Fibromyalgia & Chronic Pain LIFE Sep/Oct 2012, Issue 6 - Page 12

Paintracking: Your Personal Guide to Living Well with Chronic Pain by Deborah Barrett ($20, Prometheus Books, 2012) Paintracking is an extraordinary book, well written and comprehensive, covering treatment strategies from medication to meditation, including cognitive behavioral therapy (CBT), biofeedback, mindfulness practice, breathing exercises, massage therapy, as well as methods to enhance sleep, pace oneself, and exercise judiciously. An empowering approach, “paintracking,” helps individuals to evaluate the effectiveness of any treatment and behavioral changes they choose to try. Readers are encouraged to cultivate an experimental mindset, one that can transform “bad days” into useful data. People struggling with pain will find empathy along with hands-on strategies to decrease pain and develop adaptive coping skills. As a physician specializing in chronic pain management, I find this to be precisely what I seek for each of my patients. This book may seem to be written exclusively for patients; however it is equally pertinent to physicians. Without specialized training, few doctors are familiar or comfortable with medications used for pain treatment or with the experience of pain patients. Doctors may have heard, for example, that CBT or biofeedback is helpful, but not what they look like in practice. The book’s approach can also help doctors to individualize care by explaining how behaviors that are generally beneficial can become counterproductive when they result in worsening of symptoms. Paintracking helps individuals to experiment and then adapt as indicated by their own tracking data, which they can share with their 12  Fibromyalgia & Chronic Pain Life Sep/Oct 2012 doctor. It helps patients to become their own best advocate, essential for successful pain management. The excellent sections for patients on working effectively with healthcare professionals also provide constructive feedback for doctors, who, despite their desire to help (and often to be liked) can feel outside of their comfort zone and may say or do things that prove unhelpful. The book acknowledges the challenges doctors may face, while providing valuable reminders of the impact of their words and actions. Practical strategies for patients to prepare for office visits, presenting pertinent information, and fostering a strong therapeutic partnership with their doctor are included. The innovative categorization of medications by how they are actually used and experienced can focus discussions on what matters most. For the controversial topic of prescribing strong painkillers for chronic pain, the book provides a balanced view of the risks and necessity, including questions such as “why are you prescribing an antidepressant when I’m in pain, not depressed or crazy?” Doctors will benefit from understanding common concerns ( not always voiced directly by patients), and from the author’s gentle, reasoned responses to questions that can be difficult to answer. Paintracking assumes a bio-psycho-social perspective, demonstrating how pain and its treatment involve all aspects of a person’s life, and w h at i n d i v i d u a l s c a n d o fo r t h e m s e l ve s . • Denniz Zolnoun, MD, MPH is the Director of the Pelvic Pain Research Unit at the University of North Carolina at Chapel Hill.