Category Archives: Book Review

Chronic Pain

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Chronic Pain

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I was half listening to my latest audible book on the way to my first day of orientation at the new job. I say half because it is probably the 3rd time through those last few chapters. It isn’t because the book isn’t holding my attention, it is just it is one of those books I am talking back to as I drive and listen. It is one of the books that I will order in print and highlight and take notes in the margins.  I will review the book in more detail in some future post.

But she said something that had me wanting to scream.  She said that not treating patients in chronic pain amounts to torture.  I may be assuming too much, but it seems she was overly emphasizing opioids as a treatment for chronic pain. Firstly, opioids suck at treating most chronic pain and cause many more problems that they solve most of the time. Secondly, no one has a right to a pain free life. No one.

I was getting all judgy, as I am wont to do. Talking back to the book.  Really? Torture?  How is it my fault that you smoke, don’t exercise, drink like a fish, are 75 pounds over weight and now your knees and back hurt? Really? Sounds like that chronic pain is on your side of the net that divides us in this debate over opioids. I am not going to continue every patient in pain on the unholy trinity of Norco, Soma, and Xanax.

Then, doing my best Tevye impression ( from Fiddler on a Roof), I said, “On the other hand”, What about the obese, sedentary smoker who needs medication to control their blood pressure and blood sugars both of which are out of control because of their lifestyle choices? Do I want to say, No more Metformin for you unless you start exercising? No. Of course not.  But on the other hand, I don’t see Metformin sending the patient down a slippery slope of every escalating medications with all motivation sucked out of them now do I?

I should hold off my opinion of this book until I finish it completely.  I am finding it to be a fascinating if not somewhat biased account of the state of chronic pain diagnosis and treatment.  As loud as I shouted in the car at the author, she did not respond, so I am just venting a bit here.  Torture and not giving opioids to every chronic pain patient are entirely different things. Seriously.

I am not just frustrated with the patient, I am more upset with the system that got us on opposing sides in the opioid wars.  We all know it doesn’t work to just give folks opioids. It is so much more complicated than that.  Pain management is always a trial with an “n” of 1.   Each person is different.  Even that one person is different on a day to day basis.  Not giving out opioids to every patient is NOT torture.  Please review the history of any war of your choice to get a much clearer idea of what torture is and is not.

Mad Scientists

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http://www.amazon.com/gp/product/0143113100/ref=as_li_qf_sp_asin_il_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=0143113100&linkCode=as2&tag=doegas-20&linkId=DZ4D4HZFZYWCD6O5

As fascinated as I am by neuroplasticity, I don’t know if I can finish this book.  I had just finished this author’s book, The Brain’s Way of Healing and I liked it so much I ordered extra credits on my Audible just so I could listen to this on my drive.  I was a little creeped out by the way he kept referring to any sort of kink as a perversion with its roots in childhood medical illness with painful procedures. I thought Okay, this guy is a little old fashioned using the word “perversion” to describe so many sexual acts that are not normal intercourse between a man and woman.

But then…

He started describing those experiments that Taub conducted on monkeys. I was interested in the research as it pertains to neuroplasticity, especially in stroke victims. But as Dr. Doidge described in more detail how Taub, severed nerves in the poor creatures, amputated their fingers, repeatedly opened their skulls and restrained them for weeks/months as you see below,  I couldn’t concentrate on what the whole point of the studies might have been.  I actually yelled ” What the F…” while I was driving.

When I got home this afternoon, I Googled the creep:

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I want to go grab Taub and shake him.  We had a pet monkey, Pepe, when I was young. He was like the most annoying sibling in the world but he was child like in his affections ( and tantrums). That monkey in restraints looks so much like Pepe. I can’t imagine putting any living thing through that sort of torture, but this just breaks my heart.   I know that this horrid man advanced the field of neurology and the information gained has changed the lives of so many human victims of stroke and other CNS injury. But can we honestly believe that there was not another way to get this knowledge?

images( He looks like such a nice guy, doesn’t he?)

The book may be a great source of information, but I don’t know if I can go back to it. The author seems to be excusing Taub’s methods. I just had to turn the book off for now.

What do you think? What limits should be there be in using other animals in research? Does the good outweigh the bad?