Pain Medicine

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Pain Medicine

Postby likeafox » Sat Apr 24, 2010 3:51 am

(repost)
I went to the hospital some time about 5 months ago with severe abdominal pain. I didn't know what caused it, and I still don't. It was bad though; I was paralyzed on the floor and on the verge of passing out for about half a minute during the worst of it. The pain became bearable enough by the time I arrived at the hospital and was put in a bed that I was able to force myself to relax. Not long after, two nurses came in and started poking me with sharp things. One poke for a blood test, one to administer a salt-watery solution, etc.

"Now we're going to give you something for the pain" the nurse said. (I'm certainly not accounting it word-for-word but this will be pretty close to how it happened)
I asked what it was.
Nurse: "Morphine".
Me: "I don't want any".
Nurse: "Oh, well I can't give you anything if you don't want me to. But can I ask why?"
Me: "Because I don't think I have any need to take it, at the risk of any possible side-effects"
Nurse: "Are you worried you'll become addicted?"
Me: "No, but isn't it only to make me feel better?"
Nurse: "Well, yes"
Me: "If the only reason you're giving it to me is so I feel better, I don't need it, and I don't want any"
Nurse: "Why did you come to the hospital then? People come to the hospital to feel better"
Me: "That isn't why I came to the hospital. I came to the hospital to BE better."

This is where the conversation took a somewhat philosophical turn. I explained that I came to the hospital for two reasons: primarily to become healthy again, and secondarily to find out exactly what happened so I can avoid it from happening in the future. I explained that my comfort could play no part if it were to affect the outcome of my primary goal even to a trivial extent. Even if it didn't, my comfort was of negligible utility to me, as I couldn't do anything except lie in a hospital bed anyway; I wasn't preforming any sort of task that discomfort would impede. I acknowledged that treatment of pain could be involved in the optimal outcome of my primary goal, but this still does not mean that my comfort is a goal in itself. For example, a patient will tend to fare better over a long period of time with pain medication so that they are able to get adequate rest, as opposed to a patient who is kept awake by his discomfort. In another case, extreme pain like mine might cause involuntary muscle spasms, which could cause further damage to the ailed part of the body. But my muscles were not spasmodic at the time, and at least in the short term, I didn't see any positive health effects from taking pain medication. And there are, almost without exception, side-effects to pain relieving drugs. Even if these are trivial, they are still weight on the optimal healthy outcome. I didn't pretend to know at what point it starts being beneficial to give a patient pain medication, but I gathered from her replies that she wasn't used to thinking about the problem in this way. In light of all this, I asked her to give her best judgement based on her medical knowledge. She couldn't give me an answer either way. So we took what we thought was a safe estimate and decided that I would receive some morphine if the pain became prolonged, or it got worse again.

On reflection, I see this as a parallel to many problems in life, with which I usually take a similar approach. These problems come in all forms, but I'm mainly talking about those that cause emotional or mental pain or discomfort. And with all of it, I think pain medicine is something people are all too ready to snatch up. They might drink alcohol to alter their emotional state, or transplant themselves into a virtual fantasy of World of Warcraft to forget about reality, or rationalize or deny as ego-defensive cures for their cognitive dissonance.

For many people, religion is their morphine. Religious beliefs grant people long-term relief to discomfort or even despair over the conflict between their values and reality such as: mortality; bad people not being punished, and good people not being rewarded; uncontrollable situations; apparent purposelessness of life; unattainable desires; mundanity of humans/kinship to animals; uncertainty and ignorance; lack of caring father figure or other close emotional relationships; lack of authoritative presence; etc. These and others can all be important problems for the emotional well-being of an individual, and they all have the quality of having imperfect solutions. There is no way to absolutely render immortal one's self or loved ones, no way to punish every criminal for every crime, no way to absolutely control forces of nature, no way to be certain about an objective purpose of living, etc., etc.. Religion really is the swiss army knife of emotional painkillers. But just as morphine treats physical pain, a symptom of an illness or injury, religions treat symptoms rather than problems. Religion is a way of ignoring the reality a believer finds himself in using comfortable illusions, to his benefit or detriment. And just like morphine, it can be part of a process to reach a goal, and it has side-effects as well. A side effect could very well be the illusion itself. Pain, more often than we realize, is a good thing, and we feel it because it's a good thing. It's what tells us to take our hand off the stove. Decisions based on illusions are always irrational, no matter the outcome. And because religion too builds up a psychological dependence, it becomes hard to break free of it when it is no longer beneficial. I'm not going to talk about specific benefits and detriments of religion here, but I think the question is the very same one I asked myself in the hospital: At what point do the costs of religion outweigh the benefits, or vice versa?

