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The Daily Nightly began on May 31, 2005. As Brian wrote in his first post it aims to provide a narrative of the broadcast day and a window into the editorial process at NBC Nightly News. Brian weighs in every weekday and NBC News correspondents and producers post regularly.

Brian Williams became the seventh anchor and managing editor in the history of NBC Nightly News on December 2, 2004. Read his full biography.

'The Mystery of Pain'

We have gotten a lot of e-mails from viewers since we began our four-part series "The Mystery of Pain" Tuesday night. Most begin by simply thanking us for paying attention to a subject that many believe has been vastly neglected.

Pain is such a common part of medicine. It is, after all, one of the major reasons why people seek medical attention, and usually the problem is fixed quickly. But when doctors can find no obvious cause for pain that persists, the patient can slip into what can be a horrible odyssey where chronic pain destroys the ability to work or even to have normal family and social interactions. Frequently people become dependent on narcotic pain-killing medications, making the already depressing situation even worse.

How common is chronic pain? The best estimate from the American Pain Foundation is about one in five Americans, around 50 million people, making it one of the nation’s biggest public health problems.

"It's the giant elephant under the rug in the middle of medicine," says Dr. Ann Oaklander, a pain specialist at Massachusetts General Hospital.

One of the biggest problems chronic pain patients can face is that because doctors can see no obvious cause of their pain they treat the patient as a malingerer.

Dr. Edward Covington, a chronic pain specialist at the Cleveland Clinic, says he has had patients who were actually thrilled to be diagnosed with terminal cancer because then doctors could see something wrong with them.

Dr. Oaklander says it is easy to understand the interaction from the doctor’s viewpoint as well.

"To see a patient in front of you who appears to be in distress, particularly if it's severe, who's pleading with you to help, and you don't quite know what to do, this is difficult,” she says.

Doctors say that for chronic pain there is no clear line between what is physical and what is psychological. One of the things we are exploring in the series is the key role that the brain plays in perceiving pain. We are also looking at new discoveries that are revealing causes for chronic pain that doctors had not discovered before. As always with a series like this, we can never say everything that we would like to in the time allotted. But this is a subject we plan to revisit often.

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COMMENTS

Thank you so much for this series on chronic pain. My husband has suffered from RSD for nearly 3 years. He cannot use his right arm without lightning bolts of pain. We cannot touch him on his right side, so this very affectionate man cannot give or receive hugs. He can no longer work or do the things he loves, like go hiking, play the guitar or piano, or draw/paint. Private doctors have turned him away, as they don't see anything wrong. The VA hospital just gives him more pain meds, which makes him a near vegetable (but thank God we have the VA, cause no one else would help). Hearing his screams of pain whenever he moves wrong causes me to be a nervous wreck, and I have stress related medical problems since shortly after his illness presented. We can no longer go out places because people absentmindedly touch him, even members of our family who should know better. I hope your series will draw attention to this crisis, and the impact it has on the victims and their families. And I hope that more doctors and other medical professionals will become educated regarding RSD and other chronic pain ailments.

Mr Bazell,
I've suffered RSD( a painful nerve disease) for 9 1/2 years. Living with an invisible disability is far from easy. You have doubt because people can't see what causes the pain. The pain is horrible & nonstop.
We need lots more RSD Awareness, because if
RSD is not caught in 3-6 months and treated ,it
will become a lifetime disability.
What has helped me is American RSDHope
http://www.rsdhope.org/
Thank you so much for your story on Chronic pain.
Sincerely,
Catherine Rice

I want to also thank you for the series on chronic pain. I was diagnosed with CRPS/RSD three year's ago and also diagnosed with fibromyalia. I'm a 49 year old mother of four adult kids and grandmother of 8. This is very hard for me to explain how i feel day by day to my family. Theres days/hours i don't want to be "touched". It's very hard to explain to the medical field also that's not aware of what crps/rsd is. The more we can get this out in the open will help us all in alot of different ways. Thank you &
Greatly Apprecitated.

Dealing with chronic pain 24 hours every day totally changes your life. It controls who you are and what you do. Relationships become fragile. The longer the pain exists, your mental condition deteriates more rapidly. For me, it has 12 years.

I have had acute chronic pain in both feet for 3 years. I am on percoset which helps me to sleep. I deal with my pain during the daytime with no drugs, but at nighttime it is so severe that I need pain meds just to sleep. I have been on painpills for three years. I have seen three different Drs since this began and they will prescribe pain meds for up to a year, then they seem fearful of law suits or getting in trouble with their organizations, so they stop and send me elswhere. Some of them try to make me feel like a drug addict and it is very humiliating. I would not take the meds if they did"nt relieve some of this pain. I am very depressed because one Dr. said I will have to be on meds for the rest of my life (I"m 56) They have tried other drugs such as elevil and neurontin which my body cannot tolerate. The point to my message is most of the Drs. I've seen are very wary and untrusting of me because I need these pills to help relieve this pain. This makes me feel worse that I have to practically beg them for help. One Dr. made me sign a waver that I wouldnt sue him if I became addicted.

