Chronic Pain

Yesterday was injection day. I do all of the injections in one day, primarily due to Botox. If you have left over botox from one vial, you can use it for the next patient. At $500 per vial it seems a shame to waste the left over from one patient. So it was chronic pain day. Injections can help alleviate some of that for a while. But many of us suffer with pain that seems to be permanent. It's not a question of eliminating it. It's a matter of living with it. But living with pain is hard. It seems so strange. We think that there should be a diagnosis that causes the pain with a treatment for that diagnosis. But it isn't like that. There are several stumbling blocks. Some people have pain that is chronic and severe without a very clear cause. Others have a good diagnosis but the treatments aren't very effective. I see so many people who just have pain every day. Most of them just have it all of the time. It's tiring. They tend to develop depression. All we do together is try to reduce it. They try to cope with it. There are articles written about how people do better if they are told that they will have to live with pain. I'm not convinced that helps very much. Some people find solace in knowing that others are "much worse off". Others believe that even this type of suffering has a purpose. It might help to know that everything possible has been tried. Some of us can accept it. Some of us are broken in spirit by it. Narcotic medications help some people. They hurt some people as well. It's a very confusing entity, chronic pain. There isn't very much that I know about it generally because it seems to me that every individual with chronic pain is very different. Stress makes pain worse. That's true for everyone. But stress makes everything worse. Anti-stress is not an easy thing. But there's one thing that I think is true. People need each other. So if we can just "be there" it helps. I don't really do a lot for many people in a medical sense. This is especially true with the chronic pain syndromes. But the patients know that I'm there. They know that I listen. They have a sense that "I'm there". And that's helpful. With a lot of friends and family, they are abandoned. That's because we don't like seeing pain. We don't feel comfortable when someone we care about has pain and there's nothing that we can do. This is also true for many physicians. It's a deep need that we have. We have to help to fix the pain; we have to DO something. But the patients pretty much know that whatever we do, it won't do much. So the doing isn't really doing anything. That's why the doing nothing is actually what does the most. We do nothing, we're just being there. That's what helps. It helps because it decreases the loneliness that comes with the pain. Pain isolates us. I don't mean that we don't have to try everything that there is that might actually decrease the pain. We do that, of course. But it doesn't seem to be as powerful as the not-doing. It's very strange.