Wednesday, June 25, 2008

Politics and Pain


It has been a while since I posted, so I am going to start tonight, even though I am in so much pain I can hardly sit in my computer chair. My body is telling me to give up, that I am doing no good, then I will get a nice comment or e-mail and it then it gives me the courage to go on. There so many people just like me, either lying in bed with out the strength or courage to get up, while others are sitting in pain and and loneliness, staring at life passing them by, remembering plans and dreams they had for life or retirement. We aren't talking about a few thousand people, we are talking about 75 million people.
It is absolutely insane, what is going on in this and other Countries regarding Chronic Pain. In our country, the source for it is in the little photo to the left. They could also come together as it is non-partisan and do something to correct it.
Its that time again and I'm sure like me, you are tired of all of the phony promises. I don't know where they have been for the last 4 years, but it sure as "hell" hasn't been working for solutions for people living this ghastly life of Chronic pain. I can only speak for myself, but when it comes to trying to describe Chronic pain, I have no words to describe it to the point that I feel I have gotten my point across. When you have 75 million people suffering like I am, you have an epidemic on your hands. Even many of our wonderful military men and women who come home after being blown to hell by IED's or other ways are having the same problems, getting the powerful medication that it takes to knock out their pain.
This medicine is not illegal folks. It was approved by the FDA just for this purpose, yet all you hear is addiction, addiction. There no studies that I know of that shows a high level of addiction with people who live in chronic pain. I have researched this mess for to long. Most studies I have seen, have been around 2 to 3%, and for 75 million people that is nothing. Most people in chronic pain who are lucky enough to get someone to help them, hate taking the damn stuff because of the side effects. We are not lucking for a high, we are looking for a life. Most of the time we not only have to suffer from the pain, but we suffer the humiliation by a Dr. yelling at you about getting addicted. Most of them don't have enough education on it to know the correct words to use.
Its Chemical Dependency Doctor!!!! To be fair, all Doctors are not this way. We have many wonderful physicians who are educated and compassionate. They are just caught between a "rock and a hard place" with the justice dept. The Senators and Congressmen could put a stop to this insanity by putting control of the medical profession back where it is supposed to be, with the state medical boards. Then the DEA could get back to the job of stopping this massive amount of illegal drugs coming across the Mexican border. Yes there is an illegal drug problem in this country and I am all for going after them, but please not the doctors, and pain patients who can hardly make it through the day.
These politicians want your vote, so please do what I have done and continue to do. Write them, Call their offices. Its obvious from polling data that this country is fed up with politicians who forget who they represent. People are angry and their patience has grown thin, so no matter what state you live in, please jump in let them know that pain is a human issue, not a partisan issue.

Wednesday, May 21, 2008

Benefits versus risks of taking Opioids

I wish every Doctor and the DEA would read articles like the one below. I was reading a news story last night about a DEA agent that was injured while on a raid. Now he is on a morphine pump and he talked about the difficulty in trying to get a doctor to treat him. We are all at risk here folks. It can happen to anyone. That's why it is so necessary for there to be more education about opioids and why they will stop severe pain when nothing else will. There is really a lot of research going on in this area. I just hope it doesn't fall on deaf ears.


As controversy swirls about proper clinical use of opioids and other potent pain medications, research reported at the American Pain Society annual meeting shows that, contrary to widespread beliefs, less than 3 percent of patients with no history of drug abuse who are prescribed opioids for chronic pain will show signs of possible drug abuse or dependence. In his plenary session address, Srinivasa Raja, MD, professor of anesthesiology, Johns Hopkins University Medical School, urged clinicians and policy makers not to allow the small percentage of abused pain prescriptions to prevent legitimate pain patients from getting the care they need.


"Physicians today face a dilemma in trying to balance the needs of their patients with demands from society for better control of opioid medications. We also are dealing with unfounded accusations in the media that increased prescribing of opioids for severe chronic pain is responsible in large part for reported upswings in the abuse of pain medications," said Raja. "We do need stronger evidence about which patients will benefit most from these medications to help make better prescribing decisions," he added. "But for most chronic pain patients, drugs are not the sole solution. More and more studies are showing that multi-faceted treatment involving physical and cognitive-behavioral therapies and appropriate interventional strategies lead to the most favorable outcomes." According to Raja, the problem of prescription drug abuse can best be attacked and hopefully solved through collaborations involving care givers, regulatory and law enforcement agencies and the pharmaceutical industry.


