Dr. Lynn Webster [Dr. Webster]: Hello, this is Dr. Lynn Webster. Thank you for listening to this Pain Topics series of interviews on LynnWebsterMD.com. Today I am joined by Micke Brown, the Corporate Secretary & Steering Committee Chair of ThePainCommunity.org. Micke is a registered nurse with experience in clinical advisement, communications, consumer and health care professional education, advocacy and business management. Thank you for joining me today, Micke.

My first question to you is, ‘what are the three most common concerns you are hearing from people in pain?’

Micke Brown: Well I can tell you, before I list them off, they haven’t changed in the many years that I have been in the field.  I mean, I started my journey working with people with pain back in the early 90s, and I was kind of hoping that by now, we would be hearing something a little bit differently, but it seems to resonate throughout the decades, and the primary concern that I’m hearing from people with pain is that they’re still having a hard time finding somebody to help them manage their pain.  They feel like pariahs, if you will, that people don’t want to touch them, they’re afraid of them, or they have a sense of mistrust that they’re either trying to fool their provider, or it’s for they’re making more of their pain than how they’re feeling.  To me, it’s an existential crisis that is driving them into a life of loneliness and being disenfranchised.  It reminds me of the early days of the HIV/AIDs war, you know, when people weren’t believing that people were dying from this terrible disease.  I feel that people with pain are so stigmatized and discriminated upon.  It doesn’t matter what sex you are, how old you are and what type of pain that you have.  I mean, I think if you have perhaps even pain related to cancer, you might be considered a little bit more credible but once you become the survivor, you follow the same trap of somebody not really being believed which really makes that person question their own self at times, which makes be very sad as a nurse, very sad.

The other thing that I am hearing is that if they are fortunate enough to get care and have prescriptions in trying to get their pain medications, whether we’re talking about controlled medications or not, many people are still having problems getting access to their medicines being believed at the pharmacy and oftentimes they’re feeling like they’re being treated like a criminal.  I recall one pain advocate who is also a lawyer actually had to pull up her laptop and pull out the state law in front of her pharmacist to show that she had rights to have her prescription filled.  Many people are saying that, you know, it really doesn’t matter if I play by all the rules that my provider gives to me and I jump through all the hoops, it just doesn’t seem to make a difference.  I am not being believed.

I would say the last thing that I hear and continue to hear is that not only providers but oftentimes family and friends give the impressions that they don’t care, they don’t want to listen or they don’t want to believe the person living with pain.  There is an appearance that I have seen from colleagues that even at meetings where I feel like they either don’t like their patients with pain or they are afraid of them and as a former OB/GYN nurse, it kind of reminds me of some of the physicians that I used worked with way back when.  They either loved women or they hated on them, and I feel the same type of angst when I listened to some providers when they talk about their patients and I hear the same thing reflected from people with pain on how some of their providers are.  It’s not all.  We’ve certainly have some wonderful, wonderful people out there who are very dedicated but it’s not the amount that we need to take care of this terrible problem.

Dr. Webster: Thank you, Micke. That’s very informative.

Thanks again for listening to this Pain Topics interview on LynnWebsterMD.com. Please check back soon for more questions for Micke.

If you aren’t already, please follow me on Twitter @LynnRWebsterMD. Also, stay tuned to my blog for more information about my upcoming book and documentary titled The Painful Truth, to be released this fall. Have a great day!

Micke A. Brown, BSN, RN 

Ms. Brown is a nationally known pain management nurse and experienced patient advocate. In March 2013, she was invited to join a team at the University of Maryland, School of Pharmacy as the program director to coordinate the grant activities related to a Memorandum of Understanding (MOU), entitled “Controlled Dangerous Substance (CDS) Emergency Preparedness Plan”. This grant was issued by the Maryland Department of Health & Mental Hygiene (DHMH) to cover the period of March 15, 2013 through March 14, 2018. Mary Lynn McPherson PharmD, Professor and Vice Chair of the Department of Pharmacy Practice and Science and Kathryn L. Walker, Pharm.D., Assistant Professor serve as the principal investigators (PI); together this team works closely with the Maryland Behavioral Health Administration (BHA), expert advisers from the medical fields of pain management, substance use and mental health disorders along with local health departments and affected communities who experience an abrupt loss of a CDS prescriber.

Brown also serves as the Corporate Secretary of the Board of Directors and Team Coordinator for The Pain Community (TPC), a non-profit, consumer-focused pain organization based out of Alamo, California. Using her experience and commitment to quality pain care, she is working with other TPC volunteers to develop this national nonprofit organization whose mission is to build and strengthen an active, diverse and energized community of people affected by pain by providing a foundation of support where education, wellness information and advocacy are promoted. She is the former Director of Communications & Consumer Education for American Pain Foundation (APF) and Past President of the American Society for Pain Management Nursing (ASPMN).

Micke Brown is a registered pain management nurse, who received her bachelor of science in nursing degree from the University of Florida, Gainesville, along with advanced credentials in acute pain management from Schumpert Medical Center, Shreveport, Louisiana. Ms. Brown has more than 35 years experience in nursing, with 20 years in the specialty of pain management. Her career as a pain management nurse and pain advocate has included caring for and educating individuals and their families living with pain, training health care professionals about pain management and speaking out for those affected by pain in the media, during legislative hearings and with other decision makers about issues that impede access to quality pain care.

Her contributions to the American Pain Foundation (APF) were extensive. Ms. Brown helped develop and guide communications as well as educational services that provided key information for APF members and the general public while also serving as the clinical advisor to APF staff and volunteers. Micke’s advocacy work included working closely with the FDA safe use initiative on patient-provider agreements, presenting to a variety of professional and consumer audiences, (e.g. serving on a panel with the DEA, lecturing with representatives from the DOD and the VA alongside injured veterans at national meetings, co-presented with pain advocates living with pain), collaborating with staff from the National Institutes of Health (NNCAM) in the development of safe use education for complementary-alternative medicines and leading stakeholder meetings on breakthrough cancer pain.

Micke has contributed to the medical literature as co-author for the chapter on social, political and ethical forces that impact pain management nursing practice published in the 2010 edition of ASPMN Core Curriculum, a chapter about navigating pain care for the older adult for Gloth’s 2011 edition Handbook of Pain Relief in Older Adults, An Evidence-Based Approach and another that covers educating patients and caregivers about pain management for the clinician in Moore’s 2012 Handbook of Pain and Palliative Care.

Ms. Brown has volunteered on several non-profit boards: the Maryland Pain Initiative (MPI), Hospice of Washington County (Maryland), and was elected as the 2003-2004 president of the American Society for Pain Management Nursing (ASPMN), a professional organization dedicated to promoting the advancement of optimal nursing care for people affected by pain. In 2006, she was honored with Richard S. Weiner Pain Education Fund Advocacy for People with Pain Award from the American Academy of Pain Management which is given to an individual who has demonstrated outstanding commitment to assisting and advocating for people with pain.