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I'm having trouble dealing with the pain I'm having trouble dealing with the pain

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Unread 05-07-2003, 02:36 PM
I'm having trouble dealing with the pain

I have never posted on this site before and appreciate any advice you ladies might have. Sorry this is so long.

First surgery on Feb 26, 2003

after my 1st surgery the first shift of nurses would come in, check my temp. and not pay much attention according to my husband. My husband was told by my Dr. that I would wake in 30-60 min. after I came out of recovery. My husband then noticed I wasn't waking and had to go get the nurses and Dr.'s at the nurses station. When I came out of recovery, thehospital had no BP or heart rate machines on me. At 11:00pm that night I still wasn't waking up, I would wake only for a few seconds and then pass back out. My husband had to go get the nurses and they finally came to take my BP. To thier amazement, they couldn't find my BP. They thought it was the machine, and tried a 2nd one. Still to get no BP. They went to get the PA and they got my BP manually. My BP at 11:30 that night was 70 over 40. I was almost dead. They called the Dr. in and they said I had some internal bleeding. But that they had stabalized my BP and my 2nd surgery wouldn't take place until the morning. My husband asked what my BP was and they told him they couldn't tell him in fear that it would make him and I quote "it will freak you out and scare you". I went in for my 2nd surgery and they cut my stomach from one side to the other, I had a hematoma on my right ovary that ruptured. Or so they say, I still have pain in my lower right side and have been forced to go to pain mang. where they are going to do nerve blocking on my femeral nerve, because they "THINK" that's what's causing the pain. I think if they caught the bleeding before 11:30 that night, they could have taken measures to stop the bleeding, thus saving me from a 8 inch scar, and a lot of pain still 2 months after surgery. If my husband wouold not have been so persistant I would have died that night in the hospital. The Dr.'s and nurses didn't think I would make it through the night. My husband was very scared and would have been left to take care of our 3 boys by himself, all because my Dr. must have "hit something internally that caused my bleeding" I should not be having pain. I am addicted to pain killers now and am having a really hard time dealing with this pain.

Any advice is greatly appreciated. Thanks for reading, and sorry this is so long.


S Moreno
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Unread 05-09-2003, 12:01 AM
I'm having trouble dealing with the pain

Hi sweetie you have been through so much in a very short time. It didn't go the way you or the DRs planned, and now you are left having to deal with a lot of pain. Also if you are truly addicted to the painkillers then you will need help with that, too... but maybe you are not addicted but have built up a tolerance to them? Here is a thread about the use of pain killers by those with chronic pain:


I'm so glad your husband was with you there in the hospital... that is an example of why it's important to have an advocate with you. s to you both for what you have had to go through, I'm sure it was very scary for both of you.

I'm glad you found us... I hope you will find plenty of information and support here to help you move forward and hopefully find some relief for the pain.

Unread 05-09-2003, 07:02 AM
I'm having trouble dealing with the pain

S Morenro

I am so sorry about what you have had to go through. DH must have been petrified, but it was a good thing he was there!

I have alot of things that could have been done differently with my surgeries and treatments and I just have no choice but to deal with it and move on or I will go crazy thinking about it all..

As for the pain meds and addiction, If you are taking the pain meds for pain than you are not addicted, you may feel dependant on them (I know right now I do) because they are the only thing to take the pain away. Addiction is taking them to get the high feeling and abusing them in a way they were not meant to be used. I have been on pain meds for many months the past year and I can tell you that my body is dependant on them for the pain but I can honestly tell you that I am not addicted to them. I hate feeling groggy and out of it half of the time.

Do you have a follow up appt for your persistant pain? I would definetly talk to them about your concern with the pain meds.

You are not alone, feel free to vent, cry, complain, ask questions or whatever else you feel the need to do! We are all here for you!!

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Unread 05-09-2003, 12:05 PM
I'm having trouble dealing with the pain

I'm so sorry you are dealing with all this pain! Pelvic pain is so hard to diagnose and treat. It sounds like some of what you are still experiencing is shock and stress from the surgery, the complications, and being thrust suddenly into a situation where you have severe pain that is not going away. It may help to talk with someone (maybe in therapy?) about the feelings of shock and loss-of-control and changes in your life. I have had several suddenly occurring physical conditions that threw me into disability, and the stress and shock was overwhelming to me and has literally taken me years to recover from and deal with.

