Entries in Pain (19)


Girl with Rare Disorder Can't Feel Pain

Jupiterimages/Thinkstock(NEW YORK) -- From scratches on the playground to spills while biking, parents are constantly trying to protect their children from pain.  But what if pain was the one thing your child needed the most?

While Ashlyn Blocker may seem like a normal 12-year-old girl who loves pageants and playing the clarinet, she suffers from a rare genetic disorder that prevents her from feeling pain.

Blocker was born with congenital insensitivity to pain with anhidrosis (CIPA), a disorder that affects the way signals travel from her central nervous system.

Unlike most babies, she never cried when she was hungry or had a diaper rash.

“Everyone thought, ‘Oh, what a good baby you have,’ you know,” said Ashlyn’s father, John Blocker.  “But the signs, as time went on, the red flags started going up.”

Her parents first realized that something was wrong when they took their 8-month-old to the eye doctor to treat her irritated eye.

“When they put the dye in her eye, everyone kind of gasped,” John Blocker said.  ”She had a big corneal abrasion across her eye.  They were just astonished that she wasn’t in pain.”

The doctor’s visit led to the diagnosis of CIPA, which affects only about 100 people worldwide.

“It was scary because, you know , there weren’t very many good outcomes that were involved with this condition,” said Ashlyn’s mother, Tara Blocker.  “I mean, you know, people passing away from appendicitis because they didn’t have the warning signs -- and bone infections.”

Ashlyn’s toddler years were the most difficult for her parents.

She would injure herself, “biting, burning her hands, different things,” John Blocker said.  “Tara actually would wrap her hands up with athletic tape.  She’d be our little boxer.”

The family has photos that document injuries that Ashlyn sustained as a toddler.  Her father said sending his daughter out the door every day, not knowing what would happen, was “rough.”

University of Florida researchers have been testing Ashlyn since 2004.  A few years ago, they pinpointed the gene that affects the strength of pain signals sent to the brain.  The findings might offer new treatments for people with chronic pain, but are not likely to help with Ashlyn’s condition.

Copyright 2012 ABC News Radio


Flesh-Eating Disease: Severe Pain Leads Symptoms

Cassidy Cline(NEW YORK) -- When a leaky trash bag brushed his ankle during cleanup at his daughter's kindergarten class picnic two years ago, Doug Murphy initially thought nothing of it. But bacteria that entered through his ankle created a flesh-eating infection that nearly cost him his right leg – and his life.

By the next morning, he noticed "a black mark, about the size of a quarter" that he dismissed as a spider bite, located where fluid from the leaky bag had seeped through his sock. By the second morning, his temperature was 105, he couldn't stand and the black area had expanded to "the size of a pineapple. You would be scared it if was you," Murphy recalled Wednesday.

At a nearby emergency room, a savvy infectious disease specialist who examined him "thought it might be necrotizing fasciitis," better known as a flesh-eating bacterial infection. That's about the last thing Murphy remembers. He was admitted to intensive care and placed on powerful antibiotics. His kidneys began shutting down, his blood pressure sank and his temperature soared to 107.7 as the infection spread beyond the leg and throughout his bloodstream, causing sepsis. He began hallucinating and was convinced "I was invited to Brad and Angie's secret wedding in L.A."

His temperature hovered at 107.7 for days, breaking just as doctors were planning to amputate his right leg. Murphy remained hospitalized a total of six weeks before he was released with a gaping leg wound that took a year to heal. The leg, he says, looked "like you poured acid on it and it dissolved down like in [the movie] Alien."

Today, the 45-year-old father of two from Brooklyn, N.Y., says his scarred right leg doesn't hold him back as an operator of academic summer camps, or as singer-songwriter for his country-rock band. However, the infection badly damaged lymph nodes in the leg, which swells each day and must be elevated in the evenings.

Murphy was infected with Group A streptococcus, which can live harmlessly on the skin or cause strep throat, but is also the leading cause of flesh-eating bacterial infections. They also can be caused by several other organisms, including aeromonas hydrophila, staphylococcus aureus and vibrio vulnificus.

Aimee Copeland, a 24-year-old Georgia student, lost her leg almost two weeks ago to an aeromonas infection contracted in a zip line accident, and Lana Kuykendall, a paramedic from South Carolina, continues to battle a flesh-eating infection that developed soon after she delivered twins.

