Customer Reviews

Understanding Chronic Pain: A Doctor Talks to His Patients

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I have suffered chronic pain for over 5+ years and have spent a great deal of time researching the subject. I recently picked up Dr. Cochran's book and spent two days devouring his book. On the third day, I e-mailed him at his web site to explain my chronic pain problems and to my surprise, he contacted me by phone 2 days later!! I was so impressed that I subsequently flew from New Mexico to Nashville to meet with him. Dr. Cochran is a gifted physician who cares deeply for his patients and combined with his gift of listening, his expertise with neuropharmacology and his unsurpassed understanding of chronic pain he was able to come with up with a personal game plan for me. Dr. Cochran's truly understands the mind body connection and the implications that emotions can create havoc with your pain. Dr. Cochran's Book exempilfies "Thinking outside the box". I guarantee that you, the reader will be able to relate to some of his case studies. I highly recommend reading this book. I also suggest that your current or past pain physician has not spoken to some of the issues brought forward by this book. This is necessary reading to those who do suffer from chronic pain. Give a copy to your physician or at the very least discuss the book with them, as well as, your friends and family.

This is that rare book that will help and inform physicians and patients alike through fascinating and instructive "stories" (case reports.) There are no claims of dramatic breakthroughs but rather a believable success rate that can be raised from the usual 25% or so to more than 50%, which is dramatic when one considers that Dr. Cochran ends up with referrals that have not responded to any number of treatments. The approach Dr. Cochran uses involves an exceptional amount of listening to the whole history, and a willingness to try various combinations of medications and insightful thinking about factors that may trigger or perpetuate chronic pain. Readers can find other books on the subject (see cross references, Amazon), and the scientifically minded can sample controlled studies such as "Combination Therapy for Neuropathic Pain-Which Drugs, Which Combination, Which Patients", New England Journal of Medicine, 352:13, March 31,2005. As a doctor of the same vintage as Dr. Cochran, I agree that the time has arrived to use the insights of modern immunology, i.e. that the body may attack itself in certain diseases (Lupus, Rheumatoid Arthritis, etc.) in such a way that the "immune" response is counterproductive, analogous to how acute pain may provide protective reactions but chronic pain means that the mechanism has gone awry and is defeating the original purpose. Dr. Cochran describes the likely ways in which this perverted response can occur, and what might work to break the cycle. I have bought an extra copy so I can lend it to willing readers while keeping my original copy readily available.

For far too long, chronic pain sufferers have been considered as just another difficult statistic. In many previous books on the subject, very little empathy for their tortuous plight has been shown. This is no longer true with the publication of UNDERSTANDING CHRONIC PAIN: A DOCTOR TALKS TO HIS PATIENTS, in which Dr. Robert T. Cochran, Jr. effectively puts a personal face on the debilitating dilemma of chronic pain.

His compassion and determination to actually help his patients control their intense levels of pain shines though on every well-written page. By examining actual case studies, we learn emphatically that no one should suffer needlessly when legitimate pain control options are available. One can only hope Dr. Cochran's expertise and enthusiasm in this area will inspire other professionals to be more considerate in dealing with this important yet complicated area of caregiving.

To anyone who suffers from chronic pain, and those whose lives are touched by chronic pain sufferers, this book is a must-read. Dr. Cochran explores the depths and complexities to chronic pain that most doctors either can't or won't. Best of all, people like myself who do not understand medical jargon, will be able to read this book and understand it! As Dr. Cochran speaks with his patients throughout this book the reader will understand the beast of chronic pain as the layers are peeled back and injuries and memories are revisited and then the patient's pain is explainable...and proven REAL. Finally here is a physician able to show caring knowledge and offer real help and treat the whole person. Dr. Cochran's book has been so very helpful to me and also to my husband. Dear reader, if you suffer from chronic pain and cannot put into words the terrible pain you deal with daily, I highly recommend this book for you to get and give to your friends and family. Chronic pain can be so very isolating and lonely and this book certainly helped my loved ones "get it". To read other's stories and the physician's point of view in black and white was a wonderful, and much NEEDED, validation. You will not regret your purchase as it is money well spent. It will help you and those you love put a "face" to your pain and the relief you will feel is priceless.

