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Showing posts from October, 2016

Avoiding NSAIDs: A Common Sense Strategy For Prevention of Heart Failure

I remember working in retail pharmacy in the 1980s and 1990s when NSAIDs were all the rage. This class of drugs was one of the most commonly prescribed.  As the years went on, we all became aware of the problems associated with this class of drugs.  The first problem that became obvious was that patients who used these drugs on a regular basis were developing gastric ulcers and GI bleeding. For that reason, it was advised that these medications be taken with food.  One company even developed an NSAID product that contained an additional drug that was purported to protect the lining of the GI tract from injury.




After this era, a new sub-class of these drugs--known as "COX-2" inhibitors came onto the US marketplace. This class of drugs possesses all the benefits of the original NSAID drugs--but did not have the GI side effects of the original NSAID drugs.  Three COX-2 Inhibitors (Bextra®, Vioxx®, and Celebrex®) were launched in the US market in the late 1990s-early 2000s. A f…

Migraine Risk Increased When Stress Decreased...?

I have been a migraine headache sufferer for most of my adult life.  It always seemed like when I had a day off of work, or a day where I could simply relax, I could not really do so because that's when I was most apt to have a migraine.  Now if that doesn't stink to high heaven, I don't know what does...



An article from March of 2014 has recently helped me to understand why this has been the case.  A study conducted at Yeshiva University concluded that persistent stress followed by relaxation is actually a trigger for migraine headache. The study authors came to this conclusion after examining headache diaries of migraine patients.

According to study authors, this finding emphasizes the importance of stress reduction and healthy lifestyle habits for migraine sufferers. In the US there are reported to be 37 million migraine sufferers,  of which almost 5 million experience attacks at least once monthly.  More women are affected than men, and the average age of these patien…

Endomorphins: An Emerging Pain Management Strategy

New research into a group of compounds known as endomorphins may offer hope to chronic pain patients of the future.  These compounds are based on endorphins, which are the human body's naturally occurring pain relievers.  Researchers say that these compounds appear to be superior to morphine in terms of analgesia, and have fewer side effects as well.  The other big advantage to these compounds is that there appears to be no risk of addiction, respiratory depression, constipation, and some of the other problems that develop with the use of opioids.  This would be a most wonderful development in the world of pain management!



In the meantime, one of the best ways to help your body deal with chronic pain is to practice activities that help to increase natural endorphin levels.  According to Reader's Digest, here are eight ways to reach this goal:
The scent of vanilla and lavender are said to increase endorphin levels.  Try adding some vanilla to your morning coffee or bathe with l…

New Pain Management Device Mimics Natural Response To Pain

Spinal cord stimulators (SCS) have been a part of the pain management marketplace for a very long time. These devices are all basically the same; they are electrodes, surgically implanted in the epidural space of the spine.  These electrodes are attached to an impulse generator which is implanted in the abdomen or gluteus.  The other key piece of the system is a remote control which is used to modify the the electrical signals being transmitted to the spinal cord via the electrodes.  These electrical signals become "white noise" to the nervous system in an effort to "scramble" the pain signals, making pain more bearable for the patient.. The goal here is to maximize the patient's comfort while minimizing dependency on pain medication. These devices are most commonly used for patients with failed back surgeries, who really have no alternative but to find ways to cope with chronic pain.




Up until recently, these devices were pretty similar to each other-that is t…

Chronic Pain Management: The Three Legged Stool Approach

Today I am sharing an article about one multi-modal approach to chronic pain that makes a lot of sense to me...
I don't want to elaborate too much because I think it's worth it for you to read for yourself.  All I can say in advance is that this article makes me think of a three-legged stool.  If you only rely on one leg of the stool, it's certainly not going to be very useful.

So without further ado, here is a link to the article I am speaking of.  Read and contemplate...comments are appreciated!

Sources: statnews.com; wikimedia


Can Opioids Suppress The Immune System?

Rheumatoid Arthritis (RA) is a progressive, painful crippling disease. It's unfortunately a common condition, and RA patients comprise a large segment of the chronic pain population. Fortunately, for the most part, the current standards of treatment for this condition do NOT include the use of opioids.




A recent study published in Arthritis & Rheumatology examined chronic opioid usage in almost 14,000 RA patients over a fourteen year period.  Surprisingly, when the patients in the study were using chronic opioids, they had a significant increase in rate of infection.  The study authors found a twofold risk of infection in opioid vs. non-opioid populations.

Why is this so?  In vitro studies have shown that certain opioids--morphine, methadone, and fentanyl--have immune suppressive properties. This can be attributed to inhibition of T-cell receptor signaling, reductions in natural killer cell activity, and depletion of lymphocytes, according to said studies.

The authors of the 

The Role of Genetics in Pain Mangement

Pain management is a complicated field.  For one thing, there is an objective goal--that is to say, to determine what is causing pain in the first place, and what to do about it. But we also have to consider subjective aspect of pain management.  One of the tenets of pain management is this: If a person says they are in pain, we cannot deny that the pain exists.  But sometimes it's hard to determine why that person is experiencing this discomfort, or why it seems to be as severe as they claim.




