The Pain Is In Your Brain: Your Knees Know Next to Nothing
By HANS DUVEFELT
A “frozen shoulder” can be manipulated to move freely again under general anesthesia. The medications we use to put patients to sleep for such procedures work on the brain and don’t concentrate in the shoulder joints at all.
An ingrown toenail can be removed or an arthritic knee can be replaced by injecting a local anesthetic – at the base of the toe or into the spine – interrupting the connection between the body and the brain.
An arthritic knuckle can stop hurting and move more freely after a steroid injection that dramatically reduces inflammation, giving lasting relief long after any...
Source: The Health Care Blog - April 14, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Patients Physicians Primary Care Hans Duvefelt Pain Management Source Type: blogs
Misguided Opioid Narrative Takes On More Water
Jeffrey A. SingerThe seemingly unsinkable prevailing narrative that the opioid overdose crisis was caused by health care practitioners ‘hooking” their pain patients on opioids just took on more water.Researchers in the surgery departments at Case Western Reserve University, University of Alabama at Birmingham, and American University of Antigua College of Medicine expected that opioids used to manage pain in trauma patients would lead to a higher rate of injury‐related deaths—including the subcategories of suicide, homicide, and “unintentional deaths” (a leading cause of which is drug overdoses). Using sta...
Source: Cato-at-liberty - April 6, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
The Quigley Maneuver for Ankle Fractures
Certain emergency department procedures bring us a sense of accomplishment. We cheer after a shoulder returns to its correct position from our relocation technique and smile when a laceration closes just right. Emergency department procedures can be very rewarding for providers and patients, especially during times of stress in the workplace. Sometimes, just stapling a scalp or molding the perfect splint may seem cathartic. There are days where we can only see so much abdominal and chest pain—and COVID-19.The double-person Quigley maneuver technique for an ankle fracture. Photo by Martha Roberts.This month we want to ...
Source: The Procedural Pause - August 3, 2020 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
One-Stop Pain Control for Trimalleolar Fractures
The incidence of all ankle fractures is about 187 cases per 100,000 people each year. Trimalleolar fractures occur in seven to 11 percent of those cases. (Orthop J Sports Med. 2019;7[11 Suppl 6]; https://bit.ly/3eQ4lRl.) Trimalleolar fractures involve the lateral and medial malleolus and the distal posterior aspect of the tibia (sometimes called the posterior malleolus).These fractures are serious and often unstable. They typically but not always need urgent or even emergent surgery. Often, they are reduced with a closed reduction prior to surgery. We suggest using a hematoma block to assist with pain control during...
Source: The Procedural Pause - July 1, 2020 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The thought cancers that almost took my life
The night I almost swallowed a bottle of Percocet post-call in residency is still clear in my mind, as is the hours leading up to it; the thoughts going through my head, the swirl of emotions seemingly pulling me like an ocean undertow. I can only attribute my pause to a power greater than myself. […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - December 18, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/maiysha-clairborne" rel="tag" > Maiysha Clairborne, MD < /a > < /span > Tags: Physician Practice Management Psychiatry Source Type: blogs
What is the Definition of “Opioid”?
What is the Definition of “Opioid”?
The definition of opioid is as follows: Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others.
Opioids work by interacting with the opioid receptors on nerve cells in the body and brain. By interacting with these receptors, opioids medications are able to cut off communication between the pain point on the body to the brain. This chemical interaction gives it’s users pain relief that is too great for over-t...
Source: Cliffside Malibu - November 15, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction to Pharmaceuticals fentanyl heroin heroin addiction opiate opiate abuse opiate addiction opiates opioid opioids Source Type: blogs
Opioids for acute pain: How much is too much?
In this study, the researchers looked at opioid prescriptions in 2016, and the numbers are shocking. In the US, 22% of prescriptions written by dentists were for opioids, compared with just 0.6% for British dentists, and US dentists prescribed about 35 opioids per 1,000 population, compared to just 0.5 opioid prescriptions per 1,000 population in England. Additionally, the opioid prescribed in England was a relatively weak codeine-like drug, whereas in the US the majority of prescriptions were for hydrocodone, a stronger opioid with greater abuse potential.
When does an opioid prescription make sense?
It is simply impossib...
Source: Harvard Health Blog - July 24, 2019 Category: Consumer Health News Authors: Scott Weiner, MD Tags: Addiction Pain Management Source Type: blogs
Undoing the harm: Tapering down from high-dose opioids
For many years, health care providers like me were told that we were undertreating pain and that pain was a vital sign that needed to be measured. Concurrently, we were reassured that opioids were a safe and effective way to treat pain, with very little potential for development of abuse. As a result, opioid prescriptions in the United States skyrocketed. A common way to compare opioids is to calculate their strength relative to morphine, called morphine milligram equivalents, or MMEs. In 1992, our country dispensed 25 billion MMEs of prescription opioids; by 2011, that number had reached 242 billion. Meanwhile, opioid-rel...
Source: Harvard Health Blog - May 10, 2019 Category: Consumer Health News Authors: Scott Weiner, MD Tags: Addiction Pain Management Risks and Prevention Source Type: blogs
What are the Different Drugs Used for Heroin and Opioid Detox?
