Summer 2020
In this Issue:
- So, what do we do now? by Penney Cowan
- Quality of Life Sacale Validated
- Using Over the Counter Medications
- Is Technology Use Worsening Your Chronic Pain?
- Bridging the Inherent Relationship Between Pain and Emotion
- Caregiving Among Women
- Washington State Healthcare Quality Group Releases Long-Term Opioid therapy Recommendations
- Living with a Rate Disease
- The Revised IASP Definition of Pain
- In Memory of Coleen Dunwoody
- Support Groups going Zoom Virtual Meetings
- Memorials
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So, what do we do now?
By Penney Cowan
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This has been an interesting year for all. COVID-19 has placed each one of us in a vastly different place than we imagined ourselves when we celebrated the New Year 2020. We had hopes and dreams, plans for the coming year, vacations to take, birthdays to celebrate, family to visit and graduations and weddings to attend. But all that changed in March when we were told to shelter in place for the good of our friends, families, neighbors, co-workers, and even our own well being. And so, we did.
How is that going for you now? I must wonder what impact that all these changes have had on you, your health, and your peace of mind. For many who live with chronic pain not much has changed. They are still at home and feeling isolated. But for the large majority of people who still make every effort to live a “normal” life by getting up every morning and going to work, school, volunteer efforts, and even doctor appointments, things are very different.
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It is important sometimes to go back to the basic and regroup. All the AC PA Ten Steps from Patient to Person are important to those living with pain. However, in times like these perhaps we need to focus on step nine: See the total picture. For me that means looking at the possibilities. Too often when faced with a stressful situation we focus on the negatives that created the situation and all the contributing factors that lead up to it. Right now, many of us are asking if there is any hope that things will go back to normal---at least normal for each of us and what we are comfortable with.
Perhaps we need to ask ourselves a different question. Rather than focusing on all the things that we have had to change, miss, and reorganize, we need to ask ourselves what is still possible. I completely understand that for many nothing may seem possible given the circumstances of COVID-19 and all the changes it has brought to our lives. I know I was challenged wondering what I would do given the “new normal.”
There is always something you can do. Keep in mind it is the little things in life that fill our days and build our memories. What I would like you to ask yourself is not what I cannot do, but what can I do? How can you fill the long days, many alone and isolated from friends and family? What give you a reason to get out bed in the morning?
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Zoom has become the new connection among families and friends. Even celebrations are now via some form of virtual interaction. While it is not replacing those wonderful warm hugs, you get when you meet face-to-face, at least you are connecting. We all need to have people in our lives. Phone calls and Zoom or other electronic formats is one way.
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It might be helpful to start making a list of all the things that you can still do. Perhaps you need to ask yourself what it the most important thing for you to do today---not just what you have to do, but what you want to do, what would make you happy, give you some pleasure? During these difficult times it is hard to be motivated. But we need to have a reason to get out of bed in the morning. Zoom has become the new connection among families and friends. Even celebrations are now via some form of virtual interaction. While it is not replacing those wonderful warm hugs, you get when you meet face-to-face, at least you are connecting. We all need to have people in our lives. Phone calls and Zoom or other electronic formats is one way.
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Take charge of your life! . . . To act intelligently and effectively, we still must have a plan. To the proverb which says “a journey of a thousand miles begins with a single step” I would add the words “and a road map.”
Cecile M. Springer
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Perhaps the place to start is to make a list of all your talents. I know, some of you will say that you have none. I do not believe that for a moment. There are things that you can still do. Think about it. Keep in mind that you are not alone in this “new normal.” There are lot of folks who could use a friendly phone call or funny joke sent via email or text.
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Many of the things that filled your days are no longer possible, but it is summer and for the most part we can still get out and go for walks, ride a bike, or hike on a trail. I know that many people do not think about what is around them, but if you stop and just look at what mother nature has provided, it is amazing. I am not a bird watcher by any means, but in the morning, I sit outside and watch the bids fly from our backyard feeder to a fountain that we keep going to ensure that the animals have water year round. Then there are the squirrels that tend to play havoc on the bird feeders. I realized they also must eat but watching them destroy feeder after feeder is frustrating! What amazes me about them is that they have no idea about what is going on with the rest of the world, they just go about meeting their basic needs for food and water.