As the other ladies have said, if you are still in pain and using narcotics to manage the pain, you do not have an addiction problem, you have a pain problem. I know this is hard to accept, and culturally sometimes looked down upon or negatively judged, but the costs of inadequately managed pain on your life and your family and your job, if you have on, are tremendous. I speak from first-hand experience here. I am glad you are seeing a PM specialist and your DH is supportive.

Please don't be so hard on yourself! Being in severe pain causes overwhelming stimulus physically and mentally and emotionally, and when the pain becomes long-term, medications are sometimes the only way some of us can get through the daily business of survival while we look for solutions to the problem of our pain. I have been fortunate to be able to cut back on my use of these medications, but truly, they have enabled me to continue functioning in my life while seeking treatment for my pain issues.

You are still not very far out from what was obviously a very complicated surgery and recovery, and will need alot of time to heal physcially and psychically. Please be patient and gentle and kind with yourself. This website has proven a lifesaver for me, as has prayer and my friends. Do not be afraid, and know you are not alone.

With love,
Unread 05-09-2003, 09:28 PM
I'm having trouble dealing with the pain

Hi there and welcome to Hyster Sisters I'm so happy you found us: it really is a wonderful site.

I'm sorry that your surgery proved sooo traumatic. It's such a relief that your DH was there and was able to bring to your nurse's and doctor's attention just how poorly you were doing. s to both of you, for all you've been through.

As the others have stated, it's unlikely that you are addicted to pain medication, if you are taking the meds as directed, to releave pain. I know that it's something that's hard to accept in our society, but pain meds are often the only way for some of us to get through the day. I myself regularly take meds to relieve arthritic pain and it allows me to lead a normal life. I know I'm not addicted to the meds, since I didn't need them this Winter and didn't have any withdrawal issues. But I do depend on them when the pains flare up.

I do hope that your doctors are able to help you with your pain. As others have stated, you are still relatively early in recovering from a very traumatic surgery. You might find that, as you progress in your recovery, you find that the pain is greatly relieved. I do wish this to be true for you.

Sending lots and lots of gentle s your way.
Unread 05-10-2003, 08:26 PM
I'm having trouble dealing with the pain

((S Moreno))
I live w/ pain 24/7 & have been on Long-term Narcotic Therapy for 3+yrs..when they are used as directed, for pain, that is not Addiction..dependance yes. I would rather be *dependant* than to be unable to function due to intractable pain. Here is some info that has helped me in dealing with my Chronic pain syndromes as well as understanding the need to use pain med, & that it IS ok to use them when you have no other method of relief

Chronic Pain:
Millions of people world wide seek treatment for chronic pain every year. On occasion certain medications, nerve blocks or physical therapy can make a big difference, however, in most cases a multiple-part approach to ending the downward spiral of chronic pain is required. Reversing this spiral is now commonly referred to as pain management. Pain management includes, not only medication, but also a comprehensive plan of relaxation, exercise and behavioral change. There is no magic bullet for relief of chronic pain. Managing pain is not about making the pain disappear, it is about keeping pain tolerable and there are several ways to accomplish this. Keep a Pain Journal: Record the various activities and therapies that reduce or alleviate your pain. A journal also helps track the ebb and flow of pain, so you are aware of them and know when the pain worsens and how to ease it.

Get Started on an Exercise Program: Exercise improves overall fitness, increases strength and flexibility and can reduce the risk of further injury and helps control pain.

Balance Your Life: Find a healthful balance of activities, which should include work time, exercise, recreation, hobbies, relaxation, rest and socialization with family and friends. This balance can ease pain and elevate your mood.

Medications: All medications have side effects and there are toxic risks with all medication. So which medication to use and when to use one for chronic pain is very complex.

Complementary Medicine: Unconventional therapies used (yoga or Tai Chi), which promote physical strengthening are safe and sensible when combined with exercise, diet and treatments prescribed by your doctor.

Alternative Medicine: This therapy is used instead of, or in conjunction with, traditional medical care, including homeopathic or naturopathic practitioners. The Food and Drug Administration do, not regulate herbal medications, while they may be beneficial; they may also be toxic and may interfere with prescription medication. Take with care.

Some Tips to Help in Managing Chronic Pain:

Write yourself a contract: Pledge to yourself that you are committed to managing your pain.
Keep your home environment healthful: Remove all items from your home that might lure you into unhealthy habits. Your home should reflect your positive active attitude.
Set goals for pain management: Set specific goals to address your greatest pain problems.
Monitor your progress: Prepare some type visual aid or chart to display your progress.
Accept support: Support of family, friends and physician will help you keep going on track on difficult days.
Team up with your doctor: Your doctor can work with you to overcome obstacles, keep him/her posted on your progress.
Plan each day: Schedule your exercise, relaxation, rest, work. Make a list of things to do in order to accomplish your goals.
Stay positive: Think that you will control the pain. Keep your spirits up, this will help to maintain your ability to overcome and manage pain.
Reward yourself: If you treat yourself to something enjoyable, when you reach a goal, it will reinforce a positive attitude.


