Ay yi yi. I have fallen into a deep, dark depression. Due to financial constraints, I've had to quit taking my medicines. I never was a big pill taker, so the only two that I was on were Lisinopril (for high blood pressure caused by fibro) and Lexapro (also for the fibro). I took 10 mg. of each, the lowest available dosages. Lexapro is an anti-depressant, and although the doctor put me on it to break the stress/ pain/ depression cycle, the only reason I agreed to do it was that while it helped the alleviate the pain, I always felt like me. I hate taking anti-depressants, but with such a small dosage I was still able to laugh, cry, and just "feel" in general, and my body aches diminished a lot.

I took my last one about two weeks ago. The physical withdrawals weren't fun. My mind was spacey, I cried a lot, and my whole body felt like it was vibrating 24/7. I could deal with it though, because I knew that it was just temporary. But here I am, fourteen days later, and the depression is horrendous. I'm almost totally non-functional, and that in itself is driving me mad.

I'm trying to help Tom with his business venture, but it's just been horrible. I'm getting stuff done, but it's so hard to focus. I freak out, I cry, I get angry, I sleep to escape. I feel like the most horrible person on the planet. None of this is like me at all. I do hope this all ends soon. Just needed to vent. I hate all of this. I truly do.

No real reason for the accompanying photo. I just think it looks as weird as I feel.

In Martha Beck’s book, Finding Your North Star, she discusses the concept of the essential self.  Basically, your essential self is the calm, peaceful, wise you who knows exactly what you need in every moment of your life.  When you feel flashes of intuition, you are hearing the voice of your essential self.  When you get a gut feeling, your essential self is communicating with you.  Your essential self is in harmony with everything and will always tell you what is right for you.   

If you’re listening, that is. 

All of the panic, fear, anxiety, anger, and depression surrounding your health issues do a fantastic job of blocking the communication between you and your essential self.  To communicate with her again, you need to discover the thoughts behind all of your feelings.  Those thoughts (remember the Thought Log?) are in your head making a lot of noise.  You can’t hear your essential self through all that ruckus.  All you hear is, “I’ll never get over this,” “I can’t stand this anymore,” “everyone else gets to have a normal sex life and I don’t,” and on and on and on… 

The amazing, awesome essential self is a major key to your return to health.  You absolutely want to contact her, because she is very wise.  In Finding Your North Star, Martha shows you how to access her so you can discover your true purpose in life.  For those of us with health issues, your essential self takes on a new persona.  I like to call her your Inner Healer. 

Your Inner Healer, when she can be heard, will tell you what is right for you every step of the way through your medical crisis.  She will tell you when a doctor is not the right doctor for you and when you’ve found the exact doctor you need to see.  She will tell you whether or not the medication you’re considering is really something you want to try or not.  She will tell you what alternative medicine avenues are right for you.  She will tell you what you need to do on your own to help yourself heal.  She is a genius.  But she has a very soft voice – probably because it’s hoarse from trying to shout over the noise of all those panic-creating thoughts.   

The fastest way to talk to your Inner Healer is to enter that relaxed state of being (discussed in previous posts) in which you watch your breath and remain very quiet.  As you quiet your mind, releasing your hold on your thoughts, and focus on your breath, you will start to feel an inner calm.  Stay in the breath until you feel this – it may feel like a floating sensation or just a very relaxed quiet.  It might help to take any thoughts that pop in your head and imagine them scrolling across a page and then disappearing.  Don’t panic if you don’t hear any messages or don't have any flashes of intuition.  Simply keep returning to this place as often as you can.  Soon, you will feel moments of knowledge – you will just know what is right for you.  Very peaceful yet insistent ideas will float into your head.  Sometimes these happen during the meditative state, and other times they just happen randomly.  I often hear my Inner Healer the most right at the end of a meditative session.   

I’ll be talking to you about my Inner Healer in future blog posts, so I wanted to introduce you to the idea today.  Have fun with this – your Inner Healer is a blast to get to know (she’s the person I was talking about in my last post – the one who rocks).  See if you can meet her and start the flow of communication today. 

One of my guru's in chronic pain is Dr Lance McCracken from University of Bath.

