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AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006
PAIN Pain
Pain is one complicated subject. It is generally viewed as unpleasant and to be avoided at all costs. On the other hand, there are situations where it is inflicted deliberately: parents spank their kids (or at least they used to); governments inflict pain and even torture upon combatants from enemy nations during war, and upon their own citizens who are convicted of criminal acts; some religious devotees willingly “mortify the flesh” (kill their sinful nature) by being flogged, by fasting or other forms of self-denial, by crawling on bare knees until they bleed as a display of their devotion. Others view this as highly admirable conduct. Some people can tolerate a tremendous amount of pain while others practically faint at the mere thought of certain painful injuries. Some pain is physical; some is emotional. Some pain is highly visible: the wound is jagged and bleeding. Other pain hides so well that sufferers have a hard time convincing others that their pain is real. Yes, some pain is neat and clean, black and white, like our title above. Other pain is rough and red and raw and ragged.
Pain is at the center of lots of national news these days: ironically, opioid pain killers are causing tremendous amounts of pain and suffering as a scourge of addiction and overdose deaths continues to grow. Another irony about pain is that it is actually a good thing — a very good thing — within reason. In everyday life, pain is indispensable. It instantly tells us to jerk our hand away from scalding water or a hot burner. Pain gives us immediate signals to hop off something sharp we’ve stepped on and keeps us from burning our tongue with hot soup or coffee. In clinical settings, pain is regarded as a clear and valuable indicator of a condition that needs medical attention. In that role it can prevent further injury or help halt the progression of disease. After treatment, perhaps surgical, pain is a great reminder to take it slow and give our body time to heal. It tells us to slow down; recovery isn’t complete. It’s important that we can feel that pain and that we heed it. For compliant patients, “know pain, know gain” are words to live by. But what about chronic pain that won’t Please see PAIN page 2
NOVEMBER 17, 2017
Kid’s Stuff
NOTES FROM A PEDIATRIC RESIDENT by Caroline Colden, M.D., Children’s Hospital of Georgia
Is it a milk allergy or lactose intolerance? Let’s discuss milk digestion issues in babies. Parents will often wonder if their baby’s fussiness, vomiting, constipation, diarrhea, difficulties gaining weight or other GI symptoms are possibly due to difficulties with digesting milk. Terms like “lactose intolerance” and “milk protein allergy” can get thrown around, and switches to soy or special formulas can be made with varying degrees of success. If true difficulties with digesting milk in a baby exist, milk protein allergy (MPA) is high on the differential. This is a literal allergy to the protein components of milk – casein and whey – that can worsen with repeated exposures. Babies can develop vomiting, diarrhea and/or constipation, colic and fussiness, as well other symptoms consistent with allergies. Some babies can have blood in their stool or skin changes. Most will have difficulty gaining weight. A family history of food or other allergies may be present, which increases the likelihood for a milk protein allergy to exist. Lactose intolerance, on the other hand, is totally different from MPA, in that it is an intolerance of the sugars (lactose) in milk, not an allergy to the protein. Lactose intolerance tends to run in families. However, it is very uncommon in children younger than 1 year of age. When it does occur it can cause bloating, gas, diarrhea, and abdominal discomfort Please see MILK page 8