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Surgery-age: in two weeks I will be a cyborg

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t0mp

Member
Mr. Blonde said:
are you sure it's not all in your head?
I'm pretty sure he's been over that - he also mentions his psychiatrist on the last page - meaning he's been checked out. plus it's kinda fucked to say something like that. the dude suffers from chronic pain and you just think he's milking it or something
 
t0mp said:
I'm pretty sure he's been over that - he also mentions his psychiatrist on the last page - meaning he's been checked out. plus it's kinda fucked to say something like that. the dude suffers from chronic pain and you just think he's milking it or something
Old post, but...eh.
While I'm not sure if the poster meant it in that way, there can definitely be a mental element to chronic pain. Of course, whether the pain is caused by something physical, mental, or both, the pain is no less real.
 
Just read through this hread and all I can say is...damn. Maybe when you get some time in the future, you can do a small summary to let us know the ending to your tale. Good luck, echo. I hope all is well.
 
Hey guys.

Sorry I have not updated in so long. I've sorta been avoiding this because the news has not really been so hot.

Shortly after my last post I developed a completely new pain area, basically out of nowhere. Whereas my pain once covered my right flank, from midline to spine/bottom of ribcage to waist, it has now spread down my right leg to just below my knee. The new area is excruciating. I had never experienced any skin-level sensitivity before with this condition - light pressure would get a reaction but not touch - but I have it in a big way in the leg. Even the lightest, featherweight touch causes my nerves to explode with fire. It sucks, and it's out of reach for my stimulator.

So...yeah. I've sort of been going through the same thing I went through in the early days with my abdomen and back all over again with my leg. The muscles are becoming damaged and spreading the pain further, and I am once again making new lists of things I cannot do...well, I DO get handicapped parking now. THAT is pretty freakin' sweet.

I AM able to manipulate the field enough to channel it down into my leg, and this is helping some, but nothing has helped with the skin sensitivity. My neurologist is considering a new procedure with a substance called Qutenza (sp?). It quite literally involves covering the skin with highly concentrated hot pepper extract for several hours to numb the area. Or something. I'm not sure how it works, all I know is it sounds scary as shit. But, the sensitivity is bad enough that I am probably going to try it soon. There is nothing worse than crying out in pain when your daughter runs up to give you a big hug and seeing that look in her eye. It can't be worse than that....that sounds cheeeeeeesie. But it's true.

The whole thing has been depressing as hell and I'm having trouble facing the fact that this is likely a permanent addition to my old problems. Talking about it just makes it more real...indeed, I've been in a self-imposed exile from the OT because I didn't want to be asked. I know a lot of folks here are pulling for me and it sucks to bring shitty news. But, I've been in counseling for awhile now and I think I'm okay to start visiting here again and finishing up the tale. I will cruise over the last page or so of lingering questions and also pick up where I left off. Just a brief update for now, lots more soon.

Thanks for all the support as always, OT gaf. Truly sorry to keep you hanging for so long.

Mr. Blonde said:
are you sure it's not all in your head?

Yes. Well, it depends on what you're implying here. All pain is in the head. Explain phantom limb syndrome to me.
 
Thanks for the update, man, and sorry it wasn't better news. Writing about it can't make you feel better, but might help you deal with it over the long term.

Haha, glad you are at least enjoying the handicapped parking. I found it to be irritating. Had to pay extra at work for handicapped pass. Also you really start to notice and resent people who park in handicapped stalls and walk out looking perfectly fine, or people who just park and sit there waiting to pick someone up.

Anyway, I think we will all understand if we don't hear from you but hope it helps to know we're pulling for you.

That hot pepper therapy actually sounds pretty neat.
 

Ultima_5

Member
echoshifting said:
Hey guys.

Sorry I have not updated in so long. I've sorta been avoiding this because the news has not really been so hot.

Shortly after my last post I developed a completely new pain area, basically out of nowhere. Whereas my pain once covered my right flank, from midline to spine/bottom of ribcage to waist, it has now spread down my right leg to just below my knee. The new area is excruciating. I had never experienced any skin-level sensitivity before with this condition - light pressure would get a reaction but not touch - but I have it in a big way in the leg. Even the lightest, featherweight touch causes my nerves to explode with fire. It sucks, and it's out of reach for my stimulator.

