Pain

A skeleton man rocketing 80 mph headfirst down an icy chute on a tea tray, his cranium mere inches from being knocked off and flung about the Turin countryside, is a combination that, as a red-bleeding-my-own-blooded male, just works for me. The name of this athlete, Pain, works even better. Jeff Pain, the Canadian Olympian, lost a gold medal by a snowflake’s zit to another Canadian, a skeleton man named Duff, as in golfing or beer or both. (Does placing behind Duff make Pain a sore luger?)

I have known surgeons named Carver and Butcher, a gastroenterologist named Gass and a gynecologist named Perks. I have known a foreign doctor training at our hospital named John Kwak (pronounced Quack) who was asked to consider using a different name as patients hearing “Paging Dr. Kwak to emergency” tended to panic and duck out (sorry) the exits.

And I feel like I have known Pain.

Kidney stone pain, labor pain, surgical pain, fracture pain, back pain, phantom pain, emotional pain, pain in the butt and in the gut, of the head and heart. Sharp pain, dull pain, throbbing pain, nerve pain (neuralgia), chronic pain, lancinating pain, burning pain, pressure, intractable, squeezing, jabbing, stabbing, shooting (see Cheney chums), intermittent and continuous pains.

Reaction to the same pain is highly variable. There are those who don’t want to take anything for it and will just tough it out. “Yes doctor the javelin jutting from my jaw is a bit painful but ‘tis merely a flesh wound.” These are known in medical terminology as stoic (see Monty Python).

Others want the heaviest dose of narcotics for mild pain as they must absolutely be pain-free. These are known in medical terminology as wimps.

In really recent relevant research it has been shown that the pain response is different in men and women. Women have three times more migraines, more irritable bowel (IBS), fibromyalgia, chronic pain and more menstrual cramps than men. The female approach to pain is emotionally mediated, involving fear and anxiety, making the pain episode worse. And women respond to certain pain medications differently than men, a function of certain genes that code for specific pain receptors. Women respond well, for example, to nalbuphine but this same painkiller can actually worsen pain in men! Men respond better to morphine or Coors. Medications are now being created to address this difference, the so-called “pink and blue” painkillers.

Furthermore, certain genes associated with redheads means that they actually respond better to some analgesics than even-tempered people.

It wasn’t too long ago that a country doctor who went on to found the Mayo clinic commented, “The only two things in my black bag that I know works for sure are morphine and my saw.”

Doctor’s all have bigger bags now and we can carry some newer pain medications including:

Tramacet: meant to help reduce our insane national addiction to Tylenol 3’s.

Lyrica: For nerve type pain like shingles or sciatica etc.

Sativex: Some dudes will recognize the root word of this medication and will be flying down to see the doc with several new pains to get some of this medical bud.

Pain patches: Duragesic or lidocaine patches. Can reduce your pill burden dramatically.

Red hair dye.

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