Much research looks at what drug works. Where it works. And how it works. This is all very well if you are targeting a small area of the body and you can guarantee that the drug only affects that area of the body. I can see that you can target a small area with a drug laden patch over that area through the skin. However, most areas generating pain are not at the surface but deep within the body. This means that a drug laden patch must disperse its drugs over a wide area not just in the area where the pain is being generated. If we look at pain killers that are taken via injection, via pills and via suppository we find pain killers are dispersed over a wide area not in the area of pain.
What do pain killers do? They kill pain and at the same time make the body less sensitive to pain. This has implications. We need pain and discomfort to prevent us from damaging ourselves and to make us aware of potential injury. Thus pain killers have the potential to enable us to injure ourselves without being aware of it. This has the potential in the long run to increase pain and discomfort because of the damage we have done to ourselves which in turn requires a larger pain killing dose. A vicious cycle of increasing dependence on greater pain killer dosage. Why are pain killers so easily dispensed? It comes down to economy of time. You can give a GP you symptoms of pain within a time scale of five minutes. The GP can write a prescription within a minute and you are out of the door within a period of 10 minutes with your prescription.
The body is an engineering system that consists of many sub engineering systems that interact with each other in unpredictable ways. We do not care what the myriad interactions are when we are healthy. We have adapted to these interactions. When things are not right as when an acute health problem strikes we seek medical attention and the advice of a medical professional. The acute health problem is gone after a short period of time. The problem occurs when what we think is an acute health problem turns out to be a chronic health problem turning into a health disability.
The body as an engineering system that consists of many sub engineering systems that interact with each other in unpredictable ways suddenly becomes problematic. We have spent a lifetime learning what a healthy body with no disability does. We are clueless as to what a body with a disability does because the sub engineering systems interact with each other in unpredictable ways. When we go and see the medical consultant we rely on the medical consultant to inform us about are chronic health disability. What are we informed about? We are informed about what the consultant has been told or read about. He gives us a synopsis of what he has been told or read about. This synopsis may be relevant and solves are health disability problem and we go away happy. After all we have plenty of other things that have social importance and require our attention. If we are in the unlucky group that are not helped by the consultant’s synopsis then we need something more substantial in the way of help to handle our chronic health disability.
What help is needed? Is it more drugs? Is it some fantastic new operation? Is it some new instrument that we can use? Is it a fantastic faith healer who can make us better? It is none of these. It is education to enable the person with the health disability to develop tools to investigate themselves. The tools to determine how we work so as to enable us with a chronic health disability to get the best quality of life that we can be capable of. Over the course of the last twenty years I have been told time and time again by medical experts working in the NHS that patients do not want to investigate their chronic health condition. And there the conversation ends and the concept never gets into the NHS “weasal worded” documents that lay out how the NHS admin want to make things better for patients in their 5 year plans. Truthfully I have better things to do than to investigate how I function. Unfortunately, I cannot do the better things that I want to do. My chronic pain situation continually reminds me of my short comings in the ability department. Thus I have to develop the tools to investigate myself and make predictions. My body as an engineering system consisting of many sub engineering systems that interact with each other in unpredictable ways when faced with a number of environmental circumstances. I have had to learn how to change how my body instinctively reacts. In reality unlearn one habitual response, develop a new better response and see whether the new response improves things or makes things worse. This is not a five minute thing or a ten minute thing. It is something that me takes hours of my time before understanding appears. The monitoring that it requires is exhausting. The handling of the emotional responses is a matter of trial and error until I get it right. It is trial and error because I have no experience upon which to draw on other than what happened the last time or the time before when I handled the emotional response.
Can we draw upon the psychological or psychiatric profession. My experience is that these professions can be very unreliable. There is a tendency to talk about research that gives numbers of people and nothing of depth. I found the dharma talks of Buddhist monks matched what was happening as I explored my emotional responses. They gave me the confidence to see those nasty thoughts I am having in response to this or that event are okay. There is nothing wrong with the response. You have not acted on the nasty thoughts so you have broken no social rules. You just have to act thus and you will find great peace. I was instructed by one monk when I had great difficulty to just sit on a cushion and engage in meditation and mindfulness and as the thoughts come they will go. This is what happened. Did not quite believe the monk at the time. But many of the Buddhist monks that I have spoken to live by a set of 250 rules and they have this amazing capacity to have happiness. The monks do a lot of meditation. I have met Christians who do a lot of praying. Praying is not my thing meditation is. I have seen at first hand that genuine prayer works and over time it is effective for quite a few people. Genuine Prayer is very different than what what scientific research investigates. A Buddhist monk I know of spoke in one of his dharma talks about prayer. He said: “Prayer is like a disease you catch it from someone who has it.” I have been with people who engage in prayer. I always find that something always changes. I talking about emotional change for the better here.
