EVERYONE NEEDS TO READ THIS! Why I Need Pain Relief!!!!!!!!!!!!!

Discussion in 'Fibromyalgia Main Forum' started by JLH, Feb 20, 2006.

  1. JLH

    JLH New Member

    Note: This is a GREAT article. It's long--but the BEST part--ABOUT WHY PAIN RELIEF IS NEEDED--is at the end, so be patient while reading!!!! LOL



    Sick and Tired -- Why I Need Pain Relief
    Article By Dr. David Saul


    I feel ashamed to be a member of the medical profession when I hear from my fibromyalgia (FM) patients that they left in tears from a doctor's office after being addressed in a rude and abrupt manner.


    For doctors who are skeptical about the diagnosis of FM—this article is for you. Perhaps you have assessed a few (or many) patients with generalized pain. This pain is either steady or episodic and defies any common structural or mechanical cause. You are then faced with the absence of any laboratory and diagnostic testing to confirm the diagnosis of FM. You find that the typical FM patient seems to overdo the crying, whining and complaining of a pain, which to them is often seen as incapacitating. You likely have tried various medications without any beneficial response. When you really don't know what else to do, you might just give up on the patient and the whole concept of FM.


    However, medicine is full of unknowns and processes yet to be determined. As doctors, we should still try to practice good clinical medicine despite and amid various uncertainties. But, for the patient who complains of FM-related symptoms, have you ever felt perhaps a tiny bit concerned about the psychological impact you may have on her, should you respond with any of the following statements?

    • It's all in your head.
    • Buck up and fight through the pain.
    • There is no such thing as fibromyalgia.
    • Do you want to get addicted to painkillers?
    • You are wasting my time.


    Whenever a patient with FM hears any of those statements it surely goes against the famous dictum from Hippocrates, "Divinum est opus sedare dolorem"—"Divine is the work to subdue pain."


    FM is the orphan syndrome. No one wants to deal with it and too often, the rheumatologists feel stuck with it. In the 2003, 2nd edition of Pain Medicine: A Comprehensive Review, Dr. P. Raj devoted very limited space to FM. From the very last paragraph: "This common chronic pain syndrome will obviously be a continuing source of medical and economic problems until the pathophysiology is better delineated and subsequent improved treatment methods are formulated. Furthermore, understanding the neuropathophysiologic basis of FM may have broader applicability towards an understanding of chronic pain per se."


    It is interesting that Dr. Raj suggests that besides FM, chronic pain by itself is still a great challenge to medical researchers and clinicians. Then again, while FM is still a hotly debated topic, there does exist a recent, comprehensive review of FM in the Nov. 4, 2003 issue of Journal of Musculoskeletal Pain. The entire issue, all 118 pages was devoted to FM: The Fibromyalgia Syndrome, A Clinical Case Definition for Practitioners.


    Perhaps in the very near future, basic science research will likely find that FM could have a neuropathic pain pathophysiology, similar to diabetic neuropathy, multiple sclerosis pain or phantom limb pain. While Dr. Raj struggles in his textbook for a neuropathophysiologic basis for FM, from Archives of Neurology, November 2003, neuropathic pain is reviewed: "A simple focal peripheral nerve injury unleashes a range of peripheral and central nervous system processes that can all contribute to persistent pain and abnormal sensation. Inflammation, reparatory mechanisms of neural tissues in response to injury, and the reaction of adjacent tissues to injury lead to a state of hyperexcitability in primary afferent nociceptors, a phenomenon termed peripheral sensitization. In turn, central neurons innervated by such nociceptors undergo dramatic functional changes including a state of hyperexcitability termed central sensitization. Normally these sensitization phenomena extinguish themselves as the tissue heals and inflammation subsides. However, when primary afferent function is altered in an enduring way by injury or disease of the nervous system, these processes persist and may be highly resistant to treatment." I can easily see FM fitting into this description of neuropathic pain.


    Even if the exact cause of FM continues to elude researchers or turns out to have a predominantly psychodynamic or psychiatric basis as a somatoform or depressive disorder, these patients will continue to need our support and compassion.


    Yes, the FM patient can sometimes seem demanding. It's true the office consultation is usually time-consuming and not very productive. Remember, the FM patient is often facing considerable stress from her insurance provider, her family and her workplace.


    You always have the option for referral to a chronic pain clinic, regardless that the waiting period is sometimes close to one year. Or, solicit the advice and help of your regional psychiatrist and/or rheumatologist.


    Over the years, with my FM group therapy sessions, I always began with a creative writing exercise.


    The patients handed back one page with the title, "Why I need pain relief?" without adding their names. Out of the hundreds in my binder, I would like to present just one. I feel it clearly sums up the entire FM experience. I hope it might be helpful in swaying some FM disbelievers to at least be a little bit more supportive and compassionate with the next patient complaining of FM symptoms.


    "Why I need pain relief?"