Pain Terminology:


There can be psychological effects from chronic pain. It can produce feelings of anger, sadness, hopelessness and despair. It can alter your personality, disrupt sleep and interfere with work and personal relationships.

There are numerous forms of relaxation therapy that are helpful to patients. Relaxation training and stress management, biofeedback and meditation can all be beneficial.

We believe that a time set aside each day to close your eyes, take some deep breathes, listen to some relaxing music and think only pleasant thoughts, with the idea of you controlling the pain rather than the pain taking control of you. Perhaps 15 minutes twice a day.

b] Psychological Management:[/b]

Chronic pain is a complex condition, which may begin with a physical trauma, but is always maintained by a combination of physiological, neurological and psychological factors. In recent decades, it has become increasingly accepted that effective treatment must address both the physical and the psychological aspects of chronic pain. The psychological treatment of pain is important for a number of reasons. Firstly, psychological factors play a crucial role in the onset and course of chronic pain. People with psychological problems are more at risk of injury and pain (Tunks, 1996). The author has observed for example, that poor people who get hurt at work {particularly repetitive strain injuries] often do not report the injury for fear of losing their job, leading to delayed access to medical treatment and aggravation of injury. People with pain are also more likely to develop anxiety and depression - some studies have found up to 60% of chronic pain sufferers have either clinical anxiety or depression (Tunks, ibid). Although anxiety and depression are effects of pain, they can also undermine a person's ability to cope as well as increasing their perception of the intensity of the pain. A kind of pain-stress feedback loop is created. Chronic pain also presents a number of diagnostic dilemmas, as the physical cause is often unclear. This presents the clinician with a dilemma, is it psychogenic (e.g.; a somatization disorder) or a medical problem of unknown origin? Treating a somatization disorder as a real medical problem can lead to unnecessary treatment, while treating a medical disorder as 'psychological' can lead to withholding of treatment and cause added suffering and complications. In addition, chronic pain is often poorly managed, not because of lack of know-how, but because of psychological factors. For example, one study {of cancer patients} found that over 50% were under-medicated. The reason was poor communication between doctor and patient. Other studies indicate underreporting of pain by patients is a major problem. Cultural factors such as macho attitudes may also predispose people to "putting up with it."

Thus although chronic pain may start out with physical injury, it quickly develops into a major psychological problem. Psychological factors play a part in the whole course of the development of chronic pain, including diagnosis and management. Clearly, psychological treatment is an essential part of any treatment approach. Given the difficult nature of the disorder, a preventative approach founded on early intervention is indicated.

Psychological treatment can help by:
Education - many people with chronic pain are ignorant about the causes of pain, or their rights and responsibilities as a patient, or even just how to deal with the effects of pain on their relationships. Education in the form of information about pain, communication skills, and the treatment process can empower the chronic pain sufferer and enable them to benefit more from treatment.
Provision of adequate support - adequate psychological support is known to be an essential prerequisite for coping with life stressors, including chronic pain.
Reduce anxiety and depression - this is largely achieved through changing negative feelings, thoughts and behaviors associate with pain. Once a person knows what is going on and has some ability to control things, their confidence increases and anxiety and depression are less.
Case management - the pain management psychologist is the best-qualified person to identify any psychological obstacles to recovery, and advise other treating professionals.


Physical & Occupational Therapy:

