Today I didn't know what to blog about, so I called Mel at the clinic and asked him what he could tell me about pain, since I always seem to be in it. These are the highlights of our conversation:
"I'd love to help, sweetheart," he said.
"Oh, thank you, honey. Make it simple for me, okay?" I asked. And now you will see why I stressed that.
"
Pain is usually a reflex arc," he said. "Every part of a pain response is a two-part. There is the afferent and there is efferent. Afferent is affect, and efferent is effect and--"
"Wait! Honey? What was it you just said?"
"The classic is you put your hand on a hot stove and you don't know it's hot. Pain is the afferent response. As a result of the brain feeling pain, it triggers you to pull your hand back, therefore it's efferent--or the effect. It's what the muscles do in response. So a reflex arc doesn't require a higher brain function."
"Um. Mel? Mel? Honey! Wait, I can't keep up! I can't type that fast--"
"--so treating pain is a process of cause and effect. You just have to remove what's causing the pain. It isn't usually as simple as taking a hand off the hot stove. The cause of most pain is not nearly as obvious. The best thing is to figure out what's causing the pain."
"Okay, wait, I have afferent and efferent. How do you spell those?"
"If you take away the cause, you take away the pain. While you're trying ot figure it out, you give pain blockers, which are narcotics--not something the doctor will willingly give you. Ultram is a newer pain med that works pretty well and doesn't have as much of an abuse potential, so the docs are more likely to give it to you. However, if you already take narcotics for pain--"
"Mel? Mel! Slow down! I have reflex arc for the second time. Is there another word for--"
"If you can't adequately block the pain, then you distract. That is how a tens unit works. It comes from the term trans cutaneous electrical nerve stimulation. It substitutes one pain for another, but the electrical stimulation distracts them from the old pain."
"Hold it. Wait. I'm trying to type this quickly, honey. What did you just--"
"Lidocaine, on the other hand, kills pain as an anesthetic. It doesn't block nerve endings, but it numbs them. It doesn't last long, so it doesn't work well for long-standing pain."
"Okay, lidocaine. Is that spelled with an e at the end, or--"
"General anesthesia puts the brain to sleep--another way of killing pain for surgery, though of course you can't use that for chronic pain. Epidurals are versions of lidocaine, going for bigger nerves to anesthetize, so it's a regional anesthesia."
"There! That's the word I want. Chronic pain. I need to know how to treat chronic pa--"
"For chronic pain, if you have a tens unit and use it daily, that could help distract from the pain. Capzacin has a distracting agent in it that burns the skin, but the burn tends to go away if you can stand it long enough."
"All right! Now we're on a roll!"
"Benzocaine is a topical lidocaine, so that's used for sunburns or toothache. Ambesol and Orajel are toothache benzocaines."
"How can that help with chronic pain?"
"A classic example for fixing pain is to liken it to a broken bone--not to gross anyone out-- that's out of place, when you reset it, lining the bone up is probably as good at pain control as blasting the patient with pain medi--"
"No, honey, please go back to the chronic pain treat--"
"It's the same with dislocations. It hurts when something is dislocated, and it hurts getting it back into place, but the body wants you to know about the problem with a lot of pain. You fix it, you're better. Like a thorn in the foot. You don't take pain meds for the thorn in the foot, you remove the thorn."
"Okay, honey." Sigh. "I love you! Thanks for helping. See you soon! Remember, I have an appointment for you to adjust my back today."
"Oh. Okay, sweetheart. Is that all you needed?"
"Yeah, once I get it sorted out."
So, girls, you got that? You slog through those brainiac words and decipher them. My job here is done.
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21 Comments:
SAY WHAT??? ;0 /
This made me laugh so much!! Tim talks that way about power tools - I finally just have to look at him and say "Is this something I need to know right now to get this job done?" He almost always says, "no." LOL!!
I'm going to come back in the morning and read it when my brain isn't fried. Maybe it will make sense to me then. And you are to be commended on all the spelling - wow.
I think Mel had too much coffee. Two cups kick his brain into overdrive and there's no stopping it. It's like feeding the gremlins after midnight.
Oh, and there was one misspelling I can find. It was no. I spelled it on. LOL!!
This is how telented writers take something dry and make you want to read all the way to the grizzly end. What fun. Thank you.
ROTFL, Mary-Louise! Mel and I wrote our first six medical novels in exactly that way. At first I thought there was something wrong with me because I couldn't keep up. It's difficult being a "normal" working with a genius. That was the hardest work I ever did, though satisfying once I did it. I don't include nearly as much medical these days. His genius never wore off on me.
hahahahahaha... LOVED it! I agree with Tracy and Mary-Louise! :)
Glad you enjoyed it, Cyndi. It's been awhile since I've blogged something at Mel's expense. He enjoyed it, as well, though.
Ok. Let's see if I've got this:
Chronic Pain:
* Numb it
* Distract it
* Remove it's source
* Replace it with a different pain.
:-)
Crystal
You got it, Crystal. I'm trying to remove mine. Wish I knew what it was.
That's so funny, Cheryl. I can see why it would drive you crazy. I could only take so much of that doctor jargon before my eyes would be crossed. My husband tends to give long-winded descriptions about computer stuff. I'm always saying, "Just the short version, please."
Same here, Vickie. Or my favorite, back when we were writing those books, was, "Pretend I'm in kindergarten." They need to realize they speak a whole 'nother language from us.
No wonder doctors make me nervous. Perhaps it is not the white coat, after all. It's the spiel from their lips. My doctor takes off his white coat before he comes into the room. Gotta love a man for that.
Oh, Rats, Donita! Mel thought his white coat would make him look more trustworthy than if he just wore his scrubs. Surprisingly, he explains a lot to patients that they've never heard before. I hope they understand!
Too funny!! This is only one way that men are on a completely different plane/planet/hemisphere from women. AWESOME blog post.
For sure, Miralee. It's just one of the things that make them so adorable.
Here I thought it was a combination of my pain meds and a lack of sleep that has been keeping me from completely understanding everything the doctors have been saying to me over the past five months!
Linda, I'm so sorry you're in pain. Saying a prayer for you right now, and SO identifying with you. No, it's not your lack of brain, it's the different language the doctors often speak. It's a shame, too. They could help us understand so much more than they often do. I'm glad to know that Mel actually does connect with his patients most of the time. He tries hard not to make them feel stupid or talk over anyone's head. How I wish all doctors did this.
Thanks for praying. I usually think I understand until I get home and realize my husband heard things I didn't hear. I broke my arm in September and now since it is only 50% healed they have decided that I need surgery. Right after I broke my arm I had a kidney infection and the blood work from that visit showed that I am diabetic.
I broke my arm at Disneyland when I was tripped by a little boy who was not being watched by his mom. That's a whole story in itself!
Oh, my, Linda. Sometimes it feels intentional. As if these injuries are meant to happen. I hate that!
I just started reading your books. I've read 3 in the last 5 days :). They are awesome! I am an ER nurse and have thoroughly enjoyed your stories! So I stumbled upon your website and blog and after reading this entry wanted to make a book recommendation (but maybe you've already read it?) Pain: The Gift Nobody Wants by Dr. Paul Brand and Philip Yancey. An incredible book!
Niki, I'll look for this title. Thank you for the heads-up, and for the kudos!
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