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Thread: This pain HAS to stop NOW! :(

  1. #21
    Hi Becky, here's a gentle There are many nights when I lay awake in pain, I think you have a good idea about posting here. I've thought about it but, havn't done it. Bravo' to you for doing something, anything, even in your pain!

    Sending you positive thoughts and prayers to successfully complete this semester! You've worked so hard and been through so much, I wish you the best!
    The IceDragon Avatar best represents my constant Freezing yet Burning Pain...not to mention all the other sensations that come with neuro pain

  2. #22
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    Quote Originally Posted by michaelm View Post
    Thank you for this article.

  3. #23
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    Becky hang in there and keep trying to rest. Try asking for a strong sleeping pill. It has made a lot of difference in managing my pain. I know some people are against the sleeping pills but...........

  4. #24
    I would like to see the reasons why the linked article by the pharmacologist omits the term, "central pain" among the neuropathic pains. It simply does not appear. It is the reverse of the emperor's clothes situation. What is there is NOT there because the power figures say it isn't.

    The rabbit has been put into the authority figure's hat and made to disappear. We are definitionally being subjected to a Milgram type experiment where people fall in line with the experts, despite their own observations. Just what we need, more VAGUENESS and LESS SPECIFICITY in speaking of nerve injury pain.


    I do think it is a good review of the literature, and avoids what would bring him intense criticism from those who blithely treat severe pain. Everything works, a little, so who can be blamed for subjecting a patient to a long list of margnally effective treatments. All this at phenomenal and bankrupting expense. EAT MUCH?--not if you buy all the meds mentioned and try them all!

    The alternative, unthinkable, would be to say we don't yet have a good treatment. He omits resiniferatoxin entirely, and instead mentions capsaicin.

    Yet, it is one of the best articles going,which only shows you how badly we need better measurements of pain. How can we say something is effective unless we know how severe it was, what TYPE of pain was treated, and how much benefit was conferred. If I spend five thousand dollars for a course that makes me ten dollars richer is that effective?


    It seems evident that the longstanding differentiation of pain of central origin from peripheral nerve injury is being abandoned. In my view, this is ill advised. There are clinical differences which make it easier to design therapy. There is a longstanding difference between which drugs are better for peripheral nerve injury and which might help central pain. Insufficient differentation in the article might lead to someone assuming that what is good for PNI is good for central pain.

    I also find the repeated use of the word "effective" regarding therapies which have been proven ineffective to be annoying and gullible. Certain tricyclics have been subjected to double blind studies and found ineffective in central pain.

    Again, there is NO mention of how we define effective, nor even how we define pain.

    After all the "effectives" the doctor then admits there is no definitive treatment.

    It is time to omit "effective" and say we have not yet done a good job.

    I give him ten stars (that is on the "analog scale" of 1-10 stars, the gold standard for the scientific community) for admitting that opiates have not been found to be effective in neuropathic pain. This is significant since he lists lots of questionables as "effective". If opiates cannot even make that list, then there are a lot of centers using a very expensive sedative (opiates) when something else might work as well or better.

    I am of the opinion that ANYTHING which sedates you can help you bear up to central pain. I am also specific enough to make a difference between sedation and pain relief.

    Despite all my complaining, I am glad to see ANYONE publishing a readable article. He is not really wrong on anything, but neither is he right, nor could he be, because we cannot measure anything, and are therefore dependent on self rating by doctors who treat pain. It is hard to be objective when one's livelihood is involved.

    It is hard to get excited about mention of "new" drugs which have been "shown" to be "effective" in diabetic neuropathy. What does diabetic neuropathy have to do with agonizing post SCI central pain?
    Last edited by dejerine; 04-09-2010 at 06:20 PM.

  5. #25
    Senior Member alan's Avatar
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    Every night, I wish to fall asleep and not wake up. Hasn't worked yet.
    Alan

    Proofread carefully to see if you any words out.

  6. #26
    Hi Alan, I share your wish.
    Kindly,

    The Ketamine Kitty

    All the tears, all the pain, all the rage through the night (apolgies to the rewrite) RR

    Next time I die make sure I'm gone,
    don't leave 'em nothing to work on JT

    And I ain't nothin but a dream JM

  7. #27
    Quote Originally Posted by dejerine
    How can we say something is effective unless we know how severe it was, what TYPE of pain was treated, and how much benefit was conferred. If I spend five thousand dollars for a course that makes me ten dollars richer is that effective?
    THIS!!! And since I can't emphasize how important these criteria for accurately evaluating treatment modalities are, let me add WHAT DEJ SAID!!!