"First, I believe physicians should be diligent is communicating with their patients about the benefits and risks of opioids and also screen them for drug-seeking behavior and other warning signs of potential abuse," said Raja. "Also, we must monitor patients carefully to determine when doses can be lowered over time as they improve their pain control and overall functioning." The message for law enforcement and federal and state regulatory agencies, first and foremost, is to strive for state-to-state consistency in regulating controlled substances and crack down on illegal internet pharmacies and prescription thefts and forgeries. "Progress is being made as there is increased awareness of the source of prescription opioids being diverted into the illicit market," said Raja, "and states and municipalities are stepping up their teen drug awareness education programs."


For pharmaceutical manufacturers, Raja said the key challenge is to match clinical needs for less addicting pain medication with drug development priorities. "There are novel analgesic formulations in various stages of development that we hope can be prioritized and expedited for clinical use," he said. Raja noted that fifty years ago, a commentary published in the Journal of the American Medical Association recommended that opioids should be avoided in treating cancer pain because of possible addiction, and 20 years ago it was believed infants didn't feel pain and shouldn't receive anesthesia. "We abandoned such faulty beliefs as scientific evidence proved otherwise," he said. "Now I hope history repeats itself in changing professional and public attitudes as we now know opioids are effective for treating chronic non-cancer pain and that very few legitimate pain patients abuse their medications.


Hopefully, the evidence will foster a middle-ground approach that protects the rights of patients and clinicians while upholding society's right to control medication abuse and diversion."


Thursday, May 8, 2008

Opioid use and sexual dysnfunction

I Came across this article that some of you may be interested in. I'll have to say that if you are in the kind of pain that I'm in, sex is the least of your worries. It does go to show you the amount of research that is going on but until the public, the medical profession and the Justice Department takes a different attitude about the millions of people that are suffering, and educate themselves on the use of opioids, I can't see where the great research being done is going to help. It is so sad that millions of people like me have to suffer so much because of the ego and stupidity of a few. It is happening though, every single day.

"Unfortunately, chronic pain and sexual problems often go together. Yet, many patients suffer in silence, healthcare providers rarely ask about patients’ sexual concerns, and guidance literature on the subject is relatively scarce. Ironically, the long-acting opioid medications prescribed to relieve patients’ pains often are the source of sexual dysfunction.


In an evidence-based commentary article for Pain Treatment Topics – “Opioid-Induced Sexual Dysfunction: Causes, Diagnosis, & Treatment” – Stephen Colameco, MD, MEd, discusses the problem and how healthcare providers can help their patients.
Considerable evidence suggests that long-acting opioids used on a daily basis for more than a month can reduce hormonal function in both men and women. Besides sexual dysfunction, symptoms can include weight gain, fatigue, depression, osteoporosis, and irregular menstrual cycles.


These problems can be treated, if they are properly diagnosed, but different approaches are needed in males and females. Colameco provides a number of recommendations:
-- Prior to the initiation of therapy, prescribers should inform patients that hormonal disturbances are common with higher dose, long-term opioid treatment.
-- After treatment is started, patients should be routinely evaluated for signs and symptoms of hormone deficiency, including sexual dysfunction.
-- When hormonal deficiency is suspected, appropriate laboratory testing should be ordered.
-- An important treatment in men often is testosterone supplementation. Topical, buccal, or transdermal formulations are preferred over intramuscular injections.
-- In women, testosterone treatment is controversial and supplementation with DHEA/DHEAS may be preferred due to its ability to raise hormone levels without significant side effects. Alternatively, rotation from one opioid medication to another may be effective.


In sum, opioid treatment is intended to reduce patients’ pain, and to improve physical and social functioning. Opioid-induced hormonal deficiencies and associated sexual dysfunctions are common and often overlooked consequences of opioid therapy. If left untreated, they may negate the potential benefits of this analgesic. It is hoped that through a better understanding of these problems opioid therapy can be more effectively used in the treatment of chronic pain.
The complete article (8 pages) is available for free access at:http://pain-topics.org/clinical_concepts/comments.php#Colameco ".

