Archive for the ‘Chronic Pain’ Category

It was by far the oddest setting she had ever experienced.  The room was full of Democrats and Republicans, energetic, idealistic youth, middle-aged mortgage holders with job woes and the calmer, slower elderly battling arthritis and other ailments. It was not her definition of an ideal party.

She watched from  her corner perch. People flowed through the kitchen, dropping off dishes full of treats as they exchanged hugs. Wine and conversation flourished. Music exploded from a nearby speaker as young cousins ran hand in hand. Doctors, Lawyers and Judges clinked glasses with waitresses, mechanics and store clerks. Drinks flowed, food disappeared and laughter grew. One by one the group migrated to the festive living room.

It was here people handed each other brightly wrapped packages. It was here they related stories of their past. It was here they passed out more hugs than gifts. It was here she realized that she was going to like the family she married into. It was here she discovered the values that shaped the man she loved. It was here that she realized she loved her new family.  It was here that her husband pulled her into the group for a hug. It was here that she realized the perfect gift didn’t have to come from a store. It was the ideal party.

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I vividly remember a Saturday afternoon, the summer of nineteen-sixty eight. A summer I was camping with my parents. I had done something wrong, I don’t remember what, but it was enough for my usually lenient mother to send me to the trailer, and bed as punishment. After what seemed like hours, my father came to talk to me. Feeling abused and unjustly treated, I wanted to tell my side of the story to my father. I also decided to include a new phrase I had  heard around the lake in my talk. When he told me how upset my mother was, I sat up and spouted my newly learned phrase.

“Well, she didn’t need to shit a brick over it!”  I did it! I pulled out an adult phrase showing my displeasure over their actions! I felt proud and strong. Then the hammer dropped, the room fell silent, my fathers face turned to stone. I shriveled in my skin, I had done something really bad! I spent the rest of the weekend in the trailer while my friends swam.

Years later, in the fun times known as the ’70’s, I sat in my usual place at the table during a family dinner. Feeling hip and grown up, I said, “pass the potatoes dude,” to my father. Things changed so fast I could hear the tinkle of ice as it shrouded the room. Dad slammed his fork on the table and mom fixed me in her stare. I was excused from the table and learned that I could call people dude at school and play, but NOT at home. I began to see the social rules, the morals and norms that kept families together. The values that helped us navigate the world.

Then came the children of our generation. We had already tested the water,  using lingo unique to our generation. Many of these new parents didn’t want to be “un-cool.” They let their kids be kids, speak anyway they wanted, with few boundaries. They continued to evolve, using new words and giving less respect to their parents and family. This has evolved into;

Suck it
This sucks
What ev
Meh
omg
Hate

We need to teach our kids  how to speak, with respect to themselves and others. We have to stop being “cool” and be parents. I don’t want my kid uttering the word “sucks” all day. I don’t want a “what ev” when I ask t hem to empty the trash. I want them to be able to converse, spell and build healthy adult relationships. It is up to us to give them the tools and discipline. We owe it to them to teach them how to speak, listen, learn, show respect, command respect and act. We can’t sit back and let their teenage, online communication form their adulthood. We need to have as much, if not more, input in their lives as social media.

What if today was my “This is my Done” day? What if today was the day I took my last breath? Fini, game over, you’re outta here day!

Did I do something to be proud of? Was I kind to someone? Did I take a moment to enjoy myself, or do something to enrich my life?

Or did I get up, grumble, snarl, procrastinate, complain and do nothing to better my day or the day of another?

I don’t know when I will go, I do know that today wasn’t my “done day,” so I am going to think about this when I rise. The last thing I want is for my last words being angry or critical. Kids need guidance and discipline, but I need to find a way to do both so they aren’t left with only the  criticism. I need to find a way for my mate to know I may have been angry over one of their actions, but I love them we would have worked through it.

If today was not your “done day,” you have time to rethink things and stack the deck in your favor.

I pass a mirror and gasp, surely that wasn’t my face staring back at me. If it were, it would be gray, crisscrossed with deep, black furrows cutting into the flesh and dead eyes consumed with pain the doctors can’t fix and refuse to treat. It would be tight, drawn, ugly.

My face would reflect the self-doubt clouding my mind, it would redden at the thought of my insecurities and shortcomings. It would smolder with the anger over lost careers, relationships and skills, all stolen by the pain.  A river of tears would flow over bloated cheeks, representing lonely hours, sleepless nights and a mountain of pills taken in vain.

