In 1994, responding to the need for a more useful system for describing chronic pain, the International Association for the Study of Pain (IASP) classified pain according to specific characteristics: (1) region of the body involved (e.g., abdomen, lower limbs), (2) system whose dysfunction may be causing the pain (e.g., nervous, gastrointestinal), (3) duration and pattern of occurrence, (4) intensity and time since onset, and (5) etiology. This system has been criticized by Clifford J. Woolf and others as inadequate for guiding research and treatment. According to Woolf, there are three classes of pain : nociceptive pain (see hereunder), inflammatory pain which is associated with tissue damage and the infiltration of immune cells, and pathological pain which is a disease state caused by damage to the nervous system (neuropathic pain, see hereunder) or by its abnormal function (dysfunctional pain, like in fibromyalgia, irritable bowel syndrome, tension type headache, etc.). http://en.wikipedia.org/wiki/Pain
Nociceptive pain is caused by stimulation of peripheral nerve fibers that respond only to stimuli approaching or exceeding harmful intensity (nociceptors), and may be classified according to the mode of noxious stimulation; the most common categories being “thermal” (heat or cold), “mechanical” (crushing, tearing, etc.) and “chemical” (iodine in a cut, chili powder in the eyes).
Nociceptive pain may also be divided into “visceral,” “deep somatic” and “superficial somatic” pain. Visceral structures are highly sensitive to stretch, ischemia and inflammation, but relatively insensitive to other stimuli that normally evoke pain in other structures, such as burning and cutting. Visceral pain is diffuse, difficult to locate and often referred to a distant, usually superficial, structure. It may be accompanied by nausea and vomiting and may be described as sickening, deep, squeezing, and dull. Deep somatic pain is initiated by stimulation of nociceptors in ligaments, tendons, bones, blood vessels, fasciae and muscles, and is dull, aching, poorly localized pain. Examples include sprains and broken bones. Superficial pain is initiated by activation of nociceptors in the skin or other superficial tissue, and is sharp, well-defined and clearly located. Examples of injuries that produce superficial somatic pain include minor wounds and minor (first degree) burns.
Vic’s pain falls into all of the abovementioned classes.
Today was a very bad pain day. This morning Vic said “Mommy my body is so sore I cannot cry. My eyes are just tearing…”
I don’t understand pain. I have never been seriously ill. Once every couple of years I may get a cold or flu and then I immediately start moaning and groaning. I am such a wimp!! I could never understand tummy-ache. I have NEVER had tummy ache in my life! I once said to my friend Marlene that I lie in bed and I try and will my body to “pain” – needless to say it just doesn’t happen that way. Marlene said there was a certain laxative that she had used that gave her very bad tummy cramps. I desperately needed to know what my poor baby was experiencing every day.
I bought a packet of the tablets and took one. (I sleep from half a Disprin). Emotionally I was prepared to experience the pain, more specifically the tummy ache that my child lived with every day of her life. Well, I nearly died from pain. Nothing could ever prepare me for the tearing pain that wracked my body. I cried, prayed, begged God to let me die… My ordeal lasted maybe 30 minutes…
Vic is so brave. I know with every fibre in my body that if I was subjected to that type of pain every day of my life I would end my life.
I believe in Euthanasia. The right to die with dignity. Is “die” the right word? I think not! I think a more accurate description would be “the right to stop breathing” because when one is in so much pain you are no longer living – you are only breathing. Will I ever give Vic an extra dose of morphine? Hell no!! She wants to live. She fights to breathe. She wants to see her boys grow up.
Vic was very emotional today. Maybe it is just the physical pain. It breaks my heart when she is sad. A couple of weeks ago she said to me “Mommy, it makes me so sad to know that no-one will ever love me again.” Even as a little girl Vic always wanted to be married and be a mommy. She was three years old when she started playing the “Guess what my baby’s name is going to be when I am big?” game.
This morning Lanie came to visit. She is truly a breath of fresh air. She is our biker child. Last year she bought a Ducati Monster bike. She lives life to the full. She is a fun mommy. On Friday she popped in with the girls for a quick visit. Tom, her husband, also left work early to visit. The girls, Kari and Simone, performed a little concert and for a short while we laughed and forgot about the cloud of illness, impending death and excruciating pain that hangs over our home.