Headline July 18, 2017/ ''' \ PAIN SO PURE / '''

''' \ PAIN SO PURE / '''

AN OAK  -WAS ONCE A SMALL, TINY  NUT :   that held   its ground with great dignity, with silence  but with  relentless struggle     against every element.

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Teacher Pam Costa lives an hour and half from Pete, outside Tacoma, Washington, and she occupies the other end of the pain scale.

Costa is 51, and girlish, with shoulder length auburn hair and a wide smile. At first glance, she has the rosy flash of someone who has spent time in the sun. But if you look  closer to her cheeks-

Her feet, and her legs, they bear traces of a deeper shade of plum. Everywhere there is plum, there is terrible pain.

She was born with rare neurological condition called erythromelelgia, otherwise known as   man on fire syndrome,   in which inflamed blood vessels throughout her body are constant sources of pain.

Because the inflammation is exacerbated by physical contact, stress, and even the smallest elevation of surrounding temperature, Costa lives her life with great care.

She wears loose fitting clothes because  fabric  feels like a  blowtorch against her skin. She sleeps with chilled pillows because the slightest heat makes her limbs feel like they are crackling.  

''Have you ever been out in the bitter, bitter cold, where your feet were ice?''  she asks me. ''Almost frostbite? Then you warm them up and it burns? That burning sensation : That is what it feels like all the time.''   '

Costa begins and ends every day with a  50-milligrams  dose of morphine, just as she had for the past 35 years. And there are other pills. 

''I pop a lot of these,'' Costa, barefoot, tells me as she opens her medicine cabinet and twists open a jumbo bottle of Aleve

The direction says not to exceed three pills a day, and though it is early afternoon and this her fourth such pill in the past five hours, she expects to take a couple more before the day's over.

She is an instructor of psychology at a local college and the mother of a teenage daughter, and she agonizes  over her morphine dependency. ''I have a drive to stop - to just not be dependent on opiates.'' she says. But without her medication, her pain becomes unbearable.

A year ago she she went to Las Vegas for a work conference, and the plane home got struck on the tarmac with mechanical issue. There was no air-conditioning, and the and the temperature started to rise.

''An hour and a half in, people are taking off their clothes fanning themselves,'' she says. With the plane 20 feet from the gate and her skin throbbing, Costa persuaded a flight attendant to let her off.

''I was so afraid I was going to pass out or throw up or get to where I was immobilised.'' When the doors finally opened, she fled the plane, and she sat in the airport dousing herself with  Smartwater.

Costa and  Pete have never met. Their daily negotiations with the world could not be more different.

The scientists have uncovered a  genetic link  that binds their  mirror-image conditions together, and pharmaceutical researchers are now deep into clinical trials on a new type of drug that seeks to mimic Pete's conditions to treat Costa and others living with chronic pain.

Such a drug would not merely dull inflammation the way ibuprofen does or alter our neurochemistry the way opioids do : it would block the transmission of pain signals from cell to cell without ruinous side-effects on the brain or body.

The scale of the problem that this breakthrough could help solve is so vast that it's different to take in. 

Pain has always been the price of being alive, but according to the  National Institute of Health , more than one in  10 Americans adults say that some part of their body hurts some or all of the time. 

That's more than  25 million people. 

In a study after study, more middle-aged Americans than ever before say they have trouble walking a quarter mile or climbing stairs. More say they have trouble spending time with their friends. More so they can no longer work.

To get through the day, many of these people turn to pills, and nearly  2 million Americans say they're addicted to painkillers.

If the pills stop working, many people try something else  -80 percent of heroin users previously abused prescriptions   -or they simply [up and up] their dosage.

Opioid overdoses led to  33,000  deaths in 2015, an all time high and four times as many as in 2000. 

They now kill as many Americans every year as car accidents or guns do, and the crisis, it seems, is only getting worse.    

The Honour and Serving of the latest  *Operational Research*  on Life, Health and Living continues.

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Good Night and God Bless

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