A Nation in Pain: Healing Our Biggest Health Problem, by Judy Foreman
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A Nation in Pain: Healing Our Biggest Health Problem, by Judy Foreman
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Out of 238 million American adults, 100 million live with chronic pain. And yet the press has paid more attention to the abuses of pain medications than the astoundingly widespread condition they are intended to treat. Ethically, the failure to manage pain better is tantamount to torture. When chronic pain is inadequately treated, it undermines the body and mind. Indeed, the risk of suicide for people in chronic pain is twice that of other people. Far more than just a symptom, author Judy Foreman writes, chronic pain can be a disease in its own right--and it's the biggest health problem facing America today.Published in partnership with the International Association for the Study of Pain, A Nation in Pain offers a sweeping, deeply researched account of the chronic-pain crisis, from neurobiology to public policy, and presents practical solutions that are within our grasp today. Drawing on both her personal experience with chronic pain and her background as an award-winning health journalist, she guides us through recent scientific discoveries, including genetic susceptibility to pain; gender disparities in pain conditions and treatments, perhaps linked to estrogen; the problem of undertreated pain in children; the emerging role of the immune system in pain; advances in traditional treatments such as surgery and drugs; and fair-minded assessments of the effectiveness of alternative remedies, including marijuana, acupuncture, massage, and chiropractic care. For many people, the real magic bullet, Foreman writes, is exercise. Though many patients fear it will increase their discomfort, studies show it consistently produces improvement, often dramatic. She also explores the destructive "opioid wars," which have led to a misguided demonization of prescription painkillers.Foreman presents a far-reaching but sensible plan of action, ranging from enhancing pain education in medical schools to reforms of federal policies across the board. For doctors, scientists, policy makers, and especially patients, A Nation in Pain is essential reading.
A Nation in Pain: Healing Our Biggest Health Problem, by Judy Foreman - Amazon Sales Rank: #193302 in Books
- Brand: Foreman, Judy
- Published on: 2015-05-01
- Released on: 2015-05-01
- Original language: English
- Number of items: 1
- Dimensions: 6.10" h x 1.50" w x 9.20" l, 1.72 pounds
- Binding: Paperback
- 464 pages
A Nation in Pain: Healing Our Biggest Health Problem, by Judy Foreman From Booklist *Starred Review* Health columnist Foreman didn’t fully comprehend the meaning of hurting until her own bout of severe, protracted neck pain. Five years of research and 200 interviews (with doctors, scientists, and patients) later, she discovered that inadequate management of pain is a serious health problem and, while there may not be a cure, an integrative approach to treating pain is helpful. At least 100 million Americans suffer from chronic pain. It triggers about 40 percent of hospital ER visits. Foreman explains the biology of pain and its connection to emotion. All sorts of treatments are reviewed, including a multitude of medicines, biofeedback, epidural steroid injections, acupuncture, marijuana, physical therapy, Botox, chiropractic manipulation, surgery, and even transplantation of fetal nerve cells. But it is exercise that tops the list. Opioids (narcotic drugs) receive plenty of attention: the good (they work); the bad (a possibility of fatal overdose); and the ugly (the potential for abuse and addiction). Foreman focuses on dueling dilemmas: people who truly require powerful prescription pain medications may find it difficult to obtain them, yet those who abuse these drugs access them much too easily. Finally, a scientific and empathetic book that sensibly sorts out the problems and possibilities of adequately controlling pain. What a relief! --Tony Miksanek
Review "The shadow pain casts and the toll it takes on individuals and society are revealed in this remarkable book by nationally syndicated health columnist Foreman, who chronicles the genetics of pain, types of pain receptors, and the effect of hormones and gender on pain and pain relief... this work is thoughtful and thought-provoking reading for the medical community, policymakers, and patients, especially in light of the F.D.A's recent call for tightening regulations in the administering of pain medications." --Publishers Weekly starred review
"Encyclopedic in scope... Foreman's text underscores the fact that pain really is an extraordinarily complex phenomenon that requires more research. If we continue head-in-the-sand policies, we will remain a nation in pain." --Kirkus Reviews
