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On the relative importance of chronic pain. - Piano wire. [entries|archive|friends|userinfo]
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On the relative importance of chronic pain. [Thursday, Jul. 29th, 2010|02:25 pm]
The richest girl in town.
I cannot count the friends of mine with migraines, fibromyalgia, endometriosis, and other pain conditions who have essentially been abandoned by their doctors.

I have thought and thought and thought about this -- trying to get past my knee-jerk angry reaction to Western Medicine and its relatively hysterical reaction to visible physical disability combined with its more low-key and some might even say unconcerned reaction to pain.

Perhaps it's genuinely more difficult. Perhaps it was easier to invent prostheses (some that are nearly as deft as I am), wheelchairs, crutches, grabber/extenderss, hand controls for cars, power chairs, and electronic wheelchairs that OBEY YOUR THOUGHTS than it is to come up with reliable pain relief. Seriously -- maybe it is. I am not a chemist or engineer.

Or maybe our medical minds (and donors) just don't think chronic pain is particularly important. I don't really know.


[User Picture]From: aefre
2010-07-29 10:13 pm (UTC)
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[User Picture]From: jactitation
2010-07-30 12:00 am (UTC)
I think it absolutely is harder to chemically address chronic pain. Absolutely.

However, the problem with that is the Western med issue you raise: that if there's no solution, most docs freak, take the lack of cure personally and can't handle it, throw tantrums, take it out on their patients (accuse them of malingering, of noncompliance, etc.). And partly that's also because insurance companies don't want patients who have to keep going back to doctors, so the docs know that they're going to get grief if they keep these patients (and I can't believe that such knowledge doesn't inevitably poison the medical relationship).

Because, amazing, what if the docs just offered compassion? Observation? Witness? Over and over? Weekly even? It might actually alleviate some of the suffering, if not the actual pain (and, given the docs' new and more nuanced view of the patients, could potentially yield new strategies to manage pain). But how costly it would be in our current system!

At this point, it seems almost impossible to disentangle biomedicine from capitalism--from the treatment to the research to the training--and that, to me, is the issue.

I should probably note that I am a former chronic pain sufferer (3 solid years) and still have recurrances, and only got better when I gave up hope that biomed had anything to offer me. Not necessarily the cause, but definitely affected my viewpoint.
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[User Picture]From: bronicablue
2010-07-30 12:31 am (UTC)
years ago, I was told by a "joint specialist" that I had bursitis (sp?), whish is a blanket term for chronic pain. I asked him what I could do about it & he basically said live with it.
It wasn't until years later that I began going to chiropractors, acupuncturists, and massage therapists. I still have the pain, but it's a hell of a lot more manageable now.
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[User Picture]From: jetspeaks
2010-07-30 12:40 am (UTC)
I had a chronic pain condition for about 6-7 years in my early-mid 20s. I think the difficult part for me with most doctors was that in the initial phase I was tested for *everything* - big, scary things, life-threatening things, degenerative disorders of all kinds - and then dropped once they decided it wasn't one of those. If it's big enough to be one of those, how is it now suddenly all in my mind?
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[User Picture]From: epiphanomaly
2010-07-30 12:49 am (UTC)
Ask me about the time I almost died from sepsis because the male ER doctor I saw when I could barely move from the pain of my ruptured appendix prescribed me Midol and sent me home because I "just had menstrual cramps."
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[User Picture]From: wordweaverlynn
2010-07-30 01:44 am (UTC)
Pain is just how you feel, and the western world assigns feelings to the female and therefore devalues them. All those other things are *functional*, and we value doing very highly.
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[User Picture]From: blue_estro
2010-07-30 05:49 am (UTC)
With the caveat that I am not a chemist or a doctor (or really an engineer despite some education and lifestyle choices in that direction), I don't think that it is as simple as visible disability is more upsetting than invisible pain. If I understand correctly, most of the chronic pain conditions you list are ones that they don't know what causes, and thus don't know how to fix it other than to cover the symptoms with pain medications.

Since most of what we have reported to us by dear ones and the media is the patient facing side it looks like the people with physical disabilities are the only ones cared about (and this could be true, but I doubt it is). But really, when someone is physically impaired, making a device or changing local environments to account for it is a no-brainer solution and easily implementable. Something with unknown causes with symptoms that really only one person (the sufferer) can directly observe is an entirely different issue.

I think (but I am failing to remember where I heard this) that there is huge amounts of research being conducted on the nervous system, including how pain works.
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[User Picture]From: blue_estro
2010-07-30 05:51 am (UTC)
This doesn't make it any less frustrating, or the apparently lack of attempts on the doctor's side any more excusable.
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From: outlawpoet
2010-07-30 05:31 pm (UTC)
Good pain chemistry is complicated to research because they keep reclassifying all the best stuff we find as schedule 1 or 2 controlled substances, and getting releases to study those compounds is complex and expensive.

And the few substances that manage to avoid that are of course patented up the wazoo, so only one entity can continue research in that vein with any hope of commercialization.
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[User Picture]From: slutbunwalla
2010-07-30 10:22 pm (UTC)
pain management, especially for non specific stuff like fibromyalgia for which there is no known cause and its symptoms can be so varied and unclear, is incredibly hard.
where to focus, on the brain's receptors, nerve impulses in the body...what part is wrong and is there something actually wrong with the body where the pain is located or is it perception of pain that is going on in the brain that needs to be addressed...

There are lots of scientific researchers working on this stuff all the time, Pain management is a HUGE DEAL. How to make something that isn't just numbing to the point of incapacitation? That doesn't just make you sleep? That people who may not be in pain don't immediately start abusing or the people who are end up becoming addicted to?

Working with the brain and the nervous system is so complicated, it's pretty amazing that we actually can keep making the advances we do. And those advances take years to actually be made available because one has to test and test and test and then even testing on humans is tricky stuff...and there's things that won't even show up, side effects etc until humans start trying it out.

making mechanical things that don't chemically alter brain function, even if it is a diode in your brain to control a wheel chair I would think is in a sense easier because it's tangible, very clear whether or not it works, doesn't depend on the patient's perception of their own pain etc. It's frustrating, and sometimes it seems as if no one wants to help, but I just don't think that's true.

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[User Picture]From: whataboutprom
2010-07-31 05:21 am (UTC)
I'm in constant pain, but I can't even afford to go to a doctor to be ignored. Our system is completely broken. I now understand why people self medicate, even when it's harmful, (this is something I did not get at all when I was younger.) Sometimes anything is better than waking up and going to sleep in pain.
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