I found this great powerpoint presentation, with his voiceover today, on the future of psychology in chronic pain. A great lecture that is well worth saving some time and listening to. Grab a couple of colleagues, a bottle of wine or a coffee, and spend an hour listening to his talk while following the slides. You can't download it, but you can bookmark it and return to it when you want.

[slideshare id=195448&doc=new-directions-in-the-psychology-of-chronic-pain-management-1197041721841657-3&w=425]

I have the books he refers to DAHL, J., & LUNDGREN, T. (2006). Living beyond your pain using acceptance and commitment therapy to ease chronic pain. Oakland, CA, New Harbinger Publications., and MCCRACKEN, L. M. (2005). Contextual cognitive-behavioral therapy for chronic pain. Progress in pain research and management, v. 33. Seattle, IASP Press.. Both of them are easy to read, have some depth, and help with that important process of coming to terms with accepting rather than judging the pain experience.

JUDICIAL REVIEW AND E PETITION FOR COPROXAMOL
by Jeanne Hambleton © 2008
NFA Leader Against Pain-Advocate

The coproxamol debate has apparently been ‘pushed under the carpet’ and seems to have lost its momentum with GPs disgruntled but still wanting to prescribe the 50-year-old safe painkiller. Meanwhile the Government and the Medicines and Healthcare Products Regulatory Agency dig their heels in and refuses to consider a review of the whole sorry situation and ‘bungled withdrawal’. One man is so angry as he lives with unmanaged pain, he is seriously considering spending £20,000 of his hard earned cash on a Judicial Review and another angry coproxamol patient has launched an e-petition for the attention of the Prime Minister.

Russ Mclean, making a comment on the Pulse Today website (owned by and for GPs) expressed his concern for some 60,000 patients being exposed to the possibility of life in untreated pain. As someone in pain, he had pleaded with the MHRA to sort out the failure of the "Named Patient" issue, but they had refused to reconsider the coproxamol withdrawal. Russ McLean now felt he had put up some £20,000 for legal fees to require the MHRA to be subject to a Judicial Review. Russ McLean claims he should be investing this money in helping creating much needed jobs.

P. E. G. Cope, the e-petitioner, urging everyone who has become a ‘coproxamol refugee’ to sign up and give their support to his message to Gordon Brown, writes, ‘We, the undersigned, petition the Prime Minister to allow patients to indemnify their GPs to continue prescribing coproxamol, for pity's sake.’

Of course I have rushed to sign it myself and congratulate this person - Mr. Cope – for taking this initiative.

Mr. Cope – please excuse me if I am wrong – also writes, “The Government has now withdrawn the analgesic coproxamol except for special named patients (for whom nothing else works) at their GP's risk. It is NOW clear GPs will NOT take this risk. Tens of thousands of patients are now left in unnecessary pain. DoH should be as good as their word, in Hansard, and issue a Patient Indemnity Form transferring the GP's risk to the patient, as with anesthetics. This can be done overnight. Please let it be, and end our agony. Pulse magazine found that 94% of rheumatologists favoured retention.

To sign the petition please log on to this link.

http://petitions.pm.gov.uk/Co-Prox/

I could not agree more but the burning question is, will a letter offering to indemnify our GP, if he prescribes coproxamol, be valid in a court of law? It takes less than five minutes to sign the e-petition. Please keep the debate going.

My own GP, who is not prescribing, thinks a letter of indemnity will not hold good in a court of law. He is adamant that the responsibility lies with the prescriber and that any letter written by a patient accepting responsibility, would be invalid.

There is also the question of cost. While coproxamol was a legal category drug, it was available to pharmacists at £2.79 for 100 tablets - a cheap painkiller meeting the needs of thousands of NHS patients. Once it became illegal or de-classified on January 1 2008 the price rose to £20.39 for the same quantity of tablets. How can you justify a seven-fold increase?

This, of course, must be another turn off for our GPs. Not only are they walking a legal tight rope and putting their career on the line, but they would be also pushing up the medication costs within the practice by prescribing coproxamol, not to mention the agro the PCTs are giving the doctors.

