Tuesday, June 5, 2007

The Problem of Pain

Bama's Pain

Somebody mentioned to me in an e-mail how much pain Bama has endured. I want to reassure everyone that the vets, beginning with the emergency clinic, have done an excellent job managing Bama's pain. When I first found her, I think she was somewhat in shock--she wasn't licking her wounds or anything as we drove her to the emergency clinic. I read somewhere that dogs seem to have the ability to shut down on pain when it gets to a certain level--a skill they needed to survive in the wild. Bama didn't show signs of being in pain. At the emergency clinic, they immediately gave her something to block the pain. She wore a pain patch as well as taking two Rymadyl a day for about the first week and a half or so after the accident. She was still using the patch in the picture and looks more groggy than in pain. She was still wagging her tail that day, despite everything.
She no longer uses a pain patch, but she continues to take Rymadyl. I get the impression from the way she acts now that her wounds itch more than hurt as she's beginning to heal.

Personal View of Pain: Warning--this becomes a rant and rave about fibromyalgia

My guess is that most vets are trained to think of ending suffering when an animal is severely injured, which means euthanizing them. Perhaps my viewpoint is skewed because of dealing with a high level of pain personally. I remember a point when the pain level from the fibromyalgia that resulted from a car accident was extremely high (feels like having a migraine all over your body--results in vomiting when it gets that high) without relief for an extended period of time. I told one of my friends, "If I were a dog, they would have euthanized me." I refused to consider narcotics because I felt that all I needed was a drug addiction on top of everything else I was dealing with. The medications I do use take some of the edge off the pain but do not stop it.

If any of you reading this deal with fibromyalgia, you know the frustration of having a medical condition without an identifiable cause. For example, I participated in a study of myofacial pain at a university. As part of the process, I was interviewed by a psychologist. Because I minored in Counseling Psychology when I obtained my Ph.D. in Learning Disabilities and Behavior Disorders, I am not intimidated by such an interview. Some of the folks in my Counseling Psychology class were going to be outstanding therapists; others, I shall simply say, were not. My concern was that some people with chronic pain who were interviewed by this man would be victimized by his comments.

I explained to this man that I saw a pattern of my pain being worsened by changes in barometric pressure. I tended to be better at forecasting the rain than the Weather Channel. I told him that I would wake up in the night, writhing in pain, turn on the Weather Channel, and a low pressure front would be moving through. He was so determined to prove that this pain was psychological rather than medical that he said, "Maybe you saw a cloud in the sky before you went to bed and just didn't realize it." Oh, please! Give me a break!

I told this man that Bruno Bettleheim said that autism and childhood schizophrenia were caused by "refrigerator mothers" who were unable to connect emotionally to their children. He recommended a "parentectomy" as a cure. In the sixties and seventies, his words were grabbed like gold by professionals. Now we can see the medical bases for these conditions in brain scans that were unavailable in Bettelheim's day. Can you imagine the anquish that added to these moms who were already suffering from having a child with one of these conditions?

"One day," I said to the psychologist, "you are going to owe me an apology!" I hope that day comes soon.

The danger is that when a condition is accepted as psychological, it slows research that could ultimately find the medical cause. It's scary to think that medical professionals would buy into the psychological explanations so easily. Surely they are not vain enough to assume that medicine has all the answers already and anything that is unknown must be psychological. Surely they are wiser than that! Someone once told me, "I don't believe in fibromyalgia." I assure you, this is not a condition that anyone would want for a religion. Some people say that depression causes fibromyalgia because people with fibromyalgia tend to score high on depression scores. The only way that could be said is if they tested them prior to developing fibromyalgia. When pain takes away so much of your life, you would be crazy NOT to be depressed.

Well, anyway, I finally decided that some life was better than no life, so I picked myself up off the couch and found a way to keep working. When I lost the current job that I had loved so much, I was tired of fighting to keep working. Bama's love of life--and for her, life was giving and being a part of our little family--despite what she endured, caused me to realize that I must also continue to fight to have a productive, meaningful life.

As you can tell, my view of pain is probably different than it is for most people. When I made the decision not to have Bama euthanized, it was because I was confident that she and the vets could manage the pain. I once attended a seminar by Cesar Millan who emphasized that dogs live in the moment, not in the past or future as humans tend to do. When Bama gets past this ordeal, she will truly be past it. Then she will have each day of the rest of her life without holding on to the pain of this current time. I hold the vision of that day in my mind and heart. Dogs truly have so much to teach us.

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