STORY ARCHIVE
Complex Regional Pain Syndrome is a condition where pain never goes away after an injury and even gets worse. The pain becomes a disease in its own right.
Complex Pain&
TRANSCRIPT
NARRATION:Laura Black lives in a world of agony. She experiences pain on a level most of us can?t begin to imagine.Laura Black:Sometimes the pain is so bad that you know you can't think about anything but the pain and nobody can touch you, nobody can do anything to help you. You can?t do anything to help yourself.Dr Maryanne Demasi:How long do those excruciating episodes last?Laura Black:Ah, the worst ones can be hours and hours. Laura Black:It ruins you. It really does. It changes who you are. It's changed everything about my life. You know I've gone from sort of you know a very happy person, I knew what I wanted to do with my life, to somebody who's trapped inside. I can't get out.Dr Maryanne Demasi:Pain is essential for survival. It?s usually a warning that something?s wrong. Now if I wave my hand over this flame, it hurts and the pain warns me to stop. But what happens when pain ceases to be a consequence of our actions and becomes a disease in its own right.NARRATION:That?s what?s happened to Laura. She is living with complex regional pain syndrome or CRPS. It?s a severe neurological condition under the banner of chronic pain disorders.Prof. Michael Cousins:It is a complex pain, invariably in a region, say an arm or a leg, but it can be in other regions too, it could be in the nose, it could be in a breast. It could be in a penis. And we've found recently it can even be in an internal organ.Assoc. Prof. Michael Nicholas:It's associated often with quite marked changes in the skin. You'll see colour changes, mottling, sweating. The nails can change like your fingernails, toenails can change colour and um, it can be quite um, ah, alarming.NARRATION:Most alarming though, is that the trigger is usually something trivial.Laura Black:I was hiking with some friends and it was just sort of basic teenage clumsiness I guess, I fell over a rock. When I fell it was just a very very minor injury. I twisted my knee.NARRATION:Laura was sure that after a few weeks she?d be back to normal. But the pain persisted for months even though her injury had healed. And her doctor was sceptical.Dr Maryanne Demasi:What did the doctor say to you? Laura Black:He didn't really take me seriously. He sort of passed it off as teenage hypochondria. He thought it was all in my head. Dr Maryanne Demasi:Laura what are some of the symptoms that you feel from day to day? Laura Black:My main one is a sort of I guess a deep burning pain in my bones. It feels like somebody's got a red hot corkscrew and they're they're twisting it through my bones. I can feel it sort of spiralling through. NARRATION:Pain is controlled by the brain. Within milliseconds of an injury, pain receptors relay messages in the form of electrical impulses carried along peripheral nerves to the spinal cord. Nerve fibres in the spinal cord release neurotransmitters that send messages to thalamus in the brain. This is the point at which pain is experienced. The thalamus triggers other areas of the brain and returns messages to nerve cells in order to diminish pain signals. But sometimes, the nervous system distorts and amplifies these pain messages. This over stimulation of the central nervous system is a hallmark of chronic pain. Prof. Michael Cousins:Chronic pain is really very different from acute pain. And I like to talk about them as good pain and bad pain. Acute pain is good pain, it warns you that you have a problem and you need to seek help. On the other hand chronic pain or persistent pain as I prefer to call it, is bad pain. Because it just keeps going, regardless of whether the initiating injury or disease has healed up. And I refer to this as chronic pain being a disease in its own right.NARRATION:Laura occupied her days as best she could, studying to keep her mind off the pain. She even completed her honours degree in veterinary science. But in the years that ensued, Laura?s worst fears were confirmed. Laura Black:I'd been on crutches by that time for two and a half years and been terrified that it would spread to my left leg because there was that knowledge that spread to my left would put me in a wheelchair. And now I am.NARRATION:Now the intense pain has spread to her entire body. Prof. Michael Cousins:Now there's only one way that could happen and that is due to the involvement of the brain. It can't happen at the spinal cord level, but it can happen at a brain level. NARRATION:Functional MRI?s have shown that chronic pain actually causes changes in the wiring of the brain, This ability to change is known as neuro-plasticity. The brain continues to send pain messages long after the injury has healed. NARRATION:There are a number of treatments used to block these signals, but often they?re ineffective. Laura Black:I've been through pretty much every recognised treatment for CRPS. I've been through most of the medications, I've been through sympathetic nerve blocks, um, ketamine infusionDr Maryanne Demasi:Ketamine infusions? Laura Black:Ketamine infusion. Dr Maryanne Demasi:They use that in anaesthetics. Laura Black:They do yeah, but unfortunately for me it didn't work.NARRATION:The lack of success with treatment has made life unbearable at times for Laura.Laura Black:You find yourself thinking well, why me? Prof. Michael Cousins:If you can imagine having pain every day and every night, even for a week, it's not too hard to imagine that you might start to feel helpless and Complex Regional Pain Syndrome is right up the top of the severity scale.Laura Black:I'm being treated for depression and you know in my darkest moments I have sort of thought about suicide as a way out of the pain.NARRATION:The relentless nature of this condition led one sufferer to make a harrowing decision.Prof. Michael Cousins:Last year a young lad who became so desperate that he managed to convince his surgeon to amputate his leg. So he decided that he couldn't put up with this pain any longer and he hoped that by taking the leg off he'd get rid of all the pain. But it doesn't fix the problem because there are major changes that occur in the spinal cord and also in the brain. So taking the leg off is not going to fix the whole problem.
