As a doctor, I have encountered a variety of pain problems in my clinical practice, some of which are even unbearable, making patients and their families very anxious. Today, I would like to share some insights into extreme human pain, especially those that can be called the "ceiling" of pain. These painful experiences are not only physically challenging, but also psychologically challenging. Let me tell you a case that I will never forget, about a patient who suffered from severe pain. The patient came to the emergency department with pancreatitis and was in so much pain that he could barely speak. His face was distorted and sweat was pouring down, a typical symptom of pancreatitis. The pain of pancreatitis is so intense that even the strongest painkillers often struggle to provide immediate relief. When dealing with this condition, we not only need to quickly assess and relieve pain, but also need to deal with multiple complications that can be caused at the same time.
Disease Science and Practical Guide - Pancreatitis
What is pancreatitis? Pancreatitis is an inflammation of the pancreas, which is sudden and life-threatening. The pancreas is a gland located in the back of the stomach that secretes enzymes that aid digestion and hormones that regulate blood sugar. When pancreatitis flares up, these digestive enzymes may activate inside the pancreas and begin to digest the pancreas itself, causing extreme pain and other serious complications. The main type of pancreatitis: acute pancreatitis - a sudden onset with severe symptoms but usually resolves within a few days. Chronic pancreatitis - long-term inflammation that can lead to permanent damage to the pancreas. Diagnosis of pancreatitis: Blood tests: check the level of digestive enzymes. Imaging tests, such as abdominal ultrasound, CT scan, and MRI, to look for inflammation and damage to the pancreas.
Common symptoms of pancreatitis: Severe abdominal pain, usually in the upper abdomen, that can radiate to the back. Nausea and vomiting. Fever and chills. Increased heart rate. Treatment strategy: Pain management: Depending on the severity of the pain, a range from over-the-counter analgesics to strong analgesics may be needed. Fluids: Fluids are given intravenously to prevent dehydration and to maintain a stable environment. Fasting: Fasting may be necessary in the acute phase to reduce the metabolic demands and stress of the pancreas. Nutritional support: if condition allows, feeding may be gradually resumed by mouth or via a nasogastric tube. Treatment of potential causes: For example, if gallstones are caused, surgery may be needed. Daily precautions: Avoid alcohol and smoking, both of which can increase the risk of pancreatitis. Follow a low-fat, high-nutrient diet. Have regular physical exams, especially for individuals with a family history of pancreatitis.
By understanding the basics of pancreatitis and how to deal with it in an emergency, we can manage the condition more effectively, reduce patient suffering and prevent possible complications. Disease Science and Practical Guide - Stone Pain (Kidney Stones and Gallstones)Kidney StonesKidney stones are formed by the accumulation of salts and minerals in the kidneys. They may remain in the kidneys or move to the urethra, causing severe pain. GallstonesGallstones usually form in the gallbladder and are made up of cholesterol or bile pigment crystals. When a stone blocks the biliary duct, it causes severe pain, which is known as biliary colic. Diagnostic method: Ultrasound: This is the most commonly used method to check for kidney stones and gallstones. CT scan: used to see the location and size of the stone in more detail. Common symptoms: Nephrolithiasis: severe pain in the lower back or one side of the abdomen that may radiate to the lower abdomen and thighs, urinary frequency, urgency, abnormal urine color. Gallstones: severe pain in the right upper abdomen, which may radiate to the right shoulder or back, nausea and vomiting, fever.
Treatment strategies:
Pain management: Use over-the-counter medications such as ibuprofen or prescription-grade pain relievers. Warm compresses can relieve pain caused by kidney stones. Medical intervention: Kidney stones: Smaller stones may pass on their own, and larger stones may require lithotripsy. Gallstones: Large or symptomatic stones in the gallbladder may need to be removed by cholecystectomy. Daily precautions and precautions: Adequate hydration: Drinking enough water every day is key to preventing kidney stones. Eat a healthy diet: Reduce your intake of foods high in salt, sugar and fat and increase fiber. Regular check-ups: Regular check-ups, especially if you have a family history of stones. Through the above science and guidelines, I hope to help you better understand stone pain, take appropriate preventive measures, and know how to deal with stone pain attacks. Proper knowledge and timely treatment can go a long way in alleviating the patient's suffering and preventing further health problems.
Disease Science and Practical Guide - Postherpetic neuralgia
Postherpetic neuralgia overviewPostherpetic neuralgia (PHN) is one of the most common complications of herpes zoster infection. This painful state occurs after the original shingles rash has subsided, and the pain can last for months or even years. Relationship between herpes zoster and PHN, herpes zoster is a viral infection caused by the varicella-zoster virus. The virus is latent in nerve tissue after initial infection, usually chickenpox in childhood. In the case of weakened immunity or other triggers, the virus can reactivate, leading to the occurrence of shingles. When the herpes virus affects a nerve, the pain may persist even after the rash has healed, a condition called postherpetic neuralgia. Diagnostic Method: History and Physical Examination: The doctor will make the diagnosis based on the history of the rash and the characteristics of the pain. Skin exam: Check the area after the herpes has healed Common symptoms: persistent pain, which may be burning, stinging, or pins and needles. Hypertactileness, in which the normal sense of touch is perceived as pain. Persistent discomfort at the site of the original shingles rash.
Treatment strategies:
Medications: Antivirals: Used early in shingles, they help reduce the occurrence of PHN. Neuralgia medications, such as pregabalin or gabapentin, are used to manage neuralgia. Topical medications: Lidocaine patches, such as lidocaine patches, can be applied directly to the painful area to reduce pain. Physical therapy: warm or cold: Depending on the patient's comfort, local pain can be relieved. TENS (Transcutaneous Electrical Nerve Stimulation): Uses electrical currents to stimulate nerves that may help reduce pain. Psychological support: Long-term pain can lead to emotional problems, such as depression or anxiety, and psychological support and counseling can help manage these emotional responses. Precautions: Vaccination: Adults over the age of 50 should consider getting the shingles vaccine to reduce the risk of shingles and its complications. With a thorough understanding of postherpetic neuralgia and appropriate management strategies, patients can significantly reduce pain and improve their quality of life. Proper treatment and aggressive lifestyle modifications are essential to manage this chronic pain condition.