September
16, 2003If television has taught us anything, it's that medicine has tremendous dramatic potential. News programs profile brave patients who have overcome tremendous odds to triumph over potentially lethal injury or virulent disease. Scripted dramas depict heroic health care professionals making split-second decisions while lives hang precariously in the balance. While these stories are gripping, they are only fractionally representative of the face of 21st century medicine.
The vast proportion of health care resources and services are actually used by patients with chronic illnesses like arthritis, repetitive stress injuries, peripheral neuropathy (often caused by diabetes), migraines, and fibromyalgia. Chronic illnesses are defined as conditions that last a year or more, limit patient activity, and may require continued medical care; the majority of these illnesses are marked by chronic pain.
For more than 90 million Americans and their physicians, the drama of medicine-the immediacy of miraculous success or heart-rending failure-is replaced by the long, slow grind of chronic pain assessment and management. Unlike short-term, or acute, pain-a burn, a pulled muscle, or a broken bone-chronic pain is persistent and frequently responds poorly or not at all to traditional pain treatments.
Sometimes the cause of chronic pain cannot be treated, cured, or even identified. In fact, chronic pain disorders are frequently "invisible" until they have progressed to a point at which the patient is genuinely disabled.
The invisibility of chronic pain can cause other difficulties as well. Patients' families, co-workers, and even the patients themselves may have a hard time understanding the physiological, social, and mental impact of constant or recurring pain. Because people with chronic pain conditions may show no outward signs of illness, they or others may think that their illness is "all in their heads."
Tonight's presenters,
Drs. Thomas Rudy and Doris Cope, are actively focused on alleviating the
impact of the rapidly increasing prevalence of chronic pain conditions.
Dr. Rudy will address the epidemiology of chronic pain by examining its
prevalence in and its impact on society. He will also discuss ways in
which caregivers can effectively assess their chronic pain patients. Dr.
Cope will look at the mechanisms of pain, both from the patient's perspective
and on a molecular level, and will explore current issues and treatments
in the field of chronic pain.
Thank you for joining us this evening as we investigate the difficult
and growing problem of chronic pain. While chronic illnesses may not,
on the surface, be as "exciting" as acute care, people whose
lives are transformed by breakthroughs in chronic care are finding the
changes to be dramatic indeed.
Professor of Anesthesiology
Director, UPMC Pain Medicine Program
Dr. Cope is board
certified in anesthesiology and in the subspecialty of pain medicine.
She received her medical degree from the Medical College of Georgia.
Dr. Cope was a flexible surgical intern at the Medical College of Georgia
and an anesthesiology resident at the University of South Alabama.
Dr. Cope is a noted authority on the history of anesthesiology. She
has written dozens of articles and abstracts on anesthesiology, chronic
pain, and pain medicine in the top medical journals. She is a member
of the American Society of Anesthesiologists' Committee on Pain Medicine
and is on the Board of Trustees for the Wood Library-Museum of the American
Society of Anesthesiologists. From 1998 to the present, she has been
listed in Best Doctors in America.
Professor of Anesthesiology and Psychiatry
Professor of Biostatistics, Graduate School of Public Health
Research Director, UPMC Pain Medicine at Centre Commons
Dr. Rudy's major research interests include assessment and treatment of chronic pain patients, adherence to health care recommendations, cognitive?behavioral treatment approaches, the role of perceived control in adaptation to chronic physical disease and trauma, clinical trials in the treatment of persistent pain conditions in older adults, and functional capacity testing of patients with pain and medical disabilities. Dr. Rudy has published widely and lectured internationally. In addition, he has served as a consultant to a number of agencies and hospitals and on the editorial board of several national and international pain research journals.
Print Resources
Camp Pain: Talking with Chronic Pain Patients. Jean E. Jackson. University of Pennsylvania Press, 1999.
The Chronic Pain Solution: The Comprehensive, Step-by-Step Guide to Choosing the Best of Alternative and Conventional Medicine. James N. Dillard and Leigh Ann Hirschman. Bantam Doubleday Dell Publishing, 2002.
Fibromyalgia for Dummies. Roland Staud, Christine A. Adamec. For Dummies, 2002.
Mastering Pain: A Twelve Step Program for Coping with Chronic Pain. Richard A. Sternbach. Putnam, 1987.
Mayo Clinic on Chronic Pain, 2nd Ed. David Swanson, ed., and Jeffrey Rome. Kensington Publishing Corporation, 2002.
Persistent Pain in Older Adults: An Interdisciplinary Guide for Treatment. Debra K. Weiner, Keela Herr, Thomas E. Rudy, Eds. Springer Publishing Company, 2002.
Recrafting a Life: Solutions for Chronic Pain and Illness. Charlie Johnson, Denise Webster, Steve De Shazer. Brunner-Routledge, 2002.
Sick and Tired of Feeling Sick and Tired: Living with Invisible Chronic Illness. Phil J. Donaghue and Mary E. Siegel. W.W. Norton and Co., 2000.
The Truth About Chronic Pain: Patients and Professionals on How to Face It, Understand It, Overcome It. Arthur Rosenfeld. Basic Books, 2003.
Under the Medical Gaze: Facts and Fictions of Chronic Pain. Susan Greenhalgh. University of California Press, 2001.
Web Resources
www.pain.pitt.edu/
The UPMC Pain Medicine Program is a multidisciplinary clinical, teaching, and research endeavor with offices at UPMC St. Margaret and Centre Commons. The program is committed to the evaluation and treatment of the entire range of pain, disability, and rehabilitation problems.
www.theacpa.org/
The American Chronic Pain Association provides a support system for
people with chronic pain through education in pain management skills
and self-help group activities. Groups are open to anyone with chronic
pain, regardless of race, creed, sexual orientation, or the source of
the pain.
www.painfoundation.org/
Founded in 1997, the American Pain Foundation is a nonprofit organization
serving people with pain through information, advocacy, and support.
Its mission is to improve the quality of life for people with pain by
raising public awareness, providing practical information, promoting
research, and increasing access to effective pain management.
www.ampainsoc.org/about/
The American Pain Society is a multidisciplinary organization of basic
and clinical scientists, practicing clinicians, policy analysts, and
others. The mission of the American Pain Society is to advance pain-related
research, education, treatment, and professional practice.
www.painandhealth.org/
The major goal of The Mayday Pain Project is to increase awareness and
provide objective information concerning the treatment of pain. The
project's site has an excellent index and resource center and is accessible
to everyone, from pain sufferers to family members and caregivers to
medical professionals.
www.paincare.org/
The National Foundation for the Treatment of Pain is a not-for-profit
organization dedicated to providing support for patients who are suffering
from intractable pain, their families, friends and the physicians who
treat them. It is also a resource for medical professionals and attorneys
concerned with legal issues regarding the legitimate treatment of pain.
www.headaches.org/
The National Headache Foundation is a non-profit organization dedicated
to educating patients and healthcare professionals about headache causes
and treatments.
