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Showing posts from November, 2016

"B Sure" to Avoid B12 Deficiency!

Vitamin B12--also known as cyanocobalamin is an important nutritional element.  The human body uses this vitamin to make red blood cells, DNA, and other important products.  Cyanocobalamin is also necessary for integrity of the human nervous system. In this regard, one of the symptoms of B12 deficiency is tingling or numbness in the hands and/or feet. Other signs of deficiency include anemia, problems with balance, inflammation of the tongue, jaundice, problems with thought processes, weakness and fatigue. 

A deficiency of this vitamin can be caused to a number of different things.  Some of the more common reasons people are deficient include the following:
Proton pump inhibitors--while wildly popular for their ability to quell heartburn and GERD and treat ulcers, chronic use of these medications interferes with the absorption of this crucial vitamin from the GI tract.Metformin, one of the most popular drugs used to treat type II diabetes can deplete B12 levels over time.Advanced age-…

"Stepped Care Model"--Offers New Hope For Management of Chronic Pain

For the 100 million plus Americans in chronic pain, there are sometimes more questions than answers. Many suffer day in, day out, with little to no hope for better solutions to their problems.  I would say to you all--there is hope out there...sometimes it takes time to figure out the best solution to one's problems, but there are many remediations already out there, and a lot of research into new and better solutions in the future. There is no "cookie cutter "solution to this problem; at best it is complex because pain is a unique experience to every individual.

One of the newest things on the horizon is known as the "Stepped Care Model For Pain Management" (SCM-PM).  Recently published in the Journal of Pain Research, this approach to pain management has three levels:

In the first step, a patient's pain concerns are identified by their clinician.  The patient and provider discuss the issue and focus on treatment based on self-management and intervention w…

Polyneuropathy: Diabetes Is Not The Only Cause!

You may be well aware that one of the complications of type II diabetes is neuropathy.  When caused by diabetes, the nerve damage is attributed to elevated blood glucose levels over extended periods of time.  But diabetes is NOT the only cause of neuropathy.  Some forms of neuropathy develop following illnesses, such as shingles, or physical damage to our bodies following injury, accident, or general wear and tear. The term polyneuropathy is used to describe multiple affected nerves as opposed to only one affected nerve (also known as mononeuropathy).

A new study of polyneuropathy from a team at the University of Michigan unveiled another way that this condition can develop.  According to study authors, pre-diabetes and obesity are also factors that contribute to development of this most uncomfortable condition.

For those who are weight conscious, this is a winning situation. By being careful to maintain a healthy weight you are able to fend off pre-diabetes and ultimately diabetes,…

What's Your Game Plan?

Whenever two football teams play a game, each of the teams has a strategy. The same goes for baseball teams, basketball teams, tennis players, those who play poker and other card games, chess, checkers, and so many other things. In medicine, a treatment algorithm helps guide practitioners in treating various medical conditions. The common denominator in all of the above is strategy.

You can use this same kind of thinking to battle chronic pain issues.  That is why it's so important to have many different pain management tools available.  Every individual experiences pain differently--so knowing yourself and what to try first is a good place to start. The next step is to have a "plan B" so that you have a second treatment option on hand if your first option doesn't quite do the job.  From there you may want to add subsequent steps to your treatment plan.

Multimodal pain management is highly recommended for people with chronic pain.  The beauty of this is that not eve…

Quantifying Pain: The Oswestry Disability Index

There are many ways by which pain can be evaluated.  For instance, there are a couple of scales I discussed in an earlier post (Some Thoughts On Quantifying Pain). In this post I specifically discussed the 1-10 scale that is commonly used when people are able to verbally relate their pain to a caregiver or health care provider.  I also provided an example of the FACES scale, by which a nurse or other caregiver can assess pain by the expression on a person's face.  FLACC is the third example I shared in this post, which is primarily used when a patient is unresponsive but thought to be in pain.

The above examples are all useful in assessing acute pain--following an injury, during an acute illness, surgery, etc.  But they do not really apply to chronic pain patients because chronic pain can come and go or feel better or worse on any given day.  For chronic pain it's more appropriate for a health care team to use their own questionnaire to assess the kind of pain a patient has, …

New Type of Migraine Identified?

According to the Cleveland Clinic, seventy percent of migraine sufferers are women. About sixty to seventy percent of these women report a correlation between migraine attacks and the menstrual cycle.  Most commonly this is attributed to the fact that a woman's hormones levels fluctuate throughout their cycles. This change in hormone levels over time is said to be what precipitates migraines.

A new study points to the idea that this is not the only mechanism by which a menstrual migraine can come about.  According to researchers at the Carolina Headache Institute, cyclic "end menstrual migraine" (EMM) can be the result of anemia. This anemia is the result of dropping ferritin levels due to blood loss of menstruation  The authors go on to say that more study is necessary to firm up this theory.  The good news is that the affected women in the Carolina study responded favourably to iron supplementation.  
Here again, more study is necessary to substantiate the findings...…

Alcoholism Can Contribute To Chronic Pain--And Other Health Issues,Too!