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Think back to the warm days of summer when you were a kid. What did you do to fill those days when the rain spoiled all your plans to play outside? Did you enjoy reading, sewing, coloring, building with blocks, playing board games, or perhaps you even helped around the house. You are never too old to play. I think many of us forget how to play.
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It is not about the talent you have, it is the act of actually doing the art whether it is coloring, drawing, working with clay or playdough, building with what you find around the house or something else, you can do it. It is the way we get involved in the process, the focus we have, the effort we put into what we are doing that at least for a while, lets us forget what is happening outside our creative world.
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If you think about it, we all have some ability, we just have to see the glass half full instead of always looking at it as half empty. The interesting thing about putting all your time, effort, and attention on to whatever you are doing, is that you have refocused your attention off your pain, if only momentarily. For many, this shift of focus leads to a reduced sense of suffering. If you don’t want to try any of the above suggestions or try something else. We have a great five-minute relaxation video that it free to view; many use it over and over again.
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Just remember, when you think all is lost, the future remains.
Bob Goddard
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Quality of Life Scale Validated
We are delighted to announce that the American Chronic Pain Association’s Quality of Life Scale has been validated. Because a tool must be validated to be used in clinical practice and pain-related research, our Quality of Life Scale can now be made available to hundreds of people with pain who may not have had access to it through their treatment teams before.
The validation study was conducted by Jaroslava Raudenská, Lucie Michalíkov1, Daniela Mičková, and Alena Javůrková of Charles University and University Hospital Motol and University Hospital Kralovske Vinohrady in Prague, Czech Republic and the ACPA’s Penney Cowan.
The Quality of Life Scale was developed in 1982 based on the ACPA’s belief that, while traditional 0 to 10 pain scales were useful in evaluating acute pain, they did not adequately capture the experiences of people living with chronic pain.
“We believed that, to evaluate the impact of chronic pain, it was important to look at its effect on function---the ability to carry out the tasks of daily living, said Penney Cowan, founder and chief executive officer of the ACPA. “In looking at function, we believed that we could begin to reflect pain’s more intangible impact on quality of life.”
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In addition, looking at function rather than the highly subjective pain scale numbers offers several advantages over pain scales:
- It provides a way to measure improvement (or lack of it) during treatment,
- It gives people with pain and their care team a common language for discussing the impact of pain, and
- It shifts the focus of these discussions away from simply reducing pain toward a more wholistic way of treating an ongoing condition.
While the Quality of Life Scale has been widely used by many in managing their own pain and by health care providers over the years, this validation will allow the scale to take its place as an effective measure in research studies going forward.
As reported in the study findings, “This pilot study brings into clinical practice a method of measuring quality of life that may be used for cross-sectional, as well as longitudinal follow-up studies of patients with chronic pain after various multidisciplinary interventions, including psychotherapy.” The ACPA is grateful to the researchers for their support in making this possible.
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Using Over the Counter Medications
The American Chronic Pain Association, with the support of Johnson & Johnson, conducted a survey in May of 2020 on what people know about over-the-counter medications and how to use them and store them.
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- About 75% of the respondents said that they take both prescription and OTC pain meds;
- 63% used OTC medications to supplement their prescriptions;
- Yet 40% of them have not discussed this with their provider; and
- Only about half consider the other medications they take when choosing an OTC.
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When it came to asking them about tine impact COVID-19 had on them we found the following:
- Nearly 47% have experienced increased pain
- About half report more stress and 46% say they are more anxious
- More than 40% have felt isolated and 36% say they are depressed
- Almost 42% report exercising less, 34% say they are eating more, and more than a quarter are sleeping more
- Well over a quarter say they are no longer able to see their health care provider
All of these higher-scoring behaviors are known to exacerbate pain and erode quality of life and need to be recognized in our overall understanding of COVID- 19’s impact.
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Is Technology Use Worsening
Your Chronic Pain?
By Vincent Turner, Assistant Communication Manager, Sleep Standards
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Chronic pain is one of the most common symptoms that are being reported by patients to primary caregivers. It’s common these days that patients suffer from chronic pain and consequently cannot get a good night’s sleep.