WRITE TO THE HEALTH MINISTER AND YOUR MP

It is the Government’s fault and our only chance is to write to Alan Johnson, Minister for Health, and his new health team in the hope he will right the wrongs of the past. Send your emails with a list of all your symptoms, aches and unmanaged pain to

· johnsona@parliament.uk

and plead for a review of the coproxamol withdrawal. Copy your letter to MP Anne Begg who has been doing sterling work for coproxamol but she does need some help from her us. Send a copy of your letters to your own MP. You can log on to theyworkforus.com, insert your postcode and you are presented with a message box.

· BEGGA@parliament.uk

We are counting on all you UK-iers living abroad to give us your support. Talking about Uk-iers I understand there are unlimited supplies of coproxamol in Spain – no problems.

With GPs facing possible litigation, and increased costs, it becomes painfully obvious that less and less doctors will be prepared to take the risk of prescribing coproxamol however much they know the patient cannot find an alternative and is in desperate need of this tried and tested painkiller.

CHECK MATE AND DISASTER

Unless we take some action ourselves and put pressure on the MPs and the Government, we may be faced with a ‘check-mate’ situation. Although one coproxamol manufacturer has pledged to continue providing the painkiller for ‘named patient’, if so few GPs prescribe coproxamol, this could mean that manufacturing becomes uneconomical, and it ceases. What about all the Government promises to help those who really need coproxamol – patient’s responsibility - all hot air – Government spin.

Facing pressure from the MHRA and the PCTs, the GPs facing patients who cannot find an alterative to coproxamol, are finding themselves between a rock and a hard place.

Writing on behalf of the CMP Medica in Pulse Today D. Cressey said as far back as November 2006, the UK drug regulator was passing the buck and telling patients to talk to their GPs if they wanted to continue taking coproxamol.

HYPOCRITICAL TO WITHDRAW COPROXAMOL AND RECOMMEND IT

But MHRA insisted providing individual patients prescriptions were not unusual. But GPs suggested it was ‘hypocritical to withdraw the drug yet still recommend its use.’

Following a survey of GPs and rheumatologists it was revealed that a large percentage wanted to retain the drug said Pulse.

But the Medicines and Healthcare Products Regulatory Agency had already made up its mind and dug its heels in. The agency was warning doctors of the legal risks of prescribing this painkiller. Coproxamol was withdrawn at the end of December 2007 and all pharmacies and warehouses were advised to return unused stocks.

Today I heard from a GP that an Alliance pharmacist, part of the Boots group, had said that coproxamol is no longer available not even for named patients. So who is pulling whose strings? They cannot even get their stories right. Even the pharmacists have no idea what is going on.

In 2007 it is claimed some 75,000 patients were still taking coproxamol. I doubt this is the case now. In November 2006 Pulse revealed the decision to withdraw coproxamol had split the medical profession with 70% reporting they were totally opposed to the withdrawal.

Almost a year later Dr Howard Stoate, an MP and medical practitioner, asked if the Government was so keen on patient choice and empowerment why is coproxamol, which so many people rely upon, being withdrawn?

He quoted Patricia Hewitt, who was then the Health Secretary, as saying the NHS is moving way from the old monolithic, monopoly NHS to a self improving system with more choice for people about the services they use and more freedom and responsibility for GPs to get the best service for people with long term conditions.

Dr Stoate described coproxamol as the only efficient painkiller that people with chronic rheumatic pain, had at their disposal. He said there are risks associated with coproxamol but he suggested there was a strong case for this painkiller to be made a Scheduled 3 controlled drug. With rescheduling the risk would be highlighted and extra safeguards would be introduced.

More importantly it would ensure that coproxamol would remain available to named patients.

Dr Stoate suggested the MHRA had lost its nerve and taken a decision that makes it impossible, in the practical sense of the word, to prescribe coproxamol in 2008, even to named patients. Dr Stoate suggested it is patently obvious that making coproxamol a Schedule 3 Controlled Drug remains the only viable option.

