Steven F Brena | PubMed Health

PubMed1979

Phantom urinary bladder pain--case report.

Phantom urinary phenomena are a relatively rare disease entity. Literature search has revealed only one case following cystectomy, seven cases following spinal cord injury and several other cases in hemodialysis patients. This report presents a case of painful phantom bladder following cystectomy for chronic kidney and urinary tract infection. Treatment was directed toward sensory hyperstimulation for suppression of the subjective experience of the painful phantom. Lumbar sympathetic blocks and transcutaneous electrical stimulation were used. Competent coping mechanisms were increased through relaxation training and assertiveness training to deal with a medical problem which has no standard solution. The patient's response to the Comprehensive Pain Control Program was excellent with an estimated 75% reduction in painful phantom perceptions. A brief discussion of the medical literature on the subject is presented.

Adult↗

PubMed1978

Relationship of patient semantic pain descriptions to physician diagnostic judgments, activity level measures and MMPI.

A consecutive sample of chronic pain patients presenting themselves for evaluation was studied. A set of 25 bi-polar adjectives was developed from medical records of previous pain patients' descriptions of their pain. Using the Semantic Differential (S-D) method, each patient rated the extent to which his/her pain was best described by either of the adjective pairs. The S-D findings were then compared with three other data sets and those data sets were compared with each other. First, six physicians classified each patient along an "organic"--"non-organic" continuum based on ratings derived from the full set of medical diagnostic labels each patient had accrued. Secondly, each patient, prior to examination, had completed up to two weeks of diary forms at home on which were recorded amount and distribution of time among sitting, standing/walking, and reclining. Finally, each patient completed a Minnesota Multiphasic Personality Inventory (MMPI). Few and only marginally significant relationships between patient semantic descriptions of their pain and the other measures were found. Secondly, physician agreement ot the "organic"--"non-organic" criterion, using diagnostic labels as their data, was statistically significant but clinically modest. The most substantial findings were between walking hours per week recorded on diary forms and five MMPI scales. Patients who walked more were less depressed, had fewer diffuse somatic complaints, and described themselves as less frustrated or angry and as less hypersensitive in interpersonal situations. The major conclusion of the study is that chronic pain patients present sets of interrelated problems too complex to be discriminated reliably by a single set of measures; particularly, by simple word sets.

Activities of Daily Living↗