Meeting Notes for August 15, 2018

Joan Knoertzer’s lovely piano prelude wafted members and guests gently toward the business at hand. A ring of the Rotary bell by President Emeritus John Ackenhusen, who looked remarkably relaxed from his several weeks of freedom, signaled the meeting’s commencement. James Corey came forward and delivered a cogent Inspiration, opening with a quote from acclaimed author John Green: “‘…Things can be done better and better.’ Thank you, Rotary, for all that you do.”







Song: Past President Ingrid Sheldon, accompanied by Joanie, then led us in singing several well-chosen ‘happy’ songs: “I Want to be Happy”; “You Do Something to Me”; and “Smiles,” all of which, for some reason, reminded your reporter to schedule his next dental appointment.

Following his greetings to all, and introductions of visiting Rotarians and guests, John explained that he was pinch-hitting for President Greg as a result of an accident: “Greg tore a muscle — really, a separation from the bone. He’s on a cold wrap, but will be back next week.” Concerned faces around the room betrayed similar thoughts. Was it the result of a particularly ferocious tennis match? A ruthless volleyball spike; a wrenching tee off? Has Greg been moonlighting again with his FBI comrades? More to the point, is Greg The Equalizer? We’ll find out next Wednesday. In the meantime, get well soon.

John announced that the deadline had arrived for members to update their directory information. Those members wishing to augment or change entries no doubt flocked to John White during and after the meeting.

Golf and Tennis Outing: Committee chair John Simpkins returned to the podium to request additional auction items and to urge members to register for play and/or the dinner. “As you know, the GTO is our largest fund raiser and social gathering. If you have any items [or services] you would like to donate for the auction, please contact me. Thank you.” GTO is September 10, at Travis Pointe Country Club, 10:30 a.m. – the duration.

Another announcement: John brought us up-to-date with regard to the ongoing search for a club administrator. “At the Board meeting today we put together a search committee to replace John White and Dave Keosaian, who are retiring. A search committee was formed, and their recommendation was to engage the help of an organization in our area that has done this before for non-profits like ours. This solution will entail additional administrative costs of about $2,000 a month. Dues were raised to help with that, and will be raised again, though to a lesser extent, next year.” John then invited all interested members to attend the meeting next week, which he will host.  Click here for a John’s summary of his remarks.

Speaker: Confessions of a U of M Chronic Pain Physician

“Here was a panacea [opium]…for all human woes; here was the secret of happiness, about which the philosophers had disputed for so many ages, at once discovered; happiness might now be bought for a penny, and carried in the waistcoat-pocket; portable ecstasies might be corked up in a pint-bottle; and peace of mind could be sent down by the mail.” — Thomas De Quincey, 1821

James Corey returned to the podium to introduce our speaker, Daniel J. Clauw, M.D., Professor of Anesthesiology, Rheumatology and Psychiatry at the University of Michigan. Dr. Clauw is also director of the Chronic Pain and Fatigue Research Center. He got right to the point: “We simply don’t have good drugs that treat chronic pain, which is a reason for the opioid epidemic.” A slide was shown that displayed two x-rays of knees; one healthy, with cartilage intact, the other occluded, with no apparent cartilage. “Doctors [looking at the healthy knee] will usually say ‘there isn’t anything wrong with you'”, even though the patient is suffering pain. “We would assume the patient experiencing bone-on-bone [contact] would be the one in pain, but this isn’t always true. Sometimes the person with bone-on-bone doesn’t feel any pain,” Dr. Clauw asserted. And here was a central fact of his presentation, that “pain is in the brain, more so than in the area of the body.” Indeed, for some, “the brain can be hyper-sensitive to pain through the body.” He then described various kinds of pain: 1) Mechanistic, or acute pain, the result of inflammation, which opioids, according to Clauw, are effective at relieving; 2) ‘Brain Driven’, when the brain serves as “the amplifier to the body’s ‘electric guitar.'” Dr. Clauw illustrated this with the example of pain issuing from subliminal fibromyalgia: “The pain is in the brain, not the joint.” From a treatment standpoint, then, determining a patient’s “‘volume control'” is crucial. He did take the time to observe that “men, on average, are less sensitive to pain than women.” Doubtless a result of being a far simpler organism.

For many years, until the 1990s, opioids were utilized effectively for treatment of acute, inflammatory, pain. “Since then, certain pharmaceutical companies convinced physicians to prescribe opioids for chronic pain. It was like throwing gasoline on a fire; we didn’t understand how opioid treatment could contribute to the problem.” Dr. Clauw then provided a sobering statistic: “Seventy percent of people who get opioid prescriptions get hooked on heroin, because it’s cheaper [after the prescription expires]. A side door introduction to opioid addiction can be a tooth extraction, for example.”

Medical Marijuana. Dr. Clauw cited marijuana’s effectiveness in ameliorating certain kinds of pain, particularly the chemical component CBD (Cannabidiol). “CBD really helps, not THC, which is what people want to get high.” He remarked that one problem with most medical marijuana dispensaries is that they sell high-level THC, “the kind used by recreational users.” He invited audience members to contact his office about reputable dispensaries. “There is one that we have confidence in, and work with.”

In conclusion, a slide listed several non-medicinal ways to relieve chronic pain, ranging from highly effective to modestly effective: aerobic exercise, cognitive behavior therapy, mindfulness therapy, and meditation. In the second tier were strength training and acupuncture.

In addition to his medical work, Dr. Clauw described “my real passion” — traveling to Kenya. Some years ago he vacationed there, and the experience moved him immeasurably. He has since returned many times, usually leading groups of students. “It’s a life-changing experience for them…the landscape, the Kenyan people [who] have nothing, yet are so kind and generous. They are indeed rich.” He showed a photograph of a Land-Rover full of beaming students trekking an animal preserve. “Look at their faces. They’ll never forget this.”

Applause resounded through the ballroom as John thanked Dr. Clauw. Then he adjourned the meeting by reminding everyone of JET, revered slogan of his presidency: “Join leaders, Exchange ideas, Take action!”