Pain

Our refrigerator, not surprisingly, is covered with photos of our kids, mainly of them in their sports uniforms. This morning as I was getting some orange juice, I stopped to study them and I was particularly drawn to the pictures of the boys posing with their baseball bats. You know, where they are standing as if in the batter's box waiting for a pitch. Of course I felt a sense of wonderment over how handsome they've become, but the most striking feeling I got was that of: Wow. I bet it would hurt for me to swing a bat right now. Good thing I'm not playing ball.

Is that what it's come to, being 40? I am literally in a constant state of pain in some form or another. Right now it's particularly bad because I did a heavy strength workout yesterday and my muscles are killing me. But I also have my sore elbow, sore knee, bunion on my left foot... And a history of hip bursitis and god-awful back pain that, thankfully, are no longer bothering me. When did it start, this falling apart of my body, and why didn't anyone warn the 20-year-old Jami that this would happen?

Some may be surprised that I have these problems because I am so active. Others would not be surprised because they see how I beat up my body. Pain doesn't really prevent me from doing what I want (well, for the most part), but it does take away some of the enjoyment.

And my pain is pretty minor compared with the millions who suffer chronic debilitating pain. I have a client who lost her job due to pain - she simply couldn't work anymore - and appears to be jacked up on narcotics every time she comes in to the vet clinic. What kind of life is that?

I also have an 8 year old nephew who gets migraine headaches that send him to bed for hours at a time. Think of how much he is missing, having this condition. And he's only eight!

But what can be done?

I am very interested in the pathophysiology of pain, and in the next two years I plan on delving deeper in the topic of pain management in animals. This interest stems from my own experience with pain, and also the fact that it is such a hot topic in the human medical world. People are living through injuries and diseases that would have killed them a hundred years ago, but now many of them have to deal with the repercussions of what has happened to their bodies. Also, repetitive motion is much more common in these days of factory work or computer typing, or in my case, performing surgery and dental extractions that I feel are contributing to my elbow tendinitis. Rather than doing most or all of the tasks related to survival, we are now very specialized, and with that comes overuse injuries.

Unfortunately, with all that science and medicine can do, it still cannot come up with a reliable, relatively side-effect-free way to manage chronic pain.

This morning on NPR I listened to an interview with David Loxtercamp, a physician and author of A Measure of Days: The Journal of a Country Doctor. He listed 14 things that he feels he has learned as a doctor, and that he is trying to put to use now in treating his patients:

Health is not a commodity. Risk factors are not disease. Aging is not an illness. To fix a problem is easy, to sit with another suffering is hard. Doing all we can is not the same as doing what we should. Quality is more than metrics. Patients cannot see outside their pain, we cannot see in, relationship is the only bridge between. Time is precious; we spend it on what we value. The most common condition we treat is unhappiness. And the greatest obstacle to treating a patient's unhappiness is our own. Nothing is more patient-centered than the process of change. Doctors expect too much from data and not enough from conversation. Community is a locus of healing, not the hospital or the clinic. The foundation of medicine is friendship, conversation and hope.

Well, I am not sure how much that really has to do with pain, but I did find it profound, especially the part about the most common condition being unhappiness. Being happy sounds like a topic for another blog entry, but I do think that we all suffer with physical pain much more than anyone really thinks. How much of your life is dampened by pain? No fair answering if you're a young pup of 30. Just wait, is all I say.