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What We Lose When We Undertreat Pain | Kate Nicholson | TEDxBoulder


I was at the top of my game working as a

I was at the top of my game working as a civil rights attorney at the Justice

civil rights attorney at the Justice

civil rights attorney at the Justice Department when something happened that

Department when something happened that

Department when something happened that changed the course of my life I met my

changed the course of my life I met my

changed the course of my life I met my desk drinking a latte typing away on a

desk drinking a latte typing away on a

desk drinking a latte typing away on a document due to court when my back

document due to court when my back

document due to court when my back starts to burn it feels like acid eating

starts to burn it feels like acid eating

starts to burn it feels like acid eating my spine my muscle seize and throw me

my spine my muscle seize and throw me

my spine my muscle seize and throw me from my chair I curl on the floor my

from my chair I curl on the floor my

from my chair I curl on the floor my body sears with pain over the next few

body sears with pain over the next few

body sears with pain over the next few weeks the pain becomes constant I can

weeks the pain becomes constant I can

weeks the pain becomes constant I can barely stand sitting is impossible

barely stand sitting is impossible

barely stand sitting is impossible so mostly I lie down I commute lying

so mostly I lie down I commute lying

so mostly I lie down I commute lying across the backseat of a car to work

across the backseat of a car to work

across the backseat of a car to work from a futon on the floor of my office

from a futon on the floor of my office

from a futon on the floor of my office and I use a walker to get from place to

and I use a walker to get from place to

and I use a walker to get from place to place for a while that works until one

place for a while that works until one

place for a while that works until one day my rides late I stand too long my

day my rides late I stand too long my

day my rides late I stand too long my legs go and I collapse I will be

legs go and I collapse I will be

legs go and I collapse I will be bedridden and in pain for almost twenty

bedridden and in pain for almost twenty

bedridden and in pain for almost twenty years later I learned the cause was a

years later I learned the cause was a

years later I learned the cause was a surgery when a doctor severed nerves in

surgery when a doctor severed nerves in

surgery when a doctor severed nerves in my spine the pain only appears when the

my spine the pain only appears when the

my spine the pain only appears when the damaged nerves grow back but try as they

damaged nerves grow back but try as they

damaged nerves grow back but try as they might the nerves don’t repair they

might the nerves don’t repair they

might the nerves don’t repair they rewire but malfunctioned so a light

rewire but malfunctioned so a light

rewire but malfunctioned so a light touch is a blowtorch when I shower fiery

touch is a blowtorch when I shower fiery

touch is a blowtorch when I shower fiery hot needles pierce my skin nerve pain

hot needles pierce my skin nerve pain

hot needles pierce my skin nerve pain intensifies it escalates like an alarm

intensifies it escalates like an alarm

intensifies it escalates like an alarm that gets louder and louder the longer

that gets louder and louder the longer

that gets louder and louder the longer it goes on the worse it gets

it goes on the worse it gets

it goes on the worse it gets looking back on it now the thing

looking back on it now the thing

looking back on it now the thing remember the most was the despair in my

remember the most was the despair in my

remember the most was the despair in my then husband’s face this was a man who

then husband’s face this was a man who

then husband’s face this was a man who literally carried me in his arms from

literally carried me in his arms from

literally carried me in his arms from Doctor to doctor and then they told us

Doctor to doctor and then they told us

Doctor to doctor and then they told us there would be no cure that I’d never

there would be no cure that I’d never

there would be no cure that I’d never get better and would only get worse when

get better and would only get worse when

get better and would only get worse when all of this is happening I’m working as

all of this is happening I’m working as

all of this is happening I’m working as a civil rights lawyer I’m arguing for

a civil rights lawyer I’m arguing for

a civil rights lawyer I’m arguing for the rights of people with HIV and AIDS

the rights of people with HIV and AIDS

the rights of people with HIV and AIDS to medical care for the rights of people

to medical care for the rights of people

to medical care for the rights of people who use wheelchairs to have meaningful

who use wheelchairs to have meaningful

who use wheelchairs to have meaningful work I guess the universe decided I

work I guess the universe decided I

work I guess the universe decided I needed some personal experience I became

needed some personal experience I became

needed some personal experience I became a person with a disability working as a

a person with a disability working as a

a person with a disability working as a disability rights lawyer and I loved my

disability rights lawyer and I loved my

disability rights lawyer and I loved my job I still had work to do so despite

job I still had work to do so despite

job I still had work to do so despite what the doctor said I decided to fight

what the doctor said I decided to fight

what the doctor said I decided to fight and that was a good decision I also made

and that was a good decision I also made

and that was a good decision I also made a bad one early on I refused to take

a bad one early on I refused to take

a bad one early on I refused to take opioids for pain I worried about

opioids for pain I worried about

opioids for pain I worried about addiction and stigma when my doctors

addiction and stigma when my doctors

addiction and stigma when my doctors decided to stop treatments aimed at

decided to stop treatments aimed at

decided to stop treatments aimed at numbing and ablating the nerves and

numbing and ablating the nerves and

numbing and ablating the nerves and insisted on opioids I was shattered I

insisted on opioids I was shattered I

insisted on opioids I was shattered I felt like they were giving up that I was

felt like they were giving up that I was

felt like they were giving up that I was being put out to pasture drugged up and

being put out to pasture drugged up and

being put out to pasture drugged up and written off out of options I surrendered

written off out of options I surrendered

written off out of options I surrendered and swallowed the pills and then

and swallowed the pills and then

and swallowed the pills and then something remarkable happened I improved

something remarkable happened I improved

something remarkable happened I improved I felt relief I was a foggy space opened

I felt relief I was a foggy space opened

I felt relief I was a foggy space opened in my mind and I can work again and so I

