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Acetaminophen Anecdotes #3

Children are our most valuable asset; therefore, it is good to keep safety in mind when they need to take medications.  Last month, the FDA released new recommendations for the manufacturers of pediatric products containing acetaminophen.  Here's a quick look at what is on the table:
All acetaminophen containing products are now supposed to contain the following statement:
Liver warning: This product contains acetaminophen.  Severe liver damage may occur if you take
More than [insert maximum number of daily dosage units] in24 hours, which is the maximum daily amount [optional: "for this product"] With other drugs containing acetaminophen 3 or more alcoholic drinks every day while using this product.




Here are some examples of additional recommendations for pediatric products:
that all products intended for use in children should have a concentration of less than 160mg per 5 mLthat the principal display panel contain information regarding the age range of intended use for the pro…

Acetaminophen Anecdotes # 2

Low back pain sufferers, take note...this article is for you. A recently published study in the medical journal Lancet reports that acetaminophen is of little or no value for this type of pain.  This Australian study followed 1600 subjects over a four week period. The authors concluded that anti-inflammatory medications and alternative therapy, such as manipulation were more effective.It did not matter if patients acetaminophen on a scheduled vs. as needed basis.





It's common practice in health care to use acetaminophen as first line treatment, and that most likely will not change anytime soon.  But this study sheds an interesting light on that practice, and it's likely that further studies will follow this one. You can read the article in its entirety by clicking this link.

Source: Pain Medicine News,wikipedia


Acetaminophen Anectdotes #1

Have you ever been through a pregnancy?  If so then you know from all your doctor visits that many precautions are advised in order to safeguard the health and wellness of mother and baby.  Most medications are off limits; and it is common for health care providers to tell expectant moms that it's safe to use acetaminophen for mild pain.



A Danish study that was published in JAMA Pediatrics back in April of this year sheds some new light on the safety of acetaminophen during the prenatal period. This study involved over 64,000 children and mothers during the years 1996-2002.  The information was gathered via telephone interviews during pregnancy and 6 months after birth.   Here are some of the findings:


More than half of all mothers studied used acetaminophen during their pregnancies.Children born to mothers who took acetaminophen during the prenatal period showed higherrisk of developing ADHD or hyperkinetic disorder.  Increased usage of acetaminophen (used more than 1 trimester …

Fibromyalgia: Showers vs. Baths

For those of you who have fibromyalgia or chronic fatigue syndrome...here are some thoughts about whether showering or bathing is a better option.  I recently read an article by a fibromyalgia/chronic fatigue expert on this topic.  I never stopped to think about what she says...but after reading the article I must say this is definitely food for thought.



Showering in the morning is something many of us find useful to help feel invigorated and ready to start the day.  But for those who suffer from the disorders in question, this can be a problem on a number of fronts.  Here are some examples:

1) Fibromyalgia patients often have heightened nerve response; even the pressure of the water droplets hitting the skin can be irritating.  While you might not take notice in the shower, this effect can overstimulate the nervous system and cause further problems all day long.

2) Taking a shower might cause more exertion than you may think.  It's possible that a morning shower can cause you to…

Common Causes of Chronic Foot Pain

I have tendinitis in my feet... I first experienced the problem many years ago, and was able to resolve it with the help of a podiatrist and some custom orthotics.  Years later, the problem has re-emerged, and believe you me, it's no party.  I am still trying to find my custom orthotics but in the meantime Dr. Scholl's is doing a pretty good job.  I decided that it might be a good time to write about a few conditions that cause chronic foot pain.  It seems to me that I've known a lot of folks over the years who have had the problems I am about to describe.






Tendinits 
Tendinitis, as the name implies, is the inflammation of a tendon.  My personal problem with tendinits involves the tendons in the top of the foot...the achilles tendon could also be affected by tendinits.  
The usual clue that tendinitis is present is pain, and possibly inflammation.  This can be caused by overuse; in my case I spend a lot of time on my feet, so it's no wonder there is a problem.  The trea…

Treating Headache Pain at the source. Did you know...

Headaches are a common problem...millions of Americans suffer from some form of chronic headache problem.  Migraine headache, a hereditary disorder is a very common one.  In addition, there are lots of things that can cause a person to have chronic headaches.  You might not associate
some circumstances as being the cause of chronic headache...so today I am presenting a short list of examples.  This is by no means an all inclusive list but it serves illustrate today's topic.



Eye strain is a common cause of headache.  Keeping up to date with regular eye exams and eyeglass prescriptions is the best treatment.  This problem commonly begins in school aged children but it can really happen to anyone, especially if they've never had an eye exam or are overdue.  Typically, a headache from eye strain is noticed in the temples. Taking a break from the visual task at hand will usually bring short term relief.




On a more serious note, hypertension can cause a person to experience headaches…

Reduced Brain Connectivity: A New Finding in Fibromyalgia Patients

A recent peer reviewed report in Brain Connectivity says that women who have fibromyalgia may not be able to manage pain signals as effectively as women who do not suffer from the disorder.  Why?
The article explains that affected patients appear to have reduced connectivity between the areas of the brain that regulate pain.  It is not know whether the reduced connectivity issue comes before the fibromyalgia, or vice versa.