Murphy is among survivors who have shared their stories with the National Necrotizing Fasciitis Foundation, founded by Donna Batdorff of Grand Rapids, Mich., and Jacqueline Roemmele of Watchung, N.J., who lived through similar infections and now try to help fellow survivors and patients navigate through the care and complications associated with a condition that kills one in four patients, according to the Centers for Disease Control and Prevention.

Batdorff and Roemmele heard from "tens of thousands" of survivors worldwide and are aware of at least 25 cases in which people were sickened more than once. Batdorff developed her infection while skiing in Colorado in 1996, but ignored escalating symptoms. She ended up unconscious in a hospital and woke up to her sister telling her that doctors had amputated parts of the fingers of her right hand.

One of the tricky things about necrotizing fasciitis, she said, is that "sometimes there's terrible, ugly, bulbous nasty blisters – you know there is something really wrong. But in my case, there was nothing that was really visual like that. No alarming visual signs."

Roemmele became sick in 1994 after an abdominal hernia repair that led to two hospitalizations. The ordeal left her with a hip that even today looks as if she suffered "a shark bite" as well as residual nerve damage in her fingers.

Batdorff says there are several practical considerations that can improve the odds of surviving the disease, starting with quick attention to what seem like minor skin openings: "When you get that paper cut, when you cut yourself a tiny bit with a knife, when a staple punctures your finger, when you prick your finger with a rose thorn -- the smallest, tiniest opening is an opening that bacteria can get into-- and it can kill you," she said. "The preventive is don't ignore these things. Go and wash it, put antibacterial ointment on it and cover it."

Second, she said, is recognizing that these infections can send out warning signs, including "pain that's disproportionate to the size and scope of the injury. And it's not just a little bit of pain, it's pain like you've never felt before." Other signs can be flulike symptoms, lethargy and even feeling delirious or buzzy. "That is the time when you need to get to the doctor. Just get to the emergency room."

Once in the emergency room, speak up. The symptoms often are mistaken for the flu, for brown recluse spider bites and "more people than I can ever begin to tell you about have been sent home to take antibiotics, or rest, or drink fluids ... and they come back the next day. Sometimes people are sent home a couple of times." Such patients often die "before someone figures out what's wrong with them."

"The problem is that necrotizing fasciitis behaves like a wolf in sheep's clothing," Roemmele said. "It masks itself as many things. The initial diagnostic tests like MRI or CT scan often won't show anything."

She said that many doctors have a mantra: "If you hear hooves outside your window, chances are it's a horse and not a zebra," meaning that you should first consider the obvious explanation. "Our point is, physicians need to be trained to look at necrotizing fasciitis as a horse and not a zebra."

If you suspect the disease, ask doctors to rule it out. Batdorff cited the case of "a gentleman whose wife said to the emergency room staff, 'could this be the flesh-eating bacteria?' They said no. And it was. And he died."

Copyright 2012 ABC News Radio


How to Feel Less Pain at the Doctor's Office

Siri Stafford/Photodisc/Thinkstock(NEW YORK) -- Whenever the doctor says “you’ll only feel a pinch” when giving an injection, it may feel more like a punch. Now, you can do yourself a big favor, according to one German researcher, by not watching the needle -- because it tends to hurt less that way.

“Throughout our lives, we repeatedly experience that needles cause pain when pricking our skin, but situational expectations, like information given by the clinician prior to an injection, may also influence how viewing needle pricks affects pain," Marion Höfle explains.

Höfle’s team studied participants watching video clips of hands being pricked by a needle or just hands alone as the participants also received painful or non-painful electrical stimuli applied to their own hands.

The bottom line was they complained of more pain from the electrical stimuli when watching videos of the needle pricks than just seeing clips of hands. So they recommend looking away the next time you go in for a shot.

Copyright 2012 ABC News Radio


One-Third of Cancer Patients Don't Get Drugs They Need for Pain

Pixland/Thinkstock(HOUSTON) -- As many as one-third of cancer patients may be receiving inadequate treatment to control their pain, even though many medicines are available to help, new research suggests.

