Neurologist "Oaklander sees many patients whom she describes as "bouncing around the health care system" for years with no firm diagnosis. She divides chronic pain sufferers into two groups. "One is the group that has an ongoing cause of their pain," she says. "The classic example of that is patients with arthritis. They have pain in their joints every day." Much more difficult, she says, is the second group: "Patients who have chronic pain without an obvious cause of tissue injury."
Connick falls in the second category, Oaklander says, noting that X-rays show broken bones, but not nerve damage. "It was only many years later when he was examined by a neurologist that his underlying nerve injury was identified and able to be treated," she said.
Oaklander concludes: "If you have chronic pain, don't take no for an answer....I think it's important for chronic pain patients to keep a sense of purpose, optimism and hope despite the indignities that many are subjected to."
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The problem with many doctors is that they don't consider nerve damage as a source of chronic pain. They don't see anything that would explain it, so they consider the patient is exaggerating, perhaps that the patient wants pills to party with. Or are concerned that if they prescribe pain pills, they'll be investigated and lose their license. Or fob you off with some baseless concern that you'll become an addict (statistically, less than 1% of patients do, and most of those can be identified in advance because they have Addictive Personality Disorder) -- you wouldn't call a diabetic an "insulin addict" for taking their pills every day in order to function.
I was refused pain pills for years, despite sometimes reporting level 10-of-10 pain, because they just couldn'tsee that my arthritis was bad enough to produce a level 10. They'd tell me to go take Advil, which is an anti-inflammatory and works on arthritis, but Advil is useless on neurological pain. One would assume that anyone with enough intelligence to get through medical school would know that fact.
Obviously, taking a hot bath every hour or two is not something you could do while working full-time, but that was not registering with the doctors who were telling me to suck it up and go back to work. Since I work at home, I could do that, and ThermaCare wraps came on the market right about the time that I went through my period of worst pain. Still, no patient should be left to endure nonstop Level 10 pain for months with nothing but heating pad, hot bath and Advil. It's inhumane. (The only thing that kept me sane in that time period was that I was on an experimental sleeping pill that was strong enough to put me to sleep and keep me asleep; I could take it at 5 PM if the pain was too bad and sleep till 7 AM. If not for that reliable escape mechanism, I don't know what I would've done -- maybe gone over to the hospital and slapped a couple doctors. ( )
I then went to a seminar given by a local pain management specialist who made it clear that even as little as 48 hours of nonstop pain can cause observable physical changes in the Central Nervous System, and therefore no patient should be told to just suck it up, not even for a couple days. (His theory seems to be that these objective physical changes resulting from untreated pain might be at the root of fibromyalgia.)
As Oaklander says, "don't take No for an answer". If your GP is afraid of repercussions against his license for giving you pain pills, then demand a referral to a neurologist or pain management specialist, who are less afraid because the AMA expects them to be writing a lot of prescriptions.
My quality of life improved significantly when I found someone brave enough to give me a prescription for one pain pill at bedtime. During the day, I can use baths and heating pads, but you're not supposed to leave a heating pad or ThermaCare on while you're asleep. Capsaicin helps on small areas, but not for full body pain and not on any part that might come near bodily orifices. (According to a Sandy Koufax biography, if the trainer put Capsaicin on Koufax with his bare hands, his wife made him "sleep with his hands outside the blankets". You only need to touch one of your sensitive spots once to understand why. It burns like hell on my knee, I don't even want to know what it would do if my arm got near my face while I'm asleep.)
Thanks to one Tramadol at bedtime, I can sleep, and that means I wake up feeling less like I've been hit by a truck and more like a human being. There's no telling how good I would feel if I had gotten this prescription 7 years ago when I first asked for something to ease the pain so I could sleep through the night.
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