So...yeah. I've sort of been going through the same thing I went through in the early days with my abdomen and back all over again with my leg. The muscles are becoming damaged and spreading the pain further, and I am once again making new lists of things I cannot do...well, I DO get handicapped parking now. THAT is pretty freakin' sweet.

I AM able to manipulate the field enough to channel it down into my leg, and this is helping some, but nothing has helped with the skin sensitivity. My neurologist is considering a new procedure with a substance called Qutenza (sp?). It quite literally involves covering the skin with highly concentrated hot pepper extract for several hours to numb the area. Or something. I'm not sure how it works, all I know is it sounds scary as shit. But, the sensitivity is bad enough that I am probably going to try it soon. There is nothing worse than crying out in pain when your daughter runs up to give you a big hug and seeing that look in her eye. It can't be worse than that....that sounds cheeeeeeesie. But it's true.

The whole thing has been depressing as hell and I'm having trouble facing the fact that this is likely a permanent addition to my old problems. Talking about it just makes it more real...indeed, I've been in a self-imposed exile from the OT because I didn't want to be asked. I know a lot of folks here are pulling for me and it sucks to bring shitty news. But, I've been in counseling for awhile now and I think I'm okay to start visiting here again and finishing up the tale. I will cruise over the last page or so of lingering questions and also pick up where I left off. Just a brief update for now, lots more soon.

Thanks for all the support as always, OT gaf. Truly sorry to keep you hanging for so long.



Yes. Well, it depends on what you're implying here. All pain is in the head. Explain phantom limb syndrome to me.

Reading the bolded made me feel so bad. I hope in the end everything works out for you. You have my best wishes. Good luck man
 

luiztfc

Member
echoshifting said:
Hey guys.

Sorry I have not updated in so long. I've sorta been avoiding this because the news has not really been so hot.

Shortly after my last post I developed a completely new pain area, basically out of nowhere. Whereas my pain once covered my right flank, from midline to spine/bottom of ribcage to waist, it has now spread down my right leg to just below my knee. The new area is excruciating. I had never experienced any skin-level sensitivity before with this condition - light pressure would get a reaction but not touch - but I have it in a big way in the leg. Even the lightest, featherweight touch causes my nerves to explode with fire. It sucks, and it's out of reach for my stimulator.

So...yeah. I've sort of been going through the same thing I went through in the early days with my abdomen and back all over again with my leg. The muscles are becoming damaged and spreading the pain further, and I am once again making new lists of things I cannot do...well, I DO get handicapped parking now. THAT is pretty freakin' sweet.

I AM able to manipulate the field enough to channel it down into my leg, and this is helping some, but nothing has helped with the skin sensitivity. My neurologist is considering a new procedure with a substance called Qutenza (sp?). It quite literally involves covering the skin with highly concentrated hot pepper extract for several hours to numb the area. Or something. I'm not sure how it works, all I know is it sounds scary as shit. But, the sensitivity is bad enough that I am probably going to try it soon. There is nothing worse than crying out in pain when your daughter runs up to give you a big hug and seeing that look in her eye. It can't be worse than that....that sounds cheeeeeeesie. But it's true.

The whole thing has been depressing as hell and I'm having trouble facing the fact that this is likely a permanent addition to my old problems. Talking about it just makes it more real...indeed, I've been in a self-imposed exile from the OT because I didn't want to be asked. I know a lot of folks here are pulling for me and it sucks to bring shitty news. But, I've been in counseling for awhile now and I think I'm okay to start visiting here again and finishing up the tale. I will cruise over the last page or so of lingering questions and also pick up where I left off. Just a brief update for now, lots more soon.

Thanks for all the support as always, OT gaf. Truly sorry to keep you hanging for so long.



Yes. Well, it depends on what you're implying here. All pain is in the head. Explain phantom limb syndrome to me.

Wow, thanks for taking the time to update us. Even after reading the whole thread, I can't even imagine the pain and situation you've been through.

Best of luck, man.
 
parrotbeak said:
Haha, glad you are at least enjoying the handicapped parking. I found it to be irritating. Had to pay extra at work for handicapped pass. Also you really start to notice and resent people who park in handicapped stalls and walk out looking perfectly fine, or people who just park and sit there waiting to pick someone up.