He suggested that perhaps Alan Johnson and his new health team may have learned some lessons from the coproxamol issue and should initiate a full review.
Nigel Praities writing on Pulse Today (www.pulsetoday.co.uk) in December 2007 advised GPs would receive further warnings about the legal implications if they continued to prescribe coproxamol after January 1 2008.
He reported that by October 2007 60,000 patients were still taking coproxamol, a fall of only one fifth as revealed by Cegedim Strategic Data. It was also noted that more than half of the patients who have changed to alternative treatments had lost pain control. The MHRA agency has been urging GPs to switch patients to paracetamol or ibuprofen. With my supply of coproxamol no longer available I have today been recommended to take co-codamol.
It was reported that the coproxamol withdrawal had completely divided GPs. Whatever the personal views they may have Nigel Praities on January 14 2008 reported GPs were under increased pressure following the huge seven fold price increase although in December some 60% were still prescribing coproxamol.

But it was reported by Pulse that almost 40 % of GPs had said they would continue prescribing it on a named-patient basis. Pulse Today have said this ‘bungled withdrawal’ is not working for patients or doctors.
ONE MAN’S VIEW

On 14 January 2008 Nigel Praities reported when coproxamol moved from a Category M drug to a Category C on January 1 2008, coproxamol had a reimbursement price, which was paid to chemists, of £2.79 for 100 tablets. This rocketed to £20.36 for 100 tablets, which brought more warnings from the PCTs. One doctor pointed out that there is nothing like a price hike to concentrate the mind.
In a comment to the Pulse Today website Russ McLean wrote, on January 15 2008

Dear Doctor, I read the Pulse article about legal exposure if you continue to prescribe coproxamol to patients presenting a "clinical need" on the unlicensed "named patient" basis. Whilst the MHRA are to be commended for their original aim in reducing suicides and accidental death from coproxamol, it seems the endeavour has gone too far in the ban direction, and resulted from what is written above, in some 60,000 patients being exposed to the possibility of life in untreated pain.

The purpose of my comment here is to advise, as one now in unmanaged pain, that having pleaded to the MHRA to sort the failure of the "named patient" issue out and had replies from the MHRA declining to revisit the coproxamol issue, I am now having to ante up some £20,000 for legal fees.

Not for any GP, but to require the MHRA to be subject to a Judicial Review. I should be investing this money in helping creating jobs. However, stubborn intransigence from the MHRA is meaning chronic pain, and a big pain in the wallet.
For my tuppenceworth, well done by the doctors who are honouring their commitment to the Hippocratic Oath and continuing, where clinical need presents, to prescribe coproxamol to their patients.
On the same day under another article Russ McLean wrote January15 2008
I am appalled. Sir Alasdair Breckenridge, chair of the MHRA promised a safety net for the 70,000 UK patients* such as myself that present a clinical need for coproxamol after MA withdrawal on 31st December 2007.
For the past two years, I have had the full range of experimental alternate analgesia and been hospitalised twice. All alternates proving either too strong, too weak or with intolerable side effects.
Even more frustrating, is that following spinal surgery in 1994, I was able to sign off of Higher Rate Disability Benefit and resume a meaningful working life (creating 70 jobs over ten years). Now through this MHRA mess, I am faced with unmanaged chronic pain and workless disablement because the MHRA "named patient" system is being shunned by doctors, my own included.
Today in Pulse, we have what seems like MHRA "spin" through cost rather than patient care, in another effort to again screw up the lives of thousands of patients who had effective pain management through coproxamol.
Shame on those in the MHRA who have ignored not one but two House of Commons debates and hundreds of letters of concern from senior surgeons, doctors, heads of pain management clinics, charities etc. * 70,000 as per House of Commons Debate - http://www.theyworkforyou.com/whall/?id=2007-01-17b.340.0
The background
· January 2005 – MHRA announces withdrawal of coproxamol
· October 2006 – A Pulse survey reveals 70% of GPs demand the MHRA review its decision
· January 2007 – MPs demand u-turn on withdrawal at special House of Commons debate
· October 2007 – 60,000 patients remain on coproxamol
· December 2007 – Final withdrawal of coproxamol
· January 2008 – PCTs panic as price of coproxamol soars

Chances are either you or someone you know has a prescription for an antidepressant. They have become conventional medicine’s default drug of choice: when in doubt, you’re probably depressed.

