European Stars and Stripes (Newspaper) - June 5, 1990, Darmstadt, Hesse Captive to a Savage dictates of by Kay Bartlett associated press two years and a couple of months ago i lost control of my life. Pain took Over it regulates nearly every moment of my waking life holding me captive to its Savage dictates. Twice a night too it comes to visit sometimes just to say hello and remind me it is still around other times to visit for a Long Chat. Pain makes me irritable it makes me cry. It sends me into fits of rage and sloughs of despair. My pain stems from a neck injury suffered in a fall that ironically was caused by a medication which dumped my blood pressure and sent me into a Semi convulsion in my Kitchen. I woke up choking on my blood not sure How Long i had been unconscious. The immediate damage was quickly assessed. I had knocked out my two front Teeth. Although my neck and shoulders ached it seemed like the kind of pain that Spain control new approach spares patients misery by Elisabeth Rosenthal new York times Are Volu t tonary approach to pain control pioneered at research centers Over the last 15 years is gaming rapid acceptance at hospitals across the United states. Leading the revolution in sparing patients from considerable misery is a new Type of doctor a pain so cast he brings to the bedside an Ever improving unde it standing of the mechanisms that cause Pam and new technologies to fight it. Quot we have changed the Way doctors about pain a or Richard pah director of the pain treatment Center at the University of Rochester until recently p arc cans were a nod to accept some discomfort and 1o use Power Ici pain medications sparingly he Sard. Cd. Dron were treated with special caution and infants Oft n v. A not heated for pain at ail a Quot a a a Mac Csc ii heat mint or Mem Char c run Csc of. Kwh a a a a a a r h help Quot a t a m a it a Romp ?. Quot find m the Ardc end 1 l \ a t inic a a t n act ii Narrcie is that Are take. Cir Quot a c i a Orpi of a i a nun Appl c of or. V. Fay f a Admir or Anu fee a bad go a Puich if a a a . Via it a tar Vuch the skin. Tois. To pc. Tech Iraq pcs Pai. Free inc a Sor cos. A my 11 Csepi by 1 a l Over inc pm acc a a s ult c i a a Tief i a a a nation s first acute a n so. A w. a n Quot a at the Irv Ven 1y of v. A a m e eat co i services am Gener Rily run by of ogints or soot Iii gone Are the Days when pain doctors wore widely considered the Snake Oil Salesman of the profession. Treating Pam was sort of quackery mixed up with hysteria women and acupuncture Quot said or. Kathleen Foley a neurologist who is director of the pain Relief service at Memona Sloan Kettering cancer Center in new York Quot scientific studies and advances in neuroscience have moved us out of that realm and into the realm of respectability Quot Quot i think you can argue that until very recently pain did t get treated a or get treated Well Quot said Foley. In the last decade a number of studies have shown that doctors and nurses routinely under treated patients discomfort fearing that they would become addicted to painkillers like morphine and that the drugs could dangerously lower their breathing rate Quot the typical pattern was the doctor ordered less than was helpful and the nurse gave less than was ordered Quot ready said. Research indicated that 35 to 75 percent of patients did not get adequate pain Relief after surgery he said. Experts say recent experience has proved these worries unfounded. Narcotics Given for pain control produce Only temporary physical dependence and Are not terribly addictive said Patt. Even cancer patients who Are on morphine for weeks Are readily weaned from it when they enter remission he said. Quot in fact we have to warn them not to Stop the narcotics suddenly because most can to wait to get off Quot said Patt. The drugs often have unpleasant Side effects like grog Giness and constipation and patients Are eager to shed them and their association with the disease. Two discoveries in neuroscience further paved the Way for new treatments. Although morphine an opiate has been used to quell medical discomfort for More than a Hundred years it was not until the mid-1970s that scientists first discovered How opiates work to relieve pain. The receptors Itiat recognize the drugs the researchers found a e concentrated in the spinal Cord and in a Small Region deep within the brain. The pump was first Mea eted in 1s84 new an estimated 40 percent of hospitals in the United states have at least Cne. Trough Many Are still inexperienced in using them and few off or them routinely. The pump we h contains a solution of morphine or another rare i c d hoc led up to an inf ravenous i m in the Parent s Arm and r at so that pres sing a Button do Ems a pro Meam a dose into tire l Ood steam. The Oahe Tir a Crest ire Button As often As needed a a a Caput or in a Imo d Quot or an a ire pump sets seme Sammy i v s Fiuzi might be set to deliver ene Milligram doses at least eight minutes apart with a total dose of no More than 30 milligrams in four hours said ready. Even before these safeguards come into play he went on Quot most patients who press More than they should just get drowsy and fall asleep Quot from the morphine and Quot no harm done Quot experts who have used the technique say it avoids Many Pitfalls of earlier techniques. There is no waiting for a nurse to answer pleas. Different patients need different Levels of medication and the pumps can generally take these needs into account. And the drug is delivered directly into the bloodstream so it works instantly. A patients react with great enthusiasm and the enthusiasm is greatest from patients who be had surgery before Quot said ready who has also used the pump to treat j pain stemming from a variety of conditions from Bone marrow transplants to sickle cell disease Quot they say this is dramatically studies show that the new technique does not control pain much More effectively than does properly administered conventional treatment. But Foley said patients Are much More satisfied with Quot the sense of control Quot and added Quot the patient can tolerate More pain because they know they can have pain meds whenever they want once scientists discovered clusters of of a o receptors in the spinal Cord it was a Short next step to Zee if infusing opiates into this Region would Preven. The spinal Cord is Tine common pathway f from All Over the body doctors have Long in aesthetics into the Region but Only in the i have they tried to inject narcotics specs via. / pain without the Genera numbing and by anaesthesia. Comfort to la pal 1. Nor to Ore fans 2. A i f i i c c i i o i. J v h j i in As Damn Tot c h spi Lal co urn. 3 transmitted to the brain 3. Information is relayed to the thalamus sensory Center in the brain. 4. The information then travels from the thalamus to the cerebral cortex where the brain deciphers the message to find the location and intensity of the damage. Relief 5. Brain sends Relief by sending signals via the spinal Cord to the dorsal Horn. 6. In the dorsal Horn chemicals such As endorphins Are released to Lessen the pain message from the thumb. L Page 16 a a a the stars and stripes tuesday june 5, 1990