What I have been taught by the monks is that when we have something like pain which gives us grief. We can choose to add to the grief or we can choose to let the attachment to the wanting to get rid of pain go. We let go of the attachment and the pain which is still present is no longer as bad. I now politely tell the medical professional that I will not tell them how bad my pain is as a number between 1 to 10. My experience is that trying to determine my pain number always gets my experience of pain to rise. Sometimes quite considerably
Mediation: A Way of Awakening by Ajahn Sucitto is free download from
cittaviveka.org/index.php/t...
It is one of the best books on meditation and mindfulness that I know. I have re-read it many times. It has been very helpful in learning skills to handle the difficulties of chronic pain. Meditation and mindfulness takes a long time to learn because there are subtleties. The instruction is easy the understanding and correct doing of the instruction is difficult. I find it easier to practise with a group of fellow Buddhists than by myself. Practising with others also has the advantage that when something goes wrong you can draw upon the experience of others to help with any difficulties you have. When practising posture is important. The more balanced the posture the quieter the mind. You can only discover this by doing. What is a balanced posture is not easy to discern and requires close examination. I have had much help in this matter from an Alexander Teacher and a McTimony chiropractor.
Over the years the Alexander teacher has shown me over and over again that my belief in my mastery of my body’s physical state was incorrect. There were new understandings to grasp. There is a saying by Jesus about 2000 years ago. He said: “It is easier to see the spec of dust in someone else’s eye than the plank in your own.” This truth is often misrepresented. The truth is you need the help of other people to see the errors you make. Both the Alexander teacher and the McTimony chiropractor has enabled me to say this on quite a deep level of self understanding. My Alexander teacher goes to another Alexander teacher to have their subtleties of understanding challenged.
I have been having Alexander technique lessons for about 40 years. I have been treated by McTimony chiropractic on the NHS since 1993.
My study and experience of the Alexander technique and treatment by a McTimony chiropractor has enabled me to see the relationships between body posture, muscle behaviour, movement and emotion. The exact nature of the relationship is unpredictable. I do not have the ability to totally discern what my body state is now and what my emotional state now is. I can roughly discern each and that is probably as good as it gets.
I have been studying T’ai Chi for about 40 years. Before I got beaten up by a double decker bus and after I got beaten up by a double decker bus. My t’ai chi practice has enabled me to determine that moving in certain ways changes emotions. My practice has enabled me to see the relationship between various health disabilities and the way one moves. I can move in ways that can change being suicidal to removing myself from the suicidal state. When in a suicidal state it is very difficult to remember I can move from that state to a less painful state.
I have had conversation with physiotherapists about the treatment of various mental health conditions with movement treatment regimes. What is a mental health diagnosis? It is a diagnosis of a group of symptoms that coincide and match a group of symptoms listed under a particular page in the DSM. The latest DSM is DSM-5.
From wikipedia: “Various authorities criticized the fifth edition both before and after it was formally published. Critics assert, for example, that many DSM-5 revisions or additions lack empirical support; inter-rater reliability is low for many disorders; several sections contain poorly written, confusing, or contradictory information; and the psychiatric drug industry unduly influenced the manual's content. Many of the members of work groups for the DSM-5 had conflicting interests, including ties to pharmaceutical companies.[2] Various scientists have argued that the DSM-5 forces clinicians to make distinctions that are not supported by solid evidence ...”
Many chronic pain sufferers, myself included, will meet various mental health psychiatric disorder criteria that change from day to day depending on our pain, lack of sleep and environmental stresses which push internal stress above our stress breakdown point.
Mental health disability that can be treated by movement regimes include: Anorexia nervosa, Bipolar, depression, anxiety, PTSD, schizophrenia, paranoia. This suggestion is going to get complaints from psychiatrists. It puts psychiatric jobs at risk. It puts pharmaceutical companies income from drugs at risk. If movement treatment regimes work fewer mental health nurses will be needed.
I have made a strong statement. It needs to be borne in mind that the mental health disorders named above varies considerably in causes and how bad they are. So what is suitable and will work for one person at one particular time may not work for another. So the strong statement I made needs investigation for every single case. Things are not yet available yet, but it will eventually happen. Peer support for mental health sufferers is now firmly on the NHS health agenda. Peer support owes its origins to the brave and capable mental health sufferers who took courage and went to the psychiatric conferences and told the psychiatrists present at the conferences that some of what was being presented at the conferences was untrue.
Part 3 to follow
First time on Gabapentin
First appointment at St Thomas'
Macrodactyly and Chronic Pain
Pain management services
