Life

You never know how much it hurts

  Different people experience pain differently under different circumstances. While injury is objective, pain levels are subjective. Pain is different from body temperature, blood pressure, and pulse, and there is no objective way to measure pain. So how do you judge how much pain someone else has?
  It is said that the Huichol people in Mexico believe that the pain of childbirth should be shared by men and women, so when a mother gives birth, she will hold a rope in her hand, and the other end of the rope is tied to her husband’s testicles. Every time there is pain, the mother pulls the rope hard once. In this way, the husband can not only judge the degree of pain of his wife, but also empathize. But expressing pain in this way is neither scientific nor safe.
  The doctor judges the degree of pain of the patient through the pain scale. The scale uses 0 to 10 points to indicate the level of pain, the far left represents no pain at all, and the far right represents unbearable pain. Doctors let patients choose their own pain level, but this method is only relatively accurate, and it is difficult to capture complex and specific pain sensations.
  Regarding pain, there is a saying in the hospital: the patient says it hurts, it hurts, and the patient says it hurts as much as it hurts.
  So, when others talk about pain in the future, you must not express your opinion casually, because you will never know how much others hurt.
  According to research, there are three kinds of diseases that make humans feel the most pain: neuralgia caused by herpes zoster, pain caused by cancer, and trigeminal neuralgia.
  Although pain is a subjective experience, the existence of pain also has an objective basis. Studies have shown that there is a clear nerve conduction pathway for the generation of pain sensation.
  First, various injuries stimulate the body’s tissues to release pain-causing substances, chemicals that cause pain. Next, this chemical is converted into bioelectrical signals, which are transmitted from the nerves through the spinal cord to the brain. The brain undergoes rapid and complex analysis and integration, and finally forms the sensation of pain. Therefore, if there is a problem at any point on this pathway, it will affect the pain perception.
  The wounded in World War II suffered severe trauma but did not feel pain. This is an extreme situation only in extreme scenarios. Because the war makes soldiers highly nervous, a large number of hormones secreted by the human body will act on the brain analysis and integration link in the pain nerve transmission pathway, inhibiting pain. In addition, “I am hurting, therefore I am”, can feel pain on the battlefield, which means that people are still alive, so the wounded will feel joy even if they are injured. The happy substances released by the brain due to joy also inhibit pain perception.
  For example, diabetic patients are often scalded by warm water bags. This is because diabetes has damaged the patient’s peripheral nerves, and the pathway of pain-sensing nerves has been affected, resulting in weakened pain perception. The patient cannot feel the real damage caused by the hot water bag to the skin, so he does not know how to hide, so he is burned.
  For another example, there is a rare disease in medicine-congenital painlessness. Current research shows that this rare disease is related to a certain gene mutation. The genetic mutation blocks the nerve growth factor signaling pathway, which affects the differentiation of neurons, so people with this disease suffer from pain loss. If you don’t know what pain feels like, you naturally don’t know how to hide. A child in Minnesota in the United States suffers from this disease. After she has teeth, she likes to chew her fingers like other children. However, if no one stopped her, she would gnaw her hands until they were bloody, and even exposed her bones. Later, after a hospital examination, it was found that she was suffering from congenital painlessness.
  Pain is a symptom, it is a reminder to us, it is a kind of protection for us, allowing us to avoid damage, and it is a terrible thing to not feel pain. From this point of view, feeling pain is a happy thing.
  Nietzsche said: Disease damages the human body, pain destroys the human soul. In my opinion, pain can not only destroy a person’s soul, but also cause great harm to the body if the pain lasts for a long time.
  In medicine, pain that lasts for more than one month is called chronic pain. Acute pain is usually easy to find the original disease, but many chronic pain can not find the cause. Chronic pain is a disease in itself.
  First, persistent pain can affect a patient’s quality of life. Multiple systems of the body, such as the nervous system, digestive system, endocrine system, circulatory system, and immune system, will successively experience dysfunction due to pain. Secondly, persistent pain will seriously affect the patient’s mental health, and the patient will have bad emotions such as low self-esteem, despair, anxiety, and depression. Especially the pain caused by cancer, many patients will commit suicide or even do things that endanger society.
  Pain for a long time, the nervous system will undergo pathological remodeling. That is to say, pain causes abnormalities in the pain sensory pathway, leading to pain sensory confusion, and the patient will still be in pain without being stimulated. For example, in some patients with long-term leg pain, pathological reconstruction of neural pathways will occur. After the amputation, the patient still feels pain in the leg. We call this phenomenon phantom limb pain, or imagined pain.
  How to treat pain scientifically? In this regard, I make two suggestions.
  The first suggestion is to change perceptions.
  Many people think that there should be pain when there is a disease, or that if any part of the body hurts, you can definitely find the disease related to the pain. When the disease is cured, the pain will disappear, so there is the so-called “illness”. From ancient times to the present, Chinese people have associated illness with pain. But some diseases do not make people feel pain, and although some pain is caused by the disease, it cannot be eliminated by treating the disease, especially cancer. I consulted a patient with advanced liver cancer and the cancer cells had metastasized all over the body. She said: “It hurts too much, I would rather die. Doctor, I beg you, can you let me die quickly.” At this time, pain relief becomes Her most important healing goal. The doctor then gave her painkillers. When she finally left, she left peacefully. Pain has become the fifth vital sign after body temperature, pulse, respiration, and blood pressure.
  There is also a common misconception that taking painkillers is addictive, so endure the pain. With regard to this addictive nature, people are most worried about morphine drugs. In fact, morphine is the most classic strong opioid analgesic in analgesic treatment. It is the first-line analgesic drug for severe cancer pain, the gold standard for severe cancer pain treatment, and a commonly used drug for postoperative analgesia in cancer patients. In 1984, the Pain Relief Agency of the World Health Organization announced that morphine consumption can be used as an important indicator to evaluate the state of cancer pain control in a country.
  The second suggestion is to treat pain scientifically.
  Of course, the premise of treating pain must be a diagnosis. Blind use of pain medication may mask the condition until it is diagnosed. Once the condition is clarified, all pain does not need to be tolerated, and it is the basic right of human beings to be free from pain. The International Pain Society designates the third week of October every year as “World Pain Relief Day” in order to arouse people all over the world to pay attention to pain relief.
  Pain relief is not only a humanitarian concern, but also a professional discipline. This discipline specializes in the study of the pathophysiological mechanism of pain, as well as scientific methods of analgesia, aiming to effectively remove most of the pain with drugs and surgery.
  Good pain control can prolong the life of patients and improve their quality of life. It is very unscientific and even more inhumane to treat suffering as a so-called virtue.
  Medicine only does three things: discover and treat the disease behind the pain, and then stop the pain, so that we can grow old without pain.

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