Sunday, March 31, 2019

How Pain Tolerance and Anxiety Seem to Be Connected - The New York Times

An article this week about Jo Cameron, who has lived for 71 years without experiencing pain or anxiety because she has a rare genetic mutation, prompted questions from New York Times readers.

The notion that the same gene could be responsible for the way a person processes physical and psychological pain left many perplexed: Aren't they totally different? Or does her story hint that sensitivity to one type of pain might be intertwined with sensitivity to another?

Childbirth, Ms. Cameron said, felt like "a tickle." She often relies on her husband to alert her when she is bleeding, bruised or burned because nothing hurts.

When someone close to her has died, she said, she has felt sad but "I don't go to pieces." She cannot recall ever having been riled by anything — even a recent car crash. On an anxiety disorder questionnaire, she scored zero out of 21.

"I drive people mad by being cheerful," she said.

Here's a bit about what's known.

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https://www.nytimes.com/2019/03/30/health/pain-anxiety-jo-cameron.html

At 71, She’s Never Felt Pain or Anxiety. Now Scientists Know Why. - The New York Times

She'd been told that childbirth was going to be painful. But as the hours wore on, nothing bothered her — even without an epidural.

"I could feel that my body was changing, but it didn't hurt me," recalled the woman, Jo Cameron, who is now 71. She likened it to "a tickle." Later, she would tell prospective mothers, "Don't worry, it's not as bad as people say it is."

It was only recently — more than four decades later — that she learned her friends were not exaggerating.

Rather, there was something different about the way her body experienced pain: For the most part, it didn't.
Scientists believe they now understand why. In a paper published Thursday in The British Journal of Anaesthesia, researchers attributed Ms. Cameron's virtually pain-free life to a mutation in a previously unidentified gene. The hope, they say, is that the finding could eventually contribute to the development of a novel pain treatment. They believe this mutation may also be connected to why Ms. Cameron has felt little anxiety or fear throughout her life and why her body heals quickly.

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https://www.nytimes.com/2019/03/28/health/woman-pain-anxiety.html?

Monday, March 18, 2019

Opinion | Is Pain a Sensation or an Emotion? - The New York Times

The United States uses a third of the world's opioids but a fifth of Americans still say they suffer from chronic pain. The only demonstrable effect of two decades of widespread prescription of opioids has been catastrophic harm. With more than 47,000 Americans dying of opioid overdoses in 2017 and hundreds of thousandsmore addicted to them, it was recently reported that, for the first time, Americans were more likely to die of opioids than of car accidents.

This has forced many to take a step back and ponder the very nature of pain, to understand how best to alleviate it.

The ancient Greeks considered pain a passion — an emotion rather than a sensation like touch or smell. During the Dark Ages in Europe, pain was seen as a punishment for sins, a spiritual and emotional experience alleviated through prayers rather than prescriptions.

In the 19th century, the secularization of Western society led to the secularization of pain. It was no longer a passion to be endured but a sensation to be quashed.

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https://www.nytimes.com/2019/03/16/opinion/sunday/pain-opioids.html?

Sunday, March 10, 2019

Could The Cure For A Rare Chronic Pain Disorder Be ... More Pain? : Shots - Health News : NPR

There's a before, and there's an after.

In the before, it was a relatively normal night. The kind of night any 14-year-old girl might have.

Devyn ate dinner, watched TV and had small, unremarkable interactions with her family. Then, around 10 o'clock, she decided to turn in.

"I went to bed as I normally would, and then all of a sudden ... my hips... they just hurt unimaginably!" Devyn says. "I started crying, and I started shaking."

It was around midnight, but the pain was so intense she couldn't stop herself — she cried out so loudly she woke her mother, Sheila. Together, they did everything they could to neutralize the pain — stand up, lie down, hot bath, pain medication. But there was no escape, not for Devyn, and so not for Sheila.

"You go to cancer first, right? It's like, 'OK, maybe you have cancer, maybe it's a tumor?' " Sheila says.

When she was calm enough to reason with herself, Sheila decided cancer was improbable but wondered what was going on? The only thing they could think of was that the hip pain was somehow related to the minor knee surgery Devyn had gotten a few months before — she had broken the tip of her distal femur one day during dance practice.

So as usual, Sheila snapped to attention to solve the problem. It was 2016 — surely modern medicine could fix this. (NPR is not using Devyn's or Sheila's last name to protect Devyn's privacy as a minor discussing her medical treatment.)

They started by calling Devyn's surgeon, but the surgeon had no explanation for the pain. He renewed Devyn's prescription for Percocet and wrote a new prescription for tramadol. But the pain only got worse, so they lined up more appointments: their pediatrician, a naturopath, a pain specialist, a sports medicine doctor.

Every doctor's visit was the same. The doctor would ask Devyn about her pain: Where was it, and what was her pain number on a scale from 1 to 10? Then the doctor would order some tests to find the pain's cause.

But no matter where the doctors looked in Devyn, all they saw was a perfectly normal body.

"You are healthy. Nothing is wrong." Those are the words the doctors said to Devyn and Sheila over and over again. It made no sense. And it felt, paradoxically, like the more attention they gave to the pain, the bigger the pain grew.

More ...

https://www.npr.org/sections/health-shots/2019/03/09/700823481/invisibilia-for-some-teens-with-debilitating-pain-the-treatment-is-more-pain?