Physical modalities, if appropriately used, can be effective in reducing acute or sub-acute pain and can be very beneficial for chronic pain. The use of physical therapy does not ensure the elimination of pain. This is due to the fact that the perception of pain is different from patient to patient. While total relief of pain may be ideal, it is very difficult and not always attainable, particularly in chronic pain. However, even if there is residual pain, it is very frequently less intense and is at a bearable level
and may allow the patient to engage in his or her daily activities and/or function better in work activities.A list of specific physical therapies includes:
Thermotherapy - down through history heat and cold have been used for the relief of pain. The sedative, antispasmodic, analgesic, and decongestive effects of heat are well known. Superficial heat includes hot packs, paraffin baths, and heat lamps. Hydrotherapy, (warm
or hot whirlpool bathes). Deep heat includes ultrasound, short wave diathermy, and microwave.
Cryotherapy - there is no agreement on the effectiveness of cold over heat in the control of pain, however, application of cold to local areas produce some therapeutic effects, including reduction of temperature, reduction of neuromuscular transmission, analgesia, and an anti-inflammatory effect. Cold packs, (many sizes and shapes are available commercially), are composed of a pliable gel in a thin plastic pouch, that can be stored in the freezer until ready to use. They may retain their cold for up to 30 minutes after applied. Vapocoolant sprays are available, containing either fluorimethane or ethyl chloride and are useful to relieve pain of muscle spasm and trigger points. They must be used very carefully to prevent tissue damage. Ice water is a good and inexpensive method of cold therapy, where the extremity or part to be treated is immersed in ice water. The ice stick or block method involves moving an ice stick or block, back and forth in a massaging manner, over the painful area.
Electrotherapy - has been used since ancient times for the treatment of pain. Both direct (galvanic) current and
alternating current have been and are being used in the treatment of various pain syndromes. Transcutaneous
electrical nerve stimulation (TENS) is being used with varying degrees of success for pain relief. There is the
possibility of abuse both by the physician and the patient and its usefulness has been question in some studies.
Ionophoresis is a procedure, in which, molecules or atoms (ions) are force into the tissue using an electrical field.
Mechanotherapy - massage has been used since early times, and still plays an important role in pain management. The physiologic effect of massage is to increase or regulate muscle tone. The therapist's hands, stimulates the transmission of impulses to the higher centers in the brain, producing, sensations of pleasure and well being. The mechanical effects include, increasing the circulation of blood and lymph, and produce muscular motion, stretching of adhesions and reducing the accumulation of fluid. Common techniques of massage are stroking, kneading, rubbing and percussing. Indication for massage include reducing swelling, relieving pain, and mobilization of contracted tissue. There are some contraindications for its use such as; infection at the site, thrombophlebitis, burns, malignancies, and skin disease.
Therapeutic exercise - is a cornerstone on the treatment of sub-acute and chronic pain. Body movement improves musculoskeletal function and helps to maintain a state of well-being. An exercise program that helps to increase range of motion, increase elasticity of soft tissue, decrease spasm and tension, is usually followed by exercises that increase strength and endurance. Some of the various types of exercises include isometric, isotonic, aerobic and aquatic. Traction and passive manipulation are other modalities used. There are physical exercises that are used for various part of the body, such as shoulder, neck and low back. Lists of the various modalities are listed in many texts.
Occupational therapy - is used to help return the patient to work activity. When physical or occupational therapy are ordered by the physician, it should be remembered that the therapist is a trained professional, and should be treated as a member of the treatment team. The therapist will see the patient more often than the physician and therefore may give insightful information regarding some physical and psychological problems. The order for therapy should include: evaluate and treat; specific requests by the physician; a working diagnosis; frequency of treatment; length of time treatment is to be continued; possible contraindication to treatment and precautions.
Hands on therapy - depends on the skill of the therapist regarding dysfunction of muscles and joints.
Programs to restore function - are some where between, physical therapy and the fitness center type
programs. This may consist of physical conditioning with a group of patients. Patients attend such a program two or three times a week, with sessions lasting up to two hours, during which time exercise consists of stretching, strengthening and aerobatics. It may also include education and back to work activity.
Gym programs - usually begins as the physical therapy program is ending and the patient continues to exercise in the gym independently. The gym can be and appropriately is a part of the physical therapy department or may be private. Some supervision may be provided, however, the individuals are usually on their own. It is important that they follow instructions from the therapist in order to prevent further injury.
Vocational rehabilitation - is used for those chronic pain patients who wish to return to work and it should be an integral part of the pain management program. The effort is to help these patients learn or relearn skills necessary for return to gainful employment.

Managing Chronic Pain:

Additional Resources for Patients and Patient Advocates:

Battling Back: Overcoming the Undertreatment of Chronic Pain:

Questions You Should Ask About Pain & Pain Treatment:

Pain Management:

Pain Clinics - a personal view:


You Can Overcome the Affects of Stress:

Fatigue Takes a Special Toll on Women:

Women and Pain:

Self-Discovery Through Journaling:

Hysterectomy~risks, complications:


Outcomes Similar After Total, Partial Hysterectomy: http://www.nlm.nih.gov/medlineplus/n...ory_10040.html

Myths vs. Facts about Hysterectomy:


Benefits vs. Side Effects of Hysterectomies:

Chronic Pelvic Pain Diagnosis and Management: http://www.obgyn.net/displayarticle....ter/cpp_carter

Is there a difference between physical dependence and addiction?