It's not surprising to hear...or to be... someone who drinks, or drank as a minor. Those crazy teenage and college years are what memories are what made of, right?  In these early years of life we don't always take the time to think about the long term consequences of our choices; instead we focus on having a good time our friends and forgetting about our troubles for a while.

It's really too bad that the human brain works this way.  A new study about long term consequences of alcohol consumption during the adolescent and early adult years gives us insight as to how alcohol abuse in the early years can contribute to health issues several decades later. The study was conducted by interviewing middle aged to older persons about their drinking habits during their earlier years and their current health status.  The main conclusion was that drinking heavily or excessively in the earlier years was strongly correlated with more health problems in the later years. The study menti…

Pain Management For Musicians

Americans are very interested in professional sports.  We love our Great American Pastime- Baseball, and NFL Football and of course, NHL Hockey. We generally like our college and high school sports as well.  An when an athlete is injured during play, it's natural to send them to a sports medicine practice for treatment.

We like our music as well.  And musicians are prone to injuries of many sorts, depending on which instrument is being played, and most uniquely, the human voice. I'm not a gambler but I'd bet most of us would not think about going to someone who specializes in injuries related to musical performance!  This is an emerging field; there are as of now only a few medical practices dedicated to this area. But there are many ways that musicians can prevent or manage chronic pain using devices or techniques particular to their specialty.

Here are some examples:

Guitar players...
My husband is a guitar player.  He learned of a device known as a "Neck Up"…

Medications: When more is NOT Merrier!

I believe in living simply.  And when it comes to medications, it appears that this is a good philosophy. Apparently, the folks at agree with me. This agency is an advocate for consumers--it provides informations about drugs, devices and the pros and cons of using these things.

Getting back to why they agree with me (or vice versa):

When a person takes a medication, it is important for them to know as much about it as possible

What is the name of this medication?
What is this medication used for?
What are the directions for use?
What are the possible side effects of this medication?
and lastly,
What are the potential drug interactions of this medication?

This last point may not seem any different than the others at first glance, but it is in fact, a very important point.  Drug interactions can occur in several different ways, so let's take a look at some possibilities.

Drugs can interact with other drugs.

Most pharmacies will run a drug interaction checker listing all…

Safe Disposal Of Unused Medications

Do you have medications that you are no longer using in your medicine cabinet?  It might be a good idea to have a look. No one wants a young child or potential addict to have access to these things!

My suggestion to you is twofold:

If the medications are still in date, consider donating them to a free clinic.  It's always a nice "pay it forward" for someone who can't afford a medication but could really make use of it.

If the medication you have is outdated, the FDA has suggestions for you on how to get rid of it. Here is their advice on medication disposal:


Tips for Using Medication Safely

Most everyone will find the need to take some kind of medication some time in their lives. And whether that medication is a pain medication or not, there are some general rules that apply for the safe use of all medications. While this list is not all inclusive, here are some safety tips that apply to all.

Store medications as per package directions. Some medications can be keep at room temperature, while others need to be refrigerated or perhaps frozen.  Every prescription or over-the-counter drug comes with information as to ideal storage temperature.  If you are unsure about a specific medication, ask your pharmacist.

Keep all medications out of the reach of children.

Take medications as per package directions.  Do not exceed recommended dosages.

Do not share prescription medications with other individuals.  Medications should always be used only by the person it is prescribed to.

Read package information or patient education leaflet and talk with your pharmacist about the correct usag…

Physical Therapy: First Line Therapy For Non Cancer Pain Management

No one should have to live their life in pain. That's a given.  But no one should lose their life to "Pain Killers", such as the opioids. Using these medications has landed us all in a tough spot.  Scores of people have died from opioid addiction, still more have moved beyond opioids to heroin. Heroin deaths have quadrupled in number in the last decade or so.

One of the safest approaches to pain management is physical therapy.  While chronic pain patients will likely need to employ multiple approaches of pain management, physical therapy is always a safe and effective pain management tool.  The American Physical Therapy Association has recently launched a campaign to promote this idea. Known as "#Choose PT", its aim is to make people aware of the safety and effectiveness of this form of treatment.

In 2008, a study that followed 20,000 people over a period of 11 years found that people who exercised experienced less pain than those who did not exercise.  It goe…

Australian Dream: Wonder Drug or Waste of Money?

Have you ever considered trying "Australian Dream?" I have seen ad after ad for this product time and time again.  So I started to wonder about this product, and whether or not it really works.

The first thing I did was to take a look at the "Australian Dream" website.  According to the site, the active ingredient in the product is a substance called histamine dihydrochloride.  I searched for this drug on some drug reference sites, and found that it is FDA approved as a topical analgesic, for temporary relief of minor aches and pains, arthritis, sprains, and strains. There was not too much information about side effects except that a rash could occur, in which case the product should be discontinued.

So, for the most part it's pretty safe...but does it really work?  To answer that question, I decided to check out some reviews of the product--both by consumers and professionals. On the professional front, I saw one physician review on a chronic pain web site.  …