The rise of modern technology and the use of gadgets is undoubtedly adding to the problem; millennials that spend more than 18 hours per day looking at a screen are increasingly reporting medical problems.
Risky Factor
According to Harvard Medical School, there is an increase in the last years of people suffering from physical injuries related to the use of technology. These injuries include a wide variety such as:
- Pain and numbness in hands and wrists, caused by constant pressure on the wrists and hands while typing.
- Neck and back pain, caused by the “Tech Neck,” a poor posture while typing or sitting hunched over while reading on the phone.
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Weight gain and subsequent diabetes and other obesity-related diseases and illnesses; the sedentary lifestyle associated with working with technology, has caused a significant increase in people being overweight or suffering from obesity.
The problems are not only physical. Internet addictions like online gaming have shown that specific brain structures may rewire as well as cause brain matter to shrink. The people suffering from this are showing issues with their emotional regulation and a dependency on technology. After a while, they miss the rush the game or smartphone gives them, or worse, it can lead to excessive aggression or a loss of interest in life offline. These mental issues can, in turn, cause sleep disorders through stress or depression.
In Association with Sleep Disorders
A recent study in the United States reported that Americans suffering from sleeping disorders could spend up to 20 hours per day in front of a bright screen. The use of technology, in association with sleep disorders, can affect all aspects of a person’s life and acts as a significant cause for minor and major health issues and both a severe cause and effect of chronic pain.
As the body loses sleep, it also has less time to recover and heal itself, in a way creating a Catch-22 situation:
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Technology causes loss of sleep - Loss of sleep turns into sleep disorder - Chronic pain starts due to health issues caused by sleep disorder - Chronic pain causes loss of sleep.
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Americans lose on average 42 minutes of sleep per night when suffering from chronic pain. People who suffer from chronic pain feel they have less control over their rest; they are more likely to complain about environmental factors that affect their sleeping patterns. They are also more likely to develop symptoms related to stress.
And this is not all, in this day and age where working from home is becoming the norm, the lack of ergonomic furniture is causing severe issues. Although it’s great that people can lie on the couch and type e-mails, a person’s joints might disagree with that. There is a record number of people who suffer increased pain due to the way they are working at home.
Studies showed that more than 60% of Americans suffer chronic pain that has its origin in the use of technology. Of those, 36 percent had eye strain, 30 percent had back pain, 27 percent had neck pain, 24 percent had headaches, 21 percent had wrist pain, and 11 percent had carpal tunnel syndrome. There is also a significant rise in Diabetes and Obesity.
Chronic Pain Prevention
Although everyone experiences an ache or pain symptom now and again, chronic pain lasts for more than 12 weeks despite medical treatment. Some examples of chronic pain include headaches, post-surgical pain, sports injuries, arthritis, joint pain, neck and back pain, diabetes, or even cancer-related pain. While some of these are entirely treatable with the correct medical care, some are more persistent and difficult to treat.
Early prevention always works better than cure does. People can either prevent or relieve symptoms like chronic pain and sleeping disorders caused by excessive use of technology by:
● Work on a decent sleep routine. If a person likes to read before going to bed, try getting them to read an old-fashioned paper book instead of an iPad or kindle. Also, suggest a digital curfew for the entire family, kids included. Try to set it for 2 hours, but if that is not going to work, try shorter periods like one hour or 30 minutes before bed.
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● If a person works from home, suggest that they talk to their employer to have ergonomic furniture installed in their homes. If that is not possible, speak to them about their posture and how best to work.
● Limit the use of technology whenever possible and take sufficient breaks of at least 20-30 minutes.
● Have technology safe zones---an area in the house where you have no phones, television, computers, and tablets.
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Bridging the Inherent Relationship Between Pain and Emotion
By Gadi Gilam, Ph.D.
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Pain is a natural and adaptive response that protects the body from actual or potential injury. We touch the stove top and reflexively remove our hand from it, while the burning pain at the tip of our finger alarms us to evaluate the damage. When this recently happened to me, I observed the burn on my finger before I actually experienced any pain. It allowed me to notice how the pain was more than just about the location of injury - it was unpleasant and bothersome, and it made me nervous, frustrated, and anxious.
