Self-management skills that are not top of the pops
When I carried out my informal survey of the pain self-management skills people had used in the past week, there were no real surprises. Movement, activity management (pacing – and I will have more to say about this in a couple of weeks!), sleep, attention management and doing something fun were all at the top of the list. Others were lower down and while they don’t get to shine as much, I’m not so sure they are as seldom used as this wee survey suggests.
At the bottom of the list is having hands-on treatment for relaxation or to feel good. OK, perhaps understandable because the whole ongoing debat...
Source: HealthSkills Weblog - December 10, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping strategies Occupational therapy Psychology Research Resilience/Health Science in practice assertiveness Clinical reasoning pain management Therapeutic approaches Source Type: blogs
“ S/he ’ s just not taking the message on board ” – A word to clinicians
I’ve heard it many times, probably said it myself some years back. You’ve presented an idea to the person, but they just don’t seem to be ‘getting it.’ What to do, what to do?
The context of this kind of problem is often when someone’s pain isn’t settling down, or when some kind of self-management strategy is being recommended. To the clinician, the message is probably quite logical: “Here’s some information about pain that I am telling you about” and the unspoken assumption is that the person ought to listen carefully, maybe ask some questions, but essentially...
Source: HealthSkills Weblog - December 4, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Back pain Chronic pain Clinical reasoning Coping Skills healthcare Occupational therapy pain management Therapeutic approaches Source Type: blogs
What are the most commonly used pain self-management strategies?
This study also demonstrates how novel interventions can be examined in groups with small numbers, but still allowing us to measure important changes. As an exploratory design, single case study design replicated with several participants is a method we need to use more.
In a systematic review and meta-analysis, Blasco-Belled and colleagues (2023) found that positive psychology interventions do enhance positive affect and reduce anxiety but didn’t alter depression. There were not many studies included in this analysis suggesting that we still have a hang-up on promoting joy and compassion and all the good things i...
Source: HealthSkills Weblog - November 26, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Clinical reasoning Coping Skills Coping strategies Occupational therapy Resilience Resilience/Health Science in practice biopsychosocial pain management Research Therapeutic approaches Source Type: blogs
What are the most commonly used pain self-management strategies?
In a very unscientific vox populi survey conducted via my blog, I asked people with pain to tell me the FIVE self-management strategies they’d used over the week prior. If you’re interested in completing this yourself, click here: click. (Scroll down that page to the survey).
My reason for asking the question is that we have a list of self-management strategies, but the definitions and the way strategies are used in daily life are quite murky. For example, we don’t have a clear definition of ‘activity pacing’ though we are starting to investigate it. We also don’t know whether strateg...
Source: HealthSkills Weblog - November 19, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping strategies Research Resilience/Health pain management Therapeutic approaches Source Type: blogs
What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?
A 70-something female with no previous cardiac history presented with acute chest pain. She awoke from sleep last night around 4:45 AM (3 hours prior to arrival) with pain that originated in her mid back. She stated the pain was achy/crampy. Over the course of the next hour, this pain turned into a pressure in her chest. She said this was midsternal and felt like a tightness. This originally radiated into her left arm. Over some time and the pain moved into her other arm as well as her jaw. She also had some shortness of breath. She was brought in by ambulance and re...
Source: Dr. Smith's ECG Blog - November 15, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Putting people in boxes
I just finished readingThe Invisible Kingdom: Reimagining Chronic Illness, by Meghan O ' Rourke. She lived for many years with a debilitating illness that went undiagnosed. She ultimately concluded that she had chronic sequelae of Lyme disease, likely complicated by autoimmune and other manifestations that may have been triggered by Lyme disease or possibly just co-occurring coincidentally. In her desperation to find relief, or at least answers, she saw innumerable physicians and other practitioners, ultimately resorting to people with, shall we say, unorthodox ideas who many people -- I included -- would classify as quack...
Source: Stayin' Alive - November 13, 2023 Category: American Health Source Type: blogs
How confident are clinicians to deliver pain self-management?
Over the past few weeks I’ve been talking about pain self management from many perspectives. It’s an important topic because most people living with pain will be self managing most of the time. Being able to confidently self manage leads to less disability, distress and lives that look like life, not some endless healthcare regime.
A paper by Penlington et al., (2023) explored confidence beliefs of clinicians working in the UK in primary or community settings prior to a training programme that was then delivered to them. The sample included in the survey is therefore a subset of those who might be expected t...
Source: HealthSkills Weblog - November 12, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping Skills Coping strategies Pain conditions Research Science in practice Health healthcare pain management Therapeutic approaches Source Type: blogs
Do clinicians know how to help people develop pain self management?
