ENDO Messages for October, 2002: Re: Pain Management?

Re: Pain Management?

From: Anon (anonymous@obgyn.net)
Wed Oct 30 09:29:35 2002

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In reply to: Kristy: "Re: Pain Management?"

Folks:

I'm a long time lurker, recently diagnosed. I usually have no urge to get into a shooting match with Kristi. But I could not let this post go. Please do not take everything she says about Pain Management as gospel.

I have suffered migraines and cervical disc issues for years. I know a great deal about chronic pain and current therapies. Please do not believe that Pain Management physicians simply feel that endometriosis is menstrual cramps; and subsequently they don't know how to treat that type of chronic pain. While that may have been true for the physician that Kristi interacted with, to apply it with a broad brushstroke to all Pain Management physicians is untrue and unfair to the Pain Management field

Pain Management physicians have a huge arsenal of weapons at their disposal today including a range of medications (long and short acting narcotics, antidepressants, antiseizure medications, anti-inflammatory to name just a few classes), radiofrequency ablative techniques, facet injections, trigger point injections, epidural steriod injections, physical therapy, TENS, massage therapy, biofeedback, and when helpful (usually done by the partnering OB/GYN) lap scopes for lysis if ablation of lesions, adhesions, UAE, and chronic pain mapping.

Some Pain Management physicians are so into chronic pelvic pain that they do conscious pain mapping. Meaning you are sedated just enough that they get a lap scope into you, then touch the various parts of your pelvis to see the exact part of your pelvis that hurts so much. S/he then figures out what nerve innervates that organ/tissue and whether or not it can be destroyed or ablated to permanently relieve the pain. For some women, for the first time in their life they can say "THERE, right THERE, THAT'S what hurts!" And then the doc can say "BAM!" there goes the nerve to that piece of tissue, and no more pain. Granted that's a bit dramatic but you get my point about conscious pain mapping. Pain management docs are the ones that do pain mapping.

If you want to talk to some women that are receiving chronic pain management currently for endometriosis, go here:

http://neuro-mancer.mgh.harvard.edu/cgi-bin/forumdisplay.cgi?action=topics&forum=Chronic+Pain+2&number=258&DaysPrune=1000&LastLogin Do a search on endo and read the posts. There's a wealth of info there. They can tell you their current struggles, their gains, their experiences. And they can give you a perspective that is missing from Kristi's post.

Please don't let one person's bad impression of Pain Management trick you into thinking all Pain Management docs are clueless schmucks who don't have a inkling about endo or managing the chronic pain that is associated with it.

Good Pain Management for endometriosis CAN be found. The issue is that good Pain Management for **anything** is a Godsend. Finding it is not always easy. You will probably wind up seeing more than one doc before you find one that you like. And you need to be open to all therapies - not just the ones that *you* pick and chose. And you need to be willing to work in collaboration with the doc - rather than dictating to the doc how the treatment will go. Those are mandates not to endo and chronic pain, but to chronic pain *in general*. Those are the types of things you will learn over on MGH.

Just my two cents - well, probably $0.79.

A Newly Diagnosed Anon

Migraines ACDF and now endometriosis

At Tue, 29 Oct 2002, Kristy wrote: >
>Sheila,
>
>Let her know yet again that you aren't interested in Pain
>Management and that all you want is a hysterectomy. If she
>still doesn't want to do it then find another dr.
>
>Funny that you should ask about the results of Pain Management
>drs and a friend and I found out about 2 years ago that most
>Pain Management drs don't know how to treat the pain that is
>related to chronic pain that comes from endo. There are some
>that do but they are very hard to find. My friend wrote a
>letter to the Academy of Pain Management and the lady up there
>confirmed that Pain Management drs don't have the know-how to
>treat the chronic pain that comes with Endo.
>
>One would think that b/c they are Pain Management specialists
>that they would know how to treat the pain that comes with Endo
>but that's not true. The field on the whole considers Endo to
>just be menstrual cramps and that's all. The reason it would
>seem like they should be able to know how to handle the pain
>that comes with endo is b/c they know how to treat chronic pain
>in general. I had to find out first-hand that the kind of
>illness one has determines whether or not the Pain Management dr
>will help take care of your problem.
>
>I had done some research in my area to find out if there was a
>Pain Management dr that could treat the issue of chronic pain
>related to endo and one of my other female problems. When I
>asked them they said, "Huh?" (a few of them did any way). When
>I had gone to PM for a problem that wasn't gyn related in the
>late 90s I figured I would see if I could get this dr to
>possibly help me with my female problems too. So when I saw him
>after my last surgery in 1999 I showed him the pics from that
>surgery and he looked at them like he wasn't sure of what they
>were so I had to explain them to him. After I thought about
>that interchange I thought it kind of odd that he had never
>worked with patients with these kind of problems.
>
>Shortly thereafter I started finding out what I know now. Other
>women have told me their stories with Pain Management and one
>girl told me that the PM dr even told her that her gyn should
>have never sent her there.
>
>With the PCP I have now when I first started seeing her I told
>her about what had happened with what I found out about Pain
>Management drs and boy did she ever agree with me.
>
>I hope that some day that more drs in that field will take Endo
>and other female issues seriously instead of just shrugging us
>off and acting as if we are crazy.
>
>Feel free to e-mail me privately and I wish you all the best
>with everything.
>
>Take care,
>
>=====
>Kristy :)
>
>http://www.geocities.com/sokokl/kristyspersonalpage.html
>
>I am a Medical Secretary who does a lot of learning from reading on the Net, books, my dr(s), as well as sharing my own personal experiences.
>

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In reply to: Kristy: "Re: Pain Management?"

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