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Show There are two basic types of pain: acute and chronic. Acute pain is nature's alert that something is wrong and may require attention. The message, in the form of nerve impulses, goes from your sprained ankle, say, to your brain, and you feel pain. Along with that goes your psychological reaction, what doctors call the suffering component." Acute pain disappears when the injury mends. But for some, pain persists long afterward. Many experts contend that the brain itself generates this now useless message of chronic pain. In fact, doctors sometimes are unable to pinpoint any injury or infection that might have triggered the pain. But. whatever its cause, the pain is all too real. Chronic pain has become such big business that hundreds of pain centers are cropping up nationally. Some examine one problem headaches only, for example. Others might specialize in a specific treatment acupuncture or surgery. Just recently doctors have begun to develop special programs to treat those with chronic pain syndrome. Many such patients had parents they described as abusive, disabled or alcoholic. Says Dr. Aronoff, Often, their pain is a subconscious way of saying, Now its my turn to be taken care of.' Experts from various medical disciplines share goals for the treatment of chronic pain syndrome at the New Hope Pain Center in Pasadena. Calif., at Montefiore Hospital in the Bronx , N. Y. . and at dozens of other sites around the country. Dr. Jack Pinsky. a psychiatrist, directs the New Hope chronic pain syndrome unit. We hope, he declares, our patients will leant to say, The pain may still be there, but I've stopped depending on medications. I can enjoy life.' The Boston Pain Center has only 21 patients; all the same, it is among the nation's largest. It takes up the entire tenth floor of the Spaulding Rehabilitation Hospital . The atmosphere is friendly, but the routine is demanding and the rules are tough . There are exercise classes for patients who. helpless and passive for months or years, leam to use their muscles again. No matter how crippled by pain, they must dress themselves and pick up their medication at the nursing station at set hours; if they forget, there will be no painkillers till the next time. They must get to the dining area unaided and attend every scheduled meeting. There are training sessions in different pain-relitechniques. And there are individual and group therapy sessions to explore the psychological components of their pain. Dr. Aronoff says his patients average two operations before they enter the CL Boston center as 25. More than 70 percent suffer from lower back pain. 10 percent from head and facial pain. Most have felt chronic pain for more than six years. Nearly 60 percent are women. Aronoff contends that women acknowledge the psychological side of pain more readily than men do. The patients who manage to take charge of their lives leam to admit that their pain is not just physical. At the pain center at Johns Hopkins Hospital in Baltimore, about 80 percent of the chronic pain patients are seriously depressed, estimates Dr. DonlinLong. He founded the program, which includes psychological counseling. Studies have shown that antidepressants provide pain relief. But. he says, to treat the pain, you must treat the depression too." However affected .by psychological attitudes, these patients feel real pain. and the medical profession has no cure for it. Says Dr. Edith Kepes, director of the pain center at Montefiore Hospital, Most physicians just give them pain pills. And this can lead todependence on drugs. Dr. Kepes refers pain lasts beyond healing and thousands are now fighting back jr APRIL 28, 1985 PAGE 9 many of her drug-depende- nt patients to the Boston Pain Center to help them get through withdrawal symptoms and away from family conflicts. Chronic pain syndrome is a family affair. At the Boston center, there are weekly meetings at which patients and their families leam to discuss the conflicts that chronic pain can set up. Upon arrival, more than 50 percent of the Boston patients are taking narcotics. Upon leaving, says Dr. Aronoff, less than 10 percent use drugs. All of this attention can be costly. The bill for inpatient care at the Boston center ranges from $12,000 to $14,000 for four to five weeks, depending upon how many consultants are called in on a case and upon the treatments and medications needed. (Outpatients pay $4000 lor six weeks.) Outpatient care is available at various other centers, including New Hope, where a bill for up to six weeks runs about $14,000. And after the treatment program ? In Boston, patients get individual followup sessions at the center. They also are invited to monthly meetings of Pain Copers, a self-hel- p support group for the "graduates." Aronoff says two-thirof them leave much improved. meaning they have stopped taking pain medications. have no significant depression and report that pain no longer dominates their lives. gy cripples many, but PARADE MAGAZINE some have had as many Apples! Apples! Apples! "W7tyn'.!Nr frTiwrn Grow the Incomparable Grammy Smith Apple The Crisp, Juicy, Flavorful Apple Thats so Easy to Grow! Move over Red Delicious. Golden Delicious and McIntosh, here's an apple that may heal them all the incomparahk Granny Smith. for eating fresh, for cooking, for storing, for sheer good looks Yes. the ftivfir is absolutely It s crisp, white juicy flesh has just the right amount of flavor tanness to give it that superior 'apple' flavor. What's more it stores well, keeps its for MONTHS. 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