Pain as a Public Heath and Disability Issue (chapter 22)
All in My Head raises national consciousness about chronic headaches and chronic pain in general as a serious public health and disability issue. Chronic headaches afflict people of all ages and from all walks of life, but with those from lower incomes less likely to see a doctor and be diagnosed.
Telling such stories about the experience of pain can raise awareness about how far we haven't come in actually treating chronic pain, especially the most severe and frequent forms, despite significant strides to understand its neurochemistry and triggers. As the recent study from the American Chronic Pain Association reveals, 47 percent of those with chronic pain say it is NOT under control. Fifty percent of those with ever-present pain (like the author) have this response.
Pain advocates discuss how actual limits in life, or disability, can be relieved with more accommodation and understanding from society. This includes more flexible work schedules and the ability to work at a slower pace. This accommodation can be compared to society building ramps for those in wheelchairs or providing sign language for deaf patrons to the theater; with these remedies, these "disabled" people are now less disabled. An example of a successful arrangement from the book is of a 14-year old girl with chronic daily headache who attends a special "therapeutic day school" at which she can work at a slower pace and intensity. This way she has the choice to participate in and contribute to society, instead of being completely left out like so many with chronic pain.
Pain as a Women's Issue (chapter 13)
Although men are certainly affected by chronic pain, it should be recognized as a long-neglected "women's issue." New scientific data is available to justify this political and medical focus on women (mainly from researcher Roger Fillingim, author of Sex, Gender and Pain). As pointed out above, pain disorders disproportionately affect women, mainly because of differing neurological wiring, often aggravated by hormone fluctuations.
A major complaint from women patients is that, compared to men, their pain is largely considered to be psychological in nature, and that when it does have such a component, proper medical treatment is not given. As studies also show, women are more likely than men to be medically undertreated for pain, with men more likely to be prescribed more effective narcotics and women more likely to get addictive and useless tranquilizers.
Our Broken Medical System (in chapter 22)
Ironically, while knowledge of headaches is growing and we are in an advanced technological ageable to replace severed limbs and excise the most precariously placed brain tumorsour general understanding of how to actually relieve chronic pain is still relatively primitive. All in My Head questions the often-overstated effectiveness of both Western medicine and CAM (Complementary and Allied Medicine) in treating chronic pain.
New Brain Scans Give 'Proof' and 'Legitimacy' (chapter 7)
This topic is being taken very seriously in neurological studies, with the aid of advanced brain scanning techniques, including functional MRIs and PET scans (which trace blood flow in the brain). These recent breakthroughs defy past psychoanalytic definitions of pain "you can't see" as mainly psychological in origin. Reflecting such an upsurge in medical research in the past decade in this field, scientists are now referring to chronic headaches as "Migraine Disease," reflecting a neurological basis and common progressive nature. This paradigm treats the problem of head pain more seriously and even offers hope in stemming its progression, when discovered early.
A New Generation of Women Patients Coming Out (chapter 22)
From the preface to All In My Head, pages ix - xvi. Copyright Paula Kamen 2005. All rights reserved. No part of this book maybe reproduced without written permission from the publisher, Da Capo Press.
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