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Approved-By:  Bill McGarry <wtm@SHELDEV.SHEL.ISC-BR.COM>
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Date:         Fri, 28 Aug 1992 12:17:35 EDT
Reply-To:     Bill McGarry <wtm@sheldev.shel.isc-br.com>
From:         Bill McGarry <wtm@sheldev.shel.isc-br.com>
Subject:      Handicap Digest # 2897
X-To:         LHCAP <l-hcap@VM1.NODAK.EDU>

                             THE HANDICAP DIGEST

                                 Issue # 2897

                           Friday, August 28, 1992

Today's Topics:


                                ******


                            Re: General Interest
                                epidural pump
                                    RSDS
                                  more pain
                           Re: RSD Medline Search
                              More pain...not!
                                epidural pump
                              Phantom Limb Pain
                              General Interest
                              General Interest


                                ******


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Subject: Re: General Interest
From: Caleb.Burns@p0.f14.n105.z1.fidonet.org (Caleb Burns)
Organization: FidoNet node 1:105/14.0 - Busker's Boneyard, Portland OR


[This is from the Chronic Pain Conference]

It would be interested to look at addiction rates in Canada where
tylenol (and aspirin) with codeine is sold without prescription. (It's
not on the shelves -- one asks the pharmacists and can buy a largish
bottle of the stuff.) I doubt that there is a great problem with it for
people in chronic pain, but it would be very interesting to look at the
data.

--
Uucp: ..!uunet!bunker!hcap!hnews!105!14.0!Caleb.Burns
Internet: Caleb.Burns@p0.f14.n105.z1.fidonet.org




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Subject: epidural pump
From: Joyce.Lyons@f210.n232.z1.fidonet.org (Joyce Lyons)
Organization: FidoNet node 1:232/210 - The Lyons Den, Pekin IL


[This is from the Chronic Pain Conference]

 DV>  Two weeks ago they did an epidural with .03 mg. MS and
 DV> she got some relief.
 DV>  Now they want to implant an epidural pump. My question
 DV> is, Should she? anyone out there have one? what are
 DV> the pros and cons?

First of all, have you seen a specialist?  If so go ahead and do
the epidural pump.  We have heard of a fentyl pump and a morphine
pump, which they want to put in my husband.  If there is any way
possible, I would really like to talk with you over the phone, in a
letter, or over the phone.  Could you please leave an address &/or
phone # to reach you?  My husband has RSD which is a nerve disorder
which causes A LOT!! of pain.  We tried the lumbar blocks and got
very little relief.  But again if the epidural blocks gave relief
do the pump.

                                Hope to hear from you SOON!!

                                             Joyce

--
Uucp: ..!uunet!bunker!hcap!hnews!232!210!Joyce.Lyons
Internet: Joyce.Lyons@f210.n232.z1.fidonet.org




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Subject: RSDS
From: Joyce.Lyons@f210.n232.z1.fidonet.org (Joyce Lyons)
Organization: FidoNet node 1:232/210 - The Lyons Den, Pekin IL


[This is from the Chronic Pain Conference]

Hello, my name is Joyce and my husband has Reflex Sympathetic
Dystrophy Syndrome.  It is a disabling disease dealing with
nerves.  The pain has been estimated to be 3-Times worse than child
birth.  Some symptoms:  burning pains, at the same time feeling
cold, swelling of the afected limbs, discoloration ranging from
bright red to black, shrinkage of the limbs, complete loss of use
of the affected area.  Anyone having symptoms of this nature is
advised to seek IMMEDIATE PROFESSIONAL help with an RSD specialist,
NOT a neurologist.  Treatment must be done as soon as possible for
any hopes of any recovery.

We are interested in starting a support group in the area.  Anyone
wishing to join, ask questions, or need information are more than
welcome.  We are in the Central Illinois area.  To contact us,
leave a message here or leave a message in the public message area
on The Lyons Den at (309)347-7567.

                                Bye for now,
                                Joyce.

--
Uucp: ..!uunet!bunker!hcap!hnews!232!210!Joyce.Lyons
Internet: Joyce.Lyons@f210.n232.z1.fidonet.org




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Subject: more pain
From: Michael.Rooney@f737.n106.z1.fidonet.org (Michael Rooney)
Organization: FidoNet node 1:106/737 - AirBoat OnLine, Houston TX


[This is from the Chronic Pain Conference]

KM>Has anyone used one of those electrical stimulators for managing chronic
KM>pain?  I met a woman who used one, but would like more data. Some bright

Can only give you my personal experience and tell you what the instructions
said. I tried one for a week to 10 days and it was virtually useless.
The instructions say it is not for everyone and it was not for me.
Take care, Mike...

 * SLMR 2.1a * If this were an actual tagline, it would be funny.