How can that seemingly normal face staring back at me, be mine?

 

This is a repost of a study I found.

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Opioids: Addiction vs. Dependence
by Karen Lee Richards, ChronicPainConnection Expert
One of the greatest obstacles chronic pain patients face in their quest for adequate pain relief is the widespread misunderstanding of the difference between physical dependence on a drug and addiction. Many patients, the general public, and sadly even some physicians fear that anyone taking opioid medications on a long-term basis will become addicted. As a result, pain patients are often labeled as “drug seekers” and stigmatized for their use of opioid medications. Worst of all, their pain frequently remains under-treated.
Understanding the Terminology
Before we can adequately discuss this topic, it is important to clearly define the terms we will be using.
Addiction is a neurobiological disease that has genetic, psychosocial, and environmental factors. It is characterized by one or more of the following behaviors:
• Poor control over drug use
• Compulsive drug use
• Continued use of a drug despite physical, mental and/or social harm
• A craving for the drug
Physical dependence is the body’s adaptation to a particular drug. In other words, the individual’s body gets used to receiving regular doses of a certain medication. When the medication is abruptly stopped or the dosage is reduced too quickly, the person will experience withdrawal symptoms. Although we tend to think of opioids when we talk about physical dependence and withdrawal, a number of other drugs not associated with addiction can also result in physical dependence (i.e., antidepressants, beta blockers, corticosteroids, etc.) and can trigger unpleasant withdrawal symptoms if stopped abruptly.

Tolerance is a condition that occurs when the body adapts or gets used to a particular medication, lessening its effectiveness. When that happens, it is necessary to either increase the dosage or switch to another type of medication in order to maintain pain relief.

Pseudoaddiction is a term used to describe patient behaviors that may occur when their pain is not being treated adequately. Patients who are desperate for pain relief may watch the clock until time for their next medication dose and do other things that would normally be considered “drug seeking” behaviors, such as taking medications not prescribed to them, taking illegal drugs, or using deception to obtain medications. The difference between pseudoaddiction and true addiction is that the behaviors stop when the patient’s pain is effectively treated.

Can a chronic pain patient become addicted to opioid drugs?

Although most chronic pain patients who take opioids on a long-term basis will become physically dependent on them, very few will ever become addicted to them. The rare few who do develop a problem are often highly susceptible to addiction due to a genetic predisposition. In a review of 24,000 patients who were medically prescribed opioids, only seven could be found who got into trouble with them. So a chronic pain patient becoming addicted to opioid medications is definitely the exception rather than the rule.

Opioids: Addiction vs. Dependence

How can you tell if someone is addicted to an opioid drug?
People who become addicted to opioid drugs usually report getting a feeling of euphoria or being “high.” They soon need increasing amounts of the drug to maintain that same high feeling. Unfortunately, this frequently leads to an ongoing and often desperate search for more of the drug through whatever means possible – legal or illegal.

Some behaviors that may be suggestive of possible addiction include:
• Taking medications more frequently or at higher dosages than prescribed.
• Ingesting drugs in ways other than directed, such as crushing, snorting, or injecting.
• Frequent reports of lost or stolen prescriptions.
• Doctor shopping.
• Using multiple pharmacies.

Following are some of the key differences between addicts and pain patients:
Addicts Pain Patients
Addicts take drugs to get high and avoid life Pain patients take drugs to function normally and get on with life.
Addicts isolate themselves and become lost to their families. When pain patients get adequate relief, they become active members of their families.
Addicts are unable to interact appropriately with society. When pain patients get adequate relief, they interact with and make positive contributions to society.
Addicts are eventually unable to hold down a job. When pain patients get adequate relief, they are often able to go back to work.
The life on an addict is a continuous downward spiral. When a pain patient gets adequate relief, their life progresses in a positive, upward direction.

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Sources:

The American Academy of Pain Medicine, The American Pain Society and the American Society of Addiction Medicine. (2001). Definitions related to the use of opioids for the treatment of pain. Retrieved December 1, 2008, from American Pain Society Web site: http://www.ampainsoc.org/advocacy/opioids2.htm
The National Institute on Drug Abuse. Addiction vs Dependence. Retrieved December 1, 2008 from Our Chronic Pain Mission Web site: http://www.cpmission.com/main/addiction.html
© Karen Lee Richards 2008
Updated 12/1/2008