in my mind and I can work again and so I

in my mind and I can work again and so I worked as a federal prosecutor for more

worked as a federal prosecutor for more

worked as a federal prosecutor for more than 20 years though I couldn’t sit or

than 20 years though I couldn’t sit or

than 20 years though I couldn’t sit or stand or really walk for most of them I

stand or really walk for most of them I

stand or really walk for most of them I negotiated groundbreaking settlements

negotiated groundbreaking settlements

negotiated groundbreaking settlements against the San Francisco 49ers and

against the San Francisco 49ers and

against the San Francisco 49ers and Giants and the Walt Disney Company while

Giants and the Walt Disney Company while

Giants and the Walt Disney Company while reclined on the right dose of pain

reclined on the right dose of pain

reclined on the right dose of pain medicine

medicine

medicine I want important cases in federal court

I want important cases in federal court

I want important cases in federal court arguing from a folding lawn chair once

arguing from a folding lawn chair once

arguing from a folding lawn chair once bedridden I drafted the current

bedridden I drafted the current

bedridden I drafted the current regulations under the Americans with

regulations under the Americans with

regulations under the Americans with Disabilities Act coordinated with the

Disabilities Act coordinated with the

Disabilities Act coordinated with the White House and supervised thousands of

White House and supervised thousands of

White House and supervised thousands of cases by hundreds of attorneys across

cases by hundreds of attorneys across

cases by hundreds of attorneys across the country all from my bed and when the

the country all from my bed and when the

the country all from my bed and when the pain finally improved I stopped taking

pain finally improved I stopped taking

pain finally improved I stopped taking opioids

opioids

opioids I wasn’t addicted I did have to taper to

I wasn’t addicted I did have to taper to

I wasn’t addicted I did have to taper to avoid side effects it was a happy

avoid side effects it was a happy

avoid side effects it was a happy anti-climax now many things healed me

anti-climax now many things healed me

anti-climax now many things healed me physical therapy meditation a medical

physical therapy meditation a medical

physical therapy meditation a medical device called a spinal stimulator the

device called a spinal stimulator the

device called a spinal stimulator the hundreds of people who brought groceries

hundreds of people who brought groceries

hundreds of people who brought groceries and dinner and companionship to my

and dinner and companionship to my

and dinner and companionship to my bedside for 20 years

bedside for 20 years

bedside for 20 years art but opioids were essential everyone

art but opioids were essential everyone

art but opioids were essential everyone experiences pain some of you are in pain

experiences pain some of you are in pain

experiences pain some of you are in pain right now and not just because you’re

right now and not just because you’re

right now and not just because you’re anticipating three more hours in

anticipating three more hours in

anticipating three more hours in uncomfortable chairs for most people

uncomfortable chairs for most people

uncomfortable chairs for most people pain is temporary but if it lasts three

pain is temporary but if it lasts three

pain is temporary but if it lasts three months are longer pain becomes chronic