There are three different families of antidepressants, each with a different chemical mechanism. All of these drugs work with your neurotransmitters — the brain chemicals that regulate mood, sleep, and appetite, among other things. They also have very strong side effects. As a result, physicians have come to prescribe them with care just to people who really need them.

In the 1980’s a new family of antidepressants — SSRI’s, or selective serotonin reuptake inhibitors — was developed, and appeared to deliver results in regulating mood without the more serious side effects of its predecessors.

Due to the seemingly attractive risk/benefit ratio of SSRI’s, physicians expanded antidepressant use exponentially: in the 1990’s, spending on antidepressants grew by 600%! Today the various classes of antidepressants under such trade names as Prozac, Paxil, Zoloft, Celexa, Lexapro, Wellbutrin, Effexor, Cymbalta, and Sarafem are among the most widely prescribed drugs in the world. And while we know now that diminished serotonin reuptake does factor heavily into the mood regulation equation, SSRI’s and their pharmaceutical cousins are not the magic bullet pharmaceutical companies would have us believe.

The depressing truth about antidepressants

Can so many of us have the major form of depression that warrants such rampant drug use? I doubt it! This doesn’t mean that a lot of you don’t feel depressed or have symptoms that could be related to depression, but many such symptoms can be related to stress. This stress can be emotional and/or physical — that can be resolved without pharmaceutical drugs. This is especially true when it comes to subclinical forms of mood disorders such as SAD, PMS, or post partum depression.

Some studies have shown that antidepressants are no more effective in treating this kind of mild to moderate depression than a placebo. Furthermore, depending on how one defines depression, as many as one-third to a half of depressed patients do not show significant improvement with prescription medication, while as many as half of those who receive no such treatment improve anyway.

Numerous recent studies also tell us that regular exercise — 20–30 minutes, three to six times a week — can be a powerful antidote to mild or moderate depression. Even small amounts of exercise can make all the difference in the world (though we will generally benefit more from a higher amount). These studies show that sticking to a regular workout provides long-term mood stabilization, especially when combined with other antidepression measures, such as talk therapy.

In fact, antidepressants are contraindicated for short-term treatment of minor depression — something the drug companies don’t want publicized. Clinical practice guidelines indicate that SSRI’s need to be prescribed for at least six months for minimal treatment of major depression — longer than most episodes of minor depression last.

So with such doubt about their efficacy, why are so many doctors handing out prescriptions for an ever-growing list of symptoms including headaches, insomnia, PMS, menopausal symptoms and others that are not exclusively linked with severe depression?

Remember that these products are very powerful chemicals that alter your hormonal balance and perhaps permanently change your brain’s biochemistry. No one knows what the long-term effects of antidepressants are because most clinical trials to date study 3–5-year outcomes of a single drug at a time — never a combination.

There is evidence now that SSRI’s actually decrease levels of serotonin over time. Some kind of disruption of the neurotransmitter pathways occurs, because SSRI’s don’t create a new equilibrium: at some point in time the patient must be moved to a new drug to maintain the same effect.

The side effects of SSRI’s include weight gain or loss, intense restlessness, insomnia, fatigue, sexual dysfunction, panic attacks, and anxiety. And these are not rare side effects: for example, studies indicate that 18–50% of patients experience sexual dysfunction.

Other studies show an increased risk of bleeding disorders, such as GI bleeding, bruising and nosebleeds, with use of SSRI’s. Despite years of analysis, this link remains highly complex and not well understood. SSRI’s also carry strong potential for drug interactions.

A new view of ordinary depression

What makes this all so frustrating is that many forms of depression are natural, normal and temporary — rather like menopause. Indeed, the philosophically minded might simply attribute many of these feelings to the human condition. Likewise, they can be relieved through safe, gradual methods using your body’s natural mechanisms.

As with other symptoms of imbalance, depression is your body’s way of sending you a signal that something is awry. Antidepressants don’t address the underlying problem; they drown it out with a booming Don’t worry-be happy! But for how long and at what cost?

