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**bakunin** · 17-May-2013, 08:57

Hi Tom,

If you feel it, it's real.

But maybe you have centralized pain (central nervous system). I think the article The Corneal Pain System by Perry Rosenthal is a masterpiece to understand what happens with a lot of us.

**Rebecca Petris** · 17-May-2013, 09:03

Hey I love your posts of the day.

I am biting my tongue not to say some really cheeky things about the nature of reality.

But seriously... why would it being "in your head" make it any less real? I mean the pain from third degree burns over 75% of your body would be no less "in your head", physiologically speaking. (Whence the nervous system... etc...)

"It's all in your head" is just another way of saying "buck up, you witless weakling". Which is about as unconstructive a comment as you could get either from someone else or yourself.

Not that there isn't an intelligent conversation to be had on the topic of the relationship between cornea and pre-ocular tear film physiology and pain, but intelligent conversations shouldn't be destructive.

My take?

"I hurt, therefore I hurt."

p.s. Ah rats, Whilst I was slowly tapping away, someone else jumped in and as usual said it all in far fewer words!! (((Bakunin)))

**Guest** · 17-May-2013, 09:29

Originally posted by bakunin View Post

If you feel it, it's real.

You put that perfectly!

Originally posted by Rebecca Petris View Post

"It's all in your head" is just another way of saying "buck up, you witless weakling". Which is about as unconstructive a comment as you could get either from someone else or yourself.

Agreed!

Next step is figuring out WHY it's happening to you so you can fix it. Easier said than done, I know!

**Cali** · 17-May-2013, 09:47

Doesn’t all pain emanate from the brain? So yes, it’s in your head and also yes it’s real. If the brain is registering pain then you have pain. I guess your question is, if my eyes are completely healed and technically OK, then why do they still hurt? I too look to the Perry Rosenthal, M.D. article. It’s no longer an eye problem but a brain pain looping problem. Something is screwy with your pain signals, in your head. But it is still REAL!!! REAL, REAL, REAL!!!!!

I have neuralgia in my right eye. It hurt right after I got LASIK and it comes and goes (even though I was told my eyes look fine - surgeon did a great job!). I think a nerve was damaged during the procedure and may have healed, but not correctly or normally. Or it had a tough time healing and my brain kept sending pain signals and couldn’t turn off when the nerve healed – the pain signal got stuck on “ON.” So technically it is a healed nerve but in my head it keeps registering pain, pain, pain. So yeah it’s in my head AND yeah it is real. That's what the brain does, it sends the pain signals. Pain signals don't get sent out from your left knee or right second toe. It comes from your brain, located in your head.

I get so steamed about this because I was told the same thing and sent to a psychiatrist. BTW, they were very supportive and did help me cope.

Interesting reading for someone new who hasn’t yet confronted this issue: http://eyeworld.org/article-treating-unexplainable-pain

Keep us posted on the TMS. Would love to hit my “OFF” switch.

**Guest** · 17-May-2013, 15:20

Originally posted by Cali View Post

Interesting reading for someone new who hasn’t yet confronted this issue: http://eyeworld.org/article-treating-unexplainable-pain

That's a really good article! Glad to see this issue getting more attention... it will help all of us not to be seen as merely hypochondriacs. To this day, I wish the guy who did my surgery would acknowledge this, rather than caring about nothing more than covering his own A$$.

Ahh well, not worth my time to give him any further thought... thank goodness I've got a good doctor now at least!

**SDgirl2** · 17-May-2013, 16:24

Calli-

Thank you for the link to this article. This definitely needs to be recognized by the community of surgeons in the industry. Reading posts on this forum and experiencing problems myself, I certainly feel compassion for people with any type of ailment that causes chronic pain.

On a side note, I have read a few of your past posts and I noticed you have found an occular specialist that you seem to be working well with. I may be in your neck of the woods (San Diego) and am interested in who your specialist may be. I would love to work with someone who is proactive and who listens. If you don't mind, would it be OK for you to share his/her name? Pls feel free to PM if you would like. Thank you in advance.

--arlene

**Cali** · 17-May-2013, 20:12

Hi SDgirl2 - I will send you a PM with more detail but her name is Dr. Sally Mellgren in Oceanside, CA. She listens, she collaborates and is invested and engaged in finding a treatment that works for you. I'll send more in a PM.

**tommyboy** · 18-May-2013, 09:14

Yes - that is a good article, which I have read a dozen times.... thank you

I will let everyone know how TMS goes next week. I am scheduled for Monday morning... wish me luck

Also - I have a new post I want to write ... but, my eyes are killing me so I need to stay off the computer...

**Scout** · 20-May-2013, 12:49

Hi Tom

A few years ago I attended a continuing education seminar on psychological techniques for pain management. The speaker, a psychiatrist, told us that the most effective technique for pain management (other than medications, of course) was distraction. I think you have already discovered that technique by spending time focusing on your family, playing with them and focusing on tasks that are important to you.

This article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218789/is a free, full text article that lists all the psychological techniques today for pain management. It is a great article and you may find some possible methods that you can add to your list of ways you can manage your pain.

Here is the abstract:

Psychol Res Behav Manag. 2011; 4: 41�49.
Published online 2011 May 11. doi: 10.2147/PRBM.S15375
PMCID: PMC3218789

The role of psychological interventions in the management of patients with chronic pain
Daniela Roditi and Michael E Robinson

Abstract

Chronic pain can be best understood from a biopsychosocial perspective through which pain is viewed as a complex, multifaceted experience emerging from the dynamic interplay of a patient�s physiological state, thoughts, emotions, behaviors, and sociocultural influences. A biopsychosocial perspective focuses on viewing chronic pain as an illness rather than disease, thus recognizing that it is a subjective experience and that treatment approaches are aimed at the management, rather than the cure, of chronic pain. Current psychological approaches to the management of chronic pain include interventions that aim to achieve increased self-management, behavioral change, and cognitive change rather than directly eliminate the locus of pain. Benefits of including psychological treatments in multidisciplinary approaches to the management of chronic pain include, but are not limited to, increased self-management of pain, improved pain-coping resources, reduced pain-related disability, and reduced emotional distress � improvements that are effected via a variety of effective self-regulatory, behavioral, and cognitive techniques. Through implementation of these changes, psychologists can effectively help patients feel more in command of their pain control and enable them to live as normal a life as possible despite pain. Moreover, the skills learned through psychological interventions empower and enable patients to become active participants in the management of their illness and instill valuable skills that patients can employ throughout their lives.

Keywords: chronic pain management, psychology, multidisciplinary pain treatment, cognitive behavioral therapy for pain

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