Melanie Thernstroms new book, The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the Science of Suffering, is not only a history of the nature and treatment of pain, it is a corrective to the misunderstood diagnosis of chronic pain.
Chronic pain is itself a disease. It may have started out as a result of an accident, a medical procedure, an illness, a different disorder or illness that caused the pain. But Thernstrom clarifies that chronic pain has its own distinct neuropathology: untreated pain can eventually rewrite the central nervous system, causing pathological changes to the brain and spinal cord that in turn cause greater pain. Pain perpetuates pain in a cycle from which there is often no escape or respite.
Chronic pain affects nearly 70 million Americans, yet it is undertreated. Some of the medications that would most help, opiates like Oxycontin and Percocet, are often withheld from legitimate cases because of the danger of abuse by patients. Yet those who suffer from pain are often so depressed they feel like killing themselves anyway. Which is worse?
I didnt realize how much chronic pain changes your life until my friend had several operations on her back after two car accidents. We could no longer meet for breakfast, lunch or coffee. Not just because she couldnt drive anymore because of both her pain and her medications for pain but because she couldnt sit upright for very long. When I brought her to my house so I could help fill out her Social Security Disability application, the only comfortable spot for her was laying on her back on my carpeted floor. It was incomprehensible to me that she was denied SSDI the first two times she applied, despite compelling evidence that she could no longer work as a nurse, or at anything.
That was early in her new life of pain. I have only visited her at her house in the last few years and my visits rarely last more than an hour and have to be timed based on her ability to medicate the pain. I have picked up prescriptions for her at the pharmacy, records from her doctor, and I never go to her house without asking first if she needs something from the grocery store. To simplify shopping as well as food preparation, she only eats a limited number of basic foods. Its always yogurt, cereal, milk, nuts, and fruit.
