to concentrate on my

drawing. I have also noticed problems with comprehension,

short term memory loss, and difficulty with my math skills while

wearing the patch. The combination of all these side effects

often makes it very difficult or nearly impossible to do the type of

work I'm trained for.

Others may not experience these same difficulties, and if so, I

hope they will speak up. I realize it must be very frustrating for

you to be having more pain and problems now after such a long

period of easier days. I think all of us feel a lot of regret and

anger, even, at not being able to continue to work at the jobs we

love, I know I do. I loved my work and would rather be sitting at

that drafting table designing more than anything else.....I used to

start at 8:30 in the morning and go all day and into the night on a

plan, so I am mad now that even an hour or two seems to be too

much of a strain.

It may not be that unusual for you to be having increased pain.

CP is a progressive disease, and the longer you have it, the

more damage can occur. The speed at which this happens

seems to be different with everyone, and I'm sure depends much

upon the cause of their pancreatitis and the initial degree of

damage at the onset of the disease.

I hope these personal comments were of some help. Please

don't think that just because you think your pain is less than

some other's, that you are any less entitled to our support and all

the help we can offer. Every CP patient, spouse, caregiver or

friend is vitally important in the whole scheme of things.

With hope and prayers,

Heidi

Heidi H. Griffeth

South Carolina

SC & SE Regional Rep.

PAI, Intl.

Note: All comments and advice are personal opinion only, and

should not be substituted for professional medical consultation.

" What lies behind us and what lies before us are tiny matters

compared to what lies within us. " - Ralph Waldo Emerson

September 16, 2003

Long-Term Pain Relief For Pancreatitis Patients

Many more patients with chronic pancreatitis can safely turn to a minimally

invasive operation for long-term pain relief, according to a new study by

s Hopkins physicians.

Endoscopic therapy is an effective alternative to more invasive surgery or

drugs, says N. Kalloo, M.D., director of gastrointestinal endoscopy

at Hopkins and lead author of the study that appears in the July issue of

Gastrointestinal Endoscopy.

" Doctors have been trained to avoid endoscopic interventions on the pancreas

because of the fear of significant complications, " says Kalloo. " But we

found that patients in our study had few complications, needed less pain

medication and improved their quality of life. "

Chronic pancreatitis, long-term inflammation of the pancreas, affects up to

5 percent of the United States population. Caused by various factors

including alcoholism, the disease creates severe and even crippling

upper-abdominal and back pain.

In many cases, Kalloo says, pain may be caused by elevated pressures in the

pancreatic duct. For these patients, endoscopic therapy that includes

endoscopic pancreatic sphincterotomy (EPS), in which surgeons cut the

sphincter muscle at the end of the pancreatic duct to release pressure, has

proven effective in the short term, but the Hopkins study was designed to

assess its long-term value.

Kalloo and his team reviewed data from 55 patients who underwent EPS for

chronic pancreatitis or an ailing pancreatic sphincter at s Hopkins

between August 1992 and November 1996.

Doctors included in the study all patients who could be contacted by phone

for interviews, with an average follow-up time of 16 months after surgery.

Interviewers asked patients to recall their level of pain before the

procedure and at the time of the interview.

The doctors discovered that 62 percent of the patients reported significant

improvement in their pain, with significant improvement defined as a greater

than 50 percent decrease in pain score.

" Many patients with chronic pancreatitis have not looked beyond taking pain

medication because they fear the invasive nature of surgery, " says Kalloo.

" The EPS approach offers another option that is less invasive than surgery

and has a potential to offer long-term relief. "

Other authors of the study include I. Okolo, M.D., from Northwestern

University and Pankaj J. Pasricha, M.D., from the University of Texas

Medical Branch.

Currently, Kalloo is enrolling people with chronic pancreatitis for a second

prospective study of EPS at Hopkins. For information about the new clinical

trial, please call .

I have found out some information from my physical therapist. Go to

http://www.iahp.com/ and then click on Locate Practitioners then click on

your state. The letters after the persons name you are looking for is VMI,

VMIA, VMIB, VMR, VLT, PIVM, MFR. The more letters they have after their name

the higher levels of therapy they provide. I have found that physical

therapy helps me quite a bit. I hope everyone will take the time and check

out one of these therapist close to you.

