Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

Educating the Medical Community?

AnonymousUserAAnonymousUser Posts: 49,671
edited 12/09/2013 - 3:56 PM in Chronic Pain
It has been 4 years since my surgery, 5 since my accident. I have spent a lot of time researching problems I have encountered with various pains, in addition to spinal anatomy, pharmacology, kinesiology, biochemistry, nutrition, etc. I feel like I should have my MD degree. Still I don't fully understand everything I have been going through and the continuing pain. I keep reminding myself of this when I see the DRs. Unless they have had an personal experience with CPS how can I expect them to understand. I am just so happy when I feel they believe me and want to help. They still don't teach much about chronic pain in med school, I was wondering if anyone had any ideas on how we can educate the medical community to better understand our pain.


  • terror8396tterror8396 Posts: 1,832
    edited 10/19/2013 - 12:31 PM
    i live by stanford which has an excellent hospital and i have looked at their pain management site and their doctors do take classes in pain management. most start out as anastheiologists(sp?) but they have extensive esperience in pain management. a pain doctor does not start out and say let's see today i will start pain management. they also have to take classes to continue their doctor's degrees. it is an ongoing education for not only pain doctors but for all doctors. they also read up and keep up with the research and the literature aviable. they spend many hours in office and also seeing patients that are in the hospital after surgeries and not only back. i would give them more credit for what they do and what they learn. most universities and hospitals now give classes in pain management. it is a highly specialized field that requires a lot of knowledge about the body but also medicine and how it affects the body. pain meds act differently even if they are opiates. there are reasons some will give morphine and others will give dialaudid.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • AnonymousUserAAnonymousUser Posts: 49,671
    edited 10/19/2013 - 12:45 PM
    but ALL DRs. There is an interesting article about Pain by the former head of Stanford Medical School, Philip Pizzo. If you can get your hands on a copy of New England Journal of Medicine, I would suggest you read it. He spent time on the IOM committe for pain and his experience with pain leads to the same conclusions I have.
    Working at a hospital for 20 years I have many friends that are DRs and health professionals who would agree with me also. They will get education on the lastest meds, trends etc.
    MY sister and her husband are Drs and have admitted the lack of training in chronic pain, as well as other important health issues such as nutrition, and end of life emotional issues
    It has nothing to do with credit, it has to do with improving their understanding of pain.
    I do not want to get in an argument with you, so please refrain from 'lecturing' me
  • AnonymousUserAAnonymousUser Posts: 49,671
    edited 10/19/2013 - 1:47 PM
    From the Institute of Medicine...

    "Training programs for dentists, nurses, physicians, psychologists, and other health professionals should include pain education in their curricula and promote interdisciplinary learning, the report says. Many health care professionals are not adequately prepared to provide the full range of pain care or to guide patients in self-managing chronic pain. For example, a recent study found that only five of the nation's 133 medical schools have required courses on pain and just 17 offer elective courses. Licensing and certification exams should include assessment of pain-related knowledge and capabilities. Programs that train specialists or offer training in advanced pain care need to be expanded."

  • sandisandi Posts: 6,343
    edited 10/19/2013 - 2:37 PM
    Most doctors while in medical school are not trained extensively in pain management since it is not a part of the general education needs of most specialities. There is a basic overview of treatment of pain but in chronic pain treatment, it is entirely a different ballgame, with differing modalities to manage it........acute pain is where most doctors encounter patients needs as far as pain treatment goes, a week or 10 days of pain meds post surgery or acute injury, but long term management is a different field.
    CPS is an entirely different animal and those doctors tend to be anesthesiologists, who deal with that particular pain syndrome. Pain management as a speciality , like any other in medicine, has it's own criteria for certification and education, just as anesthesiology does, or surgery does.
  • AnonymousUserAAnonymousUser Posts: 49,671
    edited 10/19/2013 - 3:02 PM
    Exactly why I used the phrase "our pain" (chronic). I don't only deal with pain management, I have my primary care, my gyn, my gastoenterologist, my ortho DRs. My old GI doc was wonderful. She knew I would need different sedation for my colonoscopies. The meds we take chronically affect so many aspects physiologically. My new GI not so, just wanted to use standard conscious sedation, didn't work.
    I think if we could find a way of being heard collectively we could have an impact on the IOM desire to a promote interdisciplinary program.
  • thank you sandi
    as i mentioned chronic pain doctors are well trained and it is a field into itself. pain doctors work hand in hand with other doctors. mine works with my neurologist and they keep in touch and when i had my 4th fusion, they worked closely together especially after my surgery. i would hate to think my pain doctor had no or little training. he has told me the extensive amount of training and conferances they have to attend. they are also closely monitored by the dea so they have to be extra careful when dispensing meds. he has to take these classes inorder to keep his liscense.unlike teachers do. like i said they do not wake up one day and say i want to be a pain doctor. they not only work with other doctors but with pharmacies also. it is a very confluted field that takes a lot of knowledge and training.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • I am not talking about pain doctors and it doesn't appear that the post from the IOM has been noted. I asked the question about better educating our medical professionals understanding chronic pain ,not whether you thought your pain DR was qualified. If everything is so wonderful, why so much frustration among forum participants.
  • Given the large number of people who experience pain and the enormous cost in terms of both dollars and the suffering experienced by individuals and their families, it is clear that pain is a major public health problem in America," said committee chair Philip Pizzo, dean, Carl and Elizabeth Naumann Professor of Pediatrics, and professor of microbiology and immunology, Stanford University School of Medicine, Stanford, Calif. "All too often, prevention and treatment of pain are delayed, inaccessible, or inadequate. Patients, health care providers, and our society need to overcome misperceptions and biases about pain. We have effective tools and services to tackle the many factors that influence pain and we need to apply them expeditiously through an integrated approach tailored to each patient."