If you are sick and tired of being sick and tired, please read Dr. Robert T. Cochran Jr's book, Understanding Chronic Pain: A Doctor Talks To His Patients. I am not a medical professional; I am a 51 year old woman who has, for the past 20 years been diagnosed with painful and exhausting illnesses like Chronic Fatigue Syndrome, the Epstein Barr virus, Fibromyalgia, degenerative disc disease that required surgery, menstrual problems, and rheumatoid arthritis. As soon as I find a way to ease the pain of one problem, another excruciating painful problem manifests. Some of you may suffer so badly that you can't hold a job. Your family and friends have had to deal with your unpredictable health, so your social life and intimate connections have dwindled to nothing. Unless your employer is incredibly flexible, you either can't hold a job or have to function under the stress of constant pain, worrying about when you'll make the mistake that will get you fired. To top it off, you really don't care because if you are out of work, at least you will be able to get enough rest.

Worst of all, you may think that this is all in your mind.

Let Dr. Cochran explain to you that it is all in your mind - and in your body, too. After reading this book, you will, for the first time, understand why you hurt and why you can never seem to stop the cycle of pain. You will have information that you can share with your physician that may lead to the path of a life that is not ruled by pain. I have not found the solution to my chronic pain yet, but Dr. Cochran's book has given me something that I have not had for many, many years. It has given me hope. Let it give you hope, too.

Very good book. Dr Cochran goes places that no one else goes. He talks about the psychological, psychosocial and psychiatric effects of chronic pain. He the first one to cover Conversion Disorder and Functional illness in a book of this type. This book is about treatment with medication, many different types of medication. After 30 yrs of treating chronic pain he very astute at treating it. I think that those who suffer should read with an open mind to the fact that what started out as in an injury may have transformed in to something different. He discusses the disease of the body and the mind. This isn't a feel better without medication and diet book. Thank Heavens.

Dear Sufferers,
Dear Unsuccessful Doctors of Sufferers, Dear Family, Friend, or Acquaintence of Sufferer, Dear Abuser or would be abuser,
Dear Employer, Insurance Company, Lawyer, or Otherwise Interested Party,
In his new book Dr Cochran offers case by case several of the thousands of cases he has treated over 40 years in private practice and at Vanderbilt Hospital in Nashville, Tennessee. Addressed as "A Doctor Talks To His Patients", the book is outstanding in its readability, and the chronic pain sufferer who reads this book will benefit not only in broadening his understanding of the many faces and causes of pain, but of groundbreaking, exciting, and highly effective treatments of such. Combining neurology,psychology, and creative modern pharmacology with vast experience and unwavering, empathetical dedication to his patients, Dr.Cochran herein seems to derive a new etiology-a set of symptoms, physical-neurological-and psycholocical-which NEWLY DEFINE CHRONIC PAIN in what he terms a MIND-SOUL DISEASE, allowing it to be CLINICALLY DIAGNOSABLE, thus removing quite many associated mysteries. The anecdotal histories then describe creative, sensible and very successful, LASTING RELIEF for everything from MIGRAINE to PELVIC PAIN and let's not forget THE BACK!! His love for his patients, his dedication to them and his specialty, his profound curiosity of the "nature of the beast", and his fearlessness in choosing new and effective combinations of weapons in attack are thoughtfully placed throughout.
I believe this book will be viewed as more than a milestone in the field of medicine in may ways, perhaps most importantly in establishing and clinically confirming that THE PAIN IS REAL and THERE'S A REASON FOR IT !! Dr. Cochran suggests this gains the sufferer not only a level of dignity unallowed in un-diagnosable and therefore "Questionable" pain, but he apparently then is psychologically boosted into a more promising prognosis--HOW SENSIBLE !!If you can see the enemy-you can take a promising shot at it! Dr. Cochran knows the enemy, and through this book, effectively draws the community of chronic pain sufferers together in conquering it. Relations of chronic pain to past traumas, physical and/or psychological are made. Sometimes quite disturbing truths as sexual or physical abuse, though perhaps not surprising, are exposed in a careful and thought provoking manner.
What an insightful and valueable pile of pages !!

From this book I learned much about the pharmacology of pain management. There are remedies for chronic pain, and Dr. Cochran provides examples of his practice to show that there is hope. The book also indirectly asks the reader, especially the person in pain, to examine themselves (their pain and health) along the way.