Luckily, the injury was not serious. Nevertheless, it highlighted the complex experience of pain, which is especially important when considering the suffering and burden of people with chronic pain conditions (e.g., low-back pain, migraine, Fibromyalgia). Their pain goes beyond a physical impairment, to include depression, anxiety, social isolation, and many other psychosocial symptoms. Indeed the International Association for the Study of Pain has long defined pain as a subjective psychological experience with a sensory, and an emotional component. Pain is not in the heat generated by the stove, nor is it in the injured finger. It might seem unintuitive, but pain is actually reflective of how our brain predicts and interprets the signals transmitted from our body and its internal organs, as we exist in and interact with our surroundings. This explains how in certain conditions, people can report pain without injury, or that some injuries do not elicit pain. Our lifetime experiences, such as past physical or psychological trauma, and the specific context in which we are, such as if we are in the midst of an intense basketball game, or whether a loved one is with us, shape our experience of pain. Pain is therefore a construct of the brain, and of its interactions with various biological, psychological, and socio-cultural factors.
Together with leading experts in the fields of pain and emotion, I highlight the inherent relationship between pain and emotion in a paper published in the journal Neuron. The paper, titled “What Is the Relationship Between Pain and Emotion? Bridging Constructs and Communities”, points at an important gap in our understanding of this relationship, since there is still a vigorous debate regarding the question “what is an emotion?”
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Emotions are at the core of human existence–we fall in love with another person, we anger at injustice, and we fear the impact of a globally spreading virus. Emotions are products of our brain and reflect internal states that continuously interact with the external world, shaping our thoughts and motivating our behaviors. They are adaptive–they boost survival and foster social connectedness. However, they can also negatively influence our own health and others’ well-being, as well as develop into debilitating conditions such as depression and anxiety. The quest to understand the nature of emotions begins in Western and Eastern ancient worlds and continues today in modern science. As two emotion researchers elegantly phrased it, “Everyone knows what an emotion is, until asked to give a definition” (Fehr and Russell, 1984). This is as true today as it was 36 years ago. For example, do we first think about an event that happened to us, like someone cutting us in line, and then feel the anger, or do we have an immediate emotional reaction to such a provocation, and only later do we think about labeling our feelings as “anger”? Will all people, at all ages, and even in the most remote civilizations, experience and express their anger in the same way, or is there a role for socio-cultural context? Do emotions such as anger, fear, joy, or surprise, each have unique and dedicated neural circuit in the brain, or can we identify more general circuits that are common to all of them? Crucially, answers to such questions serve a larger purpose–-they have practical implications for our ability to provide treatment and relief from emotion-related pathologies.
Taken together, one’s perspective on the nature of emotion has an important impact on how we understand pain, and vice versa. Crucially, millions of people across the globe suffer from various chronic pain conditions and from emotion-related pathologies, which often occur together. In the paper, we map the conceptual, functional, and neural connections between the constructs of pain and emotion and call for more direct scientific efforts to study their bi-directional relationship. Moreover, these connections should lead to greater synergy and collaboration between the two scientific and clinical communities of pain and emotion, which remain siloed from each other. Both fields can benefit from the theories, methods, and findings accumulated in the other.
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The paper provides a framework for bridging the scientific concepts and communities of pain and emotion, with explicit actionable items that will lead to progress. For example, this can be done by explicitly articulating theoretical perspectives regarding the core definitions of pain and emotion, by improving patient-clinician communications about the nature of the pain-emotion relationship, by joint task forces and workshops for pain and emotion researchers and clinicians, and by dedicated funding mechanisms to study and treat pain and emotion together. Beyond a better understanding of what are pain and emotion, and how they influence each other, such a framework supports the development of novel, safe, and effective therapeutic interventions for hundreds of millions of people suffering from pain and/or emotional disorders worldwide. Fundamentally, pain and emotion are more closely intertwined than currently considered.
