HEY, watch your fingers there, lady! :p

Example not really necessary; let's call it what it is - "milking it". Is that "touchy"? :rolleyes:

Veterinarians are keenly aware of it - I know of a couple who tell their animal patients (only half-jokingly) to milk it with their owners to get extra petting/treats. Doctors are already well-aware too, but it begins back with pediatricians. Hey, it's learned patterned behavior reinforced by our mothers/parents. It may be subconscious for a few, but I think most really know deep down when they're doing it. I have advised... more than once on this site that people not act-out their pain/symptoms while in a doctor's presence (office, ER, hospital). This is addressed on quite a few of the sites that come up when I suggest people google: talk doctor pain. I've gotten some disagreement/flack on this point (acting out for doctors) so I'm with you on that one - I'm just not one of the people that does it (exception: domestic partnership, but that goes both ways, and nobody's fooling anyone. :D There's a difference between, "Poor sweet baby" and, "Get off your butt and feed the dog!" which, oddly enough, have actually occured in exactly that order... :rolleyes: )

I don't think I'd be so quick to put all that onus on chronic pain; anyone with any kind of chronic condition/disease is apt to fall into similar patterns. There appears to be an age element as well (second childhood?); it's the end of the world - until BINGO night. Then they're suddenly 20 years younger and a whole lot spryer, and don't get in their way... (...and I know all about adrenalin and something to look forward to...)

There's another end to that spectrum too; those that suck it up so completely because it's deemed "weak" to allow any kind of emotion/vulnerability to be seen/witnessed. That's wrong too, because those people, who really need help, are afraid/ashamed to admit/accept it, even when refusal is further detrimental. They can wind up - too often - as suicides, and that does harm to everyone.

I think we're really talking about another bell curve here.

From everything I've read, seen, and experienced with regard to the crisis in pain management, not to mention many conversations with doctors & nurses, the majority of problems stem from too many bureaucrats playing doctor - or wanting to - plain & simple. The way the system is currently set up (and works) a person would have to be crazy to even try, let alone want, to abuse it; there are too many hoops to jump through, and too much abuse to take - it's not/wouldn't be worth it. It's far easier and less expensive for junkies to get their fix on the streets. The "crisis", along with the majority of addicts & system abusers, can be dealt with very easily - end the war on drugs, and let the doctors practice medicine without interference of government and insurance companies.

This is not a chronic pain patient being "touchy" either; this is the pragmatism of one who has looked at this problem for over thirty years (decades before it affected me personally, from studies in Constitutional law, American & world history, anthropology, and others) and believes it is time to fix the problem - not the blame.

I have yet to meet a chronic pain patient who wouldn't do - or give - anything to be out of the system and productive again.

Doc

mrsD I have long believed in the conception of the "solicitious spouse", although I didn't know what it was called. A long history with a range of medical issues has taught me the danger of paying too much attention to and even looking for symptoms. I used John Sarno's books to pretty wheel get over bad chronic back pain.

I have also seen in friends and family with cancer that will power and thinking alone will only get you so far. With PN one of my strategies is to tune out from the symptoms, a bit like TRT therapy for tinnitus, it won't get rid of the problem but it makes it more livable.

So while I am actively pursuing medical solutions, I'm also using supplements, exercise and a program developed by Jon Kabat-Zinn who is a is Professor of Medicine at the Stress Reduction at the University of Massachusetts Medical School.

The best advice that I got from this forum is to work with the medical profession, but to also "own" and the charge of working with my condition.

I considered not bringing up the topic at all.

It was only a part of my seminar, which included habituation and how habituation is mediated in the brain. People become habituated to food, sugar, gambling, smoking, and other things because of basic reinforcement cues from the brain. Chronic pain is only one example where reinforcement may occur.
Starting off the seminar was an amusing example (this speaker used alot of humor) of a common habituation behavior which he delivered in the punch line=LOVE. We all fall in love at one time or another (hopefully) and this involves habit behavior, need and has a withdrawal, and involves dopamine to some extent. In fact my new kitten, Houdini, is really really attached to Weezie which now, she will roam the house calling for her. Never had a cat do THIS, in 40 yrs of having multiple cats at a time. So it even occurred to me that Houdini has reinforcement needs for her feline PAL. ;) (Houdini is very unusual anyway, and that is why I picked her out...she is very very loving and gentle).