Understanding Heroin and Opioid Detox
When someone is struggling with addiction to heroin or opioids, it can be almost impossible to quit cold turkey. This is due to unpleasant withdrawal symptoms, as well as intense drug cravings. When someone quits cold turkey, they will have to experience all these debilitating withdrawal symptoms and manage strong cravings on their own. This is extremely hard to do without the assistance of medication during heroin and opioid detox.
According to Medline, about 948,000 people used heroin during the past year. In the same year, about 11.5 million people were nonmedical users of narcotic ...
Source: Cliffside Malibu - May 7, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Addiction Recovery Addiction Treatment and Program Resources Detox Resources for Alcohol and Drugs/Opiates Painkiller Substance Abuse drug detox heroin heroin addiction heroin users luxury heroin rehab medical medical det Source Type: blogs
Could The Cure For A Rare Chronic Pain Disorder Be ... More Pain? : Shots - Health News : NPR
There's a before, and there's an after.In the before, it was a relatively normal night. The kind of night any 14-year-old girl might have.Devyn ate dinner, watched TV and had small, unremarkable interactions with her family. Then, around 10 o'clock, she decided to turn in."I went to bed as I normally would, and then all of a sudden ... my hips... they just hurt unimaginably!" Devyn says."I started crying, and I started shaking."It was around midnight, but the pain was so intense she couldn't stop herself — she cried out so loudly she woke her mother, Sheila. Together, they did everythi...
Source: Psychology of Pain - March 10, 2019 Category: Anesthesiology Source Type: blogs
More Than Just Dander
First, a sort of meta-comment in the form of a shout-out to HCRenewal ' s intrepid editor, Dr. Roy Poses, for his just-published analysis of what we might call " blogging: rise and fall. " He sees decline reflected in publications long devoted to health and health policy, yet now flaking off.Methinks, however, despite the usefulness of his overview of recent decades, Dr. P need not fret excessively. Water spilling out of the barrel ' s lip will slow down once folks come along and punch a whole bunch of little mid-section tweet-holes in it. Information still flows. (Sort of.) In any case, surely there ' s overla...
Source: Health Care Renewal - January 25, 2019 Category: Health Management Source Type: blogs
Take a close look at the number of opioid pills you ’re prescribing
Recently, a generally healthy friend of mine had two small, unrelated surgeries over the course of a few months. For the first, a small operation on his hand, he received a prescription for 30 oxycodone pills. He used one the night after surgery, to make sure pain wouldn’t wake him. Over the next few days he used a few over the counter acetaminophen tablets for his modest discomfort, and then was all done. Two months later, a small suspicious lesion had to be removed from his leg by a different doctor. Again, he got 30 tablets of oxycodone. He used one the first night and continued with acetaminophen. Problem solved.
But...
Source: Kevin, M.D. - Medical Weblog - October 15, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/tia-powell" rel="tag" > Tia Powell, MD < /a > Tags: Meds Pain Management Primary Care Source Type: blogs
Most Doctors Are Ill-Equipped to Deal With the Opioid Epidemic. Few Medical Schools Teach Addiction. - The New York Times
To the medical students, the patient was a conundrum.According to his chart, he had residual pain from a leg injury sustained while working on a train track. Now he wanted an opioid stronger than the Percocet he'd been prescribed. So why did his urine test positive for two other drugs — cocaine and hydromorphone, a powerful opioid that doctors had not ordered?It was up to Clark Yin, 29, to figure out what was really going on with Chris McQ, 58 — as seven other third-year medical students and two instructors watched."How are you going to have a conversation around the patient's positive tox screen results?&...
Source: Psychology of Pain - September 14, 2018 Category: Anesthesiology Source Type: blogs
FDA Commissioner Gottlieb ’s Sunday “Tweetorial” Is Both Encouraging and Frustrating
A fair reading of Food and Drug Administration Commissioner Scott Gottlieb ’s “Sunday Tweetorial” on the opioid overdose crisis leaves one simultaneously encouraged and frustrated. First the encouraging news. The Commissioner admits that the so-called epidemic of opioid overdoses has “evolved” from one “mostly involving [diverted] prescription drugs to one that’s increasingly fueled by illicit substances being purchased online or off the street.” Most encouraging was this passage: Even as lawful prescribing of opioids is declining, we ’re seeing large increases in deaths from accidental drug overdoses...
Source: Cato-at-liberty - July 2, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Hospitalized Patients Are Civilian Casualties in the Government's War on Opioids
A recentstory by Pauline Bartolone in the Los Angeles Times draws attention to some under-reported civilian casualties in the government ’s war on opioids: hospitalized patients in severe pain, in need of painkillers. Hospitals across the country are facing shortages of injectable morphine, fentanyl, and Dilaudid (hydromorphone). As a result, trauma patients, post-surgical patients, and hospitalized cancer patients frequently go un dertreated for excruciating pain.Hospitals, including the ones in which I practice general surgery, are working hard to ameliorate the situation by asking medical staff to use prescription opi...
Source: Cato-at-liberty - March 18, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
