多年不必要的疼痛----Ashley S. Hattle说，误诊和缺少专业医师指导使得丛集性头痛的患者无法得到正确的诊治（一）

 英语晨读 ·

山东省立医院疼痛科英语晨读已经坚持10余年的时间了，每天交班前15分钟都会精选一篇英文文献进行阅读和翻译。一是可以保持工作后的英语阅读习惯，二是可以学习前沿的疼痛相关知识。我们会将晨读内容与大家分享，助力疼痛学习。

本次文献选自Ashley S. Hattle.Years of needless pain-Misdiagnosis and lack of referral to specialists prevents people with cluster headaches from getting the help they need, says Ashley S. Hattle[J]. Nature, 2020, 586.

The first time I experienced a cluster headache, I thought I was dying. I thought it was an aneurysm or stroke, because surely this amount of pain would kill me. But then, after around 90 minutes, it was gone, leaving my body drained and my mind full of fear. Cluster headache is one of the most painful conditions people can experience. Those who have felt it rate the pain as considerably worse than that from childbirth, kidney stones and gunshot wounds. It is not like any other kind of head pain; it is a different beast entirely. However, when people like myself head to the hospital or to our physicians, we rarely get the help we need. Medical professionals commonly chalk up the pain as a migraine attack — a misdiagnosis that can take years or even decades to correct, meaning a long wait before effective treatment can finally be prescribed.

第一次丛集性头痛发作时，我以为我要死了。因为痛不欲生，我以为是动脉瘤或中风。大约90分钟后，症状消失，我感觉精疲力尽，恐惧异常。丛集性头痛是最严重的疼痛之一，经历过这种疼痛的人认为这比分娩、肾结石以及枪伤都要严重得多。它不同于其他头疼，是一个完全不同的怪物。但我们去医院或诊所就诊的时候，很难得到需要的帮助。医生通常将这种头疼归于偏头痛发作----这种误诊通常持续几年甚至几十年，这意味着患者在得到有效治疗之前，要等很长时间。

I was told for six years that I couldn’t have cluster headaches because I am a woman, and cluster headache is most common in men. My symptoms were dismissed by several clinicians. I relied on sumatriptan for relief. The drug helped to stop attacks in progress, but it cost US$215 for just two injections and came with severe side effects that I would not understand fully until my early 30s, when tests revealed evidence of a possible heart attack. Had I been offered other forms of treatment sooner, such as oxygen therapy, I could have avoided some of these injections.

六年来，我一直被告知我不可能是丛集性头痛，因为丛集性头痛常发生于男性。我看了几个临床医生，依靠舒马曲坦来缓解症状，这种药物能缓解疼痛发作，2次注射花费215美元，并且伴随严重的不良反应，我在30岁左右被认为有心脏病发作。如果我能早一点接受其他治疗，比如氧疗，就可以避免一些注射。

As my cluster-headache attacks became more frequent, I searched for answers, desperate to learn as much as I could about the condition. Finding little to no information available for patients, I began work on a textbook for people like me who were encountering uninformed medical professionals and not receiving the right treatment. But patients should not have to become experts in their own condition.

随着头痛发作越来越频繁，我开始寻找答案，迫切地想要了解这种状况。我发现病人能得到的信息很少，几乎是没有，于是我开始为像我这样遇到非专业医生，没有得到恰当治疗的病人编写教材。但是病人不该久病成医。