THOUGHT FOR THE DAY...

We can all reprogram our brain's responses by putting ourselves into new, initially uncomfortable situations. We'll learn fear might not mean 'stop'; I've come to believe fear usually means 'go.'

FUN FACTS

* Pain occurs when sounds are above 130 db. *

* The adult human brain weighs about 3 pounds (1,300-1,400 g). *

* Lack of water is the #1 trigger of daytime fatigue. *

* Our Right Lungs takes more air than our left lung. *

* Although African-Americans make up only 13% of the U.S. population, they accounted for one half of the estimated new HIV/AIDS diagnoses in 2004. *

* Stress can result in more headaches as a result of the body rerouting blood flow to other parts of the body. *

One Woman’s Answer to Chronic Pain Management - How Therapy and Support Helped the Hurt

More than 75 million Americans live in daily, debilitating pain. It causes psychological problems and can hurt your relationships with spouses, your children, and even co-workers. Read on to find out how one woman turned her personal quest for chronic pain management into a success story and created a national network to help others in agony...

Chronic pain can shatter your world. It can send you spiraling through anger, grief and depression. It can damage relationships, disrupt careers and wreck sex lives.

That’s what happened to Gwenn Herman, a Maryland clinical social worker whose life was turned upside-down in 1995 by a car accident. She felt fine at first, but a few hours later, white-hot pain surged from her shoulders to her neck and head, then spread throughout her body.

For years, pain crippled and consumed her.

“I understood what it was like to be helpless, fragile and vulnerable,’’ she writes in Making the Invisible Visible (Pain Connection), a chronic pain manual for health-care providers. “There wasn’t a day that I didn’t think of killing myself.’’

She tried neck surgery, a hip graft, cortisone injections, more than 40 different prescriptions and denervation, a procedure that destroys pain-causing nerves. The chronic pain treatment didn’t help much physically, and so did nothing to ease the psychological anguish.

Once she learned how to do her own chronic pain management, she formed a support group that meets monthly to offer others the emotional help and practical advice she’d found lacking in her own care.

That group grew into Pain Connection, a nonprofit center providing support groups, education and training.

In this exclusive interview, Herman explains why psychotherapy should be part of chronic pain management, and how people can cope with the life changes and stresses that come from hurting all the time.
If the pain is real and not in your mind, how does psychotherapy help?
Chronic pain affects every aspect of your life – physical, psychological, social and spiritual. And it affects everyone around you.

You go through a grief process because you can’t do things you used to.

Psychotherapy helps people identify what they’re feeling, explore those feelings and deal with the grief and losses. It normalizes the experience.

How does it normalize it?
Everything that people with chronic pain go through is normal [for them]. They’re not going crazy. [Psychotherapy] helps people realize it’s OK to feel this way and learn how to live again and enjoy their lives.

Did you have pain before your accident?
No, I didn’t know anything about chronic pain at all.

Did you see a doctor when you felt that first rush of pain?
Yes, they said I had whiplash and I’d be OK in 48 hours.

But you weren’t?
No, I was a complete mess. I couldn’t drive, work or take the kids anywhere. I couldn’t sleep at night. It felt like there was a knife in my neck.

Where did you seek chronic pain treatment?
I went to many doctors. I tried muscle relaxers, antidepressants and opioids. I had bad reactions to every medicine. One caused a seizure. I tried massage in the beginning, but it hurt too much.

I tried traction and acupuncture, but the pain was unbearable. A chiropractor said I was so bad that he didn’t want to touch me. He referred me to an orthopedist.

A year later, I had disc surgery and a hip graft.
Was that chronic pain management effective?
My neck pain went down a little. I had a temporary limp because of the graft.

How did all this affect you emotionally?
I completely lost my self-esteem and my whole sense of who I was.

I was waiting for other people to fix me. When it really hits you – that pain is part of your life – you go through a major identity crisis.

You need to figure out how to be more responsible for your treatment.

How did chronic pain affect your relationships?
I had horrible headaches, so I was very impatient with my kids. If they made noise, I would scream at them. So I felt a lot of guilt.

Sexual intimacy was also an issue. My husband couldn’t touch me because I was in so much pain.

I started slowly losing all my work friends. They thought I was malingering.

Did you try psychotherapy?
I went to two therapists. One had fibromyalgia and the other didn’t know anything about chronic pain. They allowed me to vent and cry, but didn’t teach me how to live.

How did you go from being a pain patient to working with other sufferers?
At one point, I found a support group, but all everyone talked about was suicide. I came out thinking, I just want to kill myself.

I decided that, if I ever got straightened out, I’m going to start my own support group.

Why a group for chronic pain management and not just individual therapy?
Pain makes you very isolated, but you don’t want to socialize because you don’t know how you’re going to react in certain situations – or how people will react to you.