Physical dependence often occurs when someone is taking psychoactive medications over a long period of time. The brain and body build a tolerance to the medication and usually the person needs to increase the dose to gain the original level of pain relief. We know there is physical dependence if the person experiences withdrawal symptoms when suddenly stopping the medication. It is very important if you are on high doses of pain medication to consult with your doctor before suddenly stopping. However, not everyone who is physically dependent to their medication becomes addicted. Some people can use medication for effective pain management.

Addiction (or substance use disorder) has a predictable course with identifiable warning signs (symptoms) along the way. My definition of addiction is a collection of symptoms (i.e., a syndrome) that is caused by a negative response to the taking mood altering substances and it has ten major characteristics listed in the table below.
  • Euphoria
    Inability to Abstain
    Addiction Centered Lifestyle
    Addictive Lifestyle Losses
    Loss of Control
    Continued Use in Spite of Problems
    Substance Induced Organic
    _Mental Disorders
The first and most important step in controlling your pain is accepting the fact that you may always have pain. Some people can significantly reduce or eliminate their pain. But if you’re like most people with chronic pain, your pain always will be a part of your life.The first and most important step in controlling your pain is accepting the fact that you may always have pain. Some people can significantly reduce or eliminate their pain. But if you’re like most people with chronic pain, your pain always will be a part of your life.

Managing chronic pain isn’t about making your pain disappear. It’s about learning how to keep your pain at a tolerable level. It’s about enjoying life again, despite your pain. And it’s about accepting that only you can control your future.

Find the right doctor:

Being in charge of your pain doesn’t mean that you can’t or shouldn’t look for help from others. A doctor can be especially helpful when you have questions or need assistance. But make sure it’s a doctor who understands your condition and communicates well with you.

The right doctor for you could be your family physician or a specialist who’s overseeing your condition. Or you may want to see a physician or a psychologist who specializes in pain management. If you’re not sure where to find a pain specialist, ask your doctor to refer you to one.

When selecting a doctor, in general, look for someone who has these characteristics:
Is knowledgeable about chronic pain
Wants to help
Listens well
Makes you feel at ease
Encourages you to ask questions
Seems honest and trustworthy
Allows you to disagree
Is willing to talk with your family or friends
Has a positive attitude toward life and your conditionBefore selecting a new doctor, however, check with your health insurance provider to make sure that the doctor is covered under your policy.

Pain centers and clinics

Learn about your condition.
Finding the right doctor isn’t the end of your job. It’ll take teamwork to manage your pain. To make this easier, make an effort to learn all that you can about your condition and your pain. One place to start is with the information provided in this Pain Management Center.
In addition, check the reference areas at your local library for medical dictionaries, books on health topics and health magazines. You also can browse through the health section in your local bookstore.
It’s important to be informed about your health, but don’t overdo it. Spending too much time reading about your condition or discussing your pain can be counterproductive. It draws your attention to your pain, instead of away from it.

Describe your pain:

Accurately describing your pain will help your doctor learn about the pattern of your pain, make a diagnosis, plan treatment and follow your progress. You can help in advance of your doctor’s appointment by preparing yourself to answer these questions:

Where is the pain located?
How long have you had pain?
Does the pain come and go or is it continuous?
How long does the pain last?
What makes the pain better?
What makes the pain worse?
What is the intensity of the pain? You may be asked to rate your pain on a scale of 0 to 10, with 0 indicating that you have no pain at all and 10 indicating that the pain is the worst possible. What does the pain feel like?
You can use words such as stinging, penetrating, dull, throbbing, achy, nagging or gnawing. Be as specific and descriptive as possible.
Has the pain changed since your last visit with your doctor?
What medications or treatments have you tried for the pain? How effective were they?

Set goals:

Everybody differs in the amount of pain that they can tolerate. A level of pain that is unbearable for you might be acceptable to another. Your doctor may help you determine your tolerance for pain by having you rate your pain on a pain intensity scale. Then you can set a goal for where you’d like to be.

For instance, if you rate your pain as 6 out of 10 on average and you decide you can tolerate 3 out of 10, then you and your doctor have a more tangible goal to work toward. You may not be able to get your pain level down to a zero, but usually you can make progress.