    We are going to have to advocate for ourselves in order for the integrated approach to be tailored effectively.
  • terror8396tterror8396 Posts: 1,832
    edited 10/20/2013 - 4:11 AM
    lot of static for this but here it goes. i believe most people advocate for themselves when it comes to chronic pain. if a doctor says there is nothing wrong then one has the option of arguing with the doctor, ignoring him, or getting a second opinion. i started off with back pain and after a while it did not go away and then is could not walk without pain. i had an mri and one doctor said my herniated disc did not seem to be that bad. so instead of arguing with him, i got a second opinion after talking to my pain doctor. he referred me to another doctor and he immediately said i had to have a fusion. before my fusion, i had something called a lasar disectomy where my disc was burned off with a lasar. it made my condition worse. this was 12 years ago where fusion surgery was a big deal. it was 12 hours i was in the hospital for 10 days, i had a collapsed lung and also developed a blood clot in my calf. before surgery, it was mandator to take classes where they gave me a binder and discussed in detail the surgery, how to get around after and everything that one needed to know about back surgery. it was twice a week for a month. after surgery, my pain doctor worked in conjunction with my surgeon and they both worked on the most effective means of meds. before surgery, i had to have mri's, x-rays, cat scans, nerve conduction tests, and a test where they injected radioactive dye into me. the final test was a disography where dye is injected into one's disc to see if it was herniated. i was first given weaker narcotics such as methadone and then given 20 mg of oxycontin and then along with both doctors and myself, my doseage was increased to 40 mg 4 times a day along with breakthrough pain meds, fenatyl lollipops that started out with 700 micrograms. they also gave me nerve meds but took me off due to the side effects. i see my pain dr every 2 months and my neurosurgeon once a year where i still have mri's every year. a lot of frustration is because people don't want to spend the time with all of the tests and pre med counseling. they want immediate help without all of the other stuff and if they want narcotics they get steamed when the doctor won't give them any. at the least the doctor will give anti inflammatory and nerve meds. a lot of times doctors say they can't find anything wrong with them which makes people more frustrated. if the doctor can't find anything wrong with someone after giving them numerous tests there is not much that can be done except to give weaker meds and suggest physical therapy. if one is not willing to go through all of the things i had to then one is not being an advocate. like is said if you think the doctor is not helping you and you truly have pain, then you should get a second opinion. and if one is not willing to jump through all of the hoops that i had to then there is not much that can be done. the problem with today's society is the fact that people want things immediately without working for it. if you have had all of the tests, surgeries, and other things i had to and doctors still say there is nothing wrong, then maybe the doctor is correct. as they say, don't shoot the messenger.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • I totally agree with you. I have a rare injury and can still walk , I am very lucky that my spinal cord was not severed, I did not realise that most Drs would not have seen my condition before. I honestly don't think Dr's want to be involved in Pain Management as it can be a no win situation. I asked my GP and he said never. I asked my niece who is a Med student and she said never. I think most Drs want to be in something where they can see results. If an animal breaks it's back they are normally put to sleep.

    I have also noticed there are many charities for people who are paralysed and in wheel chairs, but none that I could find in Australia for people in Chronic Intractable Spine Pain. There does not seem to be much research especially on thoracic spine conditions. It is a hidden condition.