months are longer pain becomes chronic

months are longer pain becomes chronic and it changes from being a symptom to a

and it changes from being a symptom to a

and it changes from being a symptom to a disease according to federal statistics

disease according to federal statistics

disease according to federal statistics 50 million Americans have persistent

50 million Americans have persistent

50 million Americans have persistent everyday or severe pain like mine that’s

everyday or severe pain like mine that’s

everyday or severe pain like mine that’s one in six it’s also significantly more

one in six it’s also significantly more

one in six it’s also significantly more than are affected by cancer heart

than are affected by cancer heart

than are affected by cancer heart disease diabetes or stroke 2.5 million

disease diabetes or stroke 2.5 million

disease diabetes or stroke 2.5 million people abuse opioids

people abuse opioids

people abuse opioids opioid abuse is devastating and in every

opioid abuse is devastating and in every

opioid abuse is devastating and in every news cycle and for the people affected

news cycle and for the people affected

news cycle and for the people affected and their families it’s heartbreaking

and their families it’s heartbreaking

and their families it’s heartbreaking and poorly managed but our response as a

and poorly managed but our response as a

and poorly managed but our response as a society to opioid abuse is hurting the

society to opioid abuse is hurting the

society to opioid abuse is hurting the treatment of pain how a lot of the

treatment of pain how a lot of the

treatment of pain how a lot of the people who abuse opioids are using

people who abuse opioids are using

people who abuse opioids are using medication that wasn’t prescribed for

medication that wasn’t prescribed for

medication that wasn’t prescribed for them they self-medicate with friends

them they self-medicate with friends

them they self-medicate with friends opioids by on the street some pose as

opioids by on the street some pose as

opioids by on the street some pose as pain patients and dr. Hopp so to stop

pain patients and dr. Hopp so to stop

pain patients and dr. Hopp so to stop abuse the law attacks doctors physicians

abuse the law attacks doctors physicians

abuse the law attacks doctors physicians have been sentenced to up to 30 years in

have been sentenced to up to 30 years in

have been sentenced to up to 30 years in prison when their patients sold the

prison when their patients sold the

prison when their patients sold the opioids they prescribed there’s a pain

opioids they prescribed there’s a pain

opioids they prescribed there’s a pain doctor right here in Boulder who’s no

doctor right here in Boulder who’s no

doctor right here in Boulder who’s no longer in practice because of a drug

longer in practice because of a drug

longer in practice because of a drug enforcement agent who posed as a pain

enforcement agent who posed as a pain

enforcement agent who posed as a pain patient the perverse result of all of

patient the perverse result of all of

patient the perverse result of all of this is that fearing prosecution doctors

this is that fearing prosecution doctors

this is that fearing prosecution doctors today are reluctant to prescribe opioids

today are reluctant to prescribe opioids

today are reluctant to prescribe opioids even when necessary and appropriate when

even when necessary and appropriate when

even when necessary and appropriate when I first moved to Boulder I couldn’t find

