By Penelope A. Domogo, MD
Last week, we discussed that “medicines can heal, medicines can kill” as the famous Dr. David Werner wrote more than 4 decades ago. This warning becomes more relevant now because of the proliferation and easy accessibility of western synthetic medicines. Before, Igorots were wary to take in western medicines; now almost everybody would look for paracetamol at the slightest pain.
Physical pain is the most common reason that moves a person to action – either to remove the cause of the pain or relieve the pain. It is the most common reason why a person seeks medical consultation – headache, toothache, stomach ache, pain in the knees, back, hands… People, generally, don’t like suffering from pain. And just like many people who want instant coffee or instant noodles, they also want instant pain relief. So they take in synthetic medicines called pain relievers (also called pain killers or analgesics) believing it will solve their problem. And then they realize later that the pain reliever did not solve their problem because the pain returns. Worse, it added to their problem by irritating their stomach. So to make our lives happier, we need to know first how pain occurs and how pain relievers work and what other options are there.
Pain is one of the defense mechanisms of our body – to warn us of any threat to our survival and well-being. Our body is equipped with pain receptors. For you to have an idea how these pain receptors look like just imagine millions of ultra microscopic satellite dishes in your body programmed to warn you of any danger. These receptors catch the danger signals just like a satellite dish catches images. The receptor forwards the message to a complicated pain pathway to your brain and your brain commands your body to take action to get away from the danger. Isn’t that really amazing? You are not even conscious of them but they are at work every second- night and day. Google the internet for “pain pathway” and there is an animated pain pathway illustration and a lot more information on how pain occurs.
Try putting your hand to the fire and of course, you will feel pain. Pain signals you to remove your hand from the fire or put out the fire. What would happen if you didn’t feel pain? You will just let it burn till it turns black. People with leprosy lose their toes and fingers because they lose the pain sensation in these parts. Even if their toes get cut, they won’t feel it and so there’s no signal for their body to take care.
Most painkillers like PARACETAMOL and ASPIRIN temporarily block the pain receptor or parts of the pain pathway so you don’t feel pain. These two also relieve pain by reducing inflammation.
Other painkillers act by reducing swelling or inflammation only. Examples of these are the Nonsteroidal Anti-inflammatory Drugs (NSAIDs) such as MEFENAMIC ACID (Ponstan is one brand) DICLOFENAC (one brand name is Voren ) and IBUFROFEN (Alaxan contains paracetamol and ibufrofen).
The disadvantage of these painkillers is that, just like other western medicines, they can also have undesirable side effects like stomach irritation which could lead to bleeding, liver toxicity and damage to the unborn child if taken by a pregnant woman. Some people have died because of bleeding inside their stomach after taking NSAIDS for a long time. Even paracetamol is deadly to the liver when taken in mega doses and in alcoholics or those with liver damage or if taken with alcohol. So a person may have been temporarily relieved of the arthritic pain but died because of internal bleeding or liver damage.
There are also some people who are allergic to paracetamol and the other medicines.
Another disadvantage is that medicines can react with the other medicines you are taking. So always read the label and literature of your medicine (those small pieces of paper inside the medicine boxes or sometimes written inside the box). Read contraindications and drug reactions.
As we discussed last week, always know the generic name of your medicine. Medicines are packaged under a lot of confusing brand names. Paracetamol is a generic name and it is sold under many brands like Biogesic, Tylenol, Tempra. Some drug companies combine paracetamol with cough and cold remedies so make sure what your medicine contains or you might overdose yourself or your child. The popular drug Bioflu contains phenylephrine hydrochloride, chlorpheniramine maleate and paracetamol.
Some side effects can be desirable. For example, paracetamol, ibufrofen and aspirin also reduce fever so these are called analgesic-antipyretic medicines. Aspirin is also a blood thinner so it is prescribed in some stroke or heart attack survivors but in tiny doses.
Aside from the deadly side effects, these pain relievers won’t remove the cause of the pain or inflammation. So these should be taken as a last resort. If you notice, the instructions of your doctor when you are prescribed paracetamol or other painkillers is that you take these “every four-six hours as necessary.” This means that if you took one tablet and the pain or fever is gone, don’t take it anymore.
The good news is that there are better treatments for pain which are gentle and have no adverse side effects – use of essential oils, palm healing/touch, massage, yoga, acupuncture, laughter. Yes, we know that laughter eases suffering, so learn to laugh at yourself.
As a long term measure, look for the cause of the pain. If you have been reading the past issues, you would know by now that a lot of our modern-day food are pain triggers – sugar, chocolates, cheeses, vetsin or monosodium glutamate, meat, eggs. As we said earlier pain is a WARNING mechanism of our body, it is a red flag catching your attention. You don’t clobber the person who shouts that your house is on fire. Instead, you heed that person and put out the fire. Do that with pain.**
“Pain in life is inevitable but suffering is not. Pain is what the world does to you, suffering is what you do to yourself. Pain is inevitable, suffering is optional. “ Buddhist saying