You know, it took me a long time to get comfortable with the idea. I carry my remote with me EVERYWHERE now and as soon as I get glared at I press it against the curious bulge in my back...and they stop. But, honestly, I'm so used to being judged on various levels. It's hard for people to understand. Though I am completely prepared to go off on the first person to give me crap about it. I've rehearsed a script. :)

A good friend of mine with an inoperable brain tumor (and - surprise - chronic pain) once caught a young woman leaving a note on her windshield, and man she tore her apart. She was the one who finally convinced me to grow a pair and just get a pass. And I'm so glad I did, I feel like fucking royalty. There has to be a perk somewhere, right? Surely I am entitled to a perk...aside from mercy at the hands of our future robot overlords, obviously.

That hot pepper therapy actually sounds pretty neat.

I'm eager to hear your impressions ;)
 

Dead Man

Member
echoshifting said:
Hey guys.

Sorry I have not updated in so long. I've sorta been avoiding this because the news has not really been so hot.

Shortly after my last post I developed a completely new pain area, basically out of nowhere. Whereas my pain once covered my right flank, from midline to spine/bottom of ribcage to waist, it has now spread down my right leg to just below my knee. The new area is excruciating. I had never experienced any skin-level sensitivity before with this condition - light pressure would get a reaction but not touch - but I have it in a big way in the leg. Even the lightest, featherweight touch causes my nerves to explode with fire. It sucks, and it's out of reach for my stimulator.

So...yeah. I've sort of been going through the same thing I went through in the early days with my abdomen and back all over again with my leg. The muscles are becoming damaged and spreading the pain further, and I am once again making new lists of things I cannot do...well, I DO get handicapped parking now. THAT is pretty freakin' sweet.

I AM able to manipulate the field enough to channel it down into my leg, and this is helping some, but nothing has helped with the skin sensitivity. My neurologist is considering a new procedure with a substance called Qutenza (sp?). It quite literally involves covering the skin with highly concentrated hot pepper extract for several hours to numb the area. Or something. I'm not sure how it works, all I know is it sounds scary as shit. But, the sensitivity is bad enough that I am probably going to try it soon. There is nothing worse than crying out in pain when your daughter runs up to give you a big hug and seeing that look in her eye. It can't be worse than that....that sounds cheeeeeeesie. But it's true.

The whole thing has been depressing as hell and I'm having trouble facing the fact that this is likely a permanent addition to my old problems. Talking about it just makes it more real...indeed, I've been in a self-imposed exile from the OT because I didn't want to be asked. I know a lot of folks here are pulling for me and it sucks to bring shitty news. But, I've been in counseling for awhile now and I think I'm okay to start visiting here again and finishing up the tale. I will cruise over the last page or so of lingering questions and also pick up where I left off. Just a brief update for now, lots more soon.

Thanks for all the support as always, OT gaf. Truly sorry to keep you hanging for so long.



Yes. Well, it depends on what you're implying here. All pain is in the head. Explain phantom limb syndrome to me.
Just glad for the update man. Don't worry about disappointing us, just keep on keeping on.
 

Wads

Banned
Sorry to hear it's gotten even worse... I hope the dr's can help you find some relief soon!!!

If it's more bad news you don't have to go into it (obviously), but how did things go with that judge? Surely, you had to qualify, right???
 
echoshifting said:
You know, it took me a long time to get comfortable with the idea. I carry my remote with me EVERYWHERE now and as soon as I get glared at I press it against the curious bulge in my back...and they stop. But, honestly, I'm so used to being judged on various levels. It's hard for people to understand. Though I am completely prepared to go off on the first person to give me crap about it. I've rehearsed a script. :)
Oh ya, I know there are lots of people who have serious problems but don't look like it. But I knew one lady who got a pass and used it cuz her doctor wrote her a note saying she can't carry more than 50 lbs or some shit like that. I had no idea being physically weak was a handicap. Also know a guy who got one for being obese. But anyway, it took me months of struggling to get a pass and so I was pretty bitter by the time I got it. It had been taking me 30 minutes to walk from my parking lot to work because I'd have to stop halfway to rest (normally was a 10-15 minute walk), and my doctor still wouldn't give me one until I was actually scheduled for surgery.

I'd never call anyone out on using a pass though, cuz ya, you never know. On the other hand I know there's lots of people who could probably use one but don't, because like you they didn't want to look like an ass. My friend had knee surgery recently and still hardly used his.
 
