Understanding Chronic Pain

Attention Deficit Disorder

[From Chapter 17 of Understanding Chronic Pain]

She described a life of relative contentment until the appearance of her pain. Her first husband died of cancer when she was fifty-five, and she remarried two years later to an old friend, himself a widower. She denied any history of depression, drug or alcohol abuse, or childhood trauma. Since the appearance of her pain, she had become sleepless with frequent painful awakenings. She denied any sense of despondency, saying only that she was frustrated by her pain. She was and had always been, she told me, contented and ever hopeful for the future. I performed my examination. There was tenderness over the muscles of the back of the neck and some limitation of neck motion but little else.

I was perplexed about why this thing had happened to her seemingly out of the blue. I anticipated that somewhere along the way the answer would be forthcoming. It usually is.

"Helen, I am writing a couple of prescriptions for you. One is for a drug called Imipramine. It is an antidepressant, and it has been around for a long time. The other is for Klonopin, an anti-convulsant that has been around almost as long. I want you to understand that I am not treating you for depression or for seizures. I learned many years ago that these drugs and some others like them can be very helpful in the treatment of chronic pain. I think there is a real prospect for you improving."

"Are they addictive drugs? I am very fearful of addiction."

"Why is that?"

"My son had a problem with drugs."

"I am very sorry. I know how distressing that is to you, and I understand your fears. There is some risk of addiction with the drugs I am giving you, but I don't anticipate any problem. Addiction usually begins in youth, and at your age I seriously doubt there will be any kind of problem if you take the medicines as I prescribe.

Could you tell me how your son is doing now?"

She replied, without batting an eye or the least show of emotion, "He is in prison."

Sam entered the conversation. "And her son's wife died of an overdose."

I've heard this kind of story too much. I offered my sincere condolences and said to her, "I know this is a terrible burden for you. Are you getting by, are you doing okay?"

You can read the rest in Dr. Cochran's book, Understanding Chronic Pain

Last Updated: Nov 19, 08:34 AM

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Neurogenic Inflammation Summing Up