In recent posts I’ve been discussing pain self management and why it’s not only necessary, but inevitable for people living with pain. Today I turn my gaze to health professionals, and the skills needed to support developing self management – because it’s not the same as ‘telling’, or ‘educating’, or even ‘advising’.
Firstly, let’s check out what people with pain want in self management. Lim and colleagues (2019) conducted a systematic review examining studies identifying ‘health information needs’ of people with low back pain. I put that tit...
Source: HealthSkills Weblog - November 5, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping Skills Low back pain Professional topics Science in practice Clinical reasoning healthcare pain management self-management Therapeutic approaches Source Type: blogs
Exploring changing definitions of addiction [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes! Join L. Joseph Parker, a research physician, as we delve into the evolving definitions of addiction, particularly in the context of chronic pain management. Explore the historical shifts in diagnostic criteria, the challenges faced by chronic pain patients, and the potential impact on their
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Exploring changing definitions of addiction [PODCAST] originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - November 3, 2023 Category: General Medicine Authors: The Podcast by KevinMD Tags: Podcast Psychiatry Source Type: blogs
" Non-STEMI " is a worthless term.
A 60 yo with 2 previous inferior (RCA) STEMIs, stented, called 911 for one hour of chest pain. He had no h/o heart failure. Here is the first prehospital ECG (time 0, after one hour of pain): I do not see evidence of OMI, and neither did the Queen of HeartsHere is the 2nd prehospital ECG (time 10 minutes, after 70 minutes of pain): No changeOn arrival, the first ED ECG was recorded 20 minutes after the last one (90 minutes after pain onset): What do you think?Here is his most recent previous ECG:This was recorded after intervention for inferior STEMI (with massive ST Elevation, see below), and shows inf...
Source: Dr. Smith's ECG Blog - October 30, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Opioid regulations: a patient advocate ’ s insights [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes! Join Richard A. Lawhern, a patient advocate. We delve into the critical issues surrounding U.S. policy for the regulation of prescription opioid pain relievers and the challenges faced by clinicians managing chronic pain patients. Explore the controversial CDC guidelines, the impact on both patients
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Opioid regulations: a patient advocate’s insights [PODCAST] originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 25, 2023 Category: General Medicine Authors: The Podcast by KevinMD Tags: Podcast Pain Management Source Type: blogs
A man in his 60s with syncope and ST depression. What does the ECG mean?
Written by Sean Trostel MD, peer reviewed by Meyers, Smith, Grauer, etc.A man in his 60s with a history of severe alcohol use disorder and epidural abscess on long-term ciprofloxacin presented to the emergency department after an episode of syncope while standing in line at a grocery store.He did not have chest pain.Here is his triage ECG: What do you think?My interpretation:Sinus rhythm, normal QRS, widespread wavy ST depression leading into late T/U-waves with very prolonged QT. No evidence of OMI. QTc/QUc is in the range of 630 msec.What is the most likely cause of the patient ’s ECG findings, and wha...
Source: Dr. Smith's ECG Blog - October 25, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
Rethinking U.S. opioid policy
I write widely as a subject matter expert on U.S. policy for the regulation of prescription opioid pain relievers and of clinicians who employ them in managing their patients’ chronic pain. Because I am a patient advocate and the spouse of a chronic pain patient, I hear from a lot of suffering people. In one form
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Rethinking U.S. opioid policy originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 24, 2023 Category: General Medicine Authors: Richard A. Lawhern, PhD Tags: Conditions Pain Management Source Type: blogs
Shear-Thinning Biomaterial for Embolic Applications: Interview with Upma Sharma, President and CEO of Arsenal Medical
Arsenal Medical, a medtech company based in Massachusetts, has developed Neocast, an embolic biomaterial designed for catheter-mediated embolization procedures. Conventional materials for embolization can have several limitations, including a lack of radiopacity, catheter clogging, catheter entrapment at the delivery site, solvent-mediated pain at the delivery site, and they can even cause sparking of electrocautery tools.
Neocast is solvent-free, avoiding delivery site pain, and functions with a unique shear-thinning action that allows deep vessel penetration. The material flows with the blood to embolize distal vessel...
Source: Medgadget - October 17, 2023 Category: Medical Devices Authors: Conn Hastings Tags: Cardiac Surgery Cardiology Exclusive Materials Neurosurgery Radiology Vascular Surgery ArsenalMedical embolization Source Type: blogs
A breakthrough in chronic pain detection?
Recently, a group of researchers at the University of California, San Francisco, reported that they may have found the holy grail of pain management. They accomplished this by performing “the first-in-human, long-term direct brain measurement of chronic pain-related neural activity.” Physicians have long sought a reliable way to detect and track the presence of chronic
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A breakthrough in chronic pain detection? originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 16, 2023 Category: General Medicine Authors: L. Joseph Parker, MD Tags: Conditions Pain Management Source Type: blogs
