Friday December 11, 2009
Preview of Our Show on Chronic Pain
Physician and humanitarian Dr. Albert Schweitzer once described pain as “a more terrible lord of mankind than death himself.”
Current estimates suggest that one in five Canadians suffers from chronic pain severe enough to require treatment. Some studies have estimated that chronic pain causes more disability than cancer and heart disease combined. Despite this, many Canadians suffer in silence, as their pain is both under-appreciated and under-treated.
There are many reasons why this sad state of affairs prevails here in Canada and in many developed nations. Health professionals receive very little education on managing pain effectively and safely. And there aren’t nearly enough experts in pain management or specialized pain clinics to meet the needs of Canadians.
Pam Squire is one such physician. The Vancouver-based family doctor has made it her life’s work to learn as much as possible about treating pain and help as many patients as time permits.
For Dr. Squire, managing pain with narcotic painkillers means managing the risk of addiction. Before prescribing narcotics, she says she always asks up front if the patient has ever been addicted to alcohol and other drugs. Some patients are offended by Dr. Squire’s direct and candid approach.
This week’s edition of WCBA examines the problem of unrelieved pain and the impact on patients. You can catch the show on Saturday, December 12 at 10 am (1030 NT) and again on Monday December 14 at 1130 am (3:30 pm NT) on CBC Radio One.
Meantime, here's a bit of what Dr. Squire says to her patients:
Previous Comments (6)
It's so hard as a legitimate pain patient to be treated by the outer medical world as a human being with a disease that needs certain medication. Who in their right mind would call up a physician of a patient on insulin and say "your patient doesn't need insulin, and they are using it just for recreation! They just have diabetes and that is that, they don't need medication to control it." It wouldn't happen, but in reality that's what every person who routinely undermines a pain patients' right to use opioid's does to them, each and every time the medications for this disease get objected to.
It SHOULD be as natural an occurance as someone with diabetes on insulin has,for accepting the patient's disease & treatment, but it's not the same way for Chronic pain sufferers... The fact is we have a disease that needs treatment and JUST because that medication is something that some unscrupulous person could take as an illegal recreational drug, we get told we shouldn't be on these med's, or worse treated like an drug seeking addict !!Legit, December 11, 2009 11:58 PM
Many, if not most of the doctors who earn their living as assessors for insurers constantly accuse doctors who try to treat chronic pain as dubious characters. For them - in the asence of "objective evidence" of pain - IME vendors tend to accuse chronic pain sufferers of sypmtom exaggeration or pain magnification. Googe "[PDF] OPIOID USE AND ABUSE & PHYSICIAN SUPPORTED FRAUD IN THE MEDICAL ..." to see the CSME stance on chronic pain and narcotics. I'm surprised to see you doing a perogram on pain given your previous show on fib-detectors with a guest who like most CSME members assesses all pain complainers as opportunists looking to defraud insurers (usually with the help of treating physicians). Maybe you could ask this guest about the role of IME vendors and their attitudes toward chronic pain?brian francis, December 12, 2009 1:15 PM
The show on chronic pain is excellent; I was particularly interested in hearing that doctors write prescriptions rather than taking the time to educate people.
I am most grateful that I had 4 doctors who took the time to educate me:
1. My breast cancer surgeon who referred me to a therapist because I was mentally overwhelmed with the diagnosis of cancer.
2. My therapist who referred me to Cognitive Behavioral Therapy (CBT) because I was depressed and my thoughts were dragging me down.
3. A surgeon who prescribed exercise after shoulder surgery for a work injury. He said if I wanted to get back to playing golf instead of going back to work, I would be more motivated to exercise and would heal much faster.
4. Another surgeon who told me that the pain in my neck after a car accident was from being the victim, and I would not have pain if I had caused the accident.
It took me a lot of time and effort, but I finally learned the difference between physical pain and emotional pain. I am fortunate to have a lot of support from family and friends - this is crucial - it's much easier to change tough habits with a partner than by your self.
The results are that I've been cancer free for 22 years, my shoulder pain is minimal if I do my exercises, and my neck pain flares up only occasionally.
My depression is manageable - it happens less frequently, I respond faster, and I've had only one severe episode in many years.
I hope that doctors will be encouraged to educate patients - they do at least need to plant the seed which doesn't have to take much time.
My best advice would be for doctors to recommend Cognitive Behavioral Therapy with every prescription they write. Or they can recommend a course such as the Chronic Disease Self Management Program which is being offered in Canada. Or else they can refer people to work with a Certified Wellness Coach such as myself – we specialize in helping people to make small changes with big benefits.