    I still think they should do more research and training on our central nervous systems - at least as much as they do on brain injury. I think it is because it is so hidden and they don't seem to have a way to measure spine pain, I saw an interesting movie called the 'Secret Life of Pain' where they are looking at ways to change the brain so it does not feel pain. There is a family that does not have the pain gene so they have isolated the pain gene.

    I really think they should as the number of people with chronic intractable pain has risen. This paper was written in 2010 so is a bit out of date, I posted this a while ago but I think it is still relevant. I don't know how they are going to put it into all curriculums.

    'Veterinarians receive five times more pain training than physicians.'

    'The first international pain summit endorsed that access to pain management is a fundamental human right.'

    'It was further acknowledged that failure to establish such laws, policies and systems is unethical and a breach of the human rights of people harmed as a result.'

    'A recent survey (39) of prelicensure pain curricula in health science and veterinary training programs across Canada identified inadequate training regarding pain among health care practitioners. This survey included medical schools and faculties that train nurses, dentists, physiotherapists and occupational therapists, as well as veterinary medicine programs. Only one-third of the programs could identify time designated for mandatory teaching about pain. The mean total number of hours designated for pain teaching over the entire academic training program was 15 for dentistry, 16 for medicine, 31 for nursing, 28 for occupational therapy, 13 for pharmacy, 41 for physical therapy and 87 for veterinarians (39). In other words, veterinarians receive five times more education for pain than physicians. Therefore, it is not surprising that when people in pain present to their community practitioners for help, these family physicians or, in some cases, nurse practitioners (where they are available) are not well equipped to help them. This is also true about the education of specialists with implications for pain care following painful medical procedures, trauma or surgery.'

    'The International Association for the Study of Pain hosted the first International Pain Summit on September 3, 2010, in Montreal, Quebec. More than 250 representatives from 84 countries, and professional and human rights organizations endorsed that access to pain management is a fundamental human right and contributed to the Declaration of Montreal. The declaration recognized the intrinsic dignity of all persons and the right of access to pain management without discrimination, and the obligation of governments and health care institutions to establish laws, policies and systems that will help to promote – and will certainly not inhibit – the access of people in pain to fully adequate pain management. It was further acknowledged that failure to establish such laws, policies and systems is unethical and a breach of the human rights of people harmed as a result.'

    It is essential that Canada takes a leading role in embracing the Declaration of Montreal and shows the rest of the world that it is possible to treat our citizens with the compassion and dignity that they deserve.

    Taken from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3084407/
  • you need to re read sandi's post about this since she basically says the same thing i do. to day doctors don't know what they are doing with respect to pain is ridiculous to say the least. drs have years of schooling and have to take classes for any discipline including chronic pain maybe it is like cancer, they are still learning. but chronic pain doctors have been around for years. if one thinks they don't know what they are doing, then don't go to one. chronic pain disclipine is taught in all medical schools since it is a booming industry. chronic pain drs don't treat the disease, only the pain associated with it. my neurosurgeon treats my disease, herniated disc, sciatica, and stenosis. my pain dr treats the pain associated with it and they both work in conjunction with each other. it is not something that a doctor will go into without knowing anyting, re lawsuits. anatheologists go into it because they are familiar with the meds associated with the pain such as morphine. they are the ones that administor the meds during and before surgery. and once agian aaron, it is jon if i was terror, i would sign my name on my liscense and bank documents as terror.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • no last month when people were dissing me on the site and it was like listening to people talk about me in the other room. third person talking is not acceptable. it would be like a group of posters saying aaron is dumb and does not know what he is talking about for 10 times. in a regular post that is different.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • AnonymousUserAAnonymousUser Posts: 49,671
    edited 10/20/2013 - 3:14 PM
    If anyone has any insight please PM me, I don't want this to become another 'Drs rude' forum. I won't be on this one because it has been taken over.

    Pain couses are required in 5 out of 133 medical schools in the US.
  • Well if seems someone can call me ridiculous. but I call that someone judgemental. MY post is removed. I had ignored him and whomever removed my post, remove the part he is call my beliefs ridiculousYES I can quess who it is YES I flagged his post. Nothing was done
    I have a journal article to back up my comments from the former Dean of the Medical school at Stanford and do not appreciate being attacked for my point of view
    I was reading some back post and it seems he has been doing the same thing since 2009

    Kamgram they probably removed your PM, because I did not get it.

  • Necksoup, I dont think they can read our PMs.. I will try to resend if you are still here to read :(

  • RangerRRanger on da rangePosts: 805
Sign In or Register to comment.