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Tuesday 25 February 2014

Pain

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, often caused by intense or damaging stimuli e.g burning a finger. Acute pain, also known as short-term pain, is pain that has started recently. Pain makes us withdraw from damaging situations, to protect a damaged body while it heals and avoid similar experiences in the future. Most pain resolves once the painful stimulus is removed and the body has healed, but sometimes pain persists despite removal of the stimulus and apparent healing of the body. Chronic, or long-term pain, is pain that has lasted for three months or more.

Sometimes pain arises in the absence of any detectable stimulus, damage or disease. Pain is the most common reason to see a doctor. It is a major symptom in many medical conditions, and can significantly interfere with a person's quality of life & functioning. Interestingly the word pain comes from the Latin poena, which means punishment or penalty, after the Roman goddess of punishment.So, inherent in our relationship with pain, is the idea that in some way it is our fault.

Psychosomatic pain, (mind - psyche and body - soma). The vast majority of people seen in pain clinics have a clear organic cause for pain, either in the present or past. It is rare to have a patient with pain arising purely from emotional causes. There is evidence of environmental and social factors affecting the exhibition of pain too. Yet all too often doctors, who really don't know that much about pain, or how to treat it, tell patients that their pain is "all in their mind". Or even worse, they tell patients that they "just have to learn to live with it". A doctor once told me I was "creating my own pain"!

Descartes said that the mind and body were separate, while the Eastern tradition had the sense to view the mind and body holistically as coming from the same energy or source. This disconnect has directed how Western medicine evolved & has had a negative effect on how chronic pain patients are perceived and treated. I know, first hand, because I have had chronic pain for most of my life since puberty.

Almost 8 million people suffer from chronic pain in the UK. People with chronic conditions should not be defined by their condition or their pain.Their lives should not be blighted & circumscribed by pain. There are ways of coping with pain other than surgery or medication. They do need to "learn how to live with it" - but they need to be taught the skills to do that. For example, relaxation, pacing, distraction technique, exercise, goal setting & action planning........http://www.britishpainsociety.org/index.htm

Sadly most GP's don't know how to cope with chronic pain patients. I was unable to find out how much time trainee doctors spend learning how to manage their patients pain. Unless much has changed it isn't a lot. Doctors training is all about curing & there's the problem - you can't cure most chronic pain.

 

Monday 17 February 2014

One Step Forward - Again

Boiler saga.

The new boiler seems determined to test my patience & resilience. Last week I noticed that the pressure was too high & the Bar setting was flashing because it was over the limit. Fortunately my electrician was here replacing the downlight damaged by the leaking roof, & alerted me to the fact that a weak spot in the system could actually burst & cause a flood. Fortunately he showed me how to drain water from a radiator to reduce the amount of water in the system till the valve could be replaced. (I've become quite adept at it after a couple of soaking wet trouser incidents!) He called the plumber who arrived today and replaced a valve that was constantly leaking water into the system. I'm relieved it's mended & wonder what else could go wrong with the plumbing. At least I'm learning a little more about the dark art of plumbing every time a plumber comes.

Then I sent an email to my vendors plumber to remind him I need a witness statement from him for the County Court case. I hadn't had any response to the request I sent 3 weeks ago. His wife replied immediately to say he "prefers not to get involved" & "declines to sign a statement" (of the facts). I can actually understand why. He works for the vendor who didn't take kindly to what he said to me when he was called out by the vendor's maintenance man, because the heating wasn't working when I moved in. However it means that the Court will have to summons him to appear to give evidence under oath & answer questions. I was really hoping to avoid this all being any more confrontational than it has to be - Obviously naive.

Sometimes life just seems to be perversely complicated. As they say "Life's a bitch & then you die". Hope all this doesn't take that long. (Not anticipating dying just yet).

Tuesday 11 February 2014

Empathy, Sympathy & Understanding - A Question of Aid.

Empathy - the power of understanding & imaginatively entering another persons feelings. The capacity to
recognize emotions that are being experienced by another.

Sympathy - the sharing of another's emotions, especially sorrow, anguish, pity & compassion - fellow feeling. The perception, understanding, and reaction to the distress or need of another human being.

Understanding - the ability to learn, judge, make decisions.

One of the things which makes us human is to be able to exhibit the first two emotions. Although very similar, they are subtly different in that the first is more passive, while the second is more active. Both require the third, because without that we can be deceived and manipulated by people simulating a particular emotional state. Not everyone is genuine & honest. We have all told lies, for whatever reason.

I am curious about what instinct, body language, facial expressions, tone of voice, choice of language give us the clues to be able to interpret someone else's state of being? What makes some people really good at it, & some seemingly completely oblivious?

I also wonder what mechanism enables us to switch off empathy, sympathy & understanding? Is there a safety valve, which we possess, because no one can live in a permanent state of heightened awareness to other people's pain and suffering?

We are confronted daily by graphic images of a huge range of human suffering in the newspapers & the media. Flooding in the UK - Bush fires in Australia - Relentless winter ice & snow storms on the East coast of America. People die from malnutrition, lack of clean drinking water, infectious disease. Then there are the current wars around the world.







1978 War in Afghanistan




2001 Islamist insurgency in Nigeria




2004 War in North-West Pakistan




2006 Mexican Drug War




2011 Syrian Civil War




2011 Iraqi insurgency (post-U.S. withdrawal)




2012 Central African Republic conflict




2013 South Sudanese conflict  
                                 

The list is endless & we could be forgiven for a feeling of powerlessness in the face of such an overwhelming need for our compassion & aid. Indeed the Daily Mail currently has a petition to use part of our foreign aid budget to help the thousands of British families whose lives have been made a misery by the floods, under the banner of "charity begins at home". I hope we have more sense than to sign it.