"Finally, a scientific and empathetic book that sensibly sorts out the problems and possibilities of adequately controlling pain. What a relief!" --Booklist
"This is a book that has been waiting to be written. Tens of millions of Americans suffer from chronic, unrelenting pain, yet until now they've had nowhere to turn to understand how pain arises or what to do about it. Whatever the source of pain -- and there can be many -- it can come to dominate the sufferer's life and be soul-destroying. Foreman has written a superb analysis of this most distressing of medical conditions. Many people will thank her for it." --Marcia Angell, M.D., Senior Lecturer in Social Medicine at Harvard Medical School and former Editor-in-Chief of The New England Journal of Medicine
"The great majority of books written on pain in the past decade provide simplistic recipes based on untested remedies. Judy Foreman's new book, A Nation in Pain, attacks the complexity of chronic pain, and thoughtfully provides a realistic approach to optimal pain management. Her research on this topic, including interviews with pain patients and pain scientists, provides a wealth of personal and professional expertise and experience. This book will be a valuable asset to patients, physicians and professional organizations wanting an encyclopedic and unbiased treatise on the very difficult topic of chronic pain." --Don L Goldenberg, M.D., Chief of Rheumatology, Newton-Wellesley Hospital; Professor of Medicine, Tufts University
"The experience of chronic pain forges new alliances and A Nation in Pain provides insights, knowledge, critiques, questions and comfort for readers -- be they individuals impacted by pain, those who care for them and those who might benefit from this thoughtful and comprehensive treatise. I am one of those individuals." --Philip Pizzo, MD, Former Dean, Stanford University School of Medicine, David and Susan Heckerman Professor of Pediatrics and of Microbiology and Immunology
"Judy Foreman has provided a masterful chronicle of the commonest of human miseries -- chronic pain. The author delves into neurobiological mechanisms and notes the failure of our educational system to prepare physicians to deliver adequate care, including the perils of ignoring benefits of non-traditional (non-Western) therapies. This is a book for everyone; scientists and sufferers, physicians and their educators." --Joseph B Martin, Lefler Distinguished Professor of Neurobiology and Dean Emeritus, Harvard Medical School
"A Nation in Pain: Healing Our Biggest Health Problem is an extensive and eye opening look into the world of pain from the heart and soul of someone who understands what it is like to live with pain. Judy Foreman explores the anatomy of pain guiding us through treatments both conventional and unconventional and the debate that many of them ignite. I found it refreshing and honest while making a strong point that we need to do a better job at managing chronic pain." --Penney Cowan, Founder, American Chronic Pain Association
"Encyclopedic in scope... Foreman's text underscores the fact that pain really is an extraordinarily complex phenomenon that requires more research. If we continue head-in-the-sand policies, we will remain a nation in pain." --Kirkus Reviews
"Finally, a scientific and empathetic book that sensibly sorts out the problems and possibilities of adequately controlling pain. What a relief!" --Booklist
"In this book, Judy Foreman, an award-winning health columnist has beautifully narrated the saga of chronic pain--how it happens, how far it can go; why it happens, why it happens to you, and why it happens to you more than the others; and why the suffering is often endless... I would recommend this book for everyone: those in pain, those healing pain, those learning pain, and those policing pain relievers (the drugs and the people who prescribe them)." --R. Goyal, British Journal of Anaesthesia
About the Author Judy Foreman is a nationally syndicated health columnist who has won more than 50 journalism awards and whose columns have appeared regularly in the Boston Globe, the Los Angeles Times, the Dallas Morning News, and other national and international outlets. She graduated Phi Beta Kappa from Wellesley College, served in the Peace Corps in Brazil for three years, and received a master's degree from the Harvard Graduate School of Education. From 2000 to 2001, she was a Fellow in Medical Ethics at Harvard Medical School. From 2001 to 2004, she was a Lecturer on Medicine at Harvard Medical School. She has also been the host of a weekly call-in radio show on Healthtalk.com. In 2014 she was the recipient of the American Pain Society's Kathleen M. Foley Journalist Award.