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Re: Pain Medicine

Postby Jakkal » Sat Apr 24, 2010 6:44 am

bah, too much text.... and phylosophy... humans always to the more comfort way of life. If they got physical pain (sounds like a Appendizitis, or Obstipation) or mental pain, they take painkillers.

Because pain (for most ppl) is a very uncomfortable feeling, which should be away as soon as possible.

About the conservation. I can''t blame the nurse for not giving a answer... I mean, you come to the hospital to feel better AND be better. On the short term you need to feel better to get better.

She probably don't have the time to give you a proper answer on your "phylosophy", making a :roll: face and saying "if he don't want his pain medication... well he can have it... but I don't discuss with him". To be honest, it would get on my nerves too, to get such "phylosophical" answers. We are trying to make our job, not to discuss about phylosophy of life, talk to the clerk about it.
Pain, more often than we realize, is a good thing, and we feel it because it's a good thing.
hah, not for me. Ever had a cronical pain disease? which didn't let you sleep every night? Ever heared of the Trigeminusneuralgy? more than the half of the ppl having it comitting suicide cos of the pain! And you want to say that pain is a good thing (no offense but you really sound like a emo to me), PAH!
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Re: Pain Medicine

Postby Cactus Jack » Sat Apr 24, 2010 1:24 pm

I think you spend way too much time over thinking things.

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Re: Pain Medicine

Postby MuffinSticks » Sat Apr 24, 2010 8:44 pm

I think you spend way too much time over thinking things.
Quoted for extreme disagree.
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Re: Pain Medicine

Postby Tom_Radigan » Sat Apr 24, 2010 9:51 pm

I think you spend way too much time over thinking things.
Quoted for extreme disagree.
When you're in the hospital and incapacitated, well, there's nothing else to do but think about things.

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Re: Pain Medicine

Postby nickspoon » Sat Apr 24, 2010 10:24 pm

There is a balance between the extent to which we can deceive ourselves about the world and the consequences of such a deception, which applies to both painkillers and religion. The pains and the consequences are different, but the same principle underlies both. In the case of painkillers, it is perfectly reasonable to take them if pain stops you from working, sleeping or thinking, or if the pain is affecting your mentality. Pain, in this case, has already served its function - to tell you something is wrong, to prevent you from repeating it - and there is no value in its continued presence. In the case of chronic pain, it is absolutely necessary that it is relieved, because the pain is the disease, not merely a symptom. Obviously, painkillers have side-effects, and taking them unnecessarily will have detrimental effect; and having no pain at all would distance one from reality and prevent one from functioning in reality.

Religion is similar. It is reasonable to want to believe that there is some meaning to your existence, or that a recently-deceased relative lives on in some higher reality. It becomes unreasonable when such considerations distance one from perceiving reality as it really is and functioning in the real world, or applying these illusory considerations to real decisions (for example, taking your own life in the belief that a better one awaits you). The issue with religion, which makes it in many ways more dangerous than painkillers, is that its slope is slipperier; once you start believing in such fanciful things, it is easy to fall in the trap of believing whatever makes you feel most comfortable, even if it is not true; it's a typical human response.
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Re: Pain Medicine

Postby osprey » Sun Apr 25, 2010 12:34 am

Nickspoon is right. Humans have a tendancy to believe things that make them the most comfortable. Much like nobody wants to go to bed with an extreme headache or muscle pain, nobody wants to go to bed with extreme worries or stresses, hence it is really easy for the human mind to fall into the trap of believing things simply to stop the stress, or to stop from having to face harsh realities, even if in the back of their mind they know these to be false. This is, I believe, a large driving force behind those who become overzealous and blind followers of religion: religion provides them a way to comfort themselves, hence why we see such widely varied interperetations of religion, made by their believers to suit their own emotional needs. Religion provides the stability that many people crave, and it is true, and many take this further once they find that first little bit of comfort and stability. I'm not saying that the processes are the same, but this is a slightly similar occurrence to people who become addicted to painkillers, although this process is entirely mental, while painkillers are a combination of mental and physical.