The whole idea of a group is realizing you’re not alone.
What therapeutic approach works well for people with chronic pain?
Cognitive therapy. It teaches people how to rethink their pain.

How does someone “rethink” pain?
There’s a lot of negative thinking when you have chronic pain: I can’t do this. I’m worthless. No one knows what I’m going through.

Instead of saying you’re worthless, you look inside and find what’s worthwhile. It’s not just changing your thoughts but learning skills to help yourself – how to pace yourself, how to ask for what you need, how to look for warning signs of a flare up.

How does that work with chronic pain management?
[For example,] somebody might think, If I go shopping, I’m going to have a horrible headache. Cognitive therapy changes that to: I am going to go shopping, and here’s what I’m going to do to take care of myself.

So maybe you won’t go for five hours. You’ll go for a half hour. And you’ll take your ice pack. And if you do feel pain, it’s OK to stop.

Isn’t that simply giving in to the pain?
It’s accepting that your body has changed and that you need to change with it. You’re angry at your body for failing you, angry and resentful that everyone else’s life is going on and yours isn’t.

You’re often trying to do things when you really can’t. The majority of people I know were high-functioning people before pain came into their lives.

It sounds like this kind of psychotherapy is all about dealing with the here and now. Do patients have to dredge up the past?
If they’ve had a history of physical or sexual abuse or other trauma, it’s important to look at that. The vulnerability [of being in chronic pain] brings up old traumas and the pain can get intensified.
What other “mind” techniques help in chronic pain management?
Guided imagery, meditation and breathing techniques to get oxygen into the body are really important for dealing with stress.

The body can go into panic mode when pain flares up. People need to learn how to control pain, rather than have it control them.

When should patients seek psychological help?
It’s not considered chronic pain until you’ve had it for three or six months. But usually people don’t seek help for at least a year.

Why not?
You’re so busy going from one doctor to another, trying procedures and medicines. Usually people come after a lot of failures.

They haven’t failed – the medical model has. But life has deteriorated and they can’t cope anymore.

Should family members also get treatment?
It’s important, especially for children. They also go through life changes.

Because the pain is invisible, younger children especially don’t understand why you can’t take them out, cook dinner or are upset and yell at them.

They see other parents doing “normal” things. They feel they’re not worth doing things for – or that they caused the pain.

The first thing in therapy is to tell children it’s not their fault.

And spouses?
They take on a new role – maybe now they’re the caregiver, breadwinner – or have to take care of the kids.

They’re often angry at first. Some family members just don’t believe it. They think you’re lazy. They tell you to just forget about the pain.

There are a lot of emotions and stress on families.

How is your pain now?
Constant. It’s as low as a 4 or 5 on good days and it goes up to an 8 or 9 on bad days. It can be a really horrible headache, [or pain in] my neck or the back of my legs. But I’ve learned how to work with it.
How do you do that?
I pace myself. I plan out what I need to do and how much time I need to rest. I meditate daily. At work, I keep an ice pack [in a freezer].

Do you use alternative remedies for chronic pain management?
I use oils to soothe my muscles. An herbalist taught me to make a mixture of lavender, St. John’s Wort oil and aloe vera gel. I take vitamins and supplements – vitamin D to help with fatigue and muscle aches, magnesium citrate for pain, Melatonin and Ashwagandha [also known as Indian ginseng] to help with sleep, selenium for my thyroid function and immune system, and cod liver oil.

What do you do on bad days when the pain hits “9”?
Guided imagery. It’s amazing. I breathe and start thinking about an image.

If the pain is really intense, I imagine my healing breath going into the pain, calming it down and breaking it up. I sometimes imagine a waterfall washing it away. Or I imagine the pain on an eagle flying away or an opening in my head allowing it to escape.

The thing is to give the pain a pathway out of my body. If none of those work, I imagine a shot of Demerol.

For more expert advice and information, visit our Pain Management Health Center.

What’s Your Inflammation IQ?
Inflammation has become a hot topic over the last few years. The latest scientific research indicates that inflammation is behind more than 80% of the conditions we suffer from – everything from arthritis to heart disease. Dr. Mark Hyman, author of The UltraSimple Diet, agrees that inflammation leads to a host of health problems. Fighting it can get you on track to a healthier, happier life.

MY ADVICE FOR CHRONIC PAIN, WHICH I LIVE IN CONSTANTLY DUE TO RSD/CRPS AND FIBROMYALGIA; IS TO STAY HAPPY AND BE COMPLETELY POSITIVE NO MATTER WHAT. JUST BECAUSE WERE IN PAIN, WE CAN STILL SMILE AND IT MAKES OUR BODIES FEEL BETTER WHEN YOUR MIND IS HAPPY. I FOUND SOME, SUPPORT GROUPS TO BE NEGATIVE AND I HAD TO STOP THEM. I CONTINUE TO SMILE AND STAY POSITIVE NO MATTER HOW MUCH PAIN I HAVE. IT HELPS TO BE HAPPY AND POSITIVE EVEN THROUGH ALL THE PAIN. P.S. I FIND EPIDURALS BY A GREAT DOCTOR, FREQUENTLY, TO BE MY BEST FRIEND...