This study contributes to an ever growing body of research that points to physical, measurable links to the disease.  At one time fibromyalgia was thought to be mostly a psychological disorder and not much of a physical disorder.  At present, the research suggests that the opposite seems to be true. For instance, a certain nerve fiber is more predominant in the palms of women with fibromyalgia. Additionally, brain scans provide a way to measure the presence of the disorder.  It's also known that poor sleep quality is prevalent, and contributes significantly t…

Fibromyalgia Coping Tips for School Students

Sadly, the disorder we know as fibromyalgia affects children and adults.  Some of the afflicted are school students; and whether they be adults or children, it's a lot more difficult for the afflicted. Today I am sharing some coping tips for students with fibromyalgia; these recently appeared in an
about.com article that I read.





Let instructors know that you (or your child) has fibromyalgia, and that school absences may occur more frequently than is desirable.  Hopefully they will be able to provide study aids such as outlines to help through the courses.  If they are unwilling to cooperate, talk to their superiors about the issue.For college students--be mindful of your course load so you don't over do it.  This is not as easy for high school students, but don't hesitate to find out what options your school district has to offer.Book bags can be heavy.  It might be possible to use electronic books (i.e. Kindle, Nook) or have a spare set of textbooks at home.  Some textbook…

Back Pain: Read All About It!

Earlier this year, Dr. Patrick Roth's Book, "The End of Back Pain" came onto the marketplace.  A few days later, it was review for HuntingtonNews.net by David Kinchen, who seems to enjoy Dr. Roth's fresh perspective on the topic. I am posting this today, hoping that it will help someone, somewhere...





Today, I looked at the same book title on Amazon.com. It has been about six months since the book was released, and there are 46 reviews of this title.  Thirty two of these people gave a five star review...I think that makes a very strong statement about it.  One person gave the book only one star, saying that the information was not helpful, especially for acute pain.  I guess you can't win them all!
And who is Dr. Patrick Roth, you might ask?  He is a New Jersey based board certified neurosurgeon who is director of a residency program at Hackensack University Medical Center.  You can read more about him and his book here.
Sources: HuntingtonNews.net, Amazon.com,Pa…

Back Pain: Eight Ways to Find Relief

NIH (National Institutes of Health) says that 8 of 10 people will experience back pain at some point in their lifetimes.  Fear not!  Sometimes this is a transient problem; for others back pain can be troublesome over long periods of time.  If you are one of the eighty percent, and you don't know where to start, here are some tips to get you started...


Rest--Often overlooked, this is one of the simplest..and sometimes the best remedy for back pain. Take a few days of from your routine, and the results may surprise you.

Exercise-Sometimes injury happens to to lack of movement.  A personal trainer can work with you to help determine what exercises are most appropriate for your situation.
Medication-within reason, over the counter pain medications can help with short term pain. As discussed in earlier posts, there are problems with using the medications on a regular basis. Some folks think that there are no risks to medications like acetaminophen, naproxen, and ibuprofen..but that is si…

Low Back Pain: A Common Problem in Older Adulta

Everyone's body experiences the wear and tear of aging..and sooner or later it catches up with us in one way or another.  One of the most common issues is low back pain, which can arise for a number of reasons.  Here's what Paul Christo, MD, MBA has to say about this issue:

Most low back pain is due to strain of muscles and ligamentsOther causes of low back pain include problems with joints in the spine, piriformis syndrome, and sacroiliac disease. Spinal changes can lead to herniated disks, causing low back pain, shooting leg pain, and a narrowing around the spinal cord (spinal stenosis) or nerve roots (lateral foraminal stenosis).If you have a problem, work to get a diagnosis first and try all other possibilities before jumping ahead to surgery.  Surgery sometimes involves fusing of vertebrae or inserting rods into the spine, and once it's done, there's no going back.Nerve blocks, medications, and physical therapy can be helpful!   When all else fails...surgery can b…

Spinal Cord Stimulators: A Success Story

Here is a success story about spinal cord stimulation...as a follow up to my earlier post this week.  It's a really amazing technique. It certainly won't help everyone with chronic pain, it can do great things for lots of folks who are out there suffering-without drug fog or risk of addiction!

The pain in Sequoia Lawson’s right arm grew so severe that she could not lift it to shake hands.
Nothing worked to dull the pain from what doctors said was nerve damage – not medication, physical therapy or multiple surgeries. That is, until she took the 3,000-mile trip from her home in Washington State to Rutgers Biomedical and Health Sciences in Newark.
Lawson, 30, had learned of the work of neurosurgeon Antonios Mammis at Rutgers New Jersey Medical School treating pain through spinal cord stimulation.  Mammis often consults with colleagues as part of a new interdisciplinary approach to pain management at Rutgers.
“I had suffered with pain for more than a decade and was willing to try anyt…

Neuromodulation: A more detailed look at spinal cord stimulators

Back in September, I posted a piece entitled, "Spinal Cord Stimulators: Early Intervention Shows High Success Rate." If you read it....or even if you didn't...it probably left you with more questions than answers.  I have done a little investigating since then, and found an interesting article that sheds more light on these devices and answers a lot of the frequently asked questions.  So, without further ado, I would like to the things I have learned with my readers.




