By Bharati Sarkar October 2001 There is nothing noble about living with pain, says neurosurgeon Dr Vijay Sheel Kumar. All it does is debilitate your positive energies, making you unfit to function or live to your full potential. Learn pain management PIONEER OF PAIN MANAGEMENT The most common symptom in the world is pain, yet nobody specializes in it,” said physician Dr C. Norman Shealy, who founded the Shealy Institute in Springfield, USA, in 1982. He has been searching for ways to deal with chronic pain since his early days as a neurosurgeon. He developed the dorsal column stimulator using electrical stimulation to help ease back pain. But he had to turn away 94 per cent of the candidates for this procedure because they were severely depressed. Wanting to treat them, he started searching for ways to do it. Dr Shealy’s philosophy was to examine everything that was reasonable, rational and safe. ”I was aware that there were a lot of alternatives out there that I did not understand,” he said. He planned a meeting that brought together alternative healers to discuss how they treated pain. ”It was obvious that these people had something to offer,” he admits, ”and the question was always ‘is it a placebo?” Dr Shealy had also begun to recognize the value of music for healing. Music heals because it relaxes and so helps to de- stress. The right kind of music brings up ‘unfinished business’ from the past, such as anger, guilt, anxiety or depression that are the root causes of most illnesses. Dr Shealy soon recognized stress as an important factor in illness. Stress is a multi-factored problem, which is chemical, physical, electro-magnetic and emotional. ”It is the interaction of those four main fields of stress that are the cause of all illness, not just some,” he says. He then learnt about autogenic training and biofeedback as alternative forms of treating pain. Biofeedback is the feeding back to a person, visually or aurally, changes taking place in the body. Dr Shealy found biofeedback successful in treating a man paralyzed from the chest down. Until then he had come across nothing to control paraplegic pain. Amazed by this success he began looking at self-regulation, and read everything from yoga to self-hypnosis. (Incidentally, his greatest source of inspiration and understanding has come from Patanjali’s Yoga Sutras). Autogenic training is a self-hypnosis program and a powerful non-biofeedback tool. H. Shultz, psychologist and discoverer of autogenic training, reported that 80 per cent of people with various psychosomatic or stress-related illnesses got well doing the training. Dr Shealy went on to earn his doctorate in psychology and wrote a manual for therapists on how to use biofeedback. He estimates that 85 per cent of people improve remarkably within two weeks without any drugs, using a combination of biofeedback and autogenic training.,br> Dr Shealy believes that the 15 per cent who do not stay healthy are those who stop doing what they’ve learned. ”The people who don’t succeed in this kind of program are those who don’t have the inner reserves to do it,” he says. Pain. Who has not known it? Every living being suffers from pain at different levels at various times in their lives. When pain is extreme, and cannot be mitigated, it is considered a kindness to kill rather than have an animal suffer it. Eminent neurosurgeon Dr Vijay Sheel Kumar says: ”Human beings suffer a wide range of pain; physical, emotional and psychic. In itself, pain is an alarm system to warn us of an ailment, much as a fever is, and the correct diagnosis goes a long way in addressing its cause.” Understanding pain as a biopsychosocial disorder is a recent development and has led to pain management and pain medicine. Acute pain, which signals tissue injury, is considered good pain or eudynia, while chronic pain, which is obstinate and serves no useful biological purpose is considered bad pain or maldynia, when the pain itself becomes the disease. In India, pain is generally accepted philosophically, as one’s lot in life, or worse still, as deserved punishment for past karma. According to Dr Kumar, medical intervention in cases of most pain ends with a typical pain-killer of varying intensity depending on the nature or perceived cause of pain and the rest is left to time to heal at its own pace. But, pain is a very real and debilitating suffering for patients and their families and it is time we woke up to its highly negative influence on our lives. Pain management is an area of medical intervention that has had the least number of protagonists and one wonders why. There are no institutes anywhere in the world for comprehensive training, nor is there a dedicated discipline to address the broad scientific and medical issues relevant to chronic pain. Dr Kumar says: ”Pain is one of the primal reactions of living beings and it originates in the brain stem in the vertebral region. The thalamus, further up, transmits it to the cerebral cortex-(so that we know there is ‘pain’)—creating a pathway of transmission.” Dr Robert Heath, using electrodes and taking a biofeedback recording of neural movement, first mapped this path. Kenneth A Follet, Chairman of the Pain Council, USA, says: ”The typical chronic pain patient visits a succession of physicians and undergoes multiple isolated interventions as each physician provides only those treatments that are within the scope of their specialty. This approach is characterized by a lack of continuity, coordination and care. Patients suffer as a result of this fragmented approach to pain treatment.” Doing pioneering work in India on pain management, Dr Vijay Sheel Kumar has lived and worked in the US for many years before settling in New Delhi, India. He is a neurosurgeon highly qualified in the traditional western methods and still listed as an Expert Independent Medical Examiner for the State of New York. His achievements are far too many to list here but his goal has always been to alleviate suffering and Kumar Pain Management & Neuroscience Clinic (KPMNC) does just that. A stylishly appointed medical center, KPMNC has incorporated technology at its finest without compromising on its aesthetic ambience. The clinic has a single agenda: to free people from pain, whatever it takes. With an open mind, Dr Kumar heads a team of doctors who specialize in neurosurgery, neurology, orthopedics, pain medicine and surgery, sports medicine, anesthesia, alternative medicine, internal medicine, psychology and psychiatry. The team is supported by physical and occupational therapists, exercise trainers, counselors, dieticians and nurses. The entire group is nurtured and cared for by Dr Kumar’s wife, Sarita, who has recently added aromatherapy to the already impressive list of available therapies at the clinic. Sarita believes in TLC (tender loving care) and gives unstintingly of it where a patient needs it. A word of encouragement, a hug, a gentle stroke on the arm or a charming smile—any or all of them boosting a patient’s morale to help him combat pain. The Kumars believe that any discipline that can relieve pain (without causing a side effect) is worth exploring. They have no quarrels with any system, however ancient or new, wherever it may have originated, provided it works. KPMNC’s multidisciplinary approach makes it possible to attend to an individual’s needs in a specific manner suitable for him/her. A range of pain intervention treatments and specialists are available under a single roof to deal with chronic pain. ”Surgery, being an invasive and traumatic intervention, is always considered as a last resort,” says Dr Kumar, adding, ”for some reason morphine is not so widely used in India as it is in the West, despite its excellent pain management properties.” Among the many treatments available here are: acupuncture and acupressure; arthroscopy; aromatherapy; biofeedback; epidural injections; endoscopic carpal tunnel release; nerve blocks; morphine pump, spinal cord stimulation for cancer pain; radio frequency lesions for conditions such as back pain, neck and shoulder pain, face attack and cancer pain; and vertebroplasty for asteoporotic and metastatic compression of the spinal vertebra. KPMNC also has a regular gym for workouts, overseen by qualified physiotherapists who monitor heartbeat and blood pressure, making sure pain does not become a part of the fitness therapy. Early morning gym users are even treated to a healthy breakfast after they have showered in the clinic so they can reach their workplace in peace. It is this attitude of giving something extra, this grace, that makes KPMNC a fine experience. The clinic provides an exemplary service at a reasonable price, giving each individual the full attention they deserve to deal with their pain. Contact:Tel: 91-11-6142392/ 6142282,Email: email@example.com
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