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Case Studies - Page 2

Was there family history of this problem? "Yes," Amy told me. "Both my mother and sister have had endometriosis that's traveled a similar route. But they're out of pain now."

Was there other family history relevant to her pain? "I've been anxious all my life," she replied. "My father was alcoholic and physically abusive, and my mother busied herself with four younger children. I'd lie awake at night and listen to them argue, worried that things would really fall apart—that the family wouldn't survive."

We covered other topics, too. What was her relationship history? Her first marriage had ended in divorce, she said, when her daughter, Suzanna, now 23, had been 2 years old. She'd been married to her current husband, Jim, for 20 years, and it appeared to be a good marriage for them both. However, she was sad that there'd been no sexual intimacy for a long time, except when she'd taken heavy pain medication—which had led to an unsatisfying experience for both of them.

As empty nesters for the last several years since Suzanna had left for college, Amy and Jim had both worked 12-hour days in demanding jobs. Her increase in pain in the last two years had coincided with her boss'e retirement and her decision to take on the work of accounts manager while she continued to do "hands-on" commercial art projects.

"What helps?" I asked. She said she got relief from heat applications, Neurontin and Vicodin as pain medications, Paxil for depression, and Ambien and melatonin for sleep. Being in nature was healing for her, she added. She had several satisfying close friendships and enjoyed bicycling, needlework, reading, and going to the movies.

"What are you most scared about?" I asked next. Her eyes filled with tears as she whispered, "I'm scared I'll never get out of this hell of pain—that I'll only get worse with time, because that's what's happened so far. I've been a commercial artist my whole life, but I may not be able to do that job anymore. I'm afraid I'll have to stop and won't be able to find something else that I can be good at."

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