1) Neuromodulation can be applied through a number of techniques.  Spinal cord stimulation is one form of this treatment; others include peripheral nerve field stimulation, peripheral nerve stimulation, brain stimulation, sacral stimulation, spinal drug delivery systems, and brain stimulation. These treatments are generally available from physicians who have training in this specialized medical field.

2) Neuromodulation is FDA approved and has been in use for over twenty five years.

3) Neuromodulation can impr…

Happy Anniversary!

The end of October marks the one year anniversary for this, my first and favorite blog.
Thanks for your readership!  I appreciate it.


Personalized Pain Management: DNA based treatment

An Ohio based company launched a new pain management initiative earlier this year. ViaQuest, a
health care company that offers hospice services, is now using DNA samples from patients to determine which pain medications and dosages will work best for a given patient. The company is focusing on pain management at present, but plans to employ the same strategy for more types of medications in the future. ViaQuest is conducting this program in conjunction with PGXL Laboratories, based in Louisville, KY. PGXL is an leader in the field of pharmacogenetics and personalized medicine.





"Pain tends to be universal in end-of-life stages, and sadly, the prescribing of pain medications often becomes guesswork for hospice patients," said Kathy Richard, vice president of home health and hospice at ViaQuest. "We are taking the guesswork out of pain management for our patients. We believe that our patients have the right to be as comfortable as possible, enabling them to experience imp…

HowStuffWorks "Mysterious Pain Quiz"

How much do you know about painful medical conditions?  This link is VERY informative!
HowStuffWorks "Mysterious Pain Quiz"

Sources:How Stuff Works; Wikimedia

Meet SENSUS: A new non-pharmaceutical device in the world of pain Management

Neurometrix, a developer of wearable medical technology recently launched a new device in the pain management marketplace. It's called SENSUS(2nd generation), a newer version of what is essentially a TENS (transcutaneous electrical nerve stimulation) unit for diabetic peripheral neuropathy.




For those who are unaware, diabetics suffer not only from difficulty in controlling blood glucose levels. They can also be afflicted by a myriad of other complications as well, including neuropathy which begins as a "pins and needles" sensation in the extremities, especially in the legs and feet. Sadly over 50 percent of diabetics suffer from this condition; the chronic pain aspect of the problem can negatively effect quality of life.

Having good control of blood glucose levels helps to slow progression of this condition; unfortunately as it progresses it may even result in total loss of sensation. To give you an example of the problem: back in college I had a friend whose mother was …

Current Approaches to Managing Chronic Bone and Joint Pain

After reading an article entitled "Chronic Bone and Joint Pain: Managing the Problem" some of the things I often think about with respect to pain management were confirmed. That is to say, while medicine is readily able to help those with acute pain issues such as broken bones, or post-operative pain...it is a lot more challenging to tackle chronic pain.  

Even though that is the case, there are things that chronic pain sufferers can do to minimize their own pain and suffering.  Here are some ideas to help with that effort:
Avoid acute pain by using common sense and safety precautions. As an example, if you have arthritis of the knee and you know that running causes acute aggravation..it might be good to become a walker instead.Avoid behaviors that tend to exacerbate chronic pain conditions, such as smoking and drinking alcohol.If  you have underlying disease states, such as depression, diabetes or rheumatoid arthritis, make your best effort to comply with your treatment plan.…

Fibromyalgia Treatment: A Review of Current Management Strategies

I don't want to bore my fibro friends with some long boring article in this post...so I am going to get to the nitty gritty as quickly as possible.  So, here we go:

A study posted in the December 2013 edition of Pain and Therapy (Okifuji & Hare) presents the results of a study that reviewed effectiveness of various strategies for managing fibromyalgia. The authors considered medications, exercise, behavioral modifications, and multimodal approaches to the condition.  In the end, they say that a lack of methodology really prevents them from statistically comparing these various strategies to each other. 

That being the case, the authors did come to a very interesting conclusion--and here it is, word for word:


"...Although there are some other variations, a typical trial testing a multidisciplinary approach includes education, exercise and psychological (typically cognitive behavioral) therapy. Programs aimed at acquisition of coping and pain management skills seem to provide …

Novel paths to pain management: older drugs doing new tricks!

If you follow the world of pain management as I do, you are always looking for new material...




For instance, recently the DEA tightened restrictions on some of the drugs already in the pain management arena.  Hydrocodone (a component of Vicodin® and the new long-acting product Zohydro®) and many other products is now a Schedule II drug.  That makes for a lot of  new restrictions/problems for those who use these products in their pain management regimen. Tramadol, which previously was not a scheduled drug , was recently placed in Schedule IV. This means that all products that contain tramadol are more tightly regulated than they used to be.


Now for some good news..

With this tightening of regulation...regarding all opioid drugs, and more recently the addition of the two above...there is research going on to find pain management applications for drugs currently in the marketplace that possess no abuse potential.  The tricyclic antidepressants and SSRI/SNRI drugs, for example, have fou…