[Fwd: more pain info/Christina, GeoB et al.]

[George Boyer]

George Boyer wrote:

> Jill - have been thinking more recently about the pain-sensation
> differentiation problem.  I'm wondering how prevalent "real pain" is vs
> "interpreted sensation".  The distinction I'm currently making is that
> pain is what was happening when I fell and broke open my stump the day I
> left the hospital......whereas sensation is the feeling of the
> stump-limb-phantom which is there more or less steady state and comes to
> consciousness whenever we are not mentally 'concentrating on' (read:
> minds are occupied by) something else.  These definitions may probably
> themselves end up being the crux of the discussion but pretend for a
> minute not so.  My contention is that the problem of misinterpreted or
> corrupted sensation is far more prevalent than pain.  (And, of course,
> that it is not appropriate to medicate for it except with tranquilizers
> and such.)  The problem is generally that a person becomes an amputee
> hating the idea beforehand because of the attitudes absorbed from the
> culture......then, being depressed by self-image and the reality of
> being an amputee, all of the sensations related to the stump and the
> images of moving around with the limb missing are INTERPRETED through
> these attitudes about amputation as being pain.  This is not pain in the
> sense of damaged tissue or spasm of muscles and nerves, as I see it.
> This is so widely true that I think a major effort to educate all new
> amputees would pay off big time and reduce headaches for everybody
> working with amputees in the early weeks and months.  George.
>
> "Jill P. McMahon" wrote:
>
> > The recent supplement of the Jnl of Pain Symptom Management
> > (Vol 19, no. 1, Suppl, 2000) has a number of articles
> > re: the use of NMDA-blockers, most recently, dextromethorphan,
> > as opioid adjuncts. -Jill