I first moved to Boulder I couldn’t find

I first moved to Boulder I couldn’t find anyone willing to treat me I had to fly

anyone willing to treat me I had to fly

anyone willing to treat me I had to fly back to DC it was expensive and painful

back to DC it was expensive and painful

back to DC it was expensive and painful and a long way to have to go to the

and a long way to have to go to the

and a long way to have to go to the doctor but I could afford it what

doctor but I could afford it what

doctor but I could afford it what happens to people who can’t and what

happens to people who can’t and what

happens to people who can’t and what about the news story we hear about

about the news story we hear about

about the news story we hear about someone in pain who goes to the doctor

someone in pain who goes to the doctor

someone in pain who goes to the doctor is prescribed opioids and becomes

is prescribed opioids and becomes

is prescribed opioids and becomes addicted it happens but it’s relatively

addicted it happens but it’s relatively

addicted it happens but it’s relatively rare and somewhat preventable when

rare and somewhat preventable when

rare and somewhat preventable when people are screened for emotional pain

people are screened for emotional pain

people are screened for emotional pain and addictive patterns and then

and addictive patterns and then

and addictive patterns and then monitored after they receive opioids the

monitored after they receive opioids the

monitored after they receive opioids the risk of addiction comes

risk of addiction comes

risk of addiction comes down significantly but there are too few

down significantly but there are too few

down significantly but there are too few doctors who screen and monitor there are

doctors who screen and monitor there are

doctors who screen and monitor there are only a few thousand pain management

only a few thousand pain management

only a few thousand pain management specialists to treat tens of millions

specialists to treat tens of millions

specialists to treat tens of millions so most people in pain go to the

so most people in pain go to the

so most people in pain go to the emergency room where there’s no

emergency room where there’s no

emergency room where there’s no screening or monitoring none or they see

screening or monitoring none or they see

screening or monitoring none or they see their primary care doctor but there’s a

their primary care doctor but there’s a

their primary care doctor but there’s a problem there too a lot of them weren’t

problem there too a lot of them weren’t

problem there too a lot of them weren’t really trained in how to treat pain

really trained in how to treat pain

really trained in how to treat pain a recent Johns Hopkins study found a

a recent Johns Hopkins study found a

a recent Johns Hopkins study found a glaring discrepancy between the

glaring discrepancy between the

glaring discrepancy between the prevalence of pain and society and time

prevalence of pain and society and time

prevalence of pain and society and time dedicated to pain in medical school only

dedicated to pain in medical school only

dedicated to pain in medical school only for us medical schools had a single

for us medical schools had a single

for us medical schools had a single required course on pain so remarkably

required course on pain so remarkably

required course on pain so remarkably the number one reason people go to the

the number one reason people go to the

the number one reason people go to the doctor pain and the number one cause of

doctor pain and the number one cause of

doctor pain and the number one cause of long-term disability in America chronic

long-term disability in America chronic

long-term disability in America chronic pain are under addressed in medical

pain are under addressed in medical

pain are under addressed in medical education that needs to change and we

education that needs to change and we

education that needs to change and we need to work with doctors not against

need to work with doctors not against

need to work with doctors not against them to expand treatment for both pain

them to expand treatment for both pain

them to expand treatment for both pain and addiction we need to educate

and addiction we need to educate

and addiction we need to educate ourselves about the dangers of sharing

ourselves about the dangers of sharing

ourselves about the dangers of sharing opioids with family and friends

opioids with family and friends

opioids with family and friends it doesn’t help them it puts lives at

it doesn’t help them it puts lives at

it doesn’t help them it puts lives at risk and about proper disposal of unused

risk and about proper disposal of unused

risk and about proper disposal of unused medication we need to develop the next

medication we need to develop the next

medication we need to develop the next generation of pain medicine something

generation of pain medicine something

generation of pain medicine something that can’t be abused but in the meantime

that can’t be abused but in the meantime

that can’t be abused but in the meantime with the heat turned up on the opioid

with the heat turned up on the opioid

with the heat turned up on the opioid epidemic let’s remember that opioids

epidemic let’s remember that opioids

epidemic let’s remember that opioids also heal people they’re the most

also heal people they’re the most

also heal people they’re the most powerful pain medicine we have instead

powerful pain medicine we have instead

powerful pain medicine we have instead of denying suffering people relief a

of denying suffering people relief a

of denying suffering people relief a life

life

life let’s properly medicate pain thank you

”

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