Perception of Chronic Pain

thebrokencolumn1944

I have been suffering from chronic pain since 10 years now. My right shoulder, arm and hand are affected from a condition called Complex Regional Pain Syndrome or CRPS in short. I also suffer from a kind of cluster headache condition with this very poetical name:  paroxysmal hemicrania continua. Despite all this problems I look normal, there is no way to see that I am sick. I often hear “you are looking great today”. Pain can only be seen on my face but mainly from people close to me.

To be short these health conditions give me moderate to severe (more severe than moderate) pain in my shoulder, arm and hand that can be described like being stabbed and electrocuted all day and night in those areas. My headaches appear at night and feel like being grabbed by the base of my skull by a clamp and stabbed straight through my head, constantly or in clusters of a minute or two, day and night for up to 6-8 weeks.

There is almost nothing that can be done to cure or stop the pain as for now. Researches are being done all over the world but the authorities, most neurologists and general practitioners are so conservative that the patients are left in distress everywhere. I will not talk about fundings and the dire situation in the public health system all over the world leaving chronic pain sufferers on the side because it is non lethal, too long and too expensive to treat!

These conditions that cause chronic pain make people loose everything: mobility, freedom, sleep, jobs and career, friends, husbands or wives, confidence, memory, creativity, moral as far as their lives. I personally considered this disease, when it stoke  me at 31, as a small death. I had to go through all the stages of grief to reach acceptance of my new self. Without help and with my mind all fuzzed up by the medication!

Then, I had to deal with people preconceived ideas on pain. It goes like this: “did you try this or this ?”, “take a painkiller”, “I had a tooth hache last year, it was sooo painful, I went to this dentist and he made everything better”, “I know someone who had a bad back and went to see this doctor and he/she made him/her better in no time”, etc, etc. This hurts, so far, there is nothing that works for us.

There are sometimes, close ones who will not accept your condition and think that tomorrow you will be cured like that, with a pill. In that situation you cannot even hope to talk about your condition to try to make them understand what it is, how it affects you, how you feel and that you need their help. It makes you feel rejected.

There is also, the difficult journey through the modern medical system who does not have time to listen to the patients anymore. It took me 6 years to find out what really was wrong we me!  In that time I was examined by  neurologists, circulatory specialists, physiotherapists, anaesthetists, radiologists, pain specialists and no one took the time to tell me what was wrong with me! I have chronic pain that’s all.

Finally lets talk a little bit about the state help. Social welfare is doing everything they can to make sure that you are left in dire straits. No help, you are left alone even if you have paid your taxes for years! They do not care. They do not try to understand what is your condition. They make you feel nothing more than a crook that wants to abuse the system. I experienced it first hand. Then, you have the position of governments on researches and access to some medication that are either too expensive or politically too controversial despite the fact that they allow sufferers to resume a quasi-normal life and leave the social welfare system to be independent again!  Worldwide, chronic pain costs as much as cancer, HIV and diabetes costs put together. Last year in the US, chronic pain cost more that the cost of all the war the US is involved in!

No changes are made or way too slowly. I have to say that goes beyond my understanding!

Obesity in Ireland

ObesityA while back the Irish government launched a campaign to try to tackle the obesity problem in the country. At the current rate the World Health Organisation has statistically forecasted that Ireland obesity problems will reach pandemic levels by 2030, in 15 years only! A study published in the Lancet in 2014 shows that around 27% of Irish girls and 17% of boys under the age of 20 are overweight or obese. In the over 20’s the rate of obesity is around 66% of men and 51% of women. These figures have increased by a rate of 28% in adults and 47% in children during the “celtic tiger’s” years. So far the Irish government has launched a campaign in which food outlets and restaurants must add the calorie count of each dishes on their menus. Since 2005 a healthy eating awareness campaign is run in schools all over the country. All this is good, even if as an ex-chef I do not believe that having a calorie count on a restaurant menu is going to do much to tackle the obesity issues in children or adults. The main issue is  in my opinion and experience more profound. The obesity problems must be tackled on three fronts: Education, Alcool and Control of the food industry.

First of all, not only children need to be taught to eat healthily. A cultural change about how and what people eat has to be encouraged. The time spent to prepare and eat meals has to be extended. People must allow themselves more time to eat, to enjoy what they eat. Ireland has a lot of great products to discover. The way food is perceived has to change too. I come from a country where food is seen has a “leisure”, a way to socialise. Here, food is a necessity. A mean to an end. People eat because they have to.

This brings me to the second point where changes have to happen: alcool. Drinking is the main way to socialise in Ireland. The pub is at the core of all Irish celebrations: christening, communions, wedding and funerals or sport and cultural events. As an example, in France where I come from, the sending of the food for a wedding meal, from the kitchen side, can take up to 4 hours. In Ireland the average sending time for a wedding, that I experienced, is 1 hour. At a french wedding the alcool is drank with the food all along the meal. In Ireland, after the meal it is open bar. Alcool and food are separated. In my eyes it looks like people eat because they have to and then socialise around a pint (or more). I am not mentioning the food at the “after” deep fried baby sausages and white processed bread sandwiches. In France the tradition is onion soup.

The last lever that should be used to tackle obesity is a better control of the food industry. There the government has to bring legislation imposing a proper, simple and coherent labelling on all food products. Then, the levels of salt and sugar has to be reduced by the industry. There is only one way to achieve this: the law and proper enforcement of the law. The minister for health needs to have the balls to bring in legislation. They managed to ban tobacco in public places as well as in the pubs. Ireland was the first European country to do it. This shows that difficult decisions can be implemented against powerful lobbies. Finally, advertising of unhealthy food has to be banned from all public services (buses, airports, etc). Proper and coherent legislation must be put in place to avoid the implantation of fast food outlets near schools or sport grounds. Where I live, there is the example of McDonald which has been granted the authorization to build a restaurant beside 3 schools (maybe 8-900 children)! No one find that unacceptable in the town council or in the county council, they allowed the project to go forward! My understanding is that the planning permission was agreed upon the fact a gym has been added to the fast food outlet building! I am sorry but as a parent I do not think that a gym is going to protect children from junk food. There is absolutely no coherence between national campaigns and local decisions!

So, the problem of obesity is only going to be addressed properly if the politicians at national and local level are coherent in the implementation of the government strategy. Strength has to be shown by ministers in tackling the bad habits of the powerful food lobbies. Finally, cultural changes must be ignited and encouraged over a long period of time. It is that simple! But, it is not going to keep you in a government nor get you elected. It is going to be unpopular and bring upon politicians a lot of pressure from lobbies. A lot of friends won’t like it either. Saying that, Mr and Mrs politicians you must have the balls to do it, otherwise it is going to be a very serious issue that has the same negative potential for your carrier.