Friday, February 26, 2021

Comments by cali

Showing 8 of 8 comments.

  • Lawrence, if you don’t want to be perceived as dismissive, then stop using language that implies chronic pain doesn’t cause real suffering and can be highly disabling, i.e., implying that it is merely an “invented” diagnosis (and suffers like myself just need to simply let go of this “identity” to feel better). I find it very disconcerting that several other commenters besides me have expressed concern that you claim chronic pain diagnoses are merely “invented” to sell drugs, and there is no consideration/acknowledgement on your end that perhaps your hypothesis needs some refining. Instead you just double down, intent to prove your exaggerated view that medicine is solely responsible for all health problems.

    Also, please stop using your personal experience to extrapolate everyone else’s experiences. As Madness Civilization told you on one of your other posts, “You seem to fall into the logical and ethical trap that psychiatry so often suffers from: you are fully confident you know the subjective experience of everyone else.” I seriously hope this isn’t what you do with your patients. You mentioned that exercise helped your back pain- what makes you think I haven’t tried exercise without success? For the record, I was previously very physically active and fit , as I exercised 5 times a week, regularly ran, played tennis, and did weights. It has been a very long road for me to get one day a week of a light workout in.

  • When I say chronic pain epidemic, I mean just that- Chronic pain epidemic is not synonymous with opioid epidemic. As I’ve already stated, not everyone with chronic pain is taking or seeking out opioids. Chronic pain is also on the rise worldwide, as chronic conditions that may be causally related to chronic pain like obesity are increasing everywhere.

  • Thanks, knowledgeispower. I find Lawrence’s dismissiveness of the the legitimacy of chronic pain both disappointingly hypocritical for MIA (aren’t many people here because a psych dismissed their emotional pain?) and upsetting. I agree that more research on holistic treatments would do a lot of good. I have seen some benefit from vitamin therapies…namely vitamin d3/k2 and magnesium . Money being the driver of MDs has certainly been my experience. Many docs (especially rheumatologists) get pissy if they can’t drug you up with potent meds like steroids, dmards, etc. If you say you want them to monitor you/your labs but want to try natural therapies instead of these drug therapies, they will make you feel like you are a waste of time.

  • Lawrence, you actually have no idea if after withdrawing from opioids the patient will be left with “tolerable” pain, nor do you know much of a person’s pain can be attributed to opioid tolerance withdrawal . I just don’t get how you can be so resistant to the idea that a person might be going on opioids in the first place because they were already dealing with pain they couldn’t manage.

    Also, you seem to be unaware of the idea that some of these so-called “MTD” diagnosis like fibromyalgia are often given when the physician is unable to make a clear diagnosis. This can happen for many reasons (symptoms don’t clearly fit a diagnosis, physician incompetence, etc). Later on, however, a “true” diagnosis may emerge. I am trying to remember where I read this, but I have seen a study somewhere talking about how autoimmune diseases like lupus often take 3-5 years to be diagnosed after the start of symptoms. I know anecdotally that many of these patients report negative experiences with physicians who do not take them seriously in the period when they are symptomatic but do not yet have a clear diagnosis.

    Finally, another consequence of blowing off a patient’s chronic pain (please do not use quotations around this as you are in no position to imply someone’s pain isn’t real) is that they are like to get hit with a psych diagnosis. This can happen for two reasons. First there is the stress of not being believed that their pain is legitimate (as you are doing). This can lead to family members also thinking the person’s pain isn’t legitimate and that they are just being lazy and don’t need to help or support them; obviously this is very stressful to deal with on top of the pain. Second, referring to psych is easy on the physician, who often doesn’t want to deal with a complicated patient. Then you might not have a opioid addicted patient but instead a SSRI/benzo addicted one.

  • I don’t doubt this is a contributor to the current chronic pain epidemic, but other pain related conditions are also on the rise so I think it is a stretch to say that these treatments are the primary drivers of the epidemic (e.g., Autoimmune diseases and obesity are on the rise and are important sources of pain)

  • When all you say is that, ” 84% of us have chronic back pain at some point. So Chronic Pain Syndrome (CPS) and Fibromyalgia were invented to justify anyone’s getting opiates”, the implicit message is that they are not disabilities, they are normative conditions. What you don’t say (i.e., acknowledge that for some of this 84%, these conditions can be quite disabling) matters too. Also, not everyone with CPS or fibromyalglia takes opiates or is opioid seeking, so would appreciate you toning down the hyperbole.

  • I’m sorry, but not all pain is created equal. Perhaps this is news to you, but some people do suffer more than the everyday aches and pains that more than 84% of the population has had at some point and it can be truly disabling. Do you have any idea what it is like to be in your 20s and have a complex injury that kept you from walking more than 500 feet maybe 2 times a week (and otherwise had at stay at home sitting or laying all day) for nearly 3 years? Really sick of the ableist attitudes sometimes on display at MIA.

    Am I saying that opioids or other addictive meds are the answer to pain (physical or emotional)? NO. However, you seem oblivious to one of the reasons why people with chronic pain conditions feel compelled to resort to dangerous treatments in an often desperate attempt to make pain subside- the lack of understanding and accommodation from others. We are often made to feel that pain is something we can push through, we are not deserving of accommodations that allow us to maintain some semblance of productivity (e.g., working from home). This attitude everyone has pain, everyone gets anxious or sad, etc only fuels the lack of empathy and understanding towards those who suffer in disabling ways.

  • Steve, a lot of the blame for this situation lies on the grant agencies (especially NIMH) more than the individual investigators. Academic researchers are forced to adhere agency priorities if they want prestigious NIH grants (and want to keep their jobs). If NIMH prioritizes research that assumes ADHD kids do better when receiving “treatment”, they will fund a study that aims to show how/when/what type of “treatment” is best over a study with a premise that “treatment” may have neutral or harmful effects.

    Look at the priorities here https://www.nimh.nih.gov/about/strategic-planning-reports/strategic-research-priorities/index.shtml. It is implicit in objectives 2 and 3 that “interventions” and “cures” will be helpful (Of course we know that isn’t the case…)