NARRATION:Kate Ross also suffers from CRPS. In fact, she met Laura on an online support group. Kate?s pain began with a minor injury during a netball game. She jumped for the ball and landed awkwardly rolling her ankle.Kate Ross:I was going okay for about a month and was having physio and everything was going along normally. And then I was home one weekend and my foot just froze up, I couldn't move my foot at all. NARRATION:Even though her injury had healed, Kate was in excruciating pain. Months had passed and her doctor remained baffled.Kate Ross:About a year down the track he said to me, "I can't do anything else for you, you're just going to have to live with it".Assoc. Prof. Michael Nicholas:It's often the case with CRPS that they will have an examination that really shows nothing. There no physical findings in terms of broken bones, they may have had one but it's now settled and yet the pain persists and the skin starts to change and they often become quite immobilised in that limb. Dr Maryanne Demasi:So these are the pictures of your ankles are they? Kate Ross:Yeah these photos were taken about six years into the CRPS. I ended up on crutches for about fifteen months with my ankle looking like this the entire time. Dr Maryanne Demasi:Now this looks really painful, was it as painful as it looks? Kate Ross:It was extremely painful.NARRATION:Like Laura, Ketamine drips, epidurals and spinal nerve blocks failed to relieve Kate?s pain. At desperation point, her doctor suggested surgery.Prof. Michael Cousins:Spinal cord stimulation is probably one of the most dramatic treatments that one can see in all of medicine for a severe condition. It doesn't work for all patients with CRPS but it works for about 60 per cent of them?.. Within several hours of starting a trial of spinal cord stimulation a patient who has a tremor will have that tremor markedly diminish. If they can't move their wrist they can now start to move the wrist, ah, if they have a lot of swelling it will start diminishing.Dr Maryanne Demasi:For many, surgical procedures and medications don?t eliminate the pain. So that?s when they come here to learn to manage their pain and get on with their lives.NARRATION:This is the ADAPT program at Sydney?s Royal North Shore Hospital. It?s a comprehensive 3 week schedule aimed at healing the emotional and physical burden associated with chronic pain.Assoc. Prof. Michael Nicholas:How are we going to be able to help you to deal with this pain which has so far not responded to any of the treatments that you?ve had.Assoc. Prof. Michael Nicholas:So the first step is really to identify what does this person wants to achieve. So it may be to walk again and if that's the case then we look at well that's going to require getting out of a wheelchair, standing, taking a few steps and so on. NARRATION:Under the watchful eye of physios, sufferers are encouraged to push through pain barriers in order to restore movement and function to the injured area. Patients are weaned off all their pain medication, an extraordinary challenge for most.Assoc. Prof. Michael Nicholas:How does that feel?Kate Ross:OK. It?s a bit sore but it?s OK.Assoc. Prof. Michael Nicholas:Good. Well done. That?s terrific.NARRATION:It?s also a mental training exercise intended to undo the neuro-plastic changes in the brain caused by years of persistent pain.Assoc. Prof. Michael Nicholas:Studies done elsewhere have reported change in brain activity after these sorts of interventions, when people start moving again, the symptoms settle, then changes have been seen along the measures like FMRIs.NARRATION:This ?brain rewiring? is now thought to be a major contributor to Complex Regional Pain Syndrome. Prof. Michael Cousins:Hello Kate.Kate Ross:Hi.Prof. Michael Cousins:Let?s just have a look and see how things are going.Prof. Michael Cousins:One of the key issues really is early diagnosis and early intervention. Because we know now that there are neuro-plasticity changes in the brain. And it appears that the longer those changes are present, the more severe they become and the harder it is to intervene. So early diagnosis is crucial.Prof. Michael Cousins:How does that feel.Kate Ross:It definitely feels colder on the left.NARRATION:Kate?s CRPS wasn?t diagnosed for 6 years. Yet despite that delay the treatments she?s had have made a big difference to her life.Kate Ross:I can now walk up and down stairs and I'm much more positive now than I was back then. I've started going out and socialising again and hanging out with my friends. There's definitely a lot to be said about how much the power of the mind can really help you through it.NARRATION: And for Laura, she waits in hope.Laura Black:I just want to get on top of this enough to be able to do something with my life. I mean my lifelong dream was to be a vet. I mean I've got the degree, I know that I'm not going to be able to go into practice but you know I want to be able to use that degree, you know, not let this win.
