Military Docs Treat Pain in New Ways and Shame in All the Old Ways

Gentle readers! I know! I am going to worsen my hernia by reading this stuff every day! I can’t help myself! It’s like tearing myself away from a Star Wars Marathon and a free case of Guinness and Harp on New Years Eve Back when I was child free and in college! Did you ever hear about that drinking game?

Because what I really need right now is more news pounding home just how EEEEEVIIIIL drugs are and how in danger some of us are of becoming dependent on them!

Especially, WOES! Those poor servicemembers, because they would never ever have a reason to use them. Not with an almost decade of war going on in two countries and the highest rate of PTSD, suicide, TBI, and other things we have ever seen in our troops before.

Now, let me slow down for a moment, because there are some really good things going on here. This nerve blocking thing sounds pretty awesome, but I am not a medical professional of any type unless you were going by the number of dram bottles I have on hand. While I have a lot of not-so-nice things to say about the already “pins and needles” feelings in my hands and feet, I will take that in other parts of my body over what I deal with now thats-for-damned-sure. But the juxtaposition of a new therapy with the whole “drugs are bad, mmmm’kay” meme is wearing on my last pain free nerve. The shaming of opiate use is tired and older than my favorite period underwear.

As more troops return from the battlefield with chronic pain, the military has seen a spike in the number of prescriptions for opiate painkillers. More troubling, abuse of painkillers is on the rise: About 22 percent of soldiers admitted misusing prescribed drugs, mostly painkillers, in a 12-month period, according to the results of a Pentagon survey released this year.

So, how did their magical survey define “misusing”? Taking more than prescribed? One more? Two more? Because you were in MORE pain than that prescribed amount of pain managed and you were having trouble getting an appointment with your PCM to get the dosage adjusted or any other treatment? Anything beyond precisely what is on the label is “misusing” a prescription. The military has an entire month devoted to prescription drug abuse awareness…but what they don’t do much to address is the underlying need that might cause servicemembers to resort to such a thing; the fact that they might be in pain and they might not have doctors paying attention or being able to pay enough attention to them or their pain.

At the VA hospital in Tampa, all patients taking painkillers are incrementally tapered off them, Clark said.

Because chronic pain never completely goes away, the hospital’s staff emphasizes physical rehabilitation to strengthen muscles and joints near the pain source. When the injury involves the brain — as in PTSD and mild TBIs — the focus is on treating symptoms that could exacerbate pain.

“Pain may make it more difficult to treat those issues,” Clark said, because “all these things interact.”

But what about the remaining pain? The article never goes on to address what is done for that remaining chronic pain. You know, the pain that never goes away. Because we know that just sucking it up doesn’t work in patients who have chronic pain, and if all patients on painkillers are taken off of them over time…well then, what the hell is actually being done?

This new treatment sounds great for the people to whom it is available, and for the people for whom it will work, but let’s not jump ahead of ourselves and pat ourselves on the backs pretending that this is some magical solution that has suddenly rid us of the need for those nasty opiates or narcotics that are JUST. SO. BAD. FOR. EVERYONE. (You fucking addicts! I mean, c’mon, you were all thinking it!) (Right?) Dr. White is one of only six doctors who do what he does, and the article doesn’t say that the others offer his fancy treatment, nor does the article make any mention of how many civilian specialists are working on this treatment.

I worry that the VA and other military treatment facilities will look at this as a sign that they should be able to deny more patients painkillers. Progress will mean exactly nothing if it sacrifices patient care or hinders the quality of life of patients in chronic pain and with life-long illness and injury. While this article correctly talks about how chronic pain is processed differently by the brain not every uniformed doctor and military medical professional subscribes to that theory, and what the military doesn’t need right now is more doctors, medical professionals, or hospitals bragging about how all of their patients are off those evil, bad, no good drugs without offering them real help.

4 Comments

  1. I find it interesting that they didn’t note what they did for the people whose nerve blocks DIDN’T work at all. I had four done recently, and every time I went, everyone who I talked to said they didn’t do a thing for them. As for the rest, how dare we treat chronic pain. /sarcasm

  2. I’ve had a nerve block installed before my forequarter amputation, and wow did that (the nerve block) hurt. Oh, and it’s effects also slowly wore off over the course of a week, just like I was developing a tolerance, which Dr White says a nerve block won’t do.

    The catheter is also a huge inconvenience. It reduced my mobility because I had to be very careful with it. It was in my neck.

    It also hurt a great deal when they pulled it out of me. I could have sworn the catheter was an inch round until I finally saw that it was only a little thicker than fishing wire.

    I’d bet that nerve blocks do work for a lot of people, but they aren’t magic like Dr. White and the article seem to make them out to be.

    The electro-stimulator looks interesting, but I do doubt it would work on my phantom limb pain. Research suggests that phantom limb sensation and pain resides mostly in the brain, not in one’s severed nerves.

    His opinion of opiates and narcotics disgust me. On top of my gabapentin I need 6-8 10-325 percocet a day to function. That’s if I don’t need to dip into my massive reserves of ms-contin and hydromorphone too.

    I would like to see Dr. White experience the difference of cognitive function when one has untreated, out of control, chronic pain and when one’s pain is managed by opiates and narcotics. I’d take the latter over the former as having experienced it. I think most people would too.

  3. Excellent post. I dearly hope people are not being left with horrible untreated pain.

  4. Thank you for sharing about your own nerve blocks, because I like to hear from people who have actual experiences with the things I write about. Good or bad. When I hear about these new things that claim to “fix” chronic pain I always want to know how well it works (being that most doctors who develop them don’t have chronic pain themselves it seems).

    And R.T.: Thank you, re : cognitive function with chronic pain and narcotic management. I sit here right now, responding to comments and such because I had to toss out my plans for today, because of chronic pain that I had to treat with narcotics. Some of that plan was actually exercise that I am hounded about doing!

    I should write up something about my experiences with the military’s pain manageement clinic. They have some odd ideas about what you are supposed to do to manage pain in order to live painkiller free. Heh.