Pain is one of the most-feared and worst symptoms of cancer.  As disease progresses, pain can become completely debilitating for cancer patients.

Dr. Michael Fisch, lead author of the study and chair of the department of general oncology at MD Anderson Cancer Center in Houston, said he undertook the research to get a better grasp on how many cancer patients need pain control and assess the current methods.

"We didn't understand enough about how people are being treated," he said.

In the largest U.S. study of its kind to date, Fisch and his colleagues looked at more than 3,000 patients for over a month who suffered from invasive cancerous tumors of the breast, prostate, lung, colon or rectum.  The patients, who were undergoing treatment at 38 different medical institutions, completed a 25-question survey, and researchers recorded the medications they were taking.

The researchers then determined the adequacy of the patients' pain management using a scale that compared the patient's symptoms of pain to the strength of medication they were taking.

At the start of the study, two-thirds of patients required medication to manage their pain.  The researchers found that of these patients, one-third were taking insufficient medications to control the pain they were experiencing.

Thirty days later, when they repeated the questionnaire and examination of the patients' medications, the situation had not improved; the percentage of patients who reported that their pain was undertreated was roughly the same.

"Past studies just looked at one snippet in time, so we wanted to see if improvements are made once the patient has good follow-up," says Fisch.  "This shows there is still work to be done,"

Surprisingly, physicians in the study were aware of the problem; in fact, for decades, doctors across the country have been aware that undertreated pain among cancer patients is a problem that needs to be addressed.

Given the constantly changing and progressing symptoms of cancer, doctors say that managing the associated pain can be difficult.  What may be successful pain management for a cancer patient on one day may not suffice the next.  Or the medication could become more than needed.

In the study, about 30 percent of the patients who were initially undertreated did gain control of their pain over the month-long study.  But 10 percent of the patients who were originally treated appropriately lost control over their pain by the follow-up visit.

Another problem that doctors face is objectively determining how much pain a patient is actually experiencing.  The commonly asked pain assessment question -- "What is your pain on a scale of one to ten?" -- often does not paint a complete picture, doctors say.

Copyright 2012 ABC News Radio


Vitamin D May Ward Off Menstrual Pains, Study Suggests

PhotoAlto/Alix Minde(NEW YORK) -- There may be some relief from the monthly period cramps that afflict almost half of all reproductive-aged women, a small trial out of Italy suggests.

Looking at 40 women -- aged 18 to 40 -- who had experienced painful menses at least four months in a row over the past six months, researchers gave half of them high-dose vitamin D, and the other half a placebo, and followed them for two months.  The vitamin D group experienced a significant decrease in their monthly period pains – quantified as 41 percent down from initially reported levels, most notable over the first month, with levels then holding steady for the second month; the latter group did not show any overall improvement.  

Also of note, none of those given vitamin D used additional pain medication, whereas 40 percent of the other group relied on Motrin-like drugs.

While this study was small and further investigation is needed, it offers some potential hope for women suffering from debilitating cramps.

Their research was published in the Archives of Internal Medicine.

Copyright 2012 ABC News Radio


Do Women Feel More Pain Than Men? Study Says 'Yes'

Pixland/Thinkstock(STANFORD, Calif.) -- Pain affects more than 116 million Americans annually and is a major cause of work disability and one of the most common reasons for taking medication, according to a 2011 Institute of Medicine report.

Of those Americans, about 50 million are women, according to the Campaign to End Chronic Pain in Women.

On Monday, a new study in the Journal of Pain reports that women seeking medical care for a wide range of medical problems in the hospital or clinics at Stanford University School of Medicine reported higher pain intensity, on average, compared with men with these same diagnoses.

Women reported more intense pain than men in 14 of 47 disease categories.  Men did not report more intense pain in any category.  Women with musculoskeletal disorders such as back, neck and joint pain, sinusitis and even high blood pressure reported more intense pain then men with these conditions.

Authors cautioned that this study cannot determine whether pain is actually experienced more intensely by women or whether women simply communicate better with their health care providers about pain.

But many other medical experts are skeptical about the Stanford study.  They say the authors didn't account for the possibility that if many women had additional diseases that caused pain, it could actually be the other diseases -- and not their gender -- which is responsible for the women having more pain than men.