    Quote Originally Posted by dejerine
    It seems evident that the longstanding differentiation of pain of central origin from peripheral nerve injury is being abandoned. In my view, this is ill advised. There are clinical differences which make it easier to design therapy. There is a longstanding difference between which drugs are better for peripheral nerve injury and which might help central pain. Insufficient differentation in the article might lead to someone assuming that what is good for PNI is good for central pain.

    <snip>

    It is hard to get excited about mention of "new" drugs which have been "shown" to be "effective" in diabetic neuropathy. What does diabetic neuropathy have to do with agonizing post SCI central pain?
    Absolutely on target, Dej. Discussing drugs that work for diabetic neuropathy with people with central pain due to spinal cord damage is no different than the conversations in which someone tries to tell you they can relate to your post SCI/D life because they once broke their leg and had to use a wheelchair for six weeks. It's apples and saxophones, people -- just because both experiences involve a wheelchair doesn't mean that they're interchangeable.

    Real answers require more specificity about the problems, proposed solutions, and outcomes, not less.
    It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

    ~Julius Caesar


  8. #28
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    In our world effective must mean you don't wish to fall asleep and not wake up.

    I do not have a scientific mind, but one thing I do know is that I sometimes fear I will go postal if one more person asks me how my pain is on a scale of 1 to 10. WTH I don't even remember what a 1 or a few days of a 6 felt like.

    But I'm not complaining because I want to wake up.

  9. #29
    Becky, I'm sorry you're hurting so bad right now. I have had the experience of waking myself up screaming. It's a terrifying experience! The pain seems unbearable. I don't have any advice...please just know I understand and I'm sending positive energy your way.
    "The truth will set you free. But first, it will piss you off." -Gloria Steinem

  10. #30

    Monty Python

    SWH

    Someone needs to make a Monty Python skit on a visit to a pain clinic.

    In walks a guy with an arrow sticking out of both sides of his head.

    In walks Cleese in a lab coat.

    And so Mr. Withersbottom, I see you have an arrow there in your head. Had it long?

    About two and a half feet long

    Does it affect you in any way.

    No effect whatsoever, except for the pain.

    Reeeeaalllly! Extraordinary. Pain you say. Well, of course, pain is a very vague and ubiquitous term. Would you help me out by not using layman's terms, sir.

    I don't really know any non-layman's terms for pain. It is most unpleasant. Oh, sorry, I guess that is layman also isn't it. I'm afraid I have no vocabulary at all.

    Hardly surprising. Well, you're the tenth arrow through the head we've seen this year. Mind using our hyperprofessional, digital, MMPI approved, analogue scale for "arrows through the head?"

    Not at all, although I'm quite sure I'm not up to it. I can't even turn on the computer. Perhaps my son could help. He's a compiler designer in C++ and Linux for BBS.

    Well, unfortunately, he's not the one with the arrow through the head, is he. I don't see how he could be of any help. You're just going to have to try.

    Very well then.

    Are you ready for our hyperanalog binary related neohieroglyphic digital testing process.

    I'll do my best for Queen and country.

    Splendid. Now, listen very carefully. On a SCALE from 1-10 how much bother would you say that arrow through your head is.

    Well, I don't know. One to ten you say. I can't really say. It hurts quite badly, that's all.

    Tapping his pencil on the chart. "Come come now, Mr. Withersbottom. You KNOW how the national health service deals with uncooperative patients, don't you. You don't want to go to the Outer Hebrides Hospital now do you, perched on a rock overhanging the angry waves. Just tell me from one to ten, how badly it hurts.(looking impatient).

    NO, please not the Outer Hebrides. Its.....Its....can you give me a little help?

    Oh rubbish. Just because this care is free, you think you can toy with me like that man! Alright! Is it say, something like a knitting needle or as bad as a mortar shell through the head.

    To be perfectly honest, I've never had a knitting needle through me head. So the mortar shell is a ten? Do you see those?

    Of course you haven't had a needle through the head. That's not the point. Just answer the question. One to Ten (holding up all ten fingers to illustrate)

    Ghastly! I suppose that would make me a three then.

    Very good. A three for the arrow through the head. For that, we use Paracetamol (tylenol). Here' s your paper. See the clerk out front.

    But what about the arrow through my head.

    What about it.

    It hurts.

    Its a THREE man, a THREE. Get a hold of yourself. You're British!

    Patient goes into agony, has a fit, and falls over dead.


    Hmmm. He's dead, as sure as Prince Charles has an English accent. A very poor estimator of severity, I must say. Probably lost a great deal of money betting on soccer matches. I suppose I'll have to estimate the analogicity of his death for him. It looked like a six but I'll give him a seven for the benefit of the doubt. It's the least I can do for Mrs. Withersbottom, considering that she had to live with this digital Cretan all those years.
    Last edited by dejerine; 04-10-2010 at 01:26 AM. Reason: misspell

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