    "I desperately need pain relief to feel and act approximately in the same manner I did before I was stricken with osteoarthritis and fibromyalgia a few years ago. I know that I have to get used to the fact that this type of chronic disease changes a person physically and mentally, but the hardest part is to adapt and accept the fact that it is here to stay for the rest of my life—unless a miracle should happen.


    "I don't recognize myself and neither do my family or my friends. People just assume that because I don't look sick, I am not sick. Some people even insinuate that I must probably enjoy being sick. Do they honestly believe it is my choice to stay at home all day and depend on others to do things for me when I feel sick and depressed?


    "I feel angry and hurt for having lost control over my body and my brain, although I know that I am in no way responsible for what has happened to me. Before I was cursed with fibromyalgia, I took more or less, many things for granted. Although my life has never been a bowl of cherries, I now take nothing for granted. The future looks bleak and scary. Fear has become part of my everyday experience.


    "I am afraid to lose the independence I have managed to salvage. I'm also scared of getting worse. Will the pain become unbearable? Will I be unable to walk? The dark and obsessive thoughts provoke my depression and frequent anxieties. Until now, these could only be controlled by medications that unfortunately all have side-effects.


    "It is humanly impossible to explain living with pain and fatigue to someone who does not have it.


    "Pain and fatigue make me irritable and tired. They make me cry and send me into a deep despair. Pain becomes more prominent in the quiet hours of night when the rest of the world is sleeping.


    "The pain can drive me crazy even in small amounts because it is always there. While distraction is great and essential, pain and fatigue always get the last laugh.


    "Pain is exhausting. It is an overwhelming feeling of incapacity, of being spaced out all the time, of being neither awake, nor asleep.


    "People tell me to stop focusing on pain. They tell me to relax and pull myself together. Obviously, these are people who don't have fibromyalgia."

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

    Dr. David Saul is a family doctor in Toronto with a practice focusing on Fibromyalgia and Chronic Fatigue Syndrome. This piece was reprinted by permission of Dr. Saul.

    Article published in
    National Fibromyalgia Association Newsletter


    [This Message was Edited on 02/22/2006]
  2. floridamarlen

    floridamarlen New Member

    awesome article. scary thing is i understood every technical term used.(oh well any knowledge is good knowledge.)this ones going to be taped to hubbys mirror tommorow morning.
    thanks
    godbless
    marlene
  3. texasmaia

    texasmaia New Member

    Truly an awesome article. Been reading Fibro news a long long time and have not read anything quite like that letter before. I think it's even better than the 'letter to normals'.

    Thanks so much for taking time to share.

    Blessings,
    Maia
  4. JLH

    JLH New Member

    I also think this article spells out really well why a person needs pain relief!!!

    I hope a lot of people take the time to read it.

    Janet
  5. suzetal

    suzetal New Member

    Ty so much for taking the time to post it.

    I hope everyone here takes the time to read it.

    I have sent it already via email to many people I know.

    Thank you again.

    Sue
  6. pirtpain

    pirtpain New Member

    THIS IS ONE OF THE BEST ARTICLES I HAVE READ IN A LONG TIME. I MAY PRINT IT AND SEND IT TO ALL OF MY FAMILY AND FRIENDS. THANKS FOR GIVING THOSE OF US WITH FM AND/OR CFS THE ACKNOWLEDGEMENT AND RESPECT THAT WE SO DESERVE!!!

    PIRT
  7. fivesue

    fivesue New Member

    The doctor who is now helping people and the lady who wrote the piece...this is the essense of the whole FM thing. No one who doesn't have chronic pain and fatigue can understand. I also love the one about look Ok and maybe liking to be sick. Give me a break!

    I just love having lost most of my friends, my grown children think I'm just...what? Don't they know me better than that? Aren't I the one who raised those teenage boys after their father left us, graduated from college, became a full-time teacher plus supported their activities, church activities, friends' actities and family concerns. I was never still....NEVER! Who was it that basically bailed my oldest son and his wife out by babysitting at the drop of a hat the first four year of my granddaughter's life? Huh? What do they think now? That somehow that person just disappeared and has CHOSEN to stay at home uninvolved in almost anything?

    I am so mad right now!

    Thank you for this article. I need to send it to my sons...need to publish it in the church newsletter, use it as a letter to the editor, send it to all doctors...etc.

    Well, that's a bit overboard. My sons, daughter-in-law and grandkids have hurt me so badly that I can't talk any longer about it or I will cry. And, I don's feel like red eyes.

    Thank you...

    Sue
  8. pamsue

    pamsue New Member

    I am so glad you sent this in. I just read it and I really needed to see something like this because I have been getting the run around by my family doctor and I just can not believe it.

    This article is so true. If it is ok with you I would like to send it in to our local paper to be printed in the health section. I think we have to keep fighting or we will never get anywhere.

    I have been passed off by my family doctor as basically crazy. Even though I have actual physical things wrong that can be seen he has not even bothered to look.

    Even doctors that I have been sent to by him are finding things and he still does not seem to get it.