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Most helpful customer reviews
33 of 34 people found the following review helpful. Encylopedic overview on a critical problem! By MD Can Help Judy Foreman has done a brilliant job of shedding light on one of the biggest problems in American medical care. The under-treatment of chronic pain in adults is an embarrassment to the medical profession, from inadequate education of medical students about any aspect of pain to a prevailing view that people requiring opioids for chronic pain are guilty until proven innocent. Sadly, even oncologists receive almost no training in pain management.The book is encyclopedic in scope, covering many research efforts, patient stories, and interviews from the nation’s leading pain experts. I can’t even imagine how much research was done to compile such a vast amount of information. This book is a gift to patients who have suffered unnecessarily AND to doctors who need more education and should be more sympathetic to people suffering with this prevalent and highly debilitating condition. When all is said and done, we are all but one major car accident away from a life of chronic pain. Judy Foreman gets a gold star for writing a book that should be required reading for all physicians.Gail Gazelle, MD, FACPAssistant Clinical Professor, Harvard Medical School
20 of 20 people found the following review helpful. A Critical read for Everyone! By ginger Judy Foreman's new book, A Nation in Pain, doesn't waste any time diving in to the shocking statistics and research related to chronic pain and the severity of the problems surrounding it. It is a mandatory reading for Chronic Pain patients, Medical professionals, and society at large - who is so often misinformed by the media and general lack of education surrounding these issues. This book covers everything from the basic definition of chronic pain --- to opioid wars --- to ideas on how to make real improvements in our nation's response to chronic pain.Some early facts in this book that i found to be highly interesting:1). "[the government] spends only about 1% of its vast budget on pain research, despite the fact that chronic pain....is a bigger problem than heart disease, cancer, and diabetes COMBINED. ...Federal spending on chronic pain is actually going down."2). Judy Foreman discussed the problem of doctors not being educated to treat or work with patients with chronic pain. She cites, "Across all the years of medical training, students got an average of 13 to 41 hours of pain education. Veterinary students got more than twice that - 87 hours on average."3). "Out of 238 million American adults, 100 million live in chronic pain. And yet the press has paid more attention to the abusers of pain medications than the astoundingly widespread condition they are intended to treat. Ethnically, the failure to manage pain better IS TANTAMOUNT TO TORTURE."I fully believe that we will be better as a country due to this book, the more people that read it the better. It is rare that any book fills me with this level of inspiration for positive change. I know i will read this book many times, and buy it for those who are important to me. Ms. Foreman's research appears to be ignited by her own personal experience, fueling her passion for this subject. I am further impressed as I emailed her with some of my questions and comments and she responded within 24 hours! If you are interested in improving our country and preventing the unnecessary torture of our citizens, i highly recommend you read this book!
27 of 29 people found the following review helpful. I Just Bought the Kindle version By Wayne J. Anderson The reason I am buying is that both my wife and I have pain issues. The following is from a very reliable web site I subscribe to that gave this review. Another reason I am buying the book. After reading I will adjust the stars rating based on my feelings about the book.The following review was written by SB. Leavitt, MA, PhD at Pain Topics News & Research.Of nearly 240 million adults in the United States, more than 4 in 10, or about 100 million, live with chronic pain of some sort. Yet, the professional and popular news media focus more on abuses of pain medications than the dreaded conditions the drugs are intended to treat. Meanwhile, the suffering of untreated or mistreated patients with pain is largely overlooked.In her new book — A Nation in Pain: Healing Our Biggest Health Problem — author Judy Foreman provides a deeply researched account of today’s chronic pain crisis and reasons behind it, and she discusses some solutions that could be within reach. Far more than just a symptom, Foreman explains, chronic pain can be a disease in its own right, and the failure to manage pain better in the U.S. and other countries worldwide may be tantamount to torture.A great many (perhaps, too many) books have been written on the subject of pain; all are well-intentioned and often they are self-published. While some of the books are of interest, most appear to be riddled with personal opinion, biased perspectives, and/or misinformation rather than being guided by facts and solid evidence. As a journalist and investigative health reporter, Foreman has done a noteworthy job of crafting easy-to-read text that also is excellently documented with enough citations of her evidentiary sources to satisfy even the most skeptical readers — which is quite rare for a book intended for both lay and professional audiences, as is A Nation in Pain.The 464 page book, published by Oxford University Press, is ambitious in scope, covering in a mere 14 chapters subjects ranging from the nature of pain to genetic, age, gender, immune system, and mind-body influences. Foreman also examines various traditional, newly discovered, and alternative therapies for chronic pain.She says that her research for A Nation in Pain spanned 5 years, during which time Foreman consulted a library of books and hundreds of scientific papers on pain. She also interviewed nearly 200 scientists and physicians, as well as countless patients, a few lawyers, and