Wads said:
Sorry to hear it's gotten even worse... I hope the dr's can help you find some relief soon!!!

If it's more bad news you don't have to go into it (obviously), but how did things go with that judge? Surely, you had to qualify, right???

The decision was unfavorable but my lawyer expects to win on appeal. The judge claimed that, while I am clearly disabled today, it cannot be demonstrated that I was disabled before my social security benefits expired in spring of 2008, and therefore the evidence used to prove my disability must be disregarded (i.e., he threw out all of the doctor's notes, procedures, etc...everything from after that date). It took us awhile to figure out what was really wrong with me - for years we treated it as a GI problem - so most, if not all, of the substantial evidence he used in conceding my current disability fails before this standard.

But this is not necessarily bad news. As my lawyer explained it, this gives us very solid grounds to appeal as he thinks he can demonstrate that my condition has been consistent along a timeline prior to that date. If the appeals board agrees, they MUST approve disability since the judge stated in his decision that he believes I am presently disabled; they must stick with that aspect of his decision; in other words, they can't claim that, while they agree that my condition has been adequately consistent prior to that date, they feel that I am not presently disabled. We just have to prove the timeline, connect the last dot.

Again...this is how my attorney explained it. I claim no legal expertise here. The sad truth is that it is very difficult to get disability in this country. The federal government is more concerned with ensuring that the system is not abused than it is with ensuring help is distributed where it is needed. And I suppose one could make an argument for that, though I disagree, not only because of my personal experiences, but also because of the horror stories I have heard from others who are drowning in medical bills and unable to satisfactorily demonstrate their disability in court.

He just filed the appeal a couple weeks ago. Probably won't hear 'til the end of the summer.
 

Dead Man

Member
That sounds... aggravating. Even if it is not the end of the process it sounds like it must just be frustrating as hell. Hope thing turn up for you man.
 
Part 3 of 2
I should probably start by explaining why this update has taken so long, shouldn’t I? Yeah, I think that would be a good place to start.

Around the time I started writing this update I had a major falling out with “Dr. S.” MAJOR falling out. And we’re going into the part where she runs in and saves the day; I could not bring myself to write one positive word about her at that time (to be honest, I still can’t). I worried, too…would GAF believe Dr. S’s interpretation to be accurate? What happens to this thread when I reach that point of the story? How many doctors am I allowed to have a disagreement with before it starts to seem that the “bad” doctors were right all along? Surely, some will think this way. It wasn’t something I wanted to face. The past six months have been an extremely delicate period.

Reason two is, I’ve given you guys a lot more detail than I’ve given to most of my extended family and I’m starting to feel pretty shitty about that. I felt like I needed a way to tell them all of this (beyond simply linking here). I still haven’t found it, and I still feel pretty shitty about it. But, I enjoy the anonymity I am afforded in this setting. It makes it much easier to talk; I’ve missed it.

Much has happened between now and then, so let’s not pretend that I’m going to be able to provide a satisfying conclusion to this story. Probably ever. The fact is that I live with a disorder that is incredibly complex and unpredictable – see my last couple of posts about my new leg pain. I have yet to find that ending, happy or sad, which will allow me to move beyond this and focus on the parts of my life I enjoy. I won’t attempt to create the illusion of one here, and to suggest that I would be able to do so was a mistake. I’m sorry.

On that note, I’m not going to try to spin this yarn in a way that sets up cliffhangers and whatnot. That was dirty pool. It won’t happen again. I’ll certainly continue updating this thread whenever anything interesting happens…and I’ll warn you right now that I’m not going to be able to catch us up completely to present day in this post. I will endeavor to return sooner, though.

Now then. Where was I…oh right! Let’s talk about paddle leads, and hope my fuzzy brain can remember how this all went down.

This is a paddle lead:
bh0o5j.jpg


And this a description from Medtronic’s website:
Medtronic said:
“Designed to improve the effect of neurostimulation therapy on low back pain, the Specify 5-6-5 surgical lead features 16 electrodes arrayed in three columns on a durable, flexible, curved paddle that conforms to the anatomy of the epidural space. The electrodes – six in the middle column and five in each of the outside columns – are securely embedded in the paddle with patent-pending DuraLoc™ electrode technology. They are arranged in a diamond pattern that is intended to maximize therapeutic effectiveness while minimizing energy consumption. Each electrode can be activated and programmed independently, which enables customization and adjustment of neurostimulation therapy based on individual patient needs.”

