Pain and Suffering-2

Pain can cloud your judgment. Can? It will cloud your judgment. It certainly clouded mine.

Anything, I’ll take anything to be rid of this pain in my leg and hip–sciatica. First oxycodone, an opiate prescribed by my doctor. Small dose: 5 mg. No help. So then 10 mg–my doctor said I could. Then a few hours later I was going to call my cousin to tell her how wonderful life is– friends, living in the country, my dogs with me, my work–then I realized that this is from the oxycodone: relaxed, still pain but I didn’t care much, and a contented feeling. So that’s what opiates can do. Not a wild high, just a soft contentment. I would have been seduced if it also took away the pain. But it didn’t. Worse, the oxycodone and a muscle relaxant made me racy, waking up constantly at night with pain and wild, unsettling dreams, and when I got up in the morning racy, no rest, anxious. Got rid of those pills. Then my doctor said to take tramadol and a different muscle relaxant. For more than a week racy and no help with the pain. So I stopped them: no pain pills, no muscle relaxants. And for the next week I was racy, nauseous, really anxious. Withdrawal, the doctor said. Withdrawal? After so little time? No more pain pills for me.

So I continued to see a good massage therapist twice a week. Also my chiropractor seemed to help. I told him that I couldn’t take the pain pills. So he gave me a “Patient Order Form for Biotics Research Products” with his name printed on it, circling two products that would help with pain and inflammation. I should give them his name and they would send these to me. OK. Anything. I’ll take anything to get rid of the pain. I was ready to call, though I thought it funny that for nutritional supplements I had to give my chiropractor’s name to order. So I slowed down a little and looked up the company on the internet. The information on one of the supplements, Intenzyme Forte, said it supports hormone processing. Not what I need when I’m on hormone suppression therapy for my prostate cancer–and I had told my chiropractor that. So I looked up the other, KappArest. It’s good for inflammation. Great. What have I got to lose? After all, it’s just a nutritional supplement–it can’t hurt me. Clouded judgment. Me, the great critical thinker. I remembered the example from my critical thinking textbook:

Zoe: I can’t believe you’re taking St. John’s wort!
Zoe’s mom: They say it’s good for depression. And it helped my friend Sally. Besides, it can’t hurt.
They sell it at the natural foods store.
Analysis Evaluating risk is evaluating reasoning. Who are “they”? Is Zoe’s mom just repeating what she heard somewhere?
To think that Sally got better after taking it because she took St. John’s wort is just post hoc reasoning. And the idea
that if something is sold at a natural foods store then it can’t hurt you is nonsense. With a little searching on the Web,
Zoe can show her mom that researchers at Duke University Clinical Research Institute found that St. John’s wort can interfere
with other medications. And even if it were harmless, taking it instead of seeking professional help for depression can be
harmful. Saying “Oh well, it can’t hurt” is just a way to avoid thinking seriously about bad consequences.

Still, I was desperate. End the pain. So I wrote to a close friend who was a physical therapist before she retired to ask what she thought of KappArest. She passed the letter on to a friend of hers, Heidi, who is also a physical therapist. Heidi wrote to me:

“”Regarding the herbal treatment to reduce inflammation, I first searched for any scientific studies undertaken by an independent body on the herbal concoction called BRC-301 in the study. I had never heard of it, but then I am not particularly knowledgeable of herbal medicines. There is one study undertaken by academics in the Dept of Biomedical and Pharmaceutical Sciences at the University of Montana. It has been peer reviewed and was made available to the Journal of Dietary supplements in 2012, so this herbal concoction has been around since at least 2011. Their results, simply stated are below:

*Collectively, our data suggest that BRC-301 may act as an effective anti-inflammatory product with little-to-no toxicity. Because of its promising anti-inflammatory effects in vitro, BRC-301 should be considered for additional testing using in vivo models of chronic inflammation and infectious disease in addition to determining the specific mechanisms underlying its anti-inflammatory effects.*

“Essentially, this states that, in a petri dish in the lab it seems to work, but more studies outside of the laboratory, (i.e. in humans), should be undertaken. I have not been able to find any double blind studies through Dr Google. So then I went to PubMed, the National Library of Medicine to do a search on any further studies and found none more recent than the one above. So it appears that no studies have been undertaken in humans. Then I searched for contraindications to taking it and found none. As for reviews of those who ordered and took KappArest, 75% gave it 5/5, 12% gave it 4/5 and then it trickled down from there. So, one also needs to take into account the placebo effect.

“My conclusion, there does not appear to be anything harmful in this treatment, so go ahead and give it a go if you want. It is not going to hurt you and you may get some relief, or may just drain your billfold. Only in trying it out will you know. I do note that it is mostly prescribed by nutritionists and chiropractors.”

What a great example of critical thinking! I thanked her, and she replied:

“Probably, the most important part of what I said is the process of research. Anyone can do that. Mostly, scientific articles will be too difficult for lay people to read. However, reading the conclusions and checking for double blind studies or articles in scientific journals are usually enough. As for sciatica: it is very painful and disheartening. And in most cases, it will resolve itself, so coping strategies in the meanwhile are important. It takes awhile before that bulging disk shrinks back into place.”

So ended my period of severe clouded judgment. I prefer to get my placebo effects from eating dark chocolate. Now I know why people used to go to Tijuana, Mexico, to get apricot-pit extract to cure their cancer. We’re desperate, ready to listen to any authority figure related to health care, no matter how little qualified he or she is in the area of our trouble.

Fortunately, the massage and chiropractic manipulation (I do trust him for that) have helped, and the pain is much less, though I can’t walk more than about 100 m yet. Or perhaps it’s just getting better with time. Me, an expert on cause-and-effect reasoning, I can’t begin to untangle what is causing my improvement. Post hoc ergo propter hoc.