Focus on one pain problem at a time. For example, you may have both back and knee pain, but your back pain is worse. Start by treating your back pain and then, once your back pain is tolerable, work on your knee. The time it takes to reach your goal depends on your diagnosis, but people often see progress during the first several months. After that, you may work toward a general pain management goal.

Understand your treatment:

Continue to be involved in your care when your physician recommends specific treatments for you. Ask why certain treatments are being proposed and find out their risks, benefits and alternatives. Be careful about accepting medications, injections or other recommendations without being aware of what each entails. Any intervention brings a chance of both benefits and complications. Talk with your doctor to ensure that the balance is in your favor.

Expect to commit some time to the treatment process. You may try a variety of treatments before your doctor finds one that works for you, so don’t become discouraged if the first treatment isn’t as effective as you had hoped. Your doctor may adjust your treatment over time, as he or she monitors how your body reacts to various regimens. People usually make progress in the first 2 to 3 months.
How is pain treated?

How is pain diagnosed?

Chronic Pelvic Pain:

Surgery Pain & Adhesions

A Statement on the Value of Opioids for People with Severe Pain:
American Pain Foundation

The diversion and abuse of opioids-strong medications used to treat people suffering with severe pain-is now making front-page news. While these often-sensationalized stories have focused primarily on the illegal and dangerous use of these medications by drug abusers, they have often failed to balance the problem of abuse with the real news about these drugs-that they provide valuable relief for people suffering with serious pain. The danger of these stories is that they perpetuate long-standing myths and misconceptions about pain management and have the potential to discourage people with pain from receiving treatment that works.The diversion and abuse of opioids-strong medications used to treat people suffering with severe pain-is now making front-page news. While these often-sensationalized stories have focused primarily on the illegal and dangerous use of these medications by drug abusers, they have often failed to balance the problem of abuse with the real news about these drugs-that they provide valuable relief for people suffering with serious pain. The danger of these stories is that they perpetuate long-standing myths and misconceptions about pain management and have the potential to discourage people with pain from receiving treatment that works.

According to Dr. James Campbell, Professor of Neurosurgery at Johns Hopkins Medical Center, past president of the American Pain Society, and Chairman of the American Pain Foundation, "Taking legal, FDA-approved opioid medications as prescribed, under the direction of a physician for pain relief, is safe and effective, and only in rare cases, leads to addiction. When properly used, these medications rarely give a "high"-they give relief. And, most importantly, they allow many people to resume their normal lives."

The management of pain is finally starting to achieve the status it deserves in healthcare. Healthcare professionals, policy makers, the public, and the media are becoming more aware of the undertreatment of pain and are beginning to take steps to address the problem. On January 1, 2001, for example, the new pain standards of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the largest accrediting body in the United States, now require all of its 19,000 hospitals, nursing homes, and other healthcare facilities to assess and treat pain, and inform patients about their right to effective pain care. If they don't comply, they can lose their accreditation.

In spite of these advances, over 50 million Americans still live with malignant or non-malignant chronic pain. And although most pain can be managed, it often goes untreated, improperly treated, or undertreated. For example, studies show that while cancer pain can almost always be relieved, more than 40% of cancer patients are undertreated for pain. Why? One reason is a false fear that opioid medications taken for pain are dangerous or addictive.

Doctors and pharmacists need to be diligent in taking security measures to keep opioid medications out of illegal and improper hands. Regulators and law enforcement officers should be tough in combating the illegal diversion of opioids into street traffic, but they should do it in a balanced way that doesn't discourage the safe and legal use of opioid medications for pain care. And the news media should always balance news about opioids with information about their value to people with severe chronic pain.

We must be careful not to turn the "War on Drugs" into a "War on Patients."
"Patients' Reluctance to Take Opioids"
After patients report their pain to their healthcare providers and receive opioid treatment, some are reluctant to or simply don’t take their prescribed opioids because they areAfter patients report their pain to their healthcare providers and receive opioid treatment, some are reluctant to or simply don’t take their prescribed opioids because they areconcerned about becoming dependent or addicted
afraid to "use up" the analgesic effect of their pain medication
fearful of severe side effects

Fear of addiction:

Anti-drug propaganda has been so successful in convincing people that "anyone who takes drugs becomes an addict" that pain patients who take opioids for intractable pain are typically categorized with drug abusers. As a result, pain patients do not take their pain medication properly because they believe they will become addicts.

