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.