Think for a moment about how SSRI’s work. The idea is that you don’t have enough serotonin, so the drug conserves the limited amount in your body, blocking it from being changed into the next substance on its metabolic pathway. If you have major depression, you need to stay on your antidepressants. However, everyone who is on or thinking about taking an antidepressant should know what their choices are.

Depression includes a range of normal negative emotions. Clinical depression differs significantly from minor or situational depression or mood disorders, even though the symptoms can be the same. The differences is that in mild depression the symptoms ebb and flow and eventually lift, while in major depression they spiral down into a full-blown, entrenched mental health crisis.

I was introduced to blogging by a friend I call Green (long story). Green's love of blogging got me interested in writing my own blog on a more regular basis. Thanks to this blog, however, I am never going to be able to run for political office. I share way too much in these web logs, and today's post is no different. You know, when I was dating, I'd go out with anybody once. It didn't matter what race or religion he was. As long as he was, in fact, a he, I'd let anybody buy me dinner. The exception was drug dealers. I had no desire to be rolled up on during my calamari and blasted to smithereens by other drug dealers. I wasn't about to do the Baby's Mama Drama that usually comes with dating street pharmacists, and I am way too pretty to go to prison for merely riding in a vehicle that contained drugs having nothing to do with me. I successfully managed to avoid the drug scene - until now. I had a baby in November by C-Section (I'm also too pretty to be contorting my face through the process of pushing a human being out of my loins), I had an emergency appendectomy in December, then I had surgery again 13 days ago. Basically, this means that for the last four months I've been high as a kite. Then it occurred to me that I've actually had 10 surgeries in the last nine years. Good Lord, I've really been high for a decade. My body laughs at OTC drugs like Tylenol and Ibuprofen, so the pain of cramps or the flu usually isn't helped with anything less than Vicodin. Vicodin doesn't dull my pain, but it relaxes me enough that I can fall asleep and snooze through some of it. For my life outside of the hospital, after foot surgery, wrist surgery, GYN surgery and the like, I get my beloved Percocet. Taking 2 Percocet is like drinking a few glasses of wine, and settling into a hot tub with a good book. For about 90 minutes, nothing matters but those moments. My pain isn't gone, but I simply could care less about it. I find myself smiling for no good reason. I answer yes to anything the hubby and kids ask. And I literally drift off to sleep drooling, and dreaming of shoe shopping sprees and chocolate fudge cake. I have developed a post-surgical tolerance to morphine (meaning it doesn't work), but some wonderful, awful, person invented Dilaudid. I have honestly never tried street drugs, but the feeling you get from Dilaudid is why I assume people get hooked on crack or heroine. Literally, you could care less about everything in the world. It is the one drug that actually erases my pain, but it erases EVERYTHING ELSE  as well. I am willing to bet that on Dilaudid, I can't spell my own name, or recite my children's birthdays. Some doctors actually write prescriptions for the home use of Dilaudid. Thank heavens, none of my docs are that irresponsible. Growing up in the inner city, you see a lot of people addicted to a lot of things. They usually do a lot of awful things to get the drugs of their choice. Those things are usually illegal, so they are in and out of jail due to addiction. Here in the suburbs, people also get addicted to a lot of things. Some of those things just happen to be legal, and all we have to do for it is whine to a doctor. While I make light of my prescriptions, I have a health care team that communicates with each other. I happen to have enough common sense (and too many kids that need me to care for them) to ask for narcotics when I don't need them.  But some people don't have my common sense. And some doctors don't care. If you know or suspect someone you love of being addicted to painkillers, talk to them. Try everything you can to get them to a Narcotics Anonymous meeting. They'll need your support. As for me, I think I feel a back spasm or a shoulder ache coming on. Excuse me while I go take a Percocet and a Vicodin. I have to cover all my bases.

All fiction, none of it's true.
From the diary of some chick:
{I think that I've come to the realization that I'm drinking a little too much. And did you know that xanax+alcohol=blackouts?
Seriously, there are big chunks of evenings I DO NOT remember. I haven't done anything crazy or stupid--okay there was that one night in when we went out for RY's bday, but it was all TL's fault because she gave me a painkiller on top of the xanax on top of 3 shots of tequila and 2 mojitos, but BESIDES that, I'm normal. I just don't remember anything. Kinda scary. But xanax rocks. And so does wine. But just not together. Gotta remember that.}

Wow, I'm glad I found that. Could help some people out.