Thank You for your seris on chronic pain.I have had severe chronic pain for 5 years since having shingles.I've had repeated shingles outbreaks in the last 5 years.My greatest problem has been receiving care from DRS.The DRS. don't seem to know what to do for a treatment,and treat me like I have two heads.It,s very frustrating to live with this.I,ve been diagnosed with MS,Lupus,cancer,stiff man syndrome and a unknown that the DRS. havn't found yet.Thanks for bringing PAIN to the forefront

My daughter is 23 and suffers from Lupus/Fibromyalgia and Sjogren's syndrome. She is going to college and taking 9 hours each semester. I would love to meet someone who could really get to the bottom of her pain issues and get her off some of the medication she is on. The medicines and pain lead to depression. Please keep this series going.

Mr. Bazell,
Every time I hear anything about chronic pain I'd like to listen since I've been living with it for 12 years. I've had numerous tests and procedures over the years which have not helped the doctors diagnose or help my pain. This is a deep pain inside my tailbone and sacral area which radiates through my entire pelvic area. I do take pain pills daily but they are not narcotics, which I have tried to stay away from. I have a tarlov cyst between S1 & S2 but doctors feel this is not the problem. I've read up about this and it is a controversial subject. I have come to the conclusion I will never find an answer even though for the longest time I did not want to give up. I am trying to accept I will be in pain the rest of my life. I am 55 years old with this pain starting at 43 years old. My life has changed drastically. I've tried meditation, exercise, pain mgmt. classes but bottom line is no matter what the pain is there. People who don't live with pain don't fully understand how it impacts ones life. Thanks for listening.

Thank you for doing this series. My daughter is suffering from chronic pain and she is only 13 - this has impacted her life completely. She is often unalbe to attend school, participate in social events and pursue her athletic interests. This has been very frustrating and getting people such as school personnel to accept and work with us in helping her to attend school has been an uphill battle. Although I know that she is inflicted with this there are definitely days when it is so frustrating because there is really nothing that can be done, except that she needs to take control of it and not let it rule her life - Easier said than done at any age! I have often thought guiltily that a cancer diagnosis might have been easier to handle than this.

THANK YOU SO VERY MUCH FOR THE PROOF I HAVE BEEN LOOKING FOR. I HAD A BUNION OPERATION AND NOW I HAVE CRPS/RSD 2YRS FEBRUARY. I TOLD MY DOCTOR IT FEELS LIKE SPIDERS WITH TOURCHES ON MY LEG AND FOOT AND IN RETURN I WAS TOLD TO LOOK AT MY LEG AND FOOT AND SEE THERE ARE NO SPIDERS. I NEVER SAID I SAW ANYTHING.
CRPS/RSD HAS BEEN AROUND SINCE 1864 WITH THAT IT HAS BROUGHT A LOT OF CONFUSION IN THE MEDICAL FIELD.
A REAL CURE IS NEEDED VERY FAST FOR I FIGHT EVERYDAY TO STAY OUT OF THE WHEEL CHAIR.

One of the biggest problems for someone with chronic pain is lack of support from a spouse or other family members. Pain meds, along with the pain itself, loss of hobbies, work, income, etc. often make the person very depressed and irritable. If that person does not receive love and caring, they can easily loose all hope. I wish doctors would take time to talk with a spouse at the beginning and explain what can happen and how to cope. Often, the spouse does not know what to do and the relationship deteriorates. I see this this as a large gap in the proper care of people with this problem.

Thank you so much for this series. I am a 55 year old female who is suffering with fibromyalgia. Some days I can barely get out of bed. My life has changed so much in the past year and nothing seems to help. These days I don't know what is worse, the depression or the pain. I'm not giving up though and I am so pleased to read that the medical field is acknowledging the existance of chronic pain and working help people like me. Again, thank you for your article.

I know someone who has been diagnosed with torticollis. She has constant pain across her neck and shoulder.
Doctors have recently given her botox injections in the neck and shoulder muscles. She has to repeat the injections every 90 days, but it seems to help a lot.

As you may or may not know, most Gulf war veterans suffer debilitating illnesses that cause severe pain like fibromyalgia. I have suffered for 15 years since i was in Saudi Arabia. The chronic pain causes anxiety, reactive depression, and all kinds of other problems.

Dear Mr. Bazell,

I'm very interested in your series on pain, as I was diagnosed with the chronic pain condition fibromyalgia at age 13. Now 26, I've learned how to deal with the pain and work through it. However, others are not as "lucky." When I was diagnosed, fibro was still a relatively new find; doctors didn't know much about it, only that 11 trigger points on the body are required for a diagnosis. More research has been done, and it may have something to do with the chemical composition of some people's brains--how they perceive pain. But those I interviewed still say the exact cause is a mystery.

I recently did a story in my own market about the disease to increase awareness and to see how others are dealing with it. According to the Mayo Clinic's website, fibromyalgia affects between three and six million people in the U-S. About 80 percent are women. If this is not a topic planned for this particular series, I would encourage you to revisit it at some time. Many thanks.

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