June 20, 2018
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Knowing chronic pain firsthand needed for treatment

By richard s. horowitz

In his Jan. 12 OpEd, “Treating chronic pain beyond opioids,” Dr. Robert J. Ferguson suggests that those who suffer with the stigma of chronic pain may be able to survive without medication. He suggests that psychological counseling can help free us from the pain.

Sure, counseling may be of some help in dealing with the condition, but compassion for the condition goes a long way. My opinion on this subject is that unless you have lived in the shoes of a victim of chronic pain, you can’t truly treat it.

It is life-altering. It is frustrating. The pain is never gone. You have to plan everything you do around your pain. You are treated like a common street junkie looking for a fix.

It may be true that counseling someone with chronic pain is beneficial. However, that does not get rid of that nagging pain. Most medical practitioners will not and do not want to take on a patient with chronic pain. Some — and I do know a few — treat those patients with disdain. They are critical of every aspect of your “junkie” life. Medical practitioners need some clinical psychology courses themselves in how to treat patients with chronic pain with respect.

Dr. Ferguson writes of “treating diabetes with no training in blood sugar monitoring.” This statement goes two ways. Treating chronic pain by someone who has no clue as to what a patient with chronic pain feels is an oxymoron way of treatment. If you can’t feel what we feel 24-7, you can’t understand the condition and can’t truly treat it. I explain to my patients what I feel with pain and how I treat it. They don’t feel that I am just handing them a line to gain their confidence; I am in their shoes.

I have suffered with chronic pain from nerve damage in my leg for what feels like forever — 20-plus years. I was injured during a rescue while I was a volunteer EMT with our local ambulance service. I never fall below a six on the pain scale of 10. Six is my zero.

I have accepted my pain and deal with it with the best I can with help from my general practitioner, who treats my pain — and me — with compassion and understanding, exercise, heat, ice, three different supports, medications (there are meds other than narcotics), altering my life activities, support from my wife, and — don’t laugh — Lamaze breathing exercises.

I don’t think Dr. Ferguson or others who “treat” chronic pain understand what it feels like to live this way. Try walking in my (our) shoes for a while (with a limp) and see how you feel about having to either beg for or have no medications. It’s no wonder many pain sufferers turn to street vendors rather than a doctor’s office for help. One person told me “it’s easier.”

Pain is a mind-over-matter subject for me. It’s there, so I deal with it.

I just get angry seeing such a column as Dr. Ferguson’s that suggests it is so easy to treat. I get angry when a patient tells me that their medical practitioner does not listen to them or refuses to help them. I have been asked many times to “describe the pain.” How do you describe something that is there all the time, like your arm — it’s just there, morning, noon and night.

Talking about it with a shrink will not make it go away. I had a patient who was suffering with an injury that was considered chronic. The pain specialist she was sent to looked her in the eye and said, “You are just trying to make some money by screwing the insurance carrier. I see no reason for you to be having pain.” Nice.

With all due respect for Dr. Ferguson and what he seems to be passionate about, if you can’t feel what we feel — if you can’t understand what we feel — then you can’t treat it.

Richard S. Horowitz is a chiropractor in Searsport.

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