About:
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Washington State Healthcare Quality Group Releases
Long-Term Opioid Therapy Recommendations
Rose Bigham
Dr. Gregory Terman
The Centers for Disease Control and Prevention released the CDC Guideline for Prescribing Opioids for Chronic Pain (1) in March 2016. Unfortunately, shortly following this release many people with chronic pain suffered unintended consequences (2) when their primary care providers dramatically changed their
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longstanding effective pain treatments because of misapplications (3) of the CDC guidelines. While the CDC works on an update of their 2016 Guidelines (4), the Bree Collaborative, in Washington State, has recently created a new, evidence-based, guideline on how to carefully assess patients in order to provide individualized safe and effective care for people with chronic pain treated with opioids.
The Bree Collaborative was established in 2011 by the Washington State Legislature: “…to provide a mechanism through which public and private health care stakeholders can work together to improve quality, health outcomes, and cost effectiveness of care in Washington State.” The Bree Collaborative chooses a few health care topics every year that are in need of informed opinion. They then form expert multi-disciplinary workgroups (often including patients such as myself) to review recent medical studies, evidence-based best practices, and expert opinion. Each workgroup then discusses and distills that information into a final report with recommendations aimed at helping Washington state’s health care purchasers and providers to improve health care quality, consistency, and affordability throughout the state.
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The Bree “Long-Term Opioid Therapy Report and Recommendations” (5), released in May of 2020, is intended for providers managing adults (over 18 years old) with chronic pain who are receiving opioid therapy. These guidelines do not apply to patients with cancer-related pain, hospitalized patients, hospice or end of life palliative care, or medications for painful procedures (as detailed in Washington state law).
A high-level summary of the recommendations includes:
- Patients and providers must establish an honest and trusting relationship in order to develop a successful treatment plan for the management of chronic pain regardless of whether prescription opioids are appropriate.
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- Treatment plans must be individualized for each patient.
- Existing patients on long-term opioid therapy should be periodically assessed for things like pain and functional status, sleep hygiene, and medical co-morbidities as well as appropriate ongoing risk mitigation efforts.
- After a detailed assessment---and in collaboration with the patient---providers should decide on one of three treatment pathways:
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Maintain and Monitor – For patients for whom pain, function and life role status have been meaningfully improved and with no history of opioid-related adverse events or aberrant behaviors, continue patient’s long-term opioid therapy with periodic review of safety and efficacy of this course of treatment.
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Tapering or discontinuation – For patients with potentially problematic opioid use, consider tapering to a reduced dose or tapering and discontinuing opioid therapy by following the 2019 HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics (6). This excellent guide has detailed specifics on how and when to consider tapering a patient on long-term opioid therapy, including ‘important considerations prior to taper’. The Bree document leans heavily on this HHS document (published during the Bree process) including guidance on “Avoid insisting on opioid tapering or discontinuation when opioid use may be warranted” and “There are serious risks to noncollaborative tapering in physically dependent patients.”
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Transition to medications for opioid use disorder --- If opioid use disorder is present, use evidence-based treatments such as those included in the 2017 Bree Collaborative Opioid Use Disorder Treatment Report and Recommendations (7) or more recent guidance, if available.
In addition, the Bree Report and Recommendations include a number of suggestions for Health Care Systems to support primary care providers, including fair reimbursement payment models, the development of metrics to monitor the process and patient outcomes of these recommendations, training staff, expanded access to Telemedicine services, and others. The report goes on to include a list of the evidence underlying the guideline, validated screening tools, and other references.
For patients with chronic pain conditions for whom prescription opioids are medically indicated, these recommendations provide clear criteria for providers to use to help assess whether maintaining the current treatment plan is appropriate. It also provides some clear warnings on what NOT to do to ensure the continuing function and safety of their patients!
Links included:
Thanks to Dr. Gregory Terman for his editorial comments on this article.
Rose Bigham is the Co-Chair of Washington Patients in Intractable Pain, a patient advocacy group in Washington State. Rose worked as a credentialed technical security/privacy program manager for over 25 years (primarily at Microsoft, then at Amazon) before becoming disabled due to multiple chronic health conditions in 2015. Rose is a Seattle-area native, person with chronic pain, and patient advocate.
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Living with a Rare Disease
Jemma-Tiffany Smith Rosewater
Founder of Hyperacusis Awareness
Approximately 1 in every 50,000 people have hyperacusis. That is currently approximately 66,620 Americans. Hyperacusis is both a rare and high impact pain disorder that causes people to experience physical pain from normal everyday noises. Often those with moderate to severe hyperacusis are unable to go to stores, restaurants, or movies, to work, etc.