In a survey of over 200 pain patients, 82% believed that they could become addicted to their pain medication easily.11 In another survey of over 200 pain patients, 27.3% of patients feared addiction from their pain medications, and 17% of them did not take their medication because of this fear of addiction.12

The truth is, as Dr. Nora Janjan, co-founder of the Multidisciplinary Metastatic Bone Pain Clinic, explains, "Addiction is behavior, not a physiologic response. What we think of as an addict is someone whose desire for drugs overwhelms everything they do, how they live. Our patients don’t do that. In fact, once the cause of the pain is treated, most patients will take themselves off the drugs." 14 In fact, studies show that addiction marks less than 1% of those taking appropriate levels of opioids for pain management.

Now, you may be asking, what is the difference between a drug addict and a patient taking opioids for intractable pain relief? Although not proven, researchers believe that pain patients and addicts respond to opioids differently because the nervous pathway that transports intractable pain develops little to no tolerance to opioids. The nervous pathways that transport sudden, sharp pain and pleasure do develop significant tolerance to opioids.

Using up pain medication too soon:

Many patients refuse to take all of their pain medication because they fear that their medication will not be effective with continued use. In fact in a survey of over 1,000 US adults, 72% believed that "if you take medication when you don’t really need it, then when you do need it, it won’t work." In another survey of over 200 pain patients, 60% believed that their medication should be saved for when they really needed it.

The truth is, opioids do not have a ceiling dosage where they cease to relieve increasing pain. Therefore, pain patients should feel comfortable taking appropriate amounts of opioids for their pain because there is no chance of opioid treatment "running out" of effectiveness.

Fear of powerful side effects:

Patients are afraid that if they take opioids to relieve their pain they will experience powerful side effects. This, however, is not the case. Patients can take increasing doses of opioids, as pain persists, without severe side effects.

Of the side effects that do occur while taking appropriate amounts of opioids, constipation, nausea, and vomiting are the most severe. Nausea and vomiting usually subside after the first week of treatment. Constipation may continue further but can be treated with a laxative.
Chronic pelvic pain: Puzzling, frustrating condition:

Overcoming Chronic Pain:

What You Don’t Know Can Hurt You: Knowledge Is Power In A Doctor/Patient Relationship:

The Benefits of Relief:

Unlike an addict, whose life becomes increasingly constricted by an obsession with drug use, a patient using the drug for pain experiences an expansion of life when relief comes from this life-inhibiting disorder, Dr. Schneider said. An addict gets high by taking the drug in a way that rapidly increases the dose reaching the brain. But opioids properly used for pain do not result in a "rush" or euphoria. When given for chronic pain, opioids are typically given in a form that provides a steady amount throughout the day.

Nor do pain patients require ever-increasing amounts of opioids to achieve pain control, because patients in pain do not become "tolerant" to properly prescribed opioids. Higher doses are needed only if an inadequate amount of the drug is given in the first place or if the pain itself worsens with time.

Tolerance does develop to some of the common side effects of opioids, including sedation, respiratory depression and nausea, although constipation tends to persist as long as the drug is taken. But an opioid taken to relieve chronic pain does not block acute pain sensations that might result, for example, from surgery or an injury. A broken arm or gallbladder surgery will hurt just as if no opioid were being taken and will require additional treatment with some other analgesic, Dr. Schneider said.

Of course, round-the-clock narcotics are only one aspect of proper treatment for chronic pain that fails to respond adequately to lesser drugs. As Dr. Schneider explained, chronic pain is "a primary disorder" that can itself cause disabling complications, including difficulty sleeping, muscle spasms and depression.

Thus, pain specialists commonly prescribe a low-dose antidepressant like Elavil to promote sounder sleep, muscle relaxants and anticonvulsants to relieve spasms, anti- inflammatory drugs, full-dose antidepressants to counter depression and an increase in physical activity to improve mood and reduce feelings of incapacity.

Patients may also be referred to psychologists for cognitive-behavioral therapy, physiatrists (for exercises and pain-relieving injections), physical therapists, hypnotists, biofeedback specialists and even acupuncturists, Dr. Schneider said.

To help reduce the risk of drug abuse, Dr. Schneider and many other pain specialists insist that before receiving opioids for chronic pain, patients sign a "contract" that, among other things, insists that only one doctor and one pharmacy be used to provide opioids and that no change in dose be made without prior consultation with the prescribing physician.