I hope this finds you and yours well

Mark E. Armstrong

Questions on pain relief

> Hello everyone.

> I hope you are all having a good day. My questions are about pain

> relief. I am 57 and have chronic, hereditary pancreatitis, only

> diagnosed in April this year. I don't think I've ever had an acute

> attack because I've never been hospitalised but my attacks of upper-

> abdominal pain, which used to be very well spaced out in childhood

> and up to my 30's, and reasonably spaced out even a few months ago,

> are now running into one another. For the first time ever I'm at

> home off work and this really depresses me. When the pain only came

> occasionally, even a day a week, I could put up with it and carry

> on. But pain nearly every day is too much. I used to take codeine

> (8mgs) and paracetamol tablets when the pain came but they have

> stopped relieving it significantly when it's at its worst. My GP

> prescribed new ones with 30 mgs codeine the other day. I had a bad

> pain yesterday and they certainly shifted it. My questions are

> (at last!): are there many of you who take pain relief all the time

> to avoid daily pain coming on at all? Do some of you work while

> taking this daily medication or using patches? Am I unusual in

> having pain so frequently? I take Creon, which definitely helps with

> the bowels, and I follow the correct diet. Within the next month

> I'll be seeing my specialist again; he has recommended a total

> pancreatectomy as there are particular complications which can occur

> with long-standing hereditary pancreatitis. (I have atrophy and

> extensive calcifications throughout the pancreas.) In the meantime

> or while waiting for the surgery, I'm desperate to get back to work!

> I feel it's better for me psychologically as it takes my mind off my

> health worries. But I'd have to manage the pain better! I still have

> times when I have no pain at all or only mild pain. I know there are

> others who have suffered a lot more than me so I hope you'll excuse

> my questions.

> Thanks for any responses and thanks to everyone who has helped me so

> far.

> Best wishes. Sorry for long message! Fliss (Felicity Brown)

>

September 16, 2003

The Therapeutic Value of CranioSacral Therapy

While the validity of the cardiovascular and respiratory rhythms is

undisputed today, for eons the very existence of these systems sparked

debates in medical communities around the globe.

Now for nearly 25 years, osteopathic physician and researcher E.

Upledger, D.O., O.M.M., has been a proponent of using the rhythm of another

body system -- the craniosacral system -- to enhance body functioning, and

help alleviate pain and discomfort.

The craniosacral system consist of the membranes and cerebrospinal fluid

that surround and protects the brain and spinal cord. It extends from the

bones of the skull, face and mouth, which make up the cranium, down to the

sacrum, or the tailbone area.

Since this vital system influences the development and performance of the

brain and spinal cord, an imbalance or restriction in it could potentially

cause any number of sensory, motor or neurological disabilities. These

problems could include chronic pain, eye difficulties, Scoliosis,

MotorCoordination impairments, learning disabilities and other health

challenges.

CranioSacral Therapy is a gentle method of detection and correction that

encourages your own natural healing mechanisms to dissipate these negative

effects of stress on your central nervous system. You also benefit from

better overall health and resistance to disease.

How is CranioSacral Therapy Performed?

CranioSacral Therapy is performed on a person fully clothed. Using a light

touch -- generally no more than the weight of a nickel -- the practitioner

monitors the rhythm of the craniosacral system to detect potential

restrictions and imbalances. The therapist then uses delicate manual

techniques to release those problem areas and relieve undue pressure on the

brain and spinal cord.

A CranioSacral Therapy session can last from about 15 minutes to more than

an hour, and the initial evaluation alone is often enough to correct a

problem. The result? A central nervous system free of restrictions. And a

body that's able to return to its greatest levels of performance.

Who can perform CranioSacral Therapy?

Because of its positive effect on so many body functions, CranioSacral

Therapy is practiced today by a wide variety of healthcare professionals.

They include osteopathic physicians, medical doctors, doctors of

chiropractic, doctors of Oriental medicine, naturopathic physicians, nurses,

psychiatric specialists, psychologists, dentists, physical therapists,

occupational therapists, speech therapists, acupuncturists, massage

therapists, and other professional bodyworkers.