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I have had hyperacusis since age 6. My childhood was very different from most kids; I have been unable to attend social events, go to stores and most public places, listen to music, wash dishes, go on vacation, or even take showers because the noise causes me extreme physical pain and lingering migraines. Most of the time I would, and still do, stay in my soundproof bedroom, closet, or grandma’s underground basement. I experience pain daily from noises like airplanes, or phones ringing. Imagine that silverware touching a plate felt like you were being stabbed in the temple and ear, and people talking and laughing felt like you were being punched in the head, and you got a migraine afterwards. I also have several other medical conditions including being legally blind, chronic migraines, and seizures.
Unfortunately, most doctors did not believe me about being in physical pain and often thought that I had a psychological condition, as there is very little research on pain hyperacusis. As a result, I was often subjected to sound exposure treatments that increased my pain and worsened my hyperacusis.
I have been on Home & Hospital many times in elementary school and attended several different educational placements. The school system has been unable to meet my needs; even in a small special education program with a lot of accommodations, attending school is intensely painful for me, and I am often absent due to lingering migraines from noise.
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In the sixth grade, I attempted suicide, as I could not bear the pain and misunderstanding of others associated with my hyperacusis. I ended up in a psychiatric hospital, and they did not make any accommodations during my stay. I was forced to participate in activities all day with kids constantly screaming and banging. I was exposed to loud music, movies, guitars, vacuum cleaners, and much more, despite altering staff that I was in extreme pain. Those two weeks were the most painful experience of my life so far, it felt like someone had broken the bones in my skull and my ears felt like they were on fire. The extreme pain only made me feel more suicidal. I was discharged with a sound exposure plan, which was very painful for me.
The next three years, attending school was still intensely painful for me, and I attempted suicide again in eighth grade. I was sent to the ER, and I prayed hard that God would prevent me from being hospitalized and help me to have a less painful life. I promised God, if he would do this that I would get baptized and give my life to him. God worked a miracle, and not only prevented me from being hospitalized, but provided me with enough medical research that I showed my parents and doctors to convince them not to do sound exposure.
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The summer before ninth grade I wanted to connect with people who had hyperacusis, so I joined a hyperacusis Facebook group. I discovered Hyperacusis Research; a nonprofit organization dedicated to finding a cure to pain hyperacusis.
In ninth grade, Hyperacusis Research published several articles about pain hyperacusis. This new research helped my doctors and adults in my life to gradually start to understand my hyperacusis better. I began to send more research papers to my doctors to make arguments in favor of sound avoidance, citing Hyperacusis Research.
I also began my first novel called Alien Princess: The Mertopian Chronicles Book One, with plans of formal publishing It is a sci-fi story, but the main character, has hyperacusis.
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In Tenth grade, I started working on a project to try to get Maryland to create a school program for students with hyperacusis. In February, for the first time I was given a chance to tell my story about being a student with Hyperacusis, in front of the Howard County Department of special education and to make recommendations. Hyperacusis Research continues to do more research about pain Hyperacusis, and for the first time they were given a grant by NIH.
and a YouTube channel called Hyperacusis awareness to try to help people with Hyperacusis. I am a member of YARR (Young Adult Rare Representatives) part of the EveryLife foundation, a contributor to the Rare Youth Revolution, and a WeGo patient leader.
Hyperacusis Awareness is trying to create a world in which those with hyperacusis, chronic pain, and rare disorders are believed by the medical field and the community about their pain and symptoms. We work to help raise awareness, educate, and develop empathy in the world for people about what it is like to live with hyperacusis which is both a rare and painful disorder. We also want to put in place policies that ensure that those with hyperacusis or other types of rare and chronic pain conditions are always able to easily have the full amount of unique accommodations that they need in all situations in order to be in as little pain as possible and are able to receive the services and help that they need in their daily life.
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Definition of Pain Updated for the First Time Since 1979
After 40 years, a multi-national, multidisciplinary IASP Task Force developed a revised definition of pain that was published today in the journal, PAIN, along with the associated commentary by President Lars Arendt-Nielsen and Immediate Past President, Judith Turner. The revised definition included input from all potential stakeholders, including persons in pain and their caregivers.