Low-Fat Diet, Fish Oil Slows Prostate Cancer

Two simple changes -- lowering dietary fat and taking fish oil supplements -- can slow the spread of prostate cancer, a new study suggests.

Researchers fed some men with prostate cancer a diet comprised of just 15 percent fat, plus 5 grams of fish oil per day. The others got a typical Western diet high in fat. After four to six weeks, both groups underwent surgical removal of the prostate.

Researchers found a reduced rate of cancer cell proliferation in the excised glands of the men fed the low-fat, fish oil diets. .

"We are extremely encouraged by our findings that a low-fat diet with fish oil may have the potential to slow the progression of prostate cancer," says William Aronson, clinical professor of urology at the University of California Los Angeles Jonsson Comprehensive Cancer Center, who reported the findings in the journal Cancer Prevention Research.

Fish oil, high in omega-3 fatty acids, has been found to fight inflammation common in many cancers.

Heavy Drinking Boosts Stomach Cancer Risk

Men who down more than four alcoholic drinks in a day may have a heightened risk of stomach cancer, a large European analysis suggests.

A number of studies have looked at whether people's drinking habits are related to their risk of stomach cancer, and come to mixed conclusions.

These latest findings, from a study of more than 500,000 European adults, suggest that heavy-drinking men are more likely to develop the cancer than light drinkers are.

At the start of the study, 10,000-plus men said they averaged more than four drinks per day. And their odds of developing stomach cancer over the next decade were twice those of light drinkers (who had the equivalent of about half a drink per day or less).

When the researchers looked more closely at the type of alcohol people consumed, they found that beer, in particular — as opposed to wine or liquor — seemed to be connected to stomach cancer risk.

There were no similar connections seen in women, according to the researchers, led by Dr. Eric J. Duell of the Catalan Institute of Oncology in Barcelona, Spain. But there were also far fewer heavy drinkers among the female participants (just under 2,300).

The findings, reported in the American Journal of Clinical Nutrition, do not prove that alcohol itself leads to stomach cancer in some men.

And the absolute risk for any one heavy drinker may be small. Of nearly 13,000 men and women who were heavy drinkers when they entered the study, just 33 developed stomach cancer over the follow-up period.

Still, experts already recommend that people who drink do so only in moderation. That generally means no more than two drinks per day for men, and no more than one for women.

Heavy drinking is linked to cancers of the mouth and throat, as well as other serious conditions like scarring of the liver.

Stomach cancer is relatively uncommon in the United States and other Western countries, though it's much more prevalent in other parts of the world, particularly developing nations. About 21,500 Americans will be diagnosed with stomach cancer this year, according to the American Cancer Society.

Smoking is one of the risk factors for the disease. And in some past studies, it's been hard to separate the possible effects of heavy drinking on stomach cancer from those of smoking — since the same people often have both habits.

In the current study, though, Duell's team found that heavy drinking was linked to stomach cancer in men regardless of smoking habits.

The link also held when the researchers factored in people's diet habits (red and processed meats, for example, have been tied to stomach cancer) and any infection with H. pylori — a type of bacteria that contributes to ulcers.

While most people with H. pylori do not develop cancer, persistent infection is thought to raise the risk of stomach cancer in certain people.

If heavy drinking is a cause of stomach cancer, it may be related to one of the metabolic byproducts of alcohol — called acetaldehyde. The substance is a known human carcinogen, Duell's team notes.

On top of that, beer contains compounds known as nitrosamines, which cause cancer in animals. So it's possible, the researchers speculate, that the combination of those substances and acetaldehyde could explain why beer, in particular, was tied to stomach cancer in this study.

6 Symptoms You Should Never Ignore

You wake up one day and notice something strange — maybe your skin has an orange tinge or you see red stripes in your hair. What gives? Are these odd body changes trying to tell you something?

Dr. Neil Shulman, associate professor of medicine at Emory University, says yes. In his book, "Your Body’s Red Light Warning Signals: Medical Tips That May Save Your Life," he and his co-authors, Drs. Jack Birge and Joon Ahn, explain symptoms that may require immediate medical attention.

"I worked in emergency rooms, and one of the things that really bothered me was that I’d see people who waited a long time for something that was really important," Shulman says, explaining the catalyst for the book. "There are some [symptoms] that are more common and there are some that are more disastrous if you miss it."