Saturday, April 19, 2008

Fibromyalgia-Chronic Pain and how it effects the brain

Even though My chronic pain does not come from fibromyalgia, there are millions of people suffering from it, and my heart goes out to them. It is hard to believe that some doctors still doubt its existence, but that is ignorance on their part of as for as I am concerned. There are to many great researchers that have come forward with evidence of the debilitating and deadly disease, to have anything but compassion for those people who suffer from it. I have a sister-in-law who suffers from it. I have watched her go from a vibrant young woman who ran several miles every day with a set of weights in each hand, to an over weight person who rarely gets out of bed anymore. We correspond by e-mail and she can relate to me and my condition better than my wife, because like me, her life is one constant nightmare of pain.


"Researchers at the University of Michigan Health System have found a key linkage between pain and a specific brain molecule, a discovery that lends new insight into fibromyalgia, an often-baffling chronic pain condition. In patients with fibromyalgia, researchers found, pain decreased when levels of the brain molecule called glutamate went down. The results of this study, which appears in the journal Arthritis and Rheumatism, could be useful to researchers looking for new drugs that treat fibromyalgia, the authors say. "If these findings are replicated, investigators performing clinical treatment trials in fibromyalgia could potentially use glutamate as a 'surrogate' marker of disease response," says lead author Richard E. Harris, Ph.D., research assistant professor in the Division of Rheumatology at the U-M Medical School's Department of Internal Medicine and a researcher at the U-M Chronic Pain and Fatigue Research Center.

The molecule glutamate is a neurotransmitter, which means it conveys information between neurons in the nervous system. When glutamate is released from one neuron, it diffuses across the space between cells, and then binds to receptors on the next neuron in line and causes the cell to become excited, or to be more active. This molecule was suspected to play a role in fibromyalgia because previous studies had shown that some brain regions in fibromyalgia patients appear to be highly excited. One such region is the insula. In functional magnetic resonance imaging (fMRI) studies, researchers at U-M had previously shown that the insula displays augmented activity in fibromyalgia, which means neurons in these patients are more active in this part of the brain.

The U-M team hypothesized, Harris notes, that more activity among these neurons might be related to the level of glutamate in this region. To gauge the linkage between pain and glutamate, the researchers used a non-invasive brain imaging techinique called proton magnetic resonance spectroscopy (H-MRS). H-MRS was performed once before and once following a four-week course of acupuncture or "sham" acupuncture. Researchers used either acupuncture or sham acupuncture to reduce pain symptoms. The sham procedure involved using a sharp device to prick the skin in order to mimic real acupuncture sensations.

Following the four weeks of treatment, both clinical and experimental pain reported were reduced significantly. More importantly the reduction in both pain outcomes was linked with reductions in glutamate levels in the insula: patients with greater reductions in pain showed greater reductions in glutamate. This suggests that glutamate may play a role in this disease and that it could potentially be used as a biomarker of disease severity. Because of the small number of participants in this study, further research should be conducted to verify the role of glutamate in fibromyalgia, Harris says. "


Everything in quotes is research information from the University of Michigan.


Tuesday, March 25, 2008

Not in America

It has been a while since I have posted anything. Lately I have just opened it up and looked at all of the posts I have made night after night and then just close the blog again. Frankly I am tired of being in pain, tired of sitting up until 4:00P.M. in the morning because I am in to much pain to sleep. You will have to forgive me tonight because I certainly don't feel like writing about pain. I keep asking myself over and over, how could this be happening in this country, a country that so many men and women have fought and died for to protect our freedoms.

I myself am a veteran of one of those wars. There have been instances in war where several men and aircraft have been sacrificed just to save one life. Why? Because that is America. That is the country I love and was willing to die for. So why do so many people have to suffer like I do. We have large medical facilities and every day it seems like more new research is discovering some new disease, medication or a better way to take the ones that have been proven to work.
Practically any morning you can turn on the news and find hundreds of volunteers out searching for a lost child, or 2-3 fire rescue engines trying to rescue a puppy. Why do we do this? Because we are a compassionate people. That is the America I know and love.

America has a dirty little secret that most people don't understand and that includes the medical profession for the most part. The ones who do, don't want any part of taking care of people like me because we are to much trouble, or to much regulatory scurnity to bother with it. I always wandered, how can a doctor let someone leave his office, take his money, yet do nothing to help that person. The most delicate part of the human body, the central nervous system, is also the most abused part of the body. Once you have some type of disease, or have an injury that breaches the CNS you are in a for a lifetime of living hell. My own injury was caused by a orthopaedic surgeon using a new procedure, that he had, one days training on.