In the end, many people need religion, or something to believe in, to function properly and to keep them sane; in the end, nobody wants to feel alone in the world, and the concept of a god, or spirits, or anything of the sort can be a comfort to many. Religion is the same as everything in the world: keep it in moderation. It is a good thing if it helps people feel happier and more secure without clouding their perception of the world and the truth; it is best used as support not as a cover-up. Religion should be a tool one uses to repair the hole in the wall, not a piece of furniture they put in front of it to hide it.
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Re: Pain Medicine

Postby datherman » Sun Apr 25, 2010 2:54 am

In the end, many people need religion, or something to believe in, to function properly and to keep them sane; in the end, nobody wants to feel alone in the world, and the concept of a god, or spirits, or anything of the sort can be a comfort to many. Religion is the same as everything in the world: keep it in moderation. It is a good thing if it helps people feel happier and more secure without clouding their perception of the world and the truth; it is best used as support not as a cover-up. Religion should be a tool one uses to repair the hole in the wall, not a piece of furniture they put in front of it to hide it.
This is a bit of a stretch, but I'm being completely serious in saying that this is partly why I've gotten so involved in the furry fandom. The points you mention can be applied (to a certain extent) to furries, or really any sort of similar group out there. The people I meet are generally good people, I use it as a social outlet, and it helps keep me sane by introducing a bit of ridicule into my life. At the same time, I must be cautious not to sink down to the level of some people I know, who don't have any friends outside the fandom and can't even comprehend the idea of doing something socially that isn't a predetermined furry meetup (I'm serious, there are people out there like that).

Yes I just compared religion to furries. Raptor Jesus FTW >_>
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Re: Pain Medicine

Postby Tom_Radigan » Sun Apr 25, 2010 3:15 am

It isn't just religion. People have blind beliefs in ideologies, even ones long discredited.

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Re: Pain Medicine

Postby Æron » Sun Apr 25, 2010 5:08 am

I do not see pain in and of itself as a good thing, nor is experiencing pain a good thing. It is of utility because it forces us to be aware of problems with our bodies. It is an alarm, a warning, like you said, it tells us to take our hand off the stove. If we continue to ail, it makes us less likely to move about and exacerbate the problem. But like most biological responses, it is not optimal in all situations, again some of these you mentioned--interfering with needed rest, or causing muscle spasms. It does not always know what is best for us, especially because it has until only recently evolved in a vacuum of modern medicine. For example, prolonged pain due to physical ailment may have been the best response for a person without modern medicine... lessening their activity level to give the body a chance to heal itself. But this is a double-edged sword. It may increase chances of survival, but it can cause lasting damage, from the body's own stress response and/or psychological trauma (depending on the intensity of the pain.)

With modern medicine, this constant alarm is not needed as much. Certainly, the initial bout of pain is very useful because it is what tells us to go to the doctor. Once you’ve been to the physician though, and have knowledge of what is wrong and what needs to be done to fix it, pain becomes at best superfluous to healing if it is low-level.

In your case, you were cogent enough to be having a discussion with a nurse on whether or not you needed pain medication, so you probably weren’t in pain severe enough to be damaging at the time. You weighed the benefits and detriments, and came to a decision that was perfectly rational in your situation. If you say that it is irrational for someone else in the same situation to accept pain medicine, though, then I would object. Maybe if they’re taking it because they want to get a buzz from it or something, then yes, but if they’re taking it simply to be comfortable, then I see no irrationality in that.

I’ve been on both sides of the fence, myself. When I had my wisdom teeth surgically removed, I was in pain for a few days afterwards, but it was a fairly tolerable amount of pain, so I did not take a single pill from the bottle of painkillers that I was given.

On the other hand, when I had ankle surgery, I was practically begging the doctors for more pain medicine. Maybe it was because I was weak, maybe it was because my depression makes me more sensitive to pain, maybe the antidepressents I was on interfered with the painkiller's effectiveness. The surgeon may have nicked a nerve. I was unable to sleep at all the night after the surgery, and the night after that I hardly slept at all. The feeling I could only describe as someone driving a MEHTUL spike into my heel. (I found out later that this was oddly accurate, because the surgeon had cut my heel bone in half in order to rebalance my ankle, and had put a MEHTUL screw through it to put it back together.) I remember calling the clinic at something like 4 in the morning, asking what could be done to help the pain. They told me I could double the dose of pain medication if I wanted. I did.

