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Living With Severe Chronic Pain

Living Beyond Pain

Prepared Patient - When Pain Doesn't End - photo from fotolia.comFor people with severe chronic pain like Kelly Young and Teresa Shaffer—both of whom have become patient advocates—coping with agony is a fact of life.  Young suffers from rheumatoid arthritis while Shaffer’s pain is linked primarily to another degenerative bone disease.

Chronic pain is one of the most difficult—and common—medical conditions.  Estimated to affect 76 million Americans—more than diabetes, cancer and heart disease combined—it accompanies illnesses and injuries ranging from cancer to various forms of arthritis, multiple sclerosis and physical trauma.

Pain is defined as chronic when it persists after an injury or illness has otherwise healed, or when it lasts three months or longer. The experience of pain can vary dramatically, depending in part on whether it is affecting bones, muscles, nerves, joints or skin. Untreated pain can itself become a disease when the brain wrongly signals agony when there is no new injury or discernable other cause. Fibromyalgia—a disease in which pain in joints, muscles and other soft tissues is the primary symptom—is believed to be linked to incorrect signaling in the brain’s pain regions.

Finding a Doctor

The first step to deal with chronic pain is Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Brain Imaging Shows Overlap Between Emotional Pain And Physical Pain

Heart-ache can be a literal thing, as well as a metaphor for all those weepy, jilted-lover torch songs.

Consensus thinking in the peer-review literature is that the parts of one’s brain responsible for physical pain, the dorsal anterior cingulate and anterior insula, also underlie emotional pain.

Researchers at Columbia University in New York recruited 40 people who’d recently ended a romantic relationship, put them in a functional magnetic resonance imaging machine, and recorded their reactions to physical and then emotional pain.

Physical pain was created by heating the person’s left forearm, compared to having the arm merely warmed. Emotional pain was created by looking at pictures of the former partner and remembering the breakup, compared to when looking at a photo of a friend.

The fMRI scans showed physical and emotional pain overlapped in the dorsal anterior cingulate and anterior insula, with overlapping increases in thalamus and right parietal opercular/insular cortex in the right side of the brain (opposite to the left arm).

The theory is that Read more »

*This blog post was originally published at ACP Internist*

Homeopathy: Fibromyalgia, A Woo Magnet

Over the weekend, my wife and I happened to be in the pharmacy section of our local Target store. We happened to be looking for one of our favorite cold remedies, because both of us have been suffering from rather annoying colds, which have plagued both of us for the last week or two.

As we perused the Cold and Flu section of the pharmacy, we were struck at how much shelf space was taken up by Airborne (which was “invented by a schoolteacher.“) Nearly three years ago Airborne had to settle a case brought against it alleging false advertising to the tune of $23 million. Despite that, Airborne is still being sold, and there are even a whole bunch of knock-off products copying it.

Then, as we continued to look for our favored cold remedy, we noted that, sitting right next to the extensive shelf space devoted to the various flavors and types of Airborne supplements, I saw Boiron’s homeopathic remedy for colds containing oscillococcinum, which is derived from duck liver and heart and diluted to 200C (a 10400-fold dilution). Yes, I was a bit depressed after that. Now I know what my skeptical friends in the U.K. go through every time they walk into a Boots pharmacy.

Still, even though homeopathy is not as popular in the U.S. as it is in the U.K. and the rest of Europe, it’s obviously making some inroads if it’s being sold in Target. Steve Novella made a point at a panel at TAM8 in July to point out that it’s also being sold in Walmart, but since I rarely, if ever, shop at Walmart, I hadn’t noticed, although I had noticed various dubious concoctions being sold at Walgreens and CVS, two large pharmacy chains here in the U.S. Its relative popularity in different parts of the world aside, ever since I learned what homeopathy is and what its precepts are, I’ve always been fascinated how it can possibly be taken seriously. Read more »

*This blog post was originally published at Science-Based Medicine*

When “Big Pharma” Is Demonized

To be blunt up front –- SBM is not apologetic about the pharmaceutical industry. We get zero funding from any company, and have no ties of any kind to “big pharma.” In today’s world I have to spend time making that clear, because despite the reality critics are free to assume and falsely claim that our message is coming straight from the bowels of hell (a.k.a. the pharmaceutical industry).

We promote science-based medicine and criticize pharmaceutical companies along with everyone else when they place other concerns ahead of scientific validity, or promote bad science, for whatever reason.

It has become fashionable, however, to not only criticize the pharmaceutical industry but to demonize them –- and the term “big pharma” has come to represent this demonization. Cynicism is a cheap imitation of skepticism –- it is the assumption of the worst, without careful thought or any hint of fairness. Read more »

*This blog post was originally published at Science-Based Medicine*

Date Rape Drug May Help Patients With Fibromyalgia?

Just a quick post on an article that caught my eye: Jazz Pharmaceuticals of Palo Alto, CA, has announced that the US FDA has accepted their new drug application (NDA) filing for JZP-6, or sodium oxybate, for the treatment of pain and fatigue associated with fibromyalgia.

The NDA was based on positive outcomes of two, Phase III clinical trials – those randomized, placebo-controlled double-blind trials that serve as the gold standard for drug efficacy. The company expects an approval decision from FDA by October 2010. Read more »

*This blog post was originally published at Terra Sigillata*

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