Here are six signals your body is sending, and when you should sound the alarm:

Sudden leg pain. Take notice if you have pain or tenderness in the back of your lower leg, especially if it appears suddenly and includes swelling, tenderness, warmth, and discoloration. It may indicate a blood clot that could be deep vein thrombosis (DVT), Shulman says. This condition can be dangerous -- part of the clot could break off, travel through the bloodstream and "cause a blood clot in your lungs that can be life-threatening," he says. Unfortunately, some people don’t know they have DVT until they show signs of a pulmonary embolism, which includes shortness of breath, pain with deep breathing, and coughing up blood, according to the National Heart Lung and Blood Institute.

Striped hair. Striped hair is not just a stylish fashion trend — but rather, a lack of dietary protein or iron, according to Joan Liebmann-Smith and Jacqueline Nardi Egan, co-authors of "Body Signs: How to Be Your Own Diagnostic Detective." The stripes may turn blond, gray, or reddish; however, these stripes also may be a sign of ulcerative colitis, a bowel disease that causes chronic inflammation of the digestive tract, abdominal pain, and diarrhea, or other conditions that may deplete protein, such as irritable bowel syndrome.

Seeing spots or floaters. Floaters — tiny spots, specks, flecks, and cobwebs — show up in your vision, and most of the time they are not cause for alarm, according to Allaboutvision.com. This fairly common and annoying sign of aging may seem pronounced when you look at a bright sky or a computer screen. If, however, you see a shower of floaters and spots, sometimes accompanied by light flashes, you should seek medical attention immediately, as those may be signs of a retinal tear or detachment.

Skin color changes. Pale skin may indicate anemia, a condition in which the body does not make enough red blood cells, according to Body Signs. Bluish skin may be a sign of cyanosis, or oxygen-deficient blood, and may develop after too much exposure to cold air, water, or high altitude. Persistent blue skin, however, may suggest conditions that block oxygen from entering the blood, such as asthma or chronic obstructive pulmonary disease. Yellow skin is a classic sign of jaundice, which stems from bilirubin, a byproduct of old red blood cells. However, if your skin is more orange than yellow it may be a sign of carotenemia, a usually harmless condition resulting from too much beta-carotene or vitamin A.

Sudden numbness, tingling, or speech problems. If you have paralysis of your arms or legs, tingling, numbness, or slurred speech, or weakness especially on one side, this could be sign of a stroke, Shulman says, and immediate treatment matters significantly. A stroke — sometimes called a brain attack — happens when blood flow gets blocked or cut off on the way to the brain. Nationwide, strokes kill about 137,000 people each year, according to the National Stroke Association.

Headache, stiff neck, and fever. If you develop a stiff and painful neck, an intense headache, and a fever, Shulman says it’s time to act fast. These are symptoms of meningitis, an infection of the protective sac covering the brain and spinal cord. This condition infects about 1,500 Americans annually, according to the National Meningitis Association. Adolescents and young adults are at increased risk for the potentially fatal condition. "It’s most common in infants, by the way, who do not show specific signs," he says. "It’s a different story in an infant and this is something that parents really, really, really need to know."

Drinking Boosts Heart Attack Survival

Women who drank anywhere from a few alcoholic drinks a month to more than three a week in the year leading up to a heart attack ended up living longer than women who never drank alcohol, according to a study.

The findings, which focused on more than 1,000 women and were published in the American Journal of Cardiology, add to mounting evidence that alcohol, regardless of the type of drink, can be good for the heart.

"One thing that was interesting was that we didn't see differences among different beverage types," said Joshua Rosenbloom, a student at Harvard Medical School who led the study.

"The most recent evidence suggests that it's the alcohol itself that's beneficial."

There was a similarly reduced risk of dying within the follow-up period whether the women drank wine, beer, or hard liquor, Rosenbloom and his colleagues found.

"One drink a day is a really good target, assuming that a person can be disciplined about that," said James O'Keefe, a cardiologist at St. Luke's Health System in Kansas City, Missouri, who was not involved in the study.

Researchers surveyed more than 1,200 women hospitalized for a heart attack. They asked questions about how many alcoholic drinks the women usually consumed, along with other health and lifestyle questions.

After at least 10 years of follow up, the team found that 44 out of every 100 women who had abstained from alcohol had died, while 25 out of every 100 light drinkers and 18 out of every 100 heavy drinkers had died.

This translated to about a 35 percent lower chance of dying during the follow-up period for women who drank, compared to those who didn't.

In an earlier study including men and women, O'Keefe found that people who continued to drink moderately after having a heart attack had better health than those who abstained.

"You don't need to assume that people need to stop drinking once they develop heart disease," he said.

"The problem is that alcohol is a slippery slope, and while we know that a little bit is good for us, a lot of it is really bad."