Table of Contents

Chapter 1: The Reality of Pain

Defining Pain
Why Different People Feel Pain Differently
Pain Is an Emotional Experience
Measuring Pain

Chapter 2: How We Feel Pain

Nerve Fibers: The Cells That Sense Pain
Sensing Pain Through Chemistry
The Pain Is in Your Head

Chapter 3: How Do You Spell Relief? N-S-A-I-D

Side Effects to Watch for
     Upset Stomach
     Toxicity

Chapter 4: Morphine-Miracle Drug Against Pain

Debunking The Myths About Morphine
      Truth 1: Morphine Use Is Safe
      Truth 2: Morphine Used to Treat Pain Does Not Cause Drug Addiction
            The Difference between Addiction and Dependence
            The Problem of Pseudo-Addiction
      Truth 3: Increasing Dosage Does Not Harm the Patient
      Truth 4: Opioid Use Now Will Not Render Later Use Ineffective
      Truth 5: The Need For Strong Pain Control Does Not Mean Death Is Near
      Truth 6: Morphine Does Not Cause Stupor
Understanding Opioid Side Effects
      Sedation
      Nausea
      Constipation
      Jerking Movements
      Low Testosterone
      Death
Pain Control Without a Ceiling

Chapter 5: Power over Chronic Pain

Chronic Pain Is as Chronic Pain Does
The Barriers to Effective Chronic Pain Control
      Roadblock #1: Use Of The Wrong Medicine
      Roadblock #2: "As Needed" Prescriptions
      Roadblock #3: Misunderstanding Morphine
      Roadblock #4: Pain Is Not Taken Seriously
      Roadblock #5: Physicians Not Trained To Treat Chronic Pain
      Roadblock #6: Pain Is Not Recognized As a Distinct Disease
Getting the Job Done
When All Else Fails, Be Creative
      Spinal Pumps
      Spinal Cord Stimulators

Chapter 6: Treating Acute Pain

Controlling Acute Pain

Chapter 7: Treating Pain When Cancer Has Spread to Bones

Detecting Cancer in the Bones
Surgery
Radiation
Medicine
Drug Therapy As Pain Control
Pain Control at the End of Life

Chapter 8: Hospice-The True Death With Dignity

Bringing Humanity Back Into Dying
How Hospice Works

Chapter 9: Potpourri

Migraine
Fibromyalgia
Arthritis
      Make Sure It's Arthritis
      Osteoarthritis
      Rheumatoid Arthritis
Multiple Sclerosis and AIDS
Sickle Cell Disease and Its Pain
Pain and Gender
Age and Pain
Alternative Approaches To Treating Pain
      Hypnosis
      Acupuncture
      Alternative Therapies

Chapter 10: Pain Control And Health Insurance

Private Insurance
      Fee-for-Service Plans
      The PPO
      The HMO
Government Insurance
      Medicare
      Filling in the Gaps
      Medicaid
If You Don't Have Insurance

Chapter 11: You and Your Doctor

Your Doctor's Duties
      Proper Qualifications
      Confidentiality
      You Decide
      The Right to Know What Is Going on
      Protection of Your Dignity
      The Right Not to Be Abandoned
      Respectful Treatment
      Keeping Up to Date
      Referral to a Specialist
      Access to a Second Opinion
      Optimal Care
Your Responsibilities to Your Doctor
      Communicate, Communicate, Communicate
      What Your Doctor May Ask You About
      Your Pain
      Be Prepared
      Ask Questions
      Follow Your Doctor's Advice
      Do Not Delay Reporting Your Pain
      Tell Your Doctor How You Feel
      Be Considerate of Your Doctor's Time
      Have Reasonable Expectations
Finding a Good Pain Control Doctor

Chapter 12: The Future Of Pain Medicine

Appendix

Index