    Thank you for posting
    pamsue
  9. leubie

    leubie New Member

    GREAT----GREAT---THANK-YOU--THANK-YOU!!!!!LOVE TO ALL--LAURA
  10. Kacjac

    Kacjac New Member

    I wish I had my printer up and running....
    I need this desperately.
  11. ilovecats94

    ilovecats94 New Member

    Janet,
    On one of your posts you mentioned sleeping with a pillow between your legs if you slept on your side. Thanks for that hint, if that was you, because I tried it last night and it really did help.

    Also I have had to take 3 Lortabs today because of pain.

    Anyway, thanks for the pillow idea as I really loved it and it really did help my back. I'm almost positive that it was you as I remember you saying that if one slept on their back they were putting 55 pounds on their back.

    Kacjac,
    Could you just save that post on Word or whatever word processing program you have and print it up when you get your printer up and running. I just had to reinstall my printer driver from the Internet today as I have had problems with it giving me an error off and on when I was trying to print things. It is a HP deskjet 5550 and I've only had it 3 years almost.

    Hugs to all,
    Faye
  12. JLH

    JLH New Member

    FiveSue - I'm really sorry that you got so upset about your sons, DIL, and grandkids; and sorry that they have hurt you so badly. I wish you lived next door, and I would come right over and give you a big, soft hug! I am identify with having to stop talking about a certain subject or I would just start crying!!! If you want to send it to your church newsletter, or to your doctor, just make sure that the authors name, etc. is included for him to be referenced.

    PamSue - See what I just mentioned to the other Sue (above) about sending this article to your newspaper to be printed. It's a shame that your family doc passes off everything you mention. If you have actual physical things wrong with you and he doesn't even bother to check them out, I would hand him a list of them next time and laugh when you say "I'm not leaving until you address each issue on this list!" We pay for their services, so they should at least listen to us!! I hope you have better luck with your doc in the future.

    Hi,Faye! - Yes, it was one of my posts that mentioned sleeping with a pillow between your legs if you slept on your side. I glad you tried it, and found out that it helped!! I used to like to lie on my back for a little while during the night to help all the pain settle down, give my shoulders a rest from sleeping on my sides, etc., until I found out that being on your back added 55 PSI (pounds per square inch) weight on your back by lying that way! So I quit pronto!!! LOL

    Has your pain eased up any? I hate to hear that you're feeling so bad. Talking about pain, I had to take a Lortab right before I can in her to get on the computer, and that was about 11:30 pm. I hope it doesn't keep me awake all night. I have the same problem with them that you do--keeping me awake instead of making me too sleepy!

    I changed the title on this post hoping more people whould read it. I hope the change works!


    Big Hugs,
    Janet
  13. WoodstocksMusic

    WoodstocksMusic New Member

    Understand how pain and lack of sleep control our lives.... this article best articulates what we all know but have been unable to express..

    Thank you again for sharing such good stuff with us all.
  14. UPK5

    UPK5 New Member

    I went to the doctor yesterday, and I all night I thought about how I need relief from this wacky doctor! I was hoping this doctor was going to help me, but instead he sent my head spinning in circles. Oh, how refreshing to read an article from a doctor who does really understand. Now I just have to find one like him close to my home!

    I DEFINITELY NEED PAIN RELIEF!!!
  15. matthewson

    matthewson New Member

    I copied a portion of the article and sent it in an email to my husband. I send him bits and pieces of articles that I find from time to time. He tends to forget that I am in pain all of the time to some extent and then when I complain, which is not very often, he says, "but you have been doing so well!" Meaning, I guess, that he thinks I don't have pain all the time! Really, I shouldn't complain, he is a good man, but he really doesn't get it!
    But then again, would I get it if I wasn't living it everyday?

    Most of my pain seems to be a neuropathic type of pain. Not stabbing or cramping, more of a burning type, but always there. Tramadol and neurontin keep it down most of the time to a tolerable level, but it is always there.

    Thanks again for the article. Sally
  16. pamsue

    pamsue New Member

    JLH, Thank you for your comments, I believe this has helped me to get stronger and angry. I am so ready to start fighting now, with all the pain I am in they are in trouble. If men think it is bad for a woman during her time of month, wait to they see what a woman with Chronic pain can do, LOL!!

    Thank you for giving me permission to send this to the Local Newspaper, I will defintely include the doctors name that wrote it, that is not a problem. I just want to get the word out there to the doctors that just don't get it!!

    hugs,
  17. marw

    marw New Member

    I read it more carefully this time.
    It made me cry! IT is so true! HOw I wish people could understand us.

    I copied to my computer. I do have a printer. If anyone wants me to print it out for them, I will. But you would have to tell me where to mail it. (And I don't know it you want to put an addy on here or not.)

    Thanks,
    Margaret
  18. JLH

    JLH New Member

    This is such a good article, that I wanted to bump in case anyone has missed it.

    Janet
  19. Cromwell

    Cromwell New Member