ekkentros free thoughts - pain

Prof. Hay: While in fight as in the case of a combating soldier in a war, the feeling of pain is considerably reduced. The body’s defensive mechanism jumps into action. The body adjusts itself and the secretions from various glands perhaps help this adjustment.It is partly psychological as well.
Sri. Kunhikrishnan: Yes. As we have discussed earlier, the mind plays an important part and is even responsible for the prompt actions of the secreting glands. What about the people who are suffering pain from prolonged illness and are nearing death? How are their pain relieved? I have read in books about the hospices. How far do they help?
Dr. Thomas: Hospices are meant for the terminally ill patients. Although the hospice movement was started with good humanitarian interests, today it has become big business in western countries.
The hospice system was founded by an English physician named Cicely Saunders who had the first hospice in London in 1967. A team of people including the patient’s relatives, doctors, social service people like health visitors, clergymen, nurses and volunteers looked after the patient dying of terminally ill and incurable diseases to give him relief from physical and mental pain. Earlier the hospice team members used to visit the residences of patients to help them. The hospices are now like special nursing homes catering to the elderly dying patients suffering from chronic or terminal diseases.
As regards medicines and methods for relieving pain, there was apparently no medicines in ancient times. In stone age they were perhaps hitting the head of the patient with a stone to make him unconscious, so that he is not aware of the pain till he wakes up again. For alleviation of pain, medicines actually started only after the second world war when anesthesia and antibiotics came into use. From the fifties and sixties of the last century, pain and palliative medicines became very important and effective drugs for the same were discovered. The discovery of anesthetics was a land mark. Then came the universal analgesic aspirin. Later came paracetamol, cox-1, cox-2 endorphins etc.. For cancer morphine oral tablets are now being given. With the advent of many pain-relieving medicines, chronic patients can now be rehabilitated.
Dr. Babu Ravindran: The management of pain is now very much advanced. Every type of pain, even acute and chronic pains have now fairly good treatment. Wherever there is swelling there is inflammation that causes pain. The pain killing tablets reduce inflammation and thereby relieve the pain. Substances called prostaglandins and kinins are formed at the site of the inflammation activating the pain receptors. Drugs like Cox (Cycloxigeneratives) and aspirin inhibit the formation of prostaglandins to reduce the swelling and pain.
Patients who are in pain are generally depressed and anxious about their pain. And this aggravates the pain. Antidepressants are therefore used to relieve the depression. For nerve and neurotic pains, there are anti-epileptic medicines.
Some of the most common painkillers have undesirable side-effects. For example, Aspirin, not only the most effective and common analgesic, but also used in the treatment of heart problems because of its ability to reduce blood clots, irritates the stomach lining, causing bleeding in the stomach. Paracetamol, which does not have this defect, is also harmful when taken in large dozes. Normally it does not accumulate in the body. Yet in huge quantities, it is poisonous, damaging the liver. It appears that there are a large number of suicides in the United States, committed merely by swallowing large overdose of Paracetamol.
Narcotics, especially opioids like morphine are widely used as pain relievers, although they are addictive if treatment is prolonged. The mechanism of giving injection of opioids in the spinal chord to relieve chronic pain is one of the modern treatments.
Prof.Richard Hay: The Calicut Medical college has a Pain and Palliative Care unit, which was in the news recently because of its excellence. When some British delegates from the medical and social professions visited the unit they found it exceptionally well managed, and the patients well taken care of. And they are supposed to have remarked that they do not have such well managed centers in England, because there it will be too expensive.
Dr. Thomas: The five main causes of pain are, Injury, Congenital defects(by birth), Degeneration, Infection, and Tumor (Cancer). Each is handled in different ways, and the drugs used for management of pain will widely vary.