Chronic Pain has stolen my live for the last 25 years. Not only do I have to live that way but I have to live the humilation of trying to find a Doctor to help me. All over America people just like me by the millions are lying in pain or perhaps sitting up like me because they are in to much pain to sleep. It doesn't have to be that way for the 70 million plus people who live the nightmare of pain that just want go away, that stays with you night and day. No it doesn't have to be that way at all.

You see the drugs that will stop that kind of pain, are the same ones sought after by drug addicts. I know there is a drug problem in this country. Drug abuse goes back to the early Roman Empire. I as a person who now lives in Chronic Pain simply cannot relate to anyone who would want to take these powerful drugs just for fun. I know one thing. With almost 1/4 of the population living like this and several thousand killing themselves ever year, because it just becomes to painful to live, it is time for the politicians to get involved and make some legislation clear enough that people who are dying, get the treatment they need and at the same time not tie the hands of the DEA from getting the real drug abusers. I don't blame the DEA. I blame the Congress and Senate, first of all for not taking it seriously as a problem, and not writeing clear and concise laws so the law enforcement community and the medical community know will know what to do. Wake up Washington, D.C. This is America not some third world country. We believe in saving lives here, not taking them.



I wander if they have ever given a thought to the fact that anyone, even them could go from being perfectly healthy to a vegtable like me in the blink of an eye. I know because that is the way it happened to me.

Sunday, February 17, 2008

Genocide in America

I am sure after a title like that you are probably asking yourself, what in the hell is he talking about? I love this Country. I am a Viet Nam Veteran. I have never taken the freedoms we have in America for granted, but there are things going on that you almost never here about in the News Media. We have always had our share of things in the past, as a compassionate people, we are not proud of. Usually it is after the fact. Example: The internment of Japanese Americans during World War II, the so-called Insane asylums and things done to these poor people in the name of medicine in the 1940s-1960s. I once had the disgusting opportunity to tour one. Of course, who can forget the movie, "One flew over the Coo-Coo's nest". Actually, it wasn't far off the mark.

I'm sure you are saying O.K., so what has all of this got to do with genocide in present day America. If you knew what I know then you would understand when I say that we are in danger of becoming a "police state" and even now a certain group of people are already having their civil rights trampled on, profiled like comman criminals, accused of being drug addicts, having compassionate doctors raided, jailed and accused of running "pill mills", when in fact all they are guilty of in most cases, are keeping people like me alive.

There is a disease in this country right now that goes virtually ignored, untreated and stigmatized. That disease is Intractable Chronic Pain. I know, the usual reaction is hell, pain is not a disease. A little pain never killed anyone, besides I have been in pain before. If you are one of those people who feels that way, then my best friend, "Jesus Christ" said it best in the Book of Proverbs. "My People Perish for lack of knowledge".


I would say you are uneducated to what is going on at this very minute in this country and so would 72.5 Million other people who are in pain, with 30 million of those just like me, living in severe intractable chronic pain. I have another "news flash" for you. You could become like me in the blink of an eye. Doomed to a life of agony and unbearable pain for the rest of your life.

Once you breach the central nervous system, (spinal cord) in any way my friend, You are in for a life time of agony. It could be an auto accident, motorcycle, a simple fall, playing sports or in my case the results of a surgical procedure gone bad.

If you really want to know some of the things that are happening right now, click on this link http://painreliefnetwork.org/index.html .

I am dieing myself, from 25 years of unrelenting pain, 24 hrs a day, 7 days a week, 365 days a year. You get very little sleep and when you do fall asleep from sheer exhaustion, the pain will wake you up in an hour or two. As I write this blog it is 2:30 A.M. and I will probably go to sleep at 4:00-5:00 in the morning. I do this night after night and usually stop when the pain gets so bad I can no longer concentrate.


While it is true that the death certificate will never say that me or anyone in my situtation died of chronic pain, what usually happens is an organ failure, like a heart attack, stroke, etc. In the last 6 months, my blood pressure has gone from being perfect to extremely high. My doctor said it was from the stress of my body fighting pain. Thousands of people every year simply can fight no longer and take their own lives. My question is what is a person supposed to do when "they don't want to die", but they are in "to much pain to live" ?