"It's a flawed study," said Dr. Lloyd Saberski, medical director of the Advanced Diagnostic Pain Treatment Centers at Yale University.  "Just how accurate is the data collected?  Probably not too accurate."

He said the study was "dangerous" and potentially misleading and adds "nothing" to doctors' understanding of pain.  Researchers did not control for factors such as coexisting depression and disease severity, he said.

Copyright 2012 ABC News Radio


Doctors Express Concern over New 'Addictive' Painkiller

iStockphoto/Thinkstock(WASHINGTON) -- It has yet to hit the market, and already a powerful new painkiller is arousing debate among doctors specializing in pain management.

The drug is a new formulation that would allow doctors for the first time ever to prescribe pure hydrocodone to their patients. According to the National Institutes of Health, hydrocodone is already a component of 404 separate branded drugs; in each case, it is mixed with some other medication. Vicodin, a well-known example, is a combination of hydrocodone and acetaminophen, which is the active ingredient in Tylenol.

But should such a product even be available, particularly in light of the country’s growing battle with prescription painkiller addiction? At the center of the debate is the question of whether the possible benefits of such a pill, which would potentially carry many times the amount of hydrocodone than the amount in current combination medicines, would outweigh the risks linked to the addictive potential.

"Oh, it is very addictive," said Dr. Lloyd Saberski, medical director of the New Haven, Ct.-based Advanced Diagnostic Pain Treatment Centers. "But so are oxycodone, Dilaudid, Demerol and morphine. Why should this product be discriminated upon more so than the other products?"

Saberski added that existing FDA regulations would protect the public from the misuse of this new drug.

Other pain management physicians say adding pure hydrocodone to the mix of addictive prescription pain drugs already available will only make the country’s painkiller abuse problem worse. One of these physicians is Dr. Joel Saper, founder and director of the Michigan Head Pain and Neurological Institute in Ann Arbor.

"I don’t think we need another opioid," Saper said. “We need better education, more sanity, and we need to stop treating benign pain with more narcotics."

Saper said that while it would make sense for pain management doctors to be able to prescribe hydrocodone as a painkiller without the acetaminophen in Vicodin -- which can cause acute liver toxicity if too much is taken -- there are currently other approaches available to doctors that allow them to treat pain with existing drugs.

Saper said that adding another drug to the mix would be a mistake in light of the country’s prescription drug abuse problem.

Copyright 2011 ABC News Radio


Expert Tips for Tackling Your Pain Problems

Creatas Images/Thinkstock(WASHINGTON) -- ABC News’ senior health and medical editor Dr. Richard Besser – a former director of the U.S. Centers for Disease Control and Prevention – offers these tips for tackling your problems with pain:

  • If you are currently managing your pain by yourself, you need to get help from an expert. There are pain specialists to help you understand your pain triggers and find the best medications. You should look for the most relief with the fewest side effects and should always work with your doctor. Don't add medications on your own. That is when you can really get into trouble.
  • Make sure you have a doctor who you feel believes you. Nothing is worse than being in pain and feeling like your doctor doesn't understand your problem. If you are in that situation, it is time to get a new doctor. There is no quick fix for most conditions that cause chronic pain. You have to believe that your doctor is on your side.
  • Educate yourself. There are a number of drug and non-drug therapies (physical therapy, yoga, meditation, massage) that can help control pain. Be open to trying new approaches. Dealing with the stress that comes with having a chronic pain condition can actually help reduce the pain itself.

For even more pain tips, click here to visit the American Pain Foundation's website.

Copyright 2011 ABC News Radio


Curing Pain...With a Piece of Felt?

Pixland/Thinkstock(HOUSTON) -- Like millions of Americans, Linda Brown, suffering from a debilitating pain in her face, struggled against the quicksand of pain medication. The more pills she took, the more she needed.

"I was becoming an addict," she said. "I was no longer functioning at, what I considered, a life."

She was taking 20 to 30 pills every day, and even set her alarm clock for 2 a.m. so she could take more medication to avoid the pain, which she described as a "bolt of lightning," a "bad electrical shock." A slight breeze or the simplest touch -- even smiling -- was excruciating. It all started in February 2002.

"I had just come home from vacation, and I had felt what I thought was this horrible toothache," she said. "It was a pain I had never experienced before."

