Why day 6 is really day 3355 in Chey Cobb's chronic pain management nightmare

Day 6 and we are keeping hope alive (despite day one, day two, day three, day four, and day five). In a moment I will explain why day 6 this is more like day 3355, but first an update. As the saying goes: My wife is resting uncomfortably. She has an appointment with a new doctor on Wednesday and, eternal optimists that we are, we are looking forward to that.

Chey reading on the aft deck of Home Shore, an 80-foot fishing trawler making the Inside PassageYou pretty much have to be an optimist to live through years of chronic pain as my wife has done. Sometimes hope is all you have to go on; hope of relief, hope of achieving management of your pain at levels that make life livable.

Chey's 50th birthday was 3,355 days ago and she was in pain that day. I remember because I baked a Baked Alaska and she only had a very small slice even though I did a pretty decent job of it (the Baked Alaska was to go with her present: passage for two on an 80-foot fishing trawler sailing from Sitka in Alaska to Seattle).

On that trip, in September of 2003, Chey had yet another really painful migraine. When we got back home she had a bad reaction to a seizure medication they sometimes prescribe for migraine. It is hard to remember any pain-free times since then.

Sadly, there is growing evidence that chronic pain is not only painful, but also life-threatening. We read on Web MD that Severe Chronic Pain Lowers Life Expectancy. The article states:
Previous research has demonstrated a clearly negative influence of chronic pain on health. Now, a new study portrays a profound link between severe chronic pain and death; inflicting nearly a 70% greater mortality risk than even cardiovascular disease.

The study indicates that even after you adjust for sociodemographic factors and the effects of long-term illness, "patients with severe chronic pain had a 49% greater risk of death compared with all-cause mortality and a 68% greater risk of death compared with all cardiovascular-disease-related deaths."

I appreciate that the author of the article agreed with me that "The most critical information to take away from this research is that withholding appropriate pain medication is a virtual death sentence." In other words, this means that doctors who "don't believe in" using narcotic pain medication "are sentencing some of their patients to an early death."

Now, put this in the context of my wife's recent experience, being cut off from pain medication for seeking more medication. The author writes:
"families and friends of severe chronic pain patients must never try to dissuade the patient from using all appropriate treatments and medications to reduce pain. Convincing such a patient to avoid narcotics, if and when they are appropriate, is equivalent to pushing them into an early grave. Instead, physicians and families must encourage the chronic pain patient to employ each and every possible treatment, including comprehensive pain management programs and powerful pain medications. It is no longer a matter of making someone more comfortable. It's a matter of life and death."

The referenced article is: Torrance N, Elliott AM, Lee AJ, Smith BH. Severe chronic pain is associated with increased 10 year mortality. A cohort record linkage study. Eur J Pain. 2010(Apr);14(4):380-386. As the author of the WebMD item notes, this new research is comprehensive, vetted and validated. There is a link to the abstract here: http://updates.pain-topics.org/2010/04/severe-chronic-pain-is-killer-study.html

If you would like a copy of the full article, leave a note in the Comment field and I will see what I can do.

1 comment:

  1. Dear Stephen:

    I am sorry about your wife's chronic pain situation. After a catastrophic accident in 2007, my wife has suffered from chronic pain. Nothing seems to help except a change of doctors.My wife now resides in a nursing home. We have not given up hope or the fight. We make the best we can out of life. I would like to communicate with a Cobb relative from Kent in the UK. Can you help? Bruce W. Cobb

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