I did, even though I had researched the medicine I was on.

And had found out that it is on the shortlist of painkillers that may be banned in the near future due to having an amount of acetaminophen that may be damaging to the liver. (At least if taken for long enough time.)

Did I make an irrational decision? Maybe. I was certainly not thinking clearly at the time due to the pain. But I still don’t regret it. I was not on the painkillers for an extended period of time, so any long-term damage they likely did was likely trivial. And, from my depressed point of view, trying to maximize my lifespan is of little utility to me because I don’t enjoy it anyway.

And forget pain medications, what about antidepressants? Their only function at all is to make you feel better, and not cure physical pain but purely mental pain. And they come with side effects and possible complications. (Some that I've been on are even seizure risks.)

I do believe people overuse painkillers in everyday life though, and I think your point is better applied here. It depends on the level of pain and the type of painkiller. For example, I don’t see any point in taking tylenol for minor headaches. If the pain is minor enough to be somewhat ignored, then why risk liver damage?

I’m going to jump straight into the religion question, “when do the costs of religion outweigh the benefits?” I think this is a difficult question to answer without a detailed analysis. But simply to go off of my biases, I see religion as being of little benefit to humanity, and what little benefits it does provide can be acquired through other means. The costs of religion... outweigh the benefits the second the religion starts promoting irrational thinking, or stigmatizes people based on gender or sexual orientation, etc, or if it starts creating tension with people of other religions. Which is pretty much all of them.

Is religion a pain medicine? Perhaps it can be at times. Maybe that is one of the reasons it evolved. Once humans developed the higher thinking necessary to contemplate our own mortality, we needed a way to cope with the stress this ability caused. Having the power of executive thinking provides many benefits for our survival, but this one detriment obviously needed to be patched up in some way. Thinking about our demise just increases the likelihood of depression, and lowers our chance of reproducing.

The big three Abrahamic religions also like to play to our other emotions, like vengeance. People who disagree with us we find annoying, and people who do terrible things we want to suffer for what they’ve done, so what better than to fantasize about them undergoing unimaginable tortures by an all-powerful, all-just being who is on our side? And what better way to get people on your side then to appeal to their basest fears and threaten them with eternal torture if they do not join you? This seems like it would be a very effective strategy in intraspecies competition, and indeed it seems it has been.

----

Note: I can see why the nurse may have been a bit harried by your discussion. Theirs is a very demanding and stressful job, and I can imagine that they tend not to like it when patients resist and/or question their methods. Not that questioning what they are doing is a bad thing!
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Re: Pain Medicine

Postby MuffinSticks » Sun Apr 25, 2010 7:40 pm

Now Jason, aren't you glad you brought the thread back?

I'm not as smart as the rest of these people, and my input would be redundant by this point, so I won't be posting my essay, in case anyone wondered what happened to that plan... Good readings though, ENCORE.
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Re: Pain Medicine

Postby Astro » Mon Apr 26, 2010 7:18 am

I promised Jason a 4 line reply

I see the goal as maximizing the area under the curve of some function f(t), which is some measure of quality of life (a combination of emotional and physical health); i.e. maximize the integral \int_0^t_{death} f(t) dt

f(t) will rise as pain decreases (thus increasing the area under the curve), and of course the total area under the curve will also increase with longer life.

So as long as the decrease in pain doesn't shorten the length of life enough to counter the increased integral of the function, painkillers are well worth it in my opinion. (what.)

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Re: Pain Medicine

Postby Dr. Dos » Mon Apr 26, 2010 8:34 am

holy shit this entire thread is tl;dr
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Re: Pain Medicine

Postby osprey » Mon Apr 26, 2010 7:01 pm

If this thread doesn't interest you, why would you even post instead of just ignoring it?
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Re: Pain Medicine

Postby Tom_Radigan » Mon Apr 26, 2010 7:13 pm

holy shit this entire thread is tl;dr
What the heck does "tl;dr" mean anyway? :?


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