From: Arthur.Saus@p160.f72.n376.z1.fidonet.org (Arthur Saus)
Newsgroups: misc.handicap
Subject: Let's Get Started
Date: 6 Oct 92 21:04:31 GMT
Reply-To: Arthur.Saus@p160.f72.n376.z1.fidonet.org
Organization: FidoNet node 1:376/72.160 - Windows of the Worl, Columbia SC
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Index Number: 24673

[This is from the Chronic Pain Conference]

Hello Phyllis!

07 Sep 92, Phyllis Cohen writes to Arthur Saus:

 PC>  We're talking such generalities here!  Statistics tell us what the
 PC> probability is of something, but just because there is only one-tenth of
 PC> a millionth chance of something, doesn't mean that the person you're
 PC> talking to can't be that very one-tenth of a millionth person!

I agree wholeheartedly!  If you have been following other
discussions in this echo, I believe you will have noticed that this
is the same idea I have been trying to convey to many others.
Statistical probabilities are great for describing a population,
but have little meaning when applied to a specific individual.

 PC>  Do you know if any formal studies have been published such as what I
 PC> described to Linda?

I believe you are referring to the question of an association
between intervertebral disk disease and spinal or epidural
anesthesia.  Again, I will state that there is no literature
suggesting there is a relationship here.  I have researched many
anesthesiology texts and journals, and have even done a Medline
search looking for any literature suggesting there may be a
relationship, and have found nothing.  As I'm sure you understand
however, you can't prove that something does not exist.

On the other hand, a spinal or epidural injection of a drug, is not
associated with the intervertebral disk.  It certainly is
associated with the back, but not the intervertebral disk.  Spinal
and Epidural anesthesia and complications associated with these
procedures have been extensively studied and well documented in the
medical literature.  Since no literature suggests a disk problem is
associated, it seems fairly unreasonable to suggest that this
procedure could later lead to complications in what is basically an
unrelated part of the anatomy.

 PC>   It does seem like something that could get funded  if
 PC> anyone was looking for something to do a longitudinal study on.  At
 PC> least, it ought to, if it turned out that folks were becoming disabled
 PC> because of some little glitch in the procedures that no one ever thought
 PC> would make a difference.

I'm sure it would be well funded and studied if there was a
reasonable chance of establishing the relationship you have
suggested.  I would think the cost of this long-term study that you
have suggested would be enormous, with very little chance of
proving any relationship or improving patient care due to the
reasons I have outlined above.

I would not think this would be an area where resources should be
invested.  It would be far better to invest those resources in
areas of research that would have a far better chance of results
that could improve peoples' lives.  Even the government does not
have limitless resources to invest in studies that have little
chance of producing results; studies that are funded at least
appear to have a chance at the beginning of "producing a return"
for the investment.

 PC> And, it would save the government big bucks in
 PC> disability benefits and medical care if it could be improved.

Yes, I'm sure there are "big bucks" expended by the government due
to disabilities related to intervertebral disk problems.  It is
highly unlikely (virtually impossible) however that these problems
are in any way related to spinal or epidural anesthesia
administration.

Arthur

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