With this experience goes an old fantasy of mine. If I could just know a couple weeks in advance when I’m going to die (cancer, liver disease, . . . who knows?) then I’d have time to get my affairs in order, find homes for my dogs, sort out my writings, say goodbye to folks, give away my money and belongings, . . . . Wrong. Either the pain would cloud my judgment so bad I couldn’t do anything, or else I’d be in a stupor from morphine.

Pain, it clouds our judgment. Learning to live with pain and think clearly, that’s a big job. We have to try.

Pain and Suffering-1

After a long absence I have returned. Pain and suffering have clouded my judgment, so I didn’t write.

Early this year I found out that I have prostate cancer. No symptoms at all. Just a blood test for prostate specific antigen (PSA) that was so high it was almost certain I had cancer. Then a scan, then another scan and a biopsy. Yup, serious all right. Hooray for prostate cancer awareness month! All those blue ribbons. Anxiety, writing up a will. Hormone suppression treatment (women? what was I thinking?). No serious side effects except weary and a bit confused at first. Then radiation therapy: high doses, but just 5 treatments. My radiation therapy doctor confused me by saying that I might feel tired. I didn’t feel tired. Quite alert. So after the second radiation dose, I went for my usual 1.5 mile walk with my dogs and collapsed half-way. Not tired (sleepy) but weak. Still, this was tolerable, short-term. And all the indications are that the treatments have worked and that my prostate cancer will be in remission (don’t hope for it to be eliminated).

Then the bigger problem. No hiking with my dogs. No chiropractor or massage therapy for my back because of the coronavirus lockdown (we’ve been pretty safe here in New Mexico because of a great governor who shut everything down right away). I developed sciatica (I didn’t even know how to pronounce it: “sigh-atica”). Really bad pain. Pain pills didn’t help. Awful. And so I write my reflections on that.

English (and some other languages) conflate two different experiences with the words “pain” and “suffering”: emotional pain/suffering and physical pain/suffering. But they are different in a very important way.

I can empathize, indeed feel strongly another person’s emotional pain. I can remember similar, even distantly similar experiences, and imagine what the other person is feeling. I reach out. If I can, I put my arm around him or her. I encourage. I can help.

But physical pain? I can’t imagine the pain you have in your shoulder. You can’t imagine the pain I have in my leg. Unless, that is, you have had pain in almost exactly the same place for the same reason. Even then, it’s hard to remember pain. Thank DOG that we cannot remember pain as we can remember joy.

So sympathy, yes. But empathy, no. Thanks for your kind wishes that I recover from the sciatica. I will, but that’s another story for the next posting. Soon, I hope.

Stay safe. When there’s no empathy, let there be sympathy.

When a trout rising to a fly gets hooked on a line and finds himself unable to swim about freely,
he begins with a fight which results in struggles and splashes and sometimes an escape. Often,
of course, the situation is too tough for him.
In the same way the human being struggles with his environment and with the hooks that catch him.
Sometimes he masters his difficulties; sometimes they are too much for him. His struggles are all that
the world sees and it naturally misunderstands them. It is hard for a free fish to understand what is
happening to a hooked one.
Karl A. Menninger

Peace and Demonstrations

Every Friday for 19 years I’ve been with other folks at a peace vigil in front of the post office in Socorro, New Mexico (except during the lockdown). We’re dedicated to ending all war. Encouraged in the lead-up to the second war with Iraq, despised after the war started (“But we have to support the troops!”), now we are not only accepted but encouraged by almost all who drive by and wave. Week after week, we are now a regular part of the community. We don’t usually take a stand on elections: we don’t think there is a Republican or Democrat who wants to send their child off to die in a war or to come back destroyed from killing. Democrats as well as Republicans have led us to war. It’s enough to try to convince people that war is bad, that war should be eliminated, and that we support the troops by calling for them to be brought home.

Lately we’ve added a placard “Black Lives Matter”. Peace, the elimination of war, begins with peace at home, justice at home. We’ve always connected racism, military spending in the economy, militarized police, the rich getting richer and the poor dying, with ending war. So it was natural for us to support the Black Lives Matter movement, though we have only a very few blacks in our community (mostly Hispanic, Native American, and Anglo here).

We see the violence in some of the protests across the country. We see calls for justice that are meant to lead to action via anger. That is not the way. Anger can lead as an initial motivation, but must be left behind if we are not to do what we abhor: demonize others, destroy, hurt. There must be changes in policing, but we have to remember that there are good people who are in the police (that’s easier here in our small town where we know the police and sheriff’s deputies). Many are dedicated to helping. And for those police who are “out of control”, it is for us to ensure that there is control, and to talk with them, engage them time and time again, hoping to change minds. They are afraid, afraid that if blacks, people of color, women get power, they will do to them what they’ve done to blacks and people of color and women. They can see the world only in terms of violence, power, not imagining that we can live together helping each other. In part that’s the world we live in: America, where we compete, and if you are left behind it’s your fault, summarized with “If you’re so smart, why aren’t you rich?”

Engaging others, calming their fears. That cannot be done with anger. Anger is destructive. The “fight” for justice should not be a fight but a constant movement toward justice, talking, engaging, not being moved from our great desire for justice and peace, organizing, speaking truth to power. We at our peace vigil always remember “There is no way to peace; peace is the way.” And we remember, too, what Mother Teresa said, “Peace begins with a smile.” Peace and justice do not begin with hatred, with violence.

We’re at the Plaza every Friday at 4:45 p.m. across from the Post Office here in Socorro. Hope to see you there–or write to us about your vigils and movements.