The difference between a standard lead and a paddle lead is substantial. Where the standard lead is simply a wire that is tethered to one spot on the spine, the paddle lead is a long strip of plastic that rests on top of the affected area. It covers a much larger area and the greater number of contact points allows for highly customizable programming. With the standard leads, all I could change on my own was the type and intensity of sensation, even if it had worked properly. Medtronic technicians could change other things within the field, but the effective range was always limited by the placement of theleads. It seems rudimentary, archaic even, when contrasted with the paddle.

As you can imagine, sitting in my new neurosurgeon’s office, reading the pamphlet about the paddles consumed me. What the hell was I doing with two shitty points of contact that didn’t even work properly when I could be flying in style with 16 electrodes? I put this question to each of my doctors as we went through the peripheral lead test, and while they each believed I may have been a good candidate for paddle leads when my SCS was first implanted (I have never been able to confirm if they were even in use at OHSU at the time), they maintained that it was just too late to take the old leads out and start over. The risk was too great.

ARGH.

After the peripheral test went poorly, though, they began to soften on the issue, and I made sure to press it at every appointment. I didn’t care about the increased risk…I wanted my stimulator to work the way the first test unit had worked (I will never forget that incredible day, documented earlier in the thread). I wanted to be able to walk more than fifty feet without collapsing, I wanted to be able to use a flight of stairs without spending an hour recovering from the ordeal, I wanted to be able to vacuum the fucking floor! This was the promise of that first test unit two years ago. It never claimed to be a perfect solution…nothing is. But it seemed on that day that these things could be within my reach, which was why the actual unit was such a disappointment. Sure, it provided some low-grade pain relief, but it didn’t seem to be improving my actual day-to-day functioning at all.

This was the point on which I eventually convinced Dr. B and Dr. S to move forward with the lead replacement surgery; Dr. B was especially pivotal in this decision. His philosophy in my treatment has always been centered on the practical; if a particular treatment is relieving 10/20/30% of my pain, but failing to get me out of the chair any more often, he considers the treatment strategy ineffective. This is a stark contrast to Dr. Stacey, for whom the 10-point pain scale was the only important measurement of a treatment’s efficacy. This can be seen in his reliance on potent narcotics: doesn’t matter how foggy the patient feels, as long as his pain is lessening. It was an approach I appreciated at the time…I didn’t care much about my activity level either! But there comes a point where you realize that what Dr. B is pushing is a much more sensible approach – as I noted in part 2 of this update, he helped wake me up to the fact that I’m not dying (well, not immediately. He seems to delight in reminding me of my shortened life expectancy, the old bastard). The focus should not be on making me as comfortable as possible, it should be on allowing me to LIVE as freely as I possibly can. It took awhile to come around to this (there was much whining on my part about Dr. B’s reluctance to prescribe potent drugs in several categories), but the contrast in my quality of life since starting up with Dr. B vs. my quality of life under Dr. Stacey’s care is hard to miss.

We never really brought Dr. H, the neurosurgeon, around on the decision to open me back up. Lemme tell ya….not so comforting, when the guy who is going to be fiddling around with your spinal cord is grumbling right up to the last minute about what a terrible idea this is and that I’m so totally asking to be paralyzed from the waist down for life. My wife kept reminding me that this is a guy who cracks skulls and mends brains for a living. From her viewpoint, he was probably covering his ass in the event anything went wrong, and nobody seemed to think that was actually likely. Except, ya know. The guy who was actually going to be doing it. Never before had I so thoroughly researched a doctor’s reputation and body of work; I found that Dr. H is well respected and he seemed competent – my only issue being that he appears to be roughly 95 years old. At this point, though, the paddles seemed like my best shot at improvement, and with the support of Dr. S and Dr. B , we rolled the dice.

So, now I’m paralyzed. Son of a bitch.

Kidding.

