The CDC has a new set of recommendations for chronic pain.
I will write about them. I have to read them first. Hurts too much, right now, the election, and all the pandemic fighting. Stress people and you see what they are really like.
My church has melted down into a huge fight. I was in a chorus singing instead of being in a meeting. Apparently there is a group that says brown people have “taken over” the national organization of the church. Um. Hello. That is discrimination. Does the color of the skin matter if it is a good leader? Why are people insane? I filled out a county survey on drug use today. I know we have methamphetamines and heroin in our high schools because patients have told me. But then I get to the race question. What race am I? I checked OTHER and wrote HUMAN. The race bullcrap is NOT SCIENCE. I haven’t done any genetics testing. I DO NOT KNOW WHAT RACE I AM THOUGH I LOOK WHITE.
It is important for medicine in that there is proven discrimination with less screen health services offered to “brown” people, whatever the heck “brown” people means. I wish the heavens would turn us all the same color over night. Or perhaps blind us. That is not nice of me and I do not care.
I am glad that this horror came out in my church. Because now the discrimination is out in the open. And the committee has sent out a message saying NO. We WILL stay part of the national organization. We WILL not give in to this discrimination. AND I SAY HOORAY AND BLESSINGS ON THEM.
Here is the new CDC set of recommendations for chronic pain: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm . You can read them yourself.
I read to this sentence so far: “Approximately one in five U.S. adults had chronic pain in 2019 and approximately one in 14 adults experienced “high-impact” chronic pain, defined as having pain on most days or every day during the past 3 months that limited life or work activities (5).”
Part of me is horrified and part of me is calm. Because pain is a part of life. Pain, love, joy, fear, it’s all part of our emotional evolved systems to survive, right? If God is love, God is also pain and fear. It is not a split. It is both.
This song is a love song. But to me, it’s a love song from heroin to a woman. One lovely day, a place where there is no pain. There will be pain on the return, the withdrawal. I have patients say, “You need to get me pain free.” My reply was “I will not get you pain free. Pain free is dead. Or at least, they can no longer tell me if the next form hurts.” In this song, “she won’t let on, that the feelings have got so strong.” Addiction, opioid overuse.
I took the photograph of Elwha yesterday. He is my relaxation mentor.
For the last 10 or so years before I retired, I was required to ask all patients at every visit to rate their pain on a scale of 0-10 (as was everyone who entered the patient’s room). People with acute on chronic pain often used numbers way higher than 10, sometimes while talking and joking and playing with their phones. They appeared quite functional, able to get in and out of bed and complete tasks that many of my patients could not complete. Others might say 1 or 2 while unable to speak in complete sentences. Clearly, this system wasn’t working. How we assess pain and how we treat pain should be closely related. We did let people know that we could not eliminate pain but could manage it. (I skimmed the CDC article and will go back and read it more carefully later.)
I’ve written a couple of poems about that: https://drkottaway.com/2017/01/28/pain-as-a-vital-sign/
I thought pain as a vital sign was stupid the instant it was out. Why not COMFORT as a vital sigh? And the answer is: because we can’t drug it.