I agree with Legit.
I started and run a non profit organization in the South Okanagan called SOFA: South Okanagan FM-ME Association for those with Fibromyalgia & Chronic Fatigue Syndrome.
In Canada there is 1.5 Million and growing by 30,000 a year with this horrid illness, disability.
This illess takes over and does disable one. With all of the doctors we have, doctors are not trained in medical school, until just in 2007, about this illness and yet it has been around for over 160 years! Thus too many times when patients are going to their doctor with their truthful complaints about pain, fatigue, irritable bowel etc. and many of the other factors of this illness, they get sent to a psychiatrist! Give us a break!
We are adults and most of us do not just complain for fun! We don't want to be out of work and the plethora of other horrid things this illness does to us.
Do any of you healthy people out there think that we would choose to live on less than $900/mo which is all that our dear government give us to live on totally, for rent, food, everything, whilst spending money like crazy on so many other things and other countries poor - what ever happend to taking care of what's at hone first!
What ever happend to paying attention and really listening to the patient and treating them with care! Do you remember what it felt like to fall down on cement straight down on your knees and the dire pain that cuased? Well, multiply that by 10 and you might have a minimal as the level of pain that comes with FM and then the fatigue that takes over and there is nothing that one can do about it. I mean nothing, but actually rest when it is needed. But, do you know that most of us with CFS could have 14 hours of sleep and still feel tired! That doesn't fit with the mind, we know, but do you think that we would just act such a thing? C'mon- get real.
If there is anyone out there in the South Okanagan with this, please contact SOFA today ! (250) 493-2002 11AM till 3PM Mon-Thurs.
Also, we need others to start a society for the Kelowna and Vernon areas - I have a list of names!
Please pay attention and show respect to your family member who is trying to tell you something and Doctors! Remember the Oath that you take when you become a Doctor! Do you live that Oath!
I was happy to FINALLY hear something in the media these days about narcotics that wasn't just uneducated sensationalistic journalism. Since the CMAJ article came out, the newspapers picked up on the story, and words like "deadly" "addictive" and "drug abusers" were the only message that the reader was given.
I have chronic non-malignant pain, and I take oxycontin for it. Before you write me off as some druggie addict who sits home all day collecting disability (which is what most people think when you say you take "oxy") - know that I have 2 jobs (college prof and in a hospital), and I have a young son whose life I participate fully in. I'm an author, I'm able to drive, and I volunteer at my son's school. I'm able to do these things because I take oxycontin daily.
For several years I've lived with severe chronic pain. How bad is the pain? Let's just say, it was so severe I didn't notice I was in labour with my son. Now, labour is a pretty intense sort of pain, so to not feel it at all, you know that the pain had to be pretty bad. There have been times I've actually considered cutting my leg off - I can fully understand why animals with their leg caught in a trap can chew their leg off. If not for painkillers, I would most certainly be bedridden, with little quality of life. That's if I hadn't already killed myself due to the extreme pain - you can only suffer for so long.
Yes - oxycontin can be dangerous for people who take it improperly. However, for those of us who use it responsibly, our quality of life is greatly improved. Many things are dangerous if used improperly - but you don't see Tylenol, cough syrup, Lysol, hair spray, and aftershave (all things that people use to get high) being branded with the same label that oxycontin has. Because of this sensationalistic CMAJ article, and the news stories that followed, there are going to be many physicians who refuse to prescribe narcotics to patients who really need it, and there will be people too scared to take narcotics because of the "deadly" "addicting" nature of these drugs. Look at research - very few patients in pain become addicted to narcotics, and easily stop using narcotics when their pain is relieved. I get very angry when I think of all the doctors too scared to prescribe these useful medications. This program with Dr. Goldman was the first balanced news story I've actually heard since the CMAJ article came out. Thanks so much Dr. Goldman for looking at the facts on chronic pain.
I was pleased to hear a discussion on some of the problems of using pain killers and that considered possible alternatives.
There are new methods available for self-treatment of pains of all sorts, with no dangers of side effects. WHEE - Wholistic hybrid derived from Eye Movement Desensitization and Reprocessing (EMDR) and Emotional Freedom Techniques (EFT) - can relieve pains from backaches, migraines, injury, surgery, cancer and more within minutes, even when these have been present for decades.
These methods are also helpful for practitioners in dealing with the Compassion Fatigue that Dr. Goldman mentioned.
Blessings on your good work in sharing this information, Dr. Goldman and Dr. Squire.