The paddle installation went just fine, and they are awesome. Awesome. Whereas I used to be limited to two aspects per program (one per lead), I could now have anywhere from one to three, and I had sixteen points of contact to choose from in designing those programs. Although I still need to see my buddy Andrew periodically to make adjustments, I possess much more personal freedom in adjusting my programs. In fairness, I would have had some additional leeway had my first set of leads been implanted properly, but nothing like what I have now. The sensation, the size of the field, the intensity…I can make these changes with a program I’m currently using – without fear of zaps! – on the fly. It typically only takes a couple of minutes.

It took awhile to trust the new lead; I kept waiting for that inevitable ZZZZAAPPP when I shifted just a bit or used the wrong program in the wrong position, but it never came, and almost a year later, it still hasn’t. It really got to a point with the first set of leads where it felt like I had allowed something invasive and terrible into my body…that I now had two monsters to deal with instead of one. There were nights when I wished I could have reached back and clawed it back out myself. I have never experienced this sensation with the paddle leads. They feel like a part of me now in a way the old leads never did.

It still isn’t that miracle cure I thought it would be after the first test, but it does allow for the kind of activity described above. The best part is the freedom; if I know I’m going to need to lean on it a lot on a particular day, I can crank it without having to worry about discharge issues. It’s hard to maintain at an extremely high level for more than a couple of hours – for some weird reason it always reminds me of those classic comic book scenes with characters like Invisible Woman or Dr. Strange, when they’re trying with all their might to keep the….shield…up….just a bit…longer! It’s only a matter of time before the intensity becomes too uncomfortable and I need to turn it down, or even completely off for a little while, and it leaves me feeling completely physically and mentally drained. Still! The fact that I have the freedom to do that is amazing. It granted me more freedom to actually live my life than I had had in quite some time. I could go out with friends every once in awhile. I could help around the house. I could attend a wedding, or a funeral (which is good, I suppose, as my best friend was to die mere months after my surgery). It’s an ongoing fight, but the SCS – with paddle leads – has finally become the asset in that fight that I always wanted it to be.

So, this is about where I intended to stop my last update, and it still seems like a good stopping point for now. I’d still like to discuss the fight for SSD, the fallout with Dr. S, to detail my new pain area and to talk about the treatment approaches I’m working on now…but there’s no way I can cover all that here. Again, I will try not to leave this thread twisting in the wind for quite so long in the future. As always, your interest, support and encouragement go a long way. Thanks, GAF. I hope this was worth the wait.

edit: Oh right, I totally forgot I said I'd throw this up here:

2r243dx.jpg


My crappy art skills aside, this has turned out to be an extremely helpful diagram. Every new doc I see asks for a copy. If you or someone you know is going in for pain treatment...do this. It makes a big difference in that initial meeting.
 

Dead Man

Member
Thanks for the update!! What an odyssey, I hope it starts to get better eventually. I do think the quality of life scale is much more useful than a generic 1-10 scale of pain. Also, try not to feel so bad about telling random people on the internet stuff first, that feeling of anonymity is a powerful thing, and you can then practise what you will tell your family and loved ones first.

Finally, did you mean to name Dr S like that? Cool if you did, I just thought I'd ask.

Edit: Glad you don't have to deal with the random zaps now, too.
 
Dr. S =/= Dr. Stacey. Dr. Stacey was the anesthesiologist who treated me while I was at OHSU. He's the guy who installed the faulty stim leads (and subsequently refused to replace them). Dr. S is the neurologist who helped me get the leads replaced.

My criticisms of Dr. Stacey's treatment are pretty well known in the Portland medical community. I don't have any problem naming him, but I prefer to keep all doctors who have implicitly condoned and supported my use of medical marijuana at least loosely anonymous.

Dead Man said:
Edit: Glad you don't have to deal with the random zaps now, too.

Meeeeee tooooooooooooo
 

cntr

Banned
Oh, whoa, an update. I was a bit scared at the lack of news, so it's really good to see you around again!
 

Demy

Member
I walked into this thread because of your tag and spent the better part of the last hour catching up. I'm humbled by your experiences. Hope things go in your favor on all fronts.
 
Thanks demy.

Sorry the update has been so long in coming, guys. Things have just not been going real well lately and it's hard to talk about. I haven't forgotten.
 
This is very interesting. A friend of mine experiences chronic pain because of some nerves in her lower back. I can't tell you what the specific details are but I know she injured it when she was young. And she gets pain all over

I really hope her condition doesn't get to your level, it does not sound good at all.
 
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