Strange Dance: Performing Wellness for Others

Chronic pain forces a strange dance: performing wellness for others | Psyche Ideas – Jude Cook – June 2020

Ten years ago, I was prescribed a non-penicillin antibiotic to clear up a routine urinary tract infection. Part of a broad group known as fluoroquinolones, the pills made me feel as dizzy as if I’d drunk the better part of a bottle of wine.

Momentary loss of motor function down one side, cranial pressure and, when I got to the accident and emergency department, blood pressure high enough to cause an imminent heart attack.

Such frightening side-effects are surprisingly common, yet doctors still prescribe these antibiotics as though they were perfectly safe.

A Classification of Pain Patient Behavior

Taxonomy of Pain Patient Behavior – Practical Pain Management – By Ron Lechnyr, PhD, DSW and Henry H. Holmes, MD – Dec 2011 (repost from Feb 2015)

I’m posting this so you can see how doctors view our behavior and what we tell them about our pain. Knowing what we look like from “the other side” can help us avoid falling into one of these categories that cause doctors to dismiss us or view us negatively.

Though all types of physical illnesses and problems have psychological issues that need to be considered in the delivery of services, there are some patients whose response style may confound the diagnostic picture.

When this happens, such patients are often given the label “hystronic,” “neurotic,” or as having a “functional overlay” to their pain or medical problems.  

EBM only works for the mythical “average patient”

Pain-Topics.org News/Research UPDATES: Expect Analgesic Failure But Seek Success – this website is dead, but my post from 2013 still feels pertinent as corporate profit-driven healthcare companies continue their push to standardize our healthcare.

Evidence-Based Medicine (EBM) figures prominently in these efforts and is vigorously pursued and implemented by corporate healthcare (whose prime directive is to create profit for shareholders).

As our healthcare system tries to move toward EBM (evidence-based medicine), it’s critical to remember that there’s no such thing as an “average patient”.

New standards will be created based on statistical evidence – like means and averages – which can be misleading in medicine. This article points out how such statistics may not make sense in the real world (where not one single family has the statistical average of 2.2 children). 

Review Finds Opioid Patients Often Feel Stigmatized

Opioid Patients Often Feel Stigmatized, Review Finds | HCPLive – by Samara Rosenfeld – Feb 2020

Patients who took opioids for chronic non-malignant pain often felt stigmatized and did not want to take the medication, according to a recent review.

Since we don’t even want to take opioids, this is clearly NOT addiction!

The findings of the review highlighted that individuals who took opioids weighed the pros and cons of the medication but felt they had no choice but to take them because of their pain.

This is exactly how I feel: what choice do I really have? 

Strange Correlations with Opiod Use

Inspire.com Opioid Information Thread – User “Seshet” – Aug 2019

This is “Seshet’s” ongoing thread that’s very similar to what I do here: finding and reporting on the latest opioid-related articles. He’s a self-described “math nerd” with a scientific background, so his analysis of these articles is based on hard facts, not sentiments or speculation.

More fascinating research from NIDA. Seems that drug initiation is seasonal.

• “First time drug use more common in summertime“
• It turns out that cold weather increases the risk of fatal opioid overdoses.
• So does altitude above sea level.

For more such “spurious correlations” see a previous post of that very name which a list of countless correlations of completely unrelated variables: “Spurious Correlations“.

The Landscape of Chronic Pain

The Landscape of Chronic Pain: Broader Perspectives – free full-text /PMC6572619/ – by Mark I. Johnson – May 2019

Here is a recent lengthy review of what’s known about chronic pain: the various aspects of various types of pain under various circumstances.

This article shows the folly of making any numerical one-dimensional measurement of chronic pain, which can arise from a variety of causes, vary greatly over time and location, and make such intrusive incursions into our inner lives.

This special issue on matters related to chronic pain aims to draw on research and scholarly discourse from an eclectic mix of areas and perspectives.  

Opioid Addiction AND Pain Treatment

One of us was a pain patient saved by opioids, the other was addicted to them. We both deserve a solution – Los Angeles Times – By Ryan Hampton and Kate M. Nicholson – Apr 2019

This is an excellent article in a popular mainstream publication written by two people on the opposite ends of the “opioid crisis”. They point out that a common solution is needed, not one at the expense of the other, as has been done in the past.

Opioids have figured prominently in both our lives.

• For Kate, they were a lifeline after a surgical mishap left her unable to sit, stand or walk for more than a decade.
• For Ryan, they were a gateway to a dark decade of heroin addiction.

many Americans believe that we have over-treated pain at the expense of those who became addicted to prescription opioids.  

Ethics of Using Facial Recognition Tech in Healthcare

What Are Important Ethical Implications of Using Facial Recognition Technology in Health Care? – AMA Journal of Ethics – Nicole Martinez-Martin, JD, PhD

Abstract:

Applications of facial recognition technology (FRT) in health care settings have been developed to identify and monitor patients as well as to diagnose genetic, medical, and behavioral conditions.

The use of FRT in health care suggests the importance of informed consent, data input and analysis quality, effective communication about incidental findings, and potential influence on patient-clinician relationships.

Privacy and data protection are thought to present challenges for the use of FRT for health applications. 

April Fools Day – A National Day of Pain

April Fools Day – A National Day of Pain – National Pain Report –by Richard A. (“Red”) Lawhern, Ph.D – Mar 2019

I wish this effort had started sooner – maybe next year.

.April Fools Day is known around the world as a day for practical and sometimes impractical jokes.

This year, chronic pain patients, their families and their doctors can instead choose to make April 1st a day of change and protest. It can become a National Day of Pain.

The needle on public policy for treatment of pain is beginning to quiver:  

The forgotten victims of the opioid epidemic

Chronic pain patients are forgotten victims of opioid epidemic – By Elyse Morgan and Jacqueline A. Schwarz – Jan 2019

In this article, the authors explain how our screwed up opioid policies arise from 3 fundamental myths firmly embedded in the American mind and endlessly repeated by PROPaganda.

Our country’s well-intentioned efforts to stop opioid abuse and related overdoses have left a group of Americans fighting for their lives. Medications including opiates have allowed hundreds of thousands of patients with chronic pain to function for many years.

Recent media stories to the contrary, research reveals that fewer than 1 percent of patients became addicted following lengthy opioid treatment. Long-term treatment does not cause addiction rates that are higher than those in the total population.