The contract also states that there will be "no early refills," no matter what the excuse, and that patients must agree to undergo random urine drug tests if the doctor suspects the drug is being abused.
The impact of Pain:

The Impact of Pain Pain is a serious public health and economic issue. According to statistics, pain touches everyone: - Pain costs $100 billion annually in lost workdays, medical The Impact of Pain Pain is a serious public health and economic issue. According to statistics, pain touches everyone: - Pain costs $100 billion annually in lost workdays, medical
expenses and other benefit costs (National Institute for
Occupational Safety and Health);

- Pain personally affects one in three people (Partners for
Understanding Pain survey); and

- Pain causes more disability than cancer and heart disease
combined (National Medical Association).

“The Partners for Understanding Pain want to raise awareness of both the medical and socioeconomic impacts of pain. Pain and its consequences are issues of unrecognized significance,” said Penney Cowan, executive director of the American Chronic Pain Association (ACPA), which is spearheading Partners for Understanding Pain. “Access to care also is an issue. Skyrocketing health care costs leave some, especially seniors, minorities, and the urban and rural poor, unable to get the help they need to manage their pain.” Specifically, more than 50 million Americans suffer from chronic pain each year, and another 25 million experience acute pain caused by injury or surgery. Fifty to 70 percent of cancer patients experience significant pain sometime during their illness, the American Cancer Society reports. But, experts say, 90 percent of cancer pain can be alleviated with proper treatment, according to the National Cancer Institute. “While pain is often a natural response to illness or injury, there are a number of techniques and medications that can help us manage our pain more effectively, which in turn can aid recovery and improve quality of life,” Carr said. More Training Needed for Physicians The majority of respondents to the Partners for Understanding Pain survey are confident that their primary care physician can effectively diagnose (79 percent) and treat (83 percent) any pain problem they may have. However, most doctors receive very little training in identifying and treating pain problems among their patients. “Few medical schools have included formal training in pain and pain management in their curriculum in the past and doctors have not felt well prepared to deal with their patients’ pain,” Carr said. “Pain has been like the elephant in the middle of the room; no one knows exactly what to do about it, so we act as if it isn’t there. Fortunately, this is changing.” Addiction Fears May Result in Suffering Fear of addiction is a major concern among survey participants. More than three out of four respondents (78 percent) believe that addiction would be very or somewhat likely when strong pain medication is given to treat pain. In fact, when prescribed for pain problems, most pain medications, including opioids, do not cause the “high” associated with street drug use and rarely cause addiction, according to Carr. Failing to provide appropriate medications to people with cancer, acute or chronic pain can cause unnecessary suffering. Pain Doesn’t Discriminate Who is most likely to suffer from chronic pain? Most respondents (43 percent) believed a typical person with ongoing pain is an adult age 65 or older. In fact, anyone can develop chronic pain, and 80 percent of those who have chronic pain are in the adult 24 to 64 age group, according to The Arthritis Foundation. Is the Pain Real? The majority of respondents agrees or agrees strongly that people sometimes exaggerate their pain to get drugs (83 percent), avoid work (84 percent) or get attention (86 percent). In fact, few people exaggerate their pain for any reason, Cowan said. However, since pain is an invisible disability, it’s impossible to know how much pain someone is experiencing by observing him or her. “People sometimes use pain behavior (grimacing, grabbing their backs, groaning) because they fear that their caregivers or families will not believe that their pain is real,” Cowan said. “That’s one reason we convened Partners for Understanding Pain – to open up a dialogue about pain and encourage greater understanding about its impact.” About Partners for Understanding Pain Partners for Understanding Pain is a consortium of more than 50 organizations that touch the lives of people with chronic, acute and cancer pain. Each member brings its own perspective to the dialogue and together they represent a comprehensive network of resources and knowledge about issues in pain management. Partners for Understanding Pain, spearheaded by the American Chronic Pain Association, strives to create greater understanding among health care professionals, individuals and families who are struggling with pain management, the business community, legislators and the general public that pain is a serious public health issue. For more information about pain management and the Partners for Understanding pain...

The rest of this article is about Pain Management; gaining acceptance..
I hope this was of some help Pls know your ((Sister)) will always be here for support in your battle to find some answers & relief
Unread 05-10-2003, 09:38 PM
I'm having trouble dealing with the pain


I'm sorry you're having such pain. I also wouldn't worry about the addiction part. What makes you think you're addicted, anyway? If it's true, you can deal with that later, so don't worry about it now.

As for the injection, that's a good thing. It's a way of determining if it really is the nerve that is the problem. Once that is known it can be dealt with more specifically. I'm dealing with what is thought to be nerve pain now as well. I'm trying Neurontin first. If it doesn't work the pain doctor will probably inject the nerve to see if that's really what's causing the pain.

Hang in, it's good you have someone helping you!

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