a handful of government officials. [Full disclosure: This writer was one of those persons consulted, and we can attest to the depth and relentless probing of her inquiries.]A most appealing approach of the book is that it is simultaneously a textbook providing research insights and hard evidence, an investigative report replete with stories of affected patients and their families, and a personal memoir relating Foreman’s own experiences with chronic pain and its treatment. Certainly, this juggling was no easy task, but the genre makes for fast-paced, informative reading while captivating even a casual reader.Overall, Foreman suggests that there is an appalling mismatch between what people in pain need and what healthcare providers know about pain and its treatment — chronic pain in particular. She found that physicians in the U.S. typically receive only about 9 hours of education specifically on pain during 4 years of medical school — even veterinarians are better educated on pain management.Systematic failure is equally evident at the federal government level; for example, in 2012 the U.S. National Institutes of Health spent only about 1% of its vast $30.8 billion budget on pain research, Foreman states, despite the fact that chronic pain was (and still is) a bigger problem than heart disease, cancer, and diabetes combined. At the same time, chronic pain in the U.S. conservatively costs as much as $650 billion per year in direct medical costs and lost productivity. Shamefully, there is no National Institute of Pain; yet, there are other Institutes addressing diverse health conditions that are important, but affect far fewer citizens and with less burden on the economy.One of the more startling chapters in A Nation in Pain discusses the mismanagement of pain in pediatrics. Among other revelations, Foreman discloses how as recently as the mid-1980s in the U.S. healthcare professionals believed that young children, especially newborns and infants, seldom needed medication for pain relief and tolerated discomfort well. She recounts the particularly disturbing story of a newborn boy who was subjected to open-heart surgery without anesthesia — a practice that apparently was commonplace at the time, but somewhat of a dark secret known only among medical insiders. In general, management of pain in children of all ages has been deficient worldwide, as Foreman reveals in an examination of the research evidence.Foreman devotes 2 chapters to the destructive "Opioid Wars," which have led to a misguided demonization of prescription opioid analgesics. Her discussion of this highly controversial topic is among the most fairly-balanced and evidence-based that we have seen. She observes that there are 2 separate public health “emergencies,” sometimes called “epidemics”: (a) undertreated pain influenced by some degree of limited access to opioids, and (b) the abuse of opioid analgesics for illegal or nonmedical purposes. She stresses, “whether the term ‘epidemic’ truly applies here is debatable.”Foreman recognizes that there are many sides to the ongoing debate and relatively little hard evidence one way or the other. As she states, “The complex truth is that opioids, especially opioids for long-term use in chronic non-cancer pain, are probably both under-prescribed for some patients and overprescribed for others.” Opioids are not a solution for all patients or all types of severe pain, she acknowledges, and at best the pain relief they afford is only partial. She accordingly emphasizes:“Opioids, in other words, may be necessary, but they are rarely sufficient. What I am saying is that government drug policy seems to be lopsided, politicized, stacked against legitimate pain patients, and fueled by public hysteria over abuse of prescription pain relievers. That hysteria, in turn, is fueled by often-misleading media coverage.”Those few sentences say a great deal about what has gone awry with concerns about opioid analgesics today. In support of those statements, Foreman laces her discussion with references to relevant research studies, while also distinguishing between good- versus poor-quality evidence — an objectively analytical perspective that is missing in most other books and articles on the subject.As Foreman observes, the controversy over prescription analgesics is a “highly emotional struggle in which much of the ‘debate’ is driven not by scientific facts but by dueling anecdotes of horror.” She aptly denounces a misguided popular press, prejudiced bureaucrats, and a small cadre of fear-mongering medical professionals for trying to foist a negatively slanted view of opioid pain relievers on the public as well as on the healthcare community at large. In balance, Foreman also tells how over-exuberant marketing by drug manufacturers has contributed to problematic analgesic prescribing and use.Throughout the book various therapeutic approaches for managing chronic pain are discussed, including new developments still in preclinical or clinical trial stages. Additionally, a whole chapter is devoted to marijuana (“The Weed America Loves to Hate”) and another focuses on exercise (“The Real Magic Bullet”). A range of CAM (Complementary & Alternative Medicine) therapies also are covered, with balanced discussions of pro and con research evidence for each.Challenges of effective chronic-pain management are complex, with many obstacles to overcome on the path to finding practical solutions. As the diverse stories of patients with pain in the book demonstrate, pain often cannot be extinguished altogether; yet, it almost always can be better managed and patients can live more fulfilling lives. Foreman offers some suggestions for action — such as expanded pain education in medical schools, reforms of federal policies across the board, and increased funding for pain research — but it would require a separate book to do justice to such proposals. Meanwhile, for healthcare providers, researchers, policy makers, and patients and their loved ones, A Nation in Pain is highly recommended reading.
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