In recent years the genetic aspect of pain management is under closer study.  One example of this is a group from Touro College of Pharmacy in New York City.  Dr. Priyank Kumar and his associates are looking at a specific human gene--namely, 118G. They are finding that variations in this particular gene help to predict a patient's response to opioids, and also the risk of respiratory depression, opioid misuse and even addiction.

Genetic testing of this sort may become commonplace in pai…

Need Motivation To Exercise? An Exercise Buddy Can Help!

If you are someone who hates to exercise, it can be really difficult to get out there and "just do it." Knowing that exercise will benefit you as a chronic pain patient is often not enough, especially when you are just starting out.  You might find it helpful to find an exercise buddy--especially someone like yourself, who is just starting to exercise, who knows the benefits will pay off...but just getting out there and doing it is a huge battle.




Having a friend along for the journey can help you to know that you are not alone in your situation. Most of us look forward to meeting up with a friend and catching up over a cup of coffee...so why not do your catching up over exercise?  Just knowing that you're meeting up with a friend might be all the motivation you need to get those sneakers on and get moving.

An exercise buddy can look at you a way you can't look at yourself--they can help you (and you can help them) to assure that your exercise technique is correct, w…

Exercise and Chronic Pain

It has been said that most people CAN exercise. That includes people with chronic pain. I think they key here is to choose types of exercise that you personally enjoy AND are within the scope of your physical limitations.  For instance if you have a problem with your knees maybe you shouldn't be doing exercise that involve impact--so instead of jumping rope or running, you consider walking or swimming...

It's probably a good idea to talk to your health care providers about which exercises are good fits for your own personal situation, especially if you are just starting out.  Prevention Magazine ran an article several years ago about this topic.  They were focusing on exercises best suited for fibromyalgia in their writings, but I think they are a good place for anyone to start.  So, without further ado here are some suggestions:

1) Walking or biking: pretty much anyone can do one of these. But, just like everything else there are exceptions.


2) Yoga: There are many forms of …

Blue Emu: What's All The Hype?

It seems like every time I turn on the television I see at least one ad for Blue Emu Products. That prompted me to ask the question: What's all the hype?

That brings us to the topic of today's post.  To give a little background you must first consider the active ingredient in this product line, which is emu oil.  According to WebMD, emu oil is an extract that is derived from the fat of a flightless ostrich type bird known as an emu bird. This extract has been used for a multitude of purposes--taken orally, it supposedly can reduce cholesterol levels, promote weight loss; it has been used in cough syrups as well.

Veterinarians use emu oil to reduce swelling of animal joints, and for cracking or peeling of paws, and other dermatological issues such as "hot spots" or flea bites.  Massage therapists sometimes use emu oil in their practices. Emu oil can be applied to the nostrils as a treatment for cold or flu.

With respect to chronic pain, emu oil can be applied to the…

Arachnoiditis: A Painful But Rare Disorder

Thankfully, arachnoiditis is a rare disorder...I say that because it is a source of chronic pain for those diagnosed, and it's also a difficult disorder to treat.  Let me begin by explaining that arachnoiditis is a condition in which the arachnoid membrane (which protects the nerves of the spinal cord) becomes inflamed because of infection, injury, chemical exposure, etc.  As a result, there is compression of the affected area of the spinal cord. Scar tissue can form, and this entire process can impair the nervous system transmissions that pass through the spinal column. Any number of symptoms can develop, including numbness, burning, stinging, cramps, or twitching.  The resulting nerve damage can affect body functions such as urination, defecation, and sexual functions.  Paralysis of the lower limbs may also be a result of arachnoiditis.






The course of this condition is not predictable, and treatments including pain relief, physical therapy, exercise, psychological intervention, …

New Non-Pharmaceutical Technique Shows Promise In Controlling Post-Operative Pain

The opioid crisis came about largely because of routine use of opioids for chronic pain conditions. Opioids are used to control post operative (acute) pain as well; and even though short term use of these drugs generally does not lead to addiction, more and more advances are being made to reduce or eliminate their usage save for very rare circumstances.




Here are a couple of examples--

1) There is a product line known as On-Q®..you can click the link to see specifics about this if you wish.  These products are drug delivery systems that can be used in some types of surgery, such as knee replacements to reduce or eliminate the need for opioids. On-Q® devices can be filled with a local anesthetic. The device has tubing with a catheter like tip that is placed in the operative site, allowing the anesthetic to be delivered directly to the affected area via the On-Q® pump.  These have been around for several years, and the results are dramatic!

2) A new technique devised by Dr. Brian Ilfie…

Drug Free Options For Managing Chronic Pain

Today I wanted to share with you a recent ABC News report about non-drug options for chronic pain. According to the report, research conducted by the Mayo Clinic is affirming that these alternatives to opioids really do work!  I don't know about you but I find the Mayo Clinic to be one of the most reputable medical institutions here in the US. So, without further ado, here is a link to the video!  



Sources: ABCNews.com