What Conditions Does CranioSacral Therapy Address?

CranioSacral Therapy strengthens your body's ability to take better care of

you. It helps alleviate a range of illness, pain and dysfunction, including:

Migraines and Headaches

Chronic Neck and Back Pain

MotorCoordination impairments

Stress and Tension-Related Problems

Chronic Pancreatitis Pain

Infantile Disorders

Traumatic Brain and Spinal Cord Injuries

Chronic Fatigue

Scoliosis

Central Nervous System Disorders

Emotional Difficulties

Temporomandibular Joint Syndrome (TMJ)

Learning Disabilities

Post_Traumatic Stress Disorder

Orthopedic Problems

And Many Other Conditions.

What is SomatoEmotional Release

Have you ever had a physical injury that seemed to plague you long after the

site had healed? That's not as unusual as you might think. Even when

CranioSacral Therapy releases restrictions in the body tissues, sometimes a

release of emotional energy is necessary to fully discharge a trauma. In

those cases, the CranioSacral Therapist may gently encourage a

SomatoEmotional Release.

Research conducted in the late '70s by Dr. Upledger and biophysicist

Zvi Karni led to the discovery that the body often retains the emotional

imprint of physical trauma. These imprints, especially of intense feelings

that may have occurred at the time of injury --anger, fear, resentment --

leave residues in the body in areas called " energy cysts " .

Although you can adapt to energy cysts, over time your body needs extra

energy to continue performing its day-to-day functions. Then as years pass

and the body becomes more stressed, it can lose its ability to adapt. That's

when symptoms and dysfunction's begin to appear and become difficult to

suppress or ignore.

Through SomatoEmotional Release, the therapist engages in imaging and

dialoguing techniques that can guide the patient through and otherwise

challenging encounter with long-held emotions. The patient does not need to

analyze the problem to release it. Often the body will spontaneously return

to the same position it was in when the injury was first sustained. As this

occurs, the therapist can feel the tissues of the body relax as the energy

cyst is expelled. Then the body is free to return to its optimal levels of

functioning.

How Do I Locate Practitioners Skilled in CranioSacral Therapy

You can locate healthcare professionals through the international

Association of Healthcare Practitioners (IAHP) membership directory. Go to

http://www.iahp.com/ and then click on Locate Practitioners then click on

your state. The letters after the persons name you are looking for is VMI,

VMIA, VMIB, VMR, VLT, PIVM, MFR. The more letters they have after their name

the higher levels of therapy they provide. If you wish to speak to a live

person contact the Upledger Institute at

How Did CranioSacral Therapy Begin?

CranioSacral Therapy dates back to 1970 when osteopathic physician E.

Upledger first witnessed the rhythmic movement of the craniosacral system

during a spinal surgery. Yet none of his colleagues nor medical texts could

explain the phenomenon.

Two years later, Dr. Upledger attended a short course on cranial Osteopathy

developed by Dr. Sutherland. The course focused on the bones of the

skull and the fact -- surprising at the time -- that they weren't fused as

doctors had been taught in medical school. Instead, Sutherland's material

demonstrated that skull bones continue to move throughout a person's life.

Putting this new information together with the odd pulsing rhythm he'd

observed years before, Dr. Upledger theorized that a hydraulic system of

sorts was functioning inside the craniosacral system. He then set out to

confirm his theories.

In 1975 he joined the Osteopathic College at Michigan State University as a

clinical researcher and Professor of Biomechanics. There he led a team of

anatomists, physiologist, biophysicists and bioengineers to test and

document the influence of therapy on the craniosacral system. For the first

time they were able to explain the function of the cranisacral system, and

demonstrate how light touch therapy could be used to evaluate and treat

malfunctions involving the brain and spinal cord.

In 1985, Dr. Upledger went on to establish the Upledger Institute to teach

the public and healthcare practitioners about the benefits of CranioSacral

Therapy. To date, The Upledger Institute has trained more than 50,000

healthcare practitioner's worldwide in the use of CranioSacral Therapy.

Check out the Upledger Institute website at www.upledger.com