We should undoubtedly be exercising empathy & sympathy to all the people affected by the flooding. Also to the hundreds of people working night and day to mitigate the effects of the unique weather conditions. 

What we should not be doing is equating that to the suffering of people trapped in dire poverty or in wars not of their own making. There is a difference & we should understand what it is & continue to fight against it.

Monday 10 February 2014

Flood Plain Speaking



160,000 acres inhabited since Paleloithic times. 32 SSSI's of National & International importance. The area is known to be prone to both tidal and land based flooding. 70% of farming is grassland for cattle & 30% is arable. The main historical "crops" are peat, willow & teazels.

I've been to the Somerset Levels to see the interesting Wetlands Visitors Centre, which gives a vivid picture of prehistoric settlement & land use as well as bio diversity. Anyone, who looks at the map & relates that to the actual landscape, can see that it is not an obvious place for permanent settlement & farming. However that is what we now have, however unsustainable that is. It seems to me that it is another example of humans trying to control nature & not liking the result when that fails.

I have lived for a year in a house that was rendered virtually uninhabitable by a water escape, so I know what it feels like. I am truly sympathetic to the people who live in flooded areas. But surely we have to look at the bigger picture & plan accordingly. Man needs to respond appropriately to the vagaries of nature & only fight battles we can win and afford to pay for.

At the moment this issue is a political football dominated by emotion. We are playing the "blame game" with a vengance - heads must roll - preferably those of the Environment Agency. What use is that? We are where we are. There are probably reasons for things which haven't been done, mostly to do with cost. Unless we are all prepared to pay more taxes or see something else cut this will always be the case. Spending is finite & difficult decisions have to be made.

Our political system means that politicians are always looking to be re-elected so they don't make the difficult & unpopular long term decisions which are in the best interests of society as a whole. We tie their hands because we are cheapskates who want to pay less & get more. Everyone needs to become better informed & take part in a genuine discussion about the long term issues which face our complex & expensive society.

In this instance we can't have it all. Whether climate change is brought about by human activity or not, it is here. We have watched it happening around the world. We need to wake up & think about the future of our world & the people who follow long after we are dead.

Friday 7 February 2014

Sochi - Let it snow, let it snow, let it snow.

Finally, I really know the world has gone mad. I thought Bahrain's $51 million indoor ski resort was bad enough. But it is totally eclipsed by the Winter Olympics in Sochi, which have cost $51 billion. More than the last three Winter Olympics combined. Or the Beijing Olympics, which had the record for over the top money spent.

As if that isn't enough, Sochi is a sub tropical beach resort. They have palm trees & grow tea there! The average winter temperature is 11 degrees C. It's a rural area & the resort of Rosa Khutor is only 3 years old. Only someone like President Putin would think it was morally right or sensible to build a winter sports venue there. But we colluded in that decision. We let them do it.

To add insult to injury the Russians have built the largest snow making system in Europe to create this man made aberration of human madness. There are 200 water reservoirs & 400 snow cannons. As if that isn't enough there is 710,000 cu inches of snow from previous years stockpiled in 10 insulated stockpiles in case they run short. You have to be some sort of megalomaniac to think it is right to try to control nature to this extent. There are also indoor arenas with refrigeration systems keeping the temperatures low enough.


It makes me feel physically sick to think of this complete waste of money and precious resources. 2.5 billion people in the world do not have access to adequate sanitation - 1 in 3 of the world's population. 68 million people in the world do not have access to safe water - Roughly 1 in 10 of the world's population.

What are our politicians thinking? How can their priorities be so criminally & thoughtlessly unbalanced. They just want the international kudos attached to a big event. How does the Olympic movement today bear any resemblance to the original concept? Only in the work & commitment of the athletes themselves as far as I can see. The rest is just hype, PR & territorial posturing.

How did we let this happen. We are sleepwalking into a catastrophe for our grandchildren. We should all be ashamed.

Tuesday 4 February 2014

Passing the Time....

I used to get very irritated with my Father when he was in his 80s. I would suggest something we might do & he would respond "it passes the time". Time was one thing I didn't have enough of, & if I'm honest, there were many other things I would rather have been doing than taking him out. Now I'm approaching 70, retired & widowed my view has changed with experience. I understand why he said that.

I fill my days as much as possible with doing things. I don't have a job as a focus, or something which defines me. So I have done a variety of volunteer roles since getting medical retirement from being a Primary Head Teacher when I was 46. (Magistrate, Mediator, Tutor for the NHS Expert Patient Programme, Lay Panel Member on a NHS panel which prioritised research bids, an Independent Monitor of Gloucester prison, & I am about to start as a volunteer events organiser for the Ashmolean Museum in Oxford). All really interesting roles - all gave me valuable experience - all essentially passing the time - all 23 years of it.

I think this is what life is. A limited period of consciousness which we have to fill. An opportunity to interact with others & contribute to their lives, hopefully in a positive way. A chance to learn & become better human beings. Voltaire said "study delivers us from the burden of our leisure".

When you are a young adult life can be a manic balance between, home & family, work & responsibility, leisure & social life. At my age life is very different, especially if you are single. You have to work at not becoming very self absorbed, not becoming a slave to boring routine, not becoming isolated. On the other hand you realise that time is very precious. Something that is not infinite & could be taken away at any moment.

Instead of simply passing the time, the trick is to be "mindful" & make every moment count. I haven't quite got the knack yet, it's a work in progress.