--
Uucp: ..!uunet!bunker!hcap!hnews!106!737!Michael.Rooney
Internet: Michael.Rooney@f737.n106.z1.fidonet.org




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Subject: Re: RSD Medline Search
From: Michael.Rooney@f737.n106.z1.fidonet.org (Michael Rooney)
Organization: FidoNet node 1:106/737 - AirBoat OnLine, Houston TX


[This is from the Chronic Pain Conference]

PL>hi michael...well, the dr. tried many meds. on me..the latest being
PL>'toradol' which my tummy couldn't tolerate ...it helped the pain, but it
PL>made me sooooooooo nauseated,i ate nothing.
PL> so i use a 't.e.n.s.' unit most of the time...plus get in spa often for
PL>water therapy...i can take 'soma compound' during day.
PL> tell me more about yourself,
PL>take care...
PL>paige

I also tried a TENS and it was useless. I am fortunate in that I
have been able to tolerate any medication that I have tried.
Currently lortab and meclomin with an occasional valium if I get
to tense and once in a while a steroid burst. Like most of us I
have my good and bad days and lately there have been more bad
than good. The upside is I know the better days are coming.<g>
Take care, Mike...

 * SLMR 2.1a * --T-A+G-L-I+N-E--+M-E-A+S-U-R+I-N-G+--G-A+U-G-E--

--
Uucp: ..!uunet!bunker!hcap!hnews!106!737!Michael.Rooney
Internet: Michael.Rooney@f737.n106.z1.fidonet.org




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Subject: More pain...not!
From: Mark.Munson@p0.f14.n279.z1.fidonet.org (Mark Munson)
Organization: FidoNet node 1:279/14.0 - Project Enable, Dunbar WV


[This is from the Chronic Pain Conference]

KM>Has anyone used one of those electrical stimulators for managing
KM>chronic pain?  I met a woman who used one, but would like more data.
KM>Some bright news to share: after nearly a year of insurance auditing
KM>into hospital charges relating to my bone marrow transplant, the
KM>insurance company will be paying over $67,000 they've been quibbling
KM>about.  I pay $0!  What a weight lifted off my head!  Hope to hear
KM>from you all soon.

Kathleen,
   I use a muscular stimulator for different reasons.  For muscle growth
   and vascular problems.  The concept is the same though.  Neural
   (spelling) muscular stimulation really only over rides you natural
   messages from the brain and cause a contraction or stimulation to a
   muscle group or nerve group.

   With chronic pain, this is what the goal is to over stimulate a
   nerve.  It's like being in shock after a traumatic injury (right
   after).. Not meaning to be crude, but a gun shot victim, or amputee
   victim etc... initial pain, but over 90% of the time they will all
   tell you they did not feel (specific pain).  A stimulator does a
   similar thing by giving direct electric shocks to a specific muscle
   group or nerve group and the chemical reactions between the neural
   transmitter become disrupted or blocked, thus electronic numbness.

   I am not a doctor, just someone who has used one for years..

   As with any type of therapy... It doesn't work with everyone, but it
   has for me.  Again for different reasons, but the concept is the
   same.

Mark

 * SLMR 2.1a * Honey turn the stimulator off, Standing on my head is ...

--
Uucp: ..!uunet!bunker!hcap!hnews!279!14.0!Mark.Munson
Internet: Mark.Munson@p0.f14.n279.z1.fidonet.org




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Subject: epidural pump
From: Arthur.Saus@p160.f72.n376.z1.fidonet.org (Arthur Saus)
Organization: FidoNet node 1:376/72.160 - Windows of the Worl, Columbia SC


[This is from the Chronic Pain Conference]

Hello David!

06 Aug 92, David Venable writes to All:

 DV> Hi. My wife was injured on the job two years ago and has had hronic back
 DV> pain since. After bone scans,MRI, Cat scans and nerve induction (EMG?)
 DV> studies, they still can't find the cause. Two weeks ago they did an
 DV> epidural with .03 mg. MS and she got some relief. Now they want to implant
 DV> an epidural pump. My question is, Should she? anyone out there have one?
 DV> what are the pros and cons? Thank you,

I don't have one myself, but maybe I can tell you something about this
 technique.  For many patients with severe pain, this is a tremendous pain
 relieving therapy.  In fact, it does such a good job at relieving pain, that
 this is one of the main problems with it!

Do I have you thoroughly confused?  I thought I might with that
statement.  Let me explain further.  Although none of us like pain,
and usually go to great lengths to avoid it, or get treatment for
it when it can't be avoided, pain is not all bad.  Pain is an
important signal that something is wrong and suggests the need for
medical attention... at least to figure out what is wrong.  The
epidural administration of a narcotic is a powerful technique to
block pain, but it is not selective.  That is it will block pain
from a large part of the body, not just the back pain.  If she
later develops some other medical problem (such as appendicitis for
instance), there may be no pain associated with it. If there is no
pain, a problem that would normally be identified early in its
course, may not become apparent until the disease process is
farther along and much more serious.  That is, it may be much more
difficult to identify, then by the time it is identified, it may be
much more difficult to treat... or may have much more serious
complications.