Reporter: Dr Maryanne Demasi
Producer: Paul Schneller
Researcher: Anja Taylor
Camera: Malcolm Crook, Kevin May
Sound: Graham Fettling, Steve Ravich
Editor: Philippa Byers, Andrew Hope
Story Contacts
Prof Michael Cousins
mcousins@nsccahs.health.nsw.gov.au
Pain Management Research InstituteRoyal North Shore HospitalSt Leonards NSW 2065
A/Prof Michael Nicholas
miken@med.usyd.adu.au
ADAPT Pain Management ProgramRoyal North Shore HospitalSt Leonards NSW 2065
Related Info
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shane fleming
Moderator: Note from moderator: As mentioned in one of these posts, Laura Black has provided a link to an online forum for CRPS sufferers - http://tamingcrps.forumotion.com/login
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Dantesnana
Moderator: Hello, I am not sure to which doctor you are referring but it might be worthwhile consulting the Pain Management Research Institute at Royal North
Shore Hospital in Sydney for more information. For general enquiries please contact: Helen JohnstonDepartment of Anaesthesia and Pain ManagementRoyal North Shore HospitalSt Leonards, NSW 2065Phone: +61 (0)2 Fax: +61 (0)2 hmjohnst@nsccahs.health.nsw.gov.auFor general enquiries about basic research at PMRI please contact:Prof Janet KeastDirector of Basic ResearchPhone: +61 (0)2 Fax: +61 (0)2 janet.keast@sydney.edu.auhttp://sydney.edu.au/medicine/pmri/
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CINDY COOLING
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Ron Morrison
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Re the CRPS story
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Lucy Baker关注微信“每日学英语”，听力、口语天天练
I'm Missing You
教程：&&浏览:3283
提示：点击文章中的单词，就可以看到词义解释
i miss you my baby qier
Ohh babe... Ohh babe...
The nights are long, 漫漫长夜
My days are cold Without the warmth you provide me when I hold没有你的温暖，我感觉好冷
You in my arms feels so long ago 拥抱的温暖似乎是很久以前
When you were there...想着你现在在哪里......（极品音乐典藏群）
I think a teardrop just fell down..禁不住泪水就滑落
I really wanna come to see you好想见到你
I really really wish I could真的，好想好想
Maybe in a couple weeks, It's only a couple weeks...两个星期后就能见面，只是两个星期...
But even know I get to, It's 14 days I gotta get trough (it's too many days babe)我知道，就是等14天（可是，亲爱的，太长了）
And I'm really really missing you..我真的真的很想你
And I miss, miss, Miss..想你
I'm missing you..我想你
And I don't know..我不知道
How I'm gonna make it trough..我该怎么熬过这几天
But I gotta, gotta, stay strong for us two..不过，我要，继续等待
I'm a man, It's a job that I gotta do我是个男人，这是我的工作，我总得要做好
So I go outside and I fake a smile..所以，带着强装的微笑我走出门去
But if they only knew, Just how many miles..我真的希望在我走过的几英里路上的人们他们都知道我的笑容是装出来的
Were between love so true但是我们的爱情是真的
I really couldn't cope the way that we do (that we do..)真的不能再违背自己的心
And I'm really really missing you, You, you..我真的真的很想你
Baby when you're near, All of my visions clear你在我身边的时候，爱得明明白白
But like a magic show, I blink and than you disapear..但像一个魔术表演一样，一眨眼的功夫，你不见了，消失了
And I frequently, Envision of it would be..我经常设想我能
To have you alone with me..我能让你和我在一起
Give me a moment so I can breathe ..给我一段时间，要让我能喘息一下
Ok. I really wanna come to see you, Baby I wish I could ...(Wish I could..)我真的要来见你，我好想来
Maybe in a couple weeks (It's only two weeks)大概就是两个星期