I've controlled my pain issues carefully like RideOn is posting about. I continued to work, and do most activities until I became too old to keep up with the stamina required. My fall and injury to some thigh tendons, was the last straw for me, and it was time for me to retire anyway. Too much stress nowadays in my work, and 13hr days often in a row, standing is just impossible for me now.

I'll also say for the newbies, I've actively pursued many avenues for my pain myself. Various patches, rubs, low level laser, ice, special shoes, magnets, and of course dietary and supplement supports. Focusing on learning about PN, pain, and looking for
ways to live with it, has reduced the pain loop for me, I believe.

We DO have to become master of our own minds and bodies today. It is a learning skill, and people have to understand that results are slow in coming, but will come for many.

That can easily be extrapolated to include anything that brings pleasure/joy.

Likewise, which is why I often couch it in terms of a journey or process. The last few weeks, especially, have been such an improvement as to motivate me further to what more I can accomplish (with regard to coping with pain).

Doc

The reinforcement process in the brain has positive and negative aspects. Negative reinforcement is defined psychologically (and somewhat differently than lay people think), as removal of a painful or noxious state by the behavioral action of the person.

Hence taking an aspirin to relieve a headache is called negative reinforcement in this context.

Much of reinforcement according to the expert I listened to involves less than what we would call "pleasure". Relieving hunger, for example, is just a reduction in some stimulus from our body to eat something. Eating something "decadent" however may cross over to pleasure.

Pain relief, for chronic pain is not going to be "pleasureable" therefore, as it is being done to remove a painful stimulus and not create euphoria or a "high".

This is not to say that some people here on PN should not consider heavy duty opiate therapy for their PN. Some PNs are so painful, there is no quality of life possible past a certain point. Deciding what to do is a personal decision, and if you and your doctor decide heavy duty pain relief is necessary, you will have to do it or at least consider it.

The net is really full of papers on habituation, reinforcement and other psychological investigations on this subject.

For the most part today, the thrust of both seminars I attended was in lifestyle interventions. Obesity and weight gain, being the primary target, and not chronic pain.

Thanks for the articles. Very interesting reading. This makes me wonder if it's worth getting a chest CT scan at all. I am not displaying any chest pains with my PN, or ay other type of pain apart from sore feet and hot hands and sometimes floatiness, so l don't want to put my body through extra risk of anything anymore.

Also the article on pain showed the the mind and how you interpret pain is crucial to leading a happy life. It's seems to be a process most people go through, and being aware is very helpful.

Sue:

At this early stage in your PN... all I would expect from a chest Xray or CTscan is evidence of lung tumors or masses.

What are you expecting to get from this test? Did I miss something?

It's is a generic list of tets attatched to my report, so it's not directed at me personally, he gives it to all patients with PN.
So it's up to me to decide if l get it done or not.

I had my lungs x-rayed a few years back and showed nothing, so not sure if l should bother with a ct scan. Don,t even know what it's for?

Sue

There is a type of PN called paraneoplastic PN.

This comes secondarily to cancers...mostly of the lung.

So a thorough doctor might want to rule out cancer. Some lymphomas will show up in a CAT scan of the chest too.

Sue,

If it were me, I would look at my probability/risks for a lung problem of this sort (cancer) - Anyone in the family had it, smoker, job or other exposure to carcinogens like asbestos, history of other cancer, etc. Then I would have a discussion with the doctor to find out why a catscan vs. x-ray (which I wouldn't be so hesitant about) and if a standard x-ray will suffice. Is he screening for other cancers as well? Is there some blood test result that's raising some suspicion?

What I find curious/puzzling is why a catscan (given what's known about them today and the rarity of this type of PN) would be given as a generic screening(?) but I'm not a doctor. I am curious as to the answer.

(That's 4-5% of patients with cancer - NOT 4-5% of patients with PN)

Doc