Of all the symptoms that arise from my illness, I think having panic attacks have to be the worse.  Recently I talked about how my doctor had moved me from Klonopin to Xanax to try to resolve some of the panic attacks I have been having.  I get so worried about taking to much medication that I try to go without it.  I worry about becoming addicted.  I talked with my pdoc nurse about this and she said as long as I was taking my medication as directed not to worry.  My doctor and I discussed my history with panic attacks.  She noted that I have gone long periods where I have not needed meds to subside my attacks.  She referenced the Xanax as like a "rescue medicine."  She also reminded me that I am on the lowest dose and through my regular visits she monitors how much I am using.

Today I had a couple of bad attacks while at work.  I felt like my shirt was moving with every rapid heartbeat.  I just froze in terror.  I don't have a job where I work on heavy machinery so please don't worry about me or my coworkers, but I had to take some medicine while at work.  The attack ceased and I worked through the day.  Below is the best description I have found for what it feels to have a panic attack.

It can happen anytime, anywhere — when you're alone, with others, at home, in public, even awakening you from a sound sleep. Suddenly, your heart begins to race, your face flushes and you experience shortness of breath. You feel dizzy, nauseated and out of control. Some people even feel like they're dying. Source: Mayo Clinic Health.

Therapy and Yoga have helped to give me breathing techniques that make it bearable until the medication takes affect. That all said, unless I want this illness to overtake my life, I am going to listen to and trust my doctor.  I have already missed too much work lately.  I refuse to feel like a criminal for taking medication that I don't abuse and that helps contribute to my well being and allows me to a productive member of society. 

Sorry, no apologies necessary.

            Research performed at the Mayo Comprehensive Pain Rehabilitation Center and presented to the American Society of Anesthesiologists at their 2007 annual meeting found that low vitamin D levels may be associated with chronic pain. Researchers found that about 26% of patients with chronic pain also have low vitamin D levels. The researchers found that patients with low vitamin D levels also needed higher dosages of pain medication. The group with low vitamin D needed twice as much morphine when compared to those with normal vitamin D levels. The researchers believe that vitamin D deficiency may not be the principle cause of pain, but may be a complicating factor.

At last, something dear to my heart hits the news!

I dropped into MedWorm and skimmed the headlines just a moment or two ago, and found this!!!

It was entitled 'Hope for low back pain sufferers' and initially my heart sank - not another 'we can fix you' article promising much relief from pain but possibly not delivering it... And then I read on.

Now medical research charity the Arthritis Research Campaign has awarded a three-year primary care fellowship of almost £132,000 to occupational therapist Carol Coole at The University of Nottingham, to develop more effective ways in which the NHS can work with employees with back pain - and their employers - to ensure that back pain doesn't drive them away from the workplace.

Being able to remain working is of critical importance to everyone involved in the experience of back pain - the person with pain who doesn't want to lose his or her job, and at the same time doesn't want to suffer from their pain; the employer who doesn't want to lose productivity or face the costs of finding a new employee; the health care funder who doesn't want to have to spend huge amounts of money on treatments only to find that the outcomes just aren't there (the longer someone stays off work, the longer they are likely to continue to stay off work); and finally, for health care providers who really don't want to continue to have a person fronting up for help for their back pain without adequate supports that they can be referred to.

In 1995, at Burwood Hospital, Christchurch, I developed a pain management programme specifically to help people who wanted to return to work despite having ongoing pain. Despite various changes and the eventual demise of that particular programme (WorkAbilities), the specific focus on integration of vocational issues within pain management has been a theme at Burwood Hospital Pain Management Centre ever since. It's absolutely vital that people who experience pain are given every support to help them return to normal life roles including work - better for health, better for quality of life, and better economically.

I'll be writing more on this over time, but for now it's GREAT to see that a significant research award has been given to an occupational therapist to address this compelling issue. I hope that many more health providers will consider how important generalising the use of pain management skills to all situations including work can be to people with chronic pain.

Congratulations to Nottingham University and Carol Coole - way to go!!