While the book took me through the trials of both patient and doctor, I found the most useful insights of the book concerned, perhaps ironically, the idea of wellness. In particular, Dr. Cochran writes about a state of intense engagement and satisfaction, which he calls "type two mania"-- in opposition to the mania associated with manic-depression. For a doctor to have a clear idea of health no doubt makes his choice of treatments much more profound and effective than that of those who simply fear that patients will fall into a pattern of abuse and deterioration. Dr. Cochran believes people will try to do good things, provided they are relatively free of pain.

The mania of wellness is a delicate thing. For many the conditions of their lives do not allow them the ability to pursue the intense pleasures associated with work dedicated to quality and lives given to excellence. For others it is the conditions of their bodies that bring their efforts to painful, unfinished ends. For many, a combination of unfortunate circumstances and crippling pain makes the type of health promoted and practiced by Dr. Cochran difficult, if not impossible, to realize.

Dr. Cochran works like a Freudian trained in neurophysiology. In doing so, he discovers patterns of abuse, often forgotten or repressed, that partially account for the suffering of his patients. Pain, in Dr. Cochran's model, is situated in the brain. The brain creates and sustains pain to the point that it becomes a pattern. Pain medication breaks the patterns and provides relief. In many cases, the neuropsychological causes cannot be found or addressed completely. Dr. Cochran honestly reveals his difficulties. His narratives frequently trail off at such points, and the reader can hear, in the silences, the doctor wondering.

Of a piece with these lost narratives is the story of the social conditions of health care in America itself. Therapeutic individualism can only partially mask the fact that 40 million people are without health insurance in the richest country in the world. How many people rely on the tranquilizers of common people: cigarettes, booze and God? (In keeping with his narrative style in which difficult questions are at times asked but unanswered, Dr. Cochran references God in the concluding pages-- an oblique and haunting reference, I think, to the fact that God has been and continues to be the only available opiate for those who suffer without access to proper medications).

This criticism does not mean to detract from Dr. Cochran's work. In fact, history shows that what becomes normal for the rich, one day becomes the custom of the ordinary for good and bad. But it does not come easy.

I certainly recommend this book to chronic pain sufferers, social scientists interested in the practice of medicine, and to physicians who struggle with the delicate issue of prescribing controlled substances.

I am so glad that Dr. Cochran wrote this book. Most books of this ilk tend to forget about the patients; relying mostly on treatments, therapies, etc. The ability of the author to speak in normal english is also somewhat unique.
I would like to recommend A Pained Life, a chronic pain journey, as a complementary book to this one. It takes Dr. Cochran's book one step further by detailing one person's pain journey through the medical maze and personal roller coaster that is chronnic pain.
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and this to the book on amazon:
http://www.amazon.com/exec/obidos/ASIN/1413406092/qid=1110307805/sr=2-1/ref=pd_bbs_b_2_1/002-5101916-9332002

My mother had the opportunity to attend a book signing with Dr. Cochran and immediatly purchased the book for me. I have suffered many years with chronic pain but the last 10 months with uncontrollable pain that NO doctor could control. As I read Dr. Cochrans book my first thought several chapters in was "he gets it" and he does, yes it has took years of training, but he used his best tool, his ears! He listened to his patients and learned from them. He puts it all together in this book and shows how our mind, circumstances throughout life, and our daily life affect our level of pain. Any physician can give you pain pills daily but when you swollow them and they don't help there has to be something else going on. Dr. Cochran explains many different individual circumstances and you yourself will be one or more of them you will relate to, as I did. Read this book, and ANYONE you know that suffers with chronic pain do them a favor and tell them about the book and also, maybe suggest to your doctor to read it, more physicians should always go the distance to help each and every patient to the best of their abilities and as you read this book you will learn that Dr. Cochrans eggerness to continue to learn all he can about chronic pain has allowed him to not only help his patients with some rather serious chronic pain conditions but to write a book about his knowledge and also his ability to share this in a way that anyone can understand what is behind chronic pain, I think in our society today we believe that surgery or pain pills are the only answer to our chronic pain, yes they may be necessary, but remember there is pain and CHRONIC PAIN, those who have it or know someone who does??? READ IT!