The (Woman) Doctor Behind President Kennedy's Pain Management

I'm happy to say that there were two articles just published in a medical journal about one of my heroes, Dr. Janet Travell, a pioneering doctor in pain (to say the least).  The articles, which discuss the autoimmune disease and the pain medicine aspects of President Kennedy's care by Dr. Travell, is found in this month's edition of the medical journal Practical Pain Management (with his image on the cover) and can be found at the link here and here.  I am especially excited as Dr. Travell has long been one of my heros - and I just wrote a post about her recently).

Dr. Janet Travell with  First Lady "Lady Bird" Johnson. Dr. Travell became President Johnson's White House Physician after the Kennedy assination. 

I'd like to point out that my "source" who knew Dr. Travell very well was not one of the doctors who wrote the articles - I don't want to mislead you - AND petty person that I am, I'd like you to know that I have excellent sources (ha! regarding "petty," true about "petty" and "excellent sources").  

There are a few problems I have with a few "facts" in the articles, but overall, the information is excellent.  Because of my extensive comments and my real effort to shorten my posts, I'll need to divide my observations into several parts.  I'm afraid that when it comes to pain management I get just a TAD (over) serious!  (Ahem!)

My reservations are mostly small, though some are important, while others are small, period.  On the other hand, there are a few points that I REALLY agree with that I'd also like to point out as excellent points made.  Today I'm starting with Dr. Jay's article in light of trying to spare people long-winded posts. (Yes, yes, I basically said that already!  Sigh!)

1. In the article by Dr. Jay, he's a bit inaccurate and I wonder how well he knew Dr. Travell when he wrote that "Her use of procaine injections was most likely into myofascial trigger points...."   UH...excuse me, but Dr. Travell wrote two volumes about myofacial trigger points, still sold at Amazon, as I noted in my post and I even placed a picture of the volumes at the end of the post.   My source tells me that she most certainly DID inject JFK's trigger points and that was also the consensus at a medical conference where she was the guest of honor.  This was when and where my source first met her as a relatively young man when she approached him in her wheelchair, knowing already who HE was, and saying she was following his career, "young man!"   (He would definitely have been too intimidated to approach her and this man is NOT easily intimidated!  Hero worship can do strange things to people (ha!).)

2. I only hope that when Dr. Jay wrote "other stimulants ... There continues to be methylphenidate for use, as well as amantadine" that this was a spelling mistake (maybe generated by the dictatorial iPad which haunts me as well!) and simply not caught by the editors.  On the other hand, I don't want readers confused by seeing this medicine quoted in this usage.  I only caught this error regarding Amantadine since Amantadine is an antiviral medication which I DO take, but for my CFIDS/CFS/ME, not for my fibromyalgia and/or myofascial pain.  The author most likely meant the stimulant, "amphetamine."

3. Dr. Jay also wrote,  "Finally, and most impressively, Dr. Travell treated more than the symptoms of pain and hormonal dysfunction.  .... Dr. Travell knew then what we know now -- physical exercise is necessary to maintain a number of physiological functions as well as to help decrease pain." 

Now this, the exercise, is a real bugaboo of mine, I fully admit it.  With all due respect, however, I beg to differ and one fibro source has even testified in court many times that exercise is not always appropriate for pain.  It all depends on the patient.   As I keep saying over and over again, we can't be plugged into any formulas!  Dr. Travell most definitely believed in what is right for each individual patient and didn't believe in any set "theory" other than going by results - and this in fact was an example of her genius! Furthermore, as I'm always saying, I've seen more theories come and go over the years, each time doctors absolutely sure that THAT was the answer.  I have finally started looking at everything as what works for me - after much damage was done to me, completely innocently, I must add, and much of it permanent damage - and I've had to long ago stop going with anyone's "dictates."  I can just imagine Dr. Travell looking down and shaking her head at some of the rigidity going on.

4. I whole-heartedly agree with the following excellent conclusion, however, and want to point it out: 

"Bottom line -- Dr. Travell treated President Kennedy in a highly appropriate fashion, using tools that most physicians today wouldn't know how to use, and even in ways they may not have been able to fathom.  I do believe that Dr. Travell knew or intuited various things about drugs and hormones that we now understand better and more deeply.  The fact that her treatment plan was so effective is a function of her exceptional skill as a physician at a time when physicians knew far less than we know now."

Now THAT quote is absolutely right!  Dr. Travell understood one could not be rigid in his/her thinking.  She also understood how much each patient varies and how each patient is unique.  In addition to her care, love and intuition of patient care, she understood that no two patients are exactly the same and each patient's care is unique to that care, something the vast majority of specialists today should remember.

"This is not cookie cutter...you gotta do it right," to quote MY source.

As always, particularly today, I hope everyone is doing their best, only better. As they say, "to be continued!"  Ciao and paka!

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