One other consideration, which may or may not concern you, is that
the implanted epidural pump is expensive and requires a minor
surgical procedure to implant it.  The prices I usually see are
around $7000.00 to $8,000.00 just for the implantable pump itself.
This does not include the hospital charges and the physicians' fees
to implant it and provide medical management.  The price I quoted
is just for the hardware itself.

Now after telling you these "negatives", let me again re-emphasize
that it does indeed provide tremendous pain relief, and usually
with fewer side effects such as sedation and mental confusion than
when narcotics are administered by any other route.  This is
because the narcotic is being delivered directly to the area where
it can be the most effective in blocking pain.  Because of this, a
much lower dose can be used than if the narcotic was being
administered by some other route such as getting an injection or
swallowing a pill.

I feel like I've given you a lot of information about this
technique, but the decision about whether use of this pain
management technique is the right thing in your particular
situation must be decided by you (or your wife in this case), and
the physicians providing the medical care.

Arthur

--
Uucp: ..!uunet!bunker!hcap!hnews!376!72.160!Arthur.Saus
Internet: Arthur.Saus@p160.f72.n376.z1.fidonet.org




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Subject: Phantom Limb Pain
From: Arthur.Saus@p160.f72.n376.z1.fidonet.org (Arthur Saus)
Organization: FidoNet node 1:376/72.160 - Windows of the Worl, Columbia SC


[This is from the Chronic Pain Conference]

Hello Shari!

07 Aug 92, Shari Messner writes to All:

 SM> friend that has just gone thru amputation - below the knee right leg.
 SM> He is doing well but has TONS of phanthom pain.

 SM> Any suggestions, length of time for relief etc.

Unfortunately, this is a very difficult problem when phantom limb
pain occurs. It will not necessarily go away with time, and there
is no specific therapy that will eliminate phantom limb pain after
it occurs.  He may find evaluation and therapy by a pain clinic
helpful, since there are some medications, physical therapy, and
other approaches that may help reduce his pain.

Arthur

--
Uucp: ..!uunet!bunker!hcap!hnews!376!72.160!Arthur.Saus
Internet: Arthur.Saus@p160.f72.n376.z1.fidonet.org




------



Subject: General Interest
From: Shelby.Sherman@f67.n123.z1.fidonet.org (Shelby Sherman)
Organization: FidoNet node 1:123/67 - Shelby's Swamp, Bartlett TN


[This is from the Chronic Pain Conference]

 > SS>I wish that I had more time to reply to this as I am
 > SS>getting ready to catch a plane.  Doctors should not worry
 > SS>about addiction, as the pain is real and should be treated.
 > SS> Again, sorry for the brevity.

 > No problem, thanks for the vote of confidence.  I agree.  I
 > think they
 > can monitor what they give the patient but at least TRY.  I know
 > Nat
 > would keep a close watch on himself.  He just wants some kind of
 > relief.
 > You know the ole sleep or lack of and continous pain wears on
 > one..
 > Have a great trip.
 > Shari

I'm back.  It is interesting that you should mention the sleep or
the lack of.  Many times when the patients are put on a strong
narcotic and finally get pain relief, they sleep a lot.
Unfortunately, this is often mistaken for sedation when in reality
the patient is just catching up on much needed sleep.  Pain is a
natural antagonist to the sedating or respiratory depressing
effects of narcotics.

--
Uucp: ..!uunet!bunker!hcap!hnews!123!67!Shelby.Sherman
Internet: Shelby.Sherman@f67.n123.z1.fidonet.org




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Subject: General Interest
From: Shelby.Sherman@f67.n123.z1.fidonet.org (Shelby Sherman)
Organization: FidoNet node 1:123/67 - Shelby's Swamp, Bartlett TN


[This is from the Chronic Pain Conference]

 > It would be interested to look at addiction rates in Canada
 > where tylenol (and aspirin) with codeine is sold without
 > prescription. (It's not on the shelves -- one asks the
 > pharmacists and can buy a largish bottle of the stuff.) I doubt
 > that there is a great problem with it for people in chronic
 > pain, but it would be very interesting to look at the data.

Addiction is often confused with tolerance or physical dependence
which are quite different from addiction.  Addiction is quite rare
among cancer patients, less than one tenth of one percent.  I was
not aware that tylenol w/codeine was available without a
prescription in Canada.

--
Uucp: ..!uunet!bunker!hcap!hnews!123!67!Shelby.Sherman
Internet: Shelby.Sherman@f67.n123.z1.fidonet.org




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                                ******

                  End of Issue # 2897 of the Handicap Digest

                                ******
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