Pain, Pain, Go Away’

 Reprinted with the permission of the author, Dr. Stanley Cohen 

(Adjunct clinical professor of pediatrics, Emory University School of Medicine;
Director of IBD Research, Children's Center for Digestive Health Care;  

Chief of Gastroenterology and Nutrition Clinics, Children's Healthcare of Atlanta at Scottish Rite Hospital in Atlanta, GA) 

We seek pleasure and avoid pain. The psychiatrists tell us this is a natural, logical (and wise) phenomenon. But we can’t always. And that’s particularly true of patients with chronic diseases.  Not that Crohn’s and colitis patients seek pain, or give in to it, but sometimes it just can’t be avoided.  A searing, agonizing scourge rends the stomach and intestines abruptly or plants itself there and seems to create an independent life and a host of problems: school or job absence, complete with teachers’ and bosses” ire: interrupted plans: bowel urgency: brief or chronic depression, and a hundred different worries.

The worst part is that it hurts, sometimes so much you can’t do or think about anything else.  That is achingly obvious—but it means that the pain is then in control, not the patient, not the doctor.  As physicians we prescribe analgesics and sedatives that may suffice temporarily or medications intended to interrupt the cascade of immuno-reaction, but often they don’t work completely or long enough.  So the equation becomes unbalanced and we escalate the medication seeking relief.  Our patients tell  us that some of what we try works no better than water, so we try again with stronger medicines, sometimes relying on potent narcotics.

The problem is that some of our patients rely on those narcotics. They would rather be in a drug induced, drunk-like stupor than another hour of excruciating , debilitating pain.  The trouble is that sometimes they’re incapacitated either way.  A few may even spend substantial time in drug rehabilitation programs—to get over medicines that have done their job too well.

What’s the solution? There are several, actually, but they are only partial answers and all are dependent on the patients and their families.  They all recognize that patients can’t do much while in acute, painful episodes. So the basis is: prepare. Know that pain may invade your life at some point and be ready when that point comes. 

How? With techniques that focus away from the pain, such as meditation or music.  Do whatever you can to relax and /or transport yourself to another part of consciousness-not so the pain will go away (it may not), but so you can gain some semblance of control.  Visualize yourself on a vacation or in a situation you enjoy. Or try a guided meditation with an available audiotape or one that’s specially  prepared for you.