The IASP Task Force crafted the revised definition, along with the six notes, to better convey the nuances and the complexity of pain in hope that it leads to improved assessment and management of those with pain.
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The 2020 revised definition of pain is:
“An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage,” and is expanded upon by the addition of six key notes and the etymology of the word pain for further valuable context:
- Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors.
- Pain and nociception are different phenomena. Pain cannot be inferred solely from activity in sensory neurons.
- Through their life experiences, individuals learn the concept of pain.
- A person’s report of an experience as pain should be respected.
- Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being.
Etymology: Middle English, from Anglo-French peine (pain, suffering), from Latin poena (penalty, punishment), in turn from Greek poine (payment, penalty, recompense).
A central change in the new definition, compared to the 1979 version, is replacing terminology that relied upon a person’s ability to describe the experience to qualify as pain. The old definition read: “An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” This wording was interpreted as excluding infants, elderly people, and others – even animals -- who could not verbally articulate their pain, said Dr. Jeffrey Mogil, Director of the Alan Edwards Center for Research on Pain, McGill University and member of the Task Force.
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In Memory of
Coleen Dunwoody
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We are saddened to announce the death of Coleen Dunwoody, past president and long-time board member of the American Chronic Pain Association. Coleen was a graduate of Presbyterian Hospital School of Nursing and a nurse for 45 years with the University of Pittsburgh Medical Center, serving patients directly and as an administrator and clinical instructor. At the time of her death, she was a research associate in the University of Pittsburgh School of Nursing.
Coleen’s life-long passion was pain management. She made enormous contributions in UPMC’s developing pain management practice, where she served as an advanced practice nurse. Coleen authored numerous publications and was in demand regionally, nationally, and internationally as a presenter and educator on pain management topics.
In her time with the ACPA, Coleen ensured that the board and staff were well informed about research developments and best practices in pain management. In addition, her intelligence and leadership skills helped the organization grow and prosper, while always staying focused on the needs of each individual with pain.
Coleen was a remarkable, accomplished woman and the ACPA was blessed to have benefited from her many talents over the years. She will be missed.
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ACPA Support Groups are going to Zoom Virtual Meetings. Here is where they are located. You can call the National Office for contact information. These groups will continue to also do face to face meetings when the shelter in place opens up.
Newly Added Zoom groups:
South Salem NY
Rocky River OH
Englewood CO
We are also offering a conference call group:
Vallejo, CA
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Falls Church VA
Hampton VA Veterans only
Union/Essex Cty NJ
Newton NJ
Ocean Park ME
Minneapolis MN
Ft Wayne IN
Chicago IL
Cincinnati OH Veterans only
Cincinnati OH
Pittsburg PA
Ft Myers FL
Austin TX
Denver CO
Boulder CO
Fremont CA
Danville CA
North Hollywood CA
La Mesa CA
Beaverton/Tigard OR
These groups will continue to also do face to face meetings when the shelter in place opens up.
Please call 800.533.3231 for contact information.
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Gifts given to the ACPA
In Loving memory:
Joseph Cavanna
Given by Gina Hartington
Mark S Reed
Given by Tami Reed
Katherine Nisch
April Cardarelli
Given by The Logues
Sam & Leslea Smedley
Sally K Sanders
Given by Bruce Hill
Gary Rutenschmer
Given by April & Greg Colvin
Joseph Saunders
of Ologies podcast
Given by Alison Ward
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Fall 2020 Combined Federal Campaign (CFC)
Consider directing your donation to the American Chronic Pain Association this year.
CFC Code number is:
10549
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You shop.
Amazon gives.
Shopping on line helps the American Chronic Pain Association
If you use Amazon for your on-line shopping, you can now support the ACPA. It is simple just go to AmazonSmile and select American Chronic Pain Association as your charity from the drop down menu.
- Amazon donates 0.5% of the same price of your eligible AmazonSmile purchases to the charitable organization of your choice.
- AmazonSmile is the same Amazon you know. Same products, same prices, same service.
- Support American Chronic Pain Association by starting your shopping at smile.amazon.com
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