It's only a couple weeks (But the problem is..)不就是两个星期（可是）
Even though I get to.. It's 14 long days that I don't have you.. (It's too many days babe)即使我熬过，没有你的漫长的14天（亲爱的这的太多了）
And I'm really really missing you..我真的真的好想你
And I miss, miss, Miss..想你
And I'm really really missing you..真的好想你
And I don't know..我不太清楚
How I'm gonna make it trough..我改怎么熬过去
But I gotta, gotta, stay strong for us two..不过，我得，继续等待
I'm a man, It's a job that I gotta do我是个男人，这是我的工作，我总得要做好
So I go outside and I fake a smile..所以，我走出门去，带着努力装出来的微笑
But if they only knew, Just how many miles..我真的希望在我走过的几英里路上的人们他们都知道我的笑容是装出来的
Were between love so true但是我们的爱情是真的
I really couldn't cope the way that we do (that we do..)我真的不能在用这种方式来应付生活了
And I'm really really missing you, You, you..我真的真的很想你
Cuz maybe one day babe 宝贝，也许那天
Not too far away不在遥远了
We can turn, all our dreams into memories. (gonna be like this forever right)我们能把梦想变成现实，然后装进美好的回忆里（永远像这样，好吗）
Baby we'll have that home, Stars stares, all that we share..宝贝，我们会有一个家，我一起看星星，我们共同享受
Too many nights, over the phone. I really wanna come to see you (uhuh)夜里，我们通过电话交谈，我真的想去看你
Baby you know I do.. Maybe in a couple weeks (I'll try)宝贝你知道我会的，也学在两个星期后（我会的）
It's only a couple weeks (Can't promiss..)只是两个星期
But even know I get to, Still don't wanna be away from you..但即使知道，我知道不想离开你
It's too many days babe, And I'm really really missing you太久了，我真的很想你
And I miss, miss, Miss.. I miss you..想你，想你，
And I don't know (I don't know) How I'm gonna make it trough..我不知道，我怎么才能熬过去
But I gotta, gotta, Hold strong for us two (strong for us two)不过，我得，继续等待
I'm a man, It's a job that I gotta do. So I go outside (I'll go outside)我是个男人，这是我的工作，我总得要做好
And I fake a smile (I'll fake a smile)所以，我走出门去，带着努力装出来的微笑
But if they only knew, Just how many miles..我真的希望在我走过的几英里路上的人们他们都知道我的笑容是装出来的
Were between love so true, I really couldn't cope the way that we 但是我们的爱情是真的 ，我真的不能在用这种方式来应付生活了do.
And I'm really really missing you...我真的真的很想你
中文简介：
&&&&&&& 姓名：Bobby Tinsley
　　音乐流派：R&B/Soul
　　年仅22岁的Bobby Tinsley，曾出过一张专辑《Page 1》和4首单曲，他的歌应该是近年才在网络上开始流行的，总体上说风格属于慢版R&B，曲风很接近BoyzIIMan和Brian Mcknight，但Bobby Tinsley的曲风确更偏温和，在加上他轻厚的声音，就像在享受冬日的阳光。懒懒散散，更难能可贵的是他还是位白人，白人的R&B很多，但能和黑人相媲美的毕竟较少，如果你喜欢R&B，特别是抒情R&B的话就不要错过这样一位有着好声音的歌手。
　　这张专辑收录了《I'm missing you》和其他的几支单曲，共17首歌。延续了上张专辑的风格，干净、宁和，让人的心情舒缓，当然节奏上也不会弱。如果你喜欢抒情R&B，但还没听过Bobby Tinsley的话，推荐听下他的《I'm missing you》，相信你会喜欢上他的声音。
　　Review
　　A Soulful Indulgence Bobby Tinsley is one of the most passionately, soulful singers I have heard. His vocal ability rivals, Brian McKnight, Robin Thicke, you name it. He is a fantastic writer who writes thoughtful, and with sincerity. Those qualities are hard to come by among current R&B singers. Not to mention he is just cool. If you have not heard Bobby s music BUY THIS!!!!! You will not be disappointed. If you want to hear some positive R&B BUY THIS!!! If your ears yearning to be tantalized buy a soulful song BUY THIS!!! Above all Bobby s character is strong and his convictions deep. You need to hear what he has to say. So, BUY THIS! --Aaron U
　　Review
　　Genius Bobby Tinsley is one of the most talented artist of are day. He has a gift for singing life, one song at a time in a way that can make your heart ache. Life is short- get a copy of this album. --ShannyB
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