Doctors offered prescription pills for her trigeminal neuralgia, an often undiagnosed condition in which even the gentlest pressure can feel like a hot poker to the nerve.

Brown became so overcome with pain that her life was starting to disappear before her eyes. After a while, even the pills stopped working, and she could no longer function.

"I was out of options," she said. "I was taking the maximum medication I could take. We had tried every other medication."

Finally she saw a neurosurgeon, Dr. Dong Kim at Memorial Hermann Hospital and UT Health, who said that he could cure her pain -- with only a tiny piece of felt. Kim operated, using the felt to cushion the trigeminal nerve, which was being squeezed between two blood vessels.

"He's my miracle man," said Brown.

After years of mind-numbing medicines and bouts of debilitating anguish, Brown's pain was eliminated by the two hour surgery.

"From the very minute I woke up, I have not had another pain," she said. "I have not taken one pill."

Thanks to Kim's surgery, she has returned to being the Linda Brown her friends and family knew and loved.

"People who had not been around me for a while, they thought I was sad. They didn't know. They didn't understand. ... It hurt to smile."

She has all of her energy back -- enough to go fishing in the pond on her property or to ride her four-wheeler. But the best gift of all is that she now has the energy and strength to spend time with her grandkids.

"I have been able to take the kids on my own and have the quality time," she said, when ABC News spoke to her a month after the surgery on a trip with the kids to the zoo. "Luke running into my arms, that couldn't have happened. Picking up Sydney and holding her by the giraffes ... I couldn't have done that. Just them and gram."

Copyright 2011 ABC News Radio


Fetus Can Feel Pain at 35 to 37 Weeks, Experts Say

Keith Brofsky/Photodisc/Thinkstock(LONDON) -- Fetuses begin to feel pain around a woman's 35th week of pregnancy, about two to four weeks before delivery, according to a new study from University College London.

Using EEG, researchers recorded the babies' brain activity in response to pain, comparing their pain responses from a touch and prick on the heels. The findings were published in the journal Current Biology.

"Babies can distinguish painful stimuli as different from general touch from around 35 to 37 weeks gestation -- just before an infant would normally be born," Lorenzo Fabrizi, lead author of the study, said in a statement.

The babies, who were 28 to 35 weeks old, showed the same bursts of brain activity for the touch and the heel lance, but babies at more than 35 weeks' gestation had a greater burst of activity in response to the lance than the simple touch.

The findings may explain why babies born prematurely have an abnormal sense of pain, the authors noted, and the findings could potentially affect treatment and care of preemies.

Fetal pain, an area that experts say is lacking in research because it is difficult to study, has often been a point of tension in the ever-controversial abortion debate. Over the past six years, six states have enacted fetal pain abortion bans, making it illegal to perform an abortion after 20 weeks. Many anti-abortion activists argue that fetuses can feel pain in the womb after 20 weeks of development.

"The findings ... should help inform the pain perception portion of the abortion debate," said Dr. F. Sessions Cole, director of the division of newborn medicine at Washington University School of Medicine at St. Louis. "Although this study specifically addresses brain wave differences between premature and term infants, not fetuses, after painful and tactile stimuli, it suggests that brain maturation required for fetal pain perception occurs in late pregnancy, more than 11 weeks after the legal limit for abortion in the United States."

"Although fetal pain perception is a complex phenomenon which we do not yet fully understand, this study raises the possibility that maternal pain relief during abortion may require administration of medications more than fetal pain relief," Cole said.

Although the babies' vital sign changes indicate that fetuses and infants perceive pain, Cole said that studies that correlate EEG findings with physiologic indicators of pain may be limited in scope.

"This study did not incorporate any vital sign monitoring, cry response, or other methods for assessing pain," said Cole.

Not unlike older children and adults, premature infants usually receive general anesthetic for surgical procedures, epidural anesthetic and analgesia, nerve blocks, IV pain killers or oral pain killers, Krane said.

"Based on this study, clinical practice in neonatal intensive care units will focus on continuing to reduce use of painful procedures in premature infants," said Cole. "Also, treatment of maternal pain during abortion procedures may require more careful attention than treatment of fetal pain."

Copyright 2011 ABC News Radio

ABC News Radio