Help for Pain
Dimond, Valerie, Sarasota Herald Tribune
A new array of therapies give relief to people who continually SUFFER.
When she was in her 30s, Longboat Key resident Diane Wight, 69, was diagnosed with fibromyalgia -- a condition that causes fatigue and widespread musculoskeletal pain, mood and sleep disorders, headaches and digestive problems.
Things got worse after her hepatic lobectomy -- removal of part of the liver -- to excise a nonmalignant tumor several years ago. The surgery was traumatic, leaving only 60 percent of her liver behind. She had painful, incapacitating scar tissue that prevented her from bending.
"I was so debilitated; I couldn't even take milk out of the refrigerator," says Wight, who used a pair of tongs to pick things up around the house.
As the agony persisted, affecting all aspects of her life, Wight found herself on a medical treadmill. She had joined the ranks of people who suffer from chronic pain.
"You are pigeonholed as a particular kind of patient," she says. "Doctors think they know how to treat you because it's in your records. Sometimes it seems nothing works, and then finally you find THE doctor. A doctor that has a good referral system is extremely important."
Chronic pain -- pain that lingers six or more months beyond the time it typically takes for an injury or illness to heal -- affects an estimated 100 million Americans, according to the Institute of Medicine.
Comorbidities are common too. Fifty percent are clinically depressed. Many have anxiety, insomnia, fatigue, sexual dysfunction, isolation and other problems that peck away at joy and well-being.
THE PILL PROBLEM
Opioid medication -- oxycodone, hydrocodone, and others -- is the most common and frequently-prescribed treatment for moderate to severe chronic pain, according to a 2013 report by the American Chronic Pain Association. That's because for most people it works.
But health care providers, mental health professionals and patients know how relying on pills alone, or taking them for long periods of time, can be a slippery slope.
"Opioids carry a lot of baggage," says Dr. Rafael Miguel, medical director of the Pain Medicine Program at Sarasota Memorial Hospital's Institute for Advanced Medicine.
Miguel says painkillers usually come with a lot of unpleasant side effects -- ranging from bothersome, to intolerable and potentially dangerous. Strict laws and increased monitoring of the way opioids are prescribed and dijstributed in Florida have also forced doctors and patients to rethink treatment options.
And patients' dependency on painkillers and fear of withdrawal can keep them tethered to a medication they'd rather not take anymore.
"My experience is that patients don't want to take a pill -- they want their lives back," says Dr. Myrdalis Diaz-Ramirez, medical director at the Comprehensive Pain Center of Sarasota. "There are many things we can do so you don't have to be attached to a pill. I'm not going to really help you if I just give you the pills and don't address everything else anyway."
Wight says that because her liver is too vulnerable to metabolize strong painkillers, she has had to find other ways to cope with chronic pain -- including a combination of tools and non-opioid treatments.
Wight now enjoys a full, active lifestyle. She also facilitates a monthly chronic pain support group at the Waldemere Medical Plaza, where she and others share experiences and learn to face up to and move beyond the limitations of chronic pain.
"I can do things now -- approaching my 70th birthday -- that I couldn't do in my 40s," says Wight.
BEYOND THE MEDS
Miguel and Diaz-Ramirez say many patients, including Wight, are managing chronic pain with less or no opioid medication -- by using analgesic injections, neurostimulation implants, antidepressants, acupuncture, cognitive and behavioral therapy, biofeedback, meditation, hypnosis, exercise, physical therapy, massage, herbs, patches, analgesic creams, supplements and better nutrition. …