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Sometimes there are measurable findings that explain
cause of pain, but we do not know why. We doctors even have fancy ways of saying, "We have no idea what's causing it."
My patient Paul was in a panic when he read about his "idiopathic pancreatitis" in his medical record. This means that he had inflammation of his pancreas that we could see on a CAT scan, yet we don't know why his pancreas became inflamed. The two most common causes of pancreatitis are gallstones and alcohol use. Paul didn't have gallstones and he never drank. He was not at risk for numbers of other uncommon causes of pancreatitis. So why pain?
The good news for Paul is that there was a way of explaining what was happening, and diagnosis guided treatment. The bad news for him is that in absence of knowing why he got pancreatitis, there was very little we could tell him to prevent further attacks. Ask anyone who's had a bout of pancreatitis and they will tell you that's not something they ever want to go through again.
It's easy to lose sight of fact that pain is there to serve you. Pain is not problem. Finding out what's causing pain is challenge.
The key for you and your doctor is to eliminate pain, but not ignore message pain is bringing. You might get medication to treat heartburn and your pain will go away, but you may overlook stress at work that's causing heartburn. It's like putting tape over dashboard in your car so you won't get distracted by flashing red trouble lights.
What do you do when you have pain that can't be explained by a lab test or X-ray or any changes your doctor can see or feel or hear when examining you? This can be a frustrating situation, both for you and your doctor. If you have ever had a headache or backache or heartache of depression, you are most likely nodding your head.
My advice is to become a medical detective. Find things to measure and describe with numbers and keep a log. Here are some measures to write down:
- Rate your pain on a scale from 1 to 10 (10 is worst ever) - Duration of episode (minutes/hours) - Number of episodes per day - Amount of sleep - Stress level (1 to 10) - Medication taken that day
You might have hunches about what's causing pain or making it better. It might be what you eat, or your physical activity or weather. This can become part of your log and a springboard for discussion with your doctor.
The next time you experience pain, listen to voice that tells you that pain is enemy. Then remind yourself that your pain is also your friend.
It's there to draw your attention to an important message if you will only listen.
Copyright © 2004 Vicki Rackner
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Vicki Rackner, MD, president of Medical Bridges, is a board- certified surgeon who left the operating room to help employees become active participants in their health care. She is a consultant, speaker and author of the *Personal Health Journal*, and author of the lead story for *Chicken Soup for the Breast Cancer Soul.* Dr. Rackner can be reached at http://www.MedicalBridges.com or (425) 451-3777.
