Martha Randolph Carr Martha Randolph Carr, 11/9/2009 [Archive]

Pain Management in the US

Pain Management in the U.S.

By Martha Randolph Carr

Chronic pain in America is just beginning to be seen as a health care crisis that needs regular medical supervision in order to restore a quality of life to the 76.2 million sufferers as reported by the National Centers for Health Statistics.

That's more than the number of cancer, diabetes, stroke and heart disease patients combined, according to the American Pain Foundation, However, it's the one area of medicine where as a society we have long-standing mixed feelings. Narcotics have become inexorably linked to abuse in our country and many physicians have become reluctant to dole out regular prescriptions for Vicodin or Percodan even when the need is apparent.

The fear is that even legitimate pain management of a patient may result in lengthy investigations that will turn their practice inside out. As a result, people who suffer from life-altering pain may not be getting the medicine they need on a regular basis in order to return them to a semblance of their old life.

Leslie Mann, a journalist in the Chicago area, found that out after Lasik surgery on her eyes in 2001 resulted in constant pain that has never left her. 'Without my meds it feels like I have a knife in my eyes,' said Leslie. After the surgery, Leslie searched for reasonable answers to the pain and as a result was dropped by her primary care physician of many years by certified letter, told to seek psychiatric help by the Lasik surgeon and was told to have the painful eye sewn shut, which would have reduced her eyesight but done nothing for the pain.

It took persistence for her to find a doctor who would even admit that Leslie was suffering every day from debilitating pain, and then do something about it. However, even finding relief from prescribed pain medicine comes with consequences that people like Leslie have to live with, possibly for the rest of their lives.

'The pre-surgery Leslie and post-surgery Leslie are two different people. My body chemistry has changed due to the meds. Gone is hay fever, new is Vitamin D deficiency. My whole career and schedule were also changed. I had to go from a Type A to a Type-get-done-whatever-you-can-while-you-feel-up-to-it.'

Leslie also deals with the side affect of 'competition', which means the body can only handle one chronic pain condition at a time. As a result, introducing any other pain medication such as anesthesia or novocaine negates both of them and leaves the patient wide-open to feeling all of it. Leslie has already had to endure pain during necessary dental surgery.

For people like Leslie the prospect of major surgery becomes a constant worry.

Carol Sveilich, author of, Just Fine: Unmasking Concealed Illness and Pain, points out that the public may be slow to respond because pain is invisible to the casual observer and is the aftermath of some other illness or accident.

Americans like their proof right up front where we can see it. We even glamorize in movies and literature anyone who bears up under pain and call them stoic or courageous. But there is a significant loss to our country even from just an economic standpoint.

The National Institutes of Health report that the annual cost of chronic pain in the United States tops $100 billion. That figure includes the price tag from healthcare expenses, lost income, and lost productivity at a time in our country when we can't afford to be casual about health care or income.

Ignoring that many Americans because we can't see them suffering is not the right answer. There is an old adage that says we are judged by how we care for the weakest among us. The vast majority of us are caring people who are helping out our neighbors and friends every day of our lives. Let's pay attention to this one as well and ask our representatives to at least let doctors do their jobs. That's a good first step for over 76 million Americans who could use a helping hand.

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