So who is to blame for this "silent epidemic" as it is called? Truthfully their is plenty of blame to go around. There is a drug addiction problem in this country from people, most are not in pain, but usually take a number of different drugs at one time to get high, lack of education for not just the general public but doctors and the DEA also. For the present time in history, The GAO (govermental accounting office) issued a report that was highly critical of the DEA and their efforts to stem the flow of illegal narcotics. Then the Bush/Ashcroft/Gonzaliz so called "War on Drug dealers" which has turned out to be a "war on doctors and pain patients"


Of course the Senators and Congressmen who head up these powerful committees like nothing better than to get some cabinet head before them and chew their ass out to look good for the cameras. At the time Asa Hutchison was appointed DEA Czar and under pressure from Congress, started with a big media campaign, deliberately useing a new drug called Oxycontin that was and still is a drug approved by the FDA for the treatment of cancer and severe intractable chronic pain. So now instead of going after the bad guys, the drug smugglers, the short answer is they went after the soft targets. The poor chronic pain patient like myself who has no desire to take anything to get high. Instead we are the targets, and all we want is something to give us a few hours away from the painful, miserable, lonely existance we live. Something about this picture is terribly wrong. Its alright to let someone die just as long as you keep them from getting addicted.

Wednesday, January 16, 2008

The Toxic dump of the human body


I will admit this picture is very disturbing, I just wish that more spine surgeons would listen to a man who is a board certified Neurosurgeon, spine surgeon and he is also certified in forensics medicine. For years he has been trying to get the attention of his collegues about the fragile central nervous system that he refers to as the "toxic dump" of the human body. The photo is the end stage of adhesive Arocnoditis. This is inside the spinal cord at the lumbar area and as you can see all of the nerves are just melted againest the spinal wall. The information below is copyrighted material taken from his site, with his permission. He is my hero and if you want to get an education on the spine please visit his site at http://www.burtonreport.com/INDEX.htm


"Despite society's frequently professed concern with the sanctity of, and need for. the preservation of human life this attitude is not always evident when reality sets in. The melamine poisoning of pets by tainted foodstuffs has created a remarkable whirlwind of world attention which has resulted in a swiftly successful scientific investigatory response to find the culprits and make sure that this does not happen again.
Unfortunately, poisoned humans have not been as lucky as their pets. The press has also recently brought to our attention the fact that a syrupy poison (diethylene glycol, the prime ingredient in antifreeze) has been substituted for more expensive and safe ingredient glycerol in oral medicines, such as cough syrup throughout the world for over a decade.The effect of the oral administration of diethylene glycol produces kidney failure, paralysis, and in most cases death (please note the similarity of symptoms with pet deaths due to melamine). Massive diethylene glycol poisonings have now been documented in Haiti, Bangladesh, Argentina, Nigeria, India, Panama, and China.In underdeveloped countries most people who die don't come to a medical facility or have toxicological autopsy studies. While some may be tempted to take some solace in being in a more advanced society, they shouldn't. Please put on your seatbelts at this point in time.You will no doubt be surprised to learn that the same poison, diethylene glycol, has been injected into the spine of unsuspecting Americans and their European cousins since the 1940s as a ingredient of oil myelograms and continues to be injected today as an ingredient of steroid suspensions frequently being used to treat back pain.When diethylene glycol gets into subarachnoid space it produces a chemical meningitis. This typically leads to adhesive arachnoiditis, which is severe scarring of the spinal cord and nerve roots. The most common symptom is constant and agonizing pain which is remarkably disabling. Many patients with adhesive arachnoiditis have taken their own lives as the only means of escaping their agony because adhesive arachnoiditis is rarely a direct cause of death. The common use of diethylene glycol as a ingredient of steroid suspensions being blindly injected into the spine is a real, present, and serious public heath problem in the United States and Europe today. Remarkably there is no hue and cry evident. The sufferers are not infrequently told that the problem is "in their heads" when a high resolution MRI could provide the specific diagnosis.Where are the medical and scientific professionals needed to investigate these tragedies? They are not in evidence. The only recourse a patient has today is in the medical-legal (if the statute of limitations hasn't run out) arena. The problem with this venue for society is that the settlements are not publicly propagated and the rest of the unsuspecting potential victims remain essentially uninformed. There just may be a slim chance, at this point in time, that the suffering of our pets from the melamine disaster might just possibly shift the spotlight a bit to the also not-wonderful-world of diethylene glycol. "


Copyrighted material of Dr. Charles V. Burton