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Dr. Sawsan As-Sanie: the following chronic overlapping pain conditions either solely or predominantly affect women—vulvodynia, temporomandibular disorders, myalgic encephalomyelitis/chronic fatigue syndrome, irritable bowel syndrome, interstitial cystitis/painful bladder syndrome, fibromyalgia...

| Article

Documentation is a many-headed beast:

  • It started out as a way to keep track of what we’ve done, to create a record that would be a legacy to patient care
  • It has transmogrified into a tool for billing, a risk management function
  • It tries to document with other professionals who are caring for...

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In geriatric patients, chronic pain is quite common as well as challenging. Due to age and comorbidities, surgery can be tough on this patient population.

What’s New?

  • Fewer surgeries are being done on patients 65
  • We have an option to provide, as the medical field is growing, minimally...

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Interest in cannabinoids is at an all-time high. Does this interest impact the perceived opioid crisis? Do we know enough about CBD and THC to make decisions? What has Dr. Jay experienced?

We don’t know enough to be certain of anything:

  • I personally hesitate to utilize and tell patients, “Oh...

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A chronic pain patient may see many doctors, from general practitioner to pain specialist. But what comes between those visits? What’s the process?


  • The patient is managed conservatively by the primary care doctor or practitioner, which may entail certain medication therapies or...

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Potential treatments

  • Increased fluid intake: sickle cell disease patients are more at risk for dehydration because they can’t concentrate their urine
  • Ibuprofen, NSAIDs
  • SSRIs, SNRIs
  • Gabapentinoids
  • Antispasmodics
  • Hot baths, heating pads, hot packs
  • Massage
  • Distraction
  • Activity when...

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Abuse deterrent formulations: different manners of preventing someone from transgressing to the inhalation or snorting of medications, or intravenous use.

  • Aversion: if someone attempts to abuse the product it would not feel good. For instance, if the product is crushed and snorted, the nose is...

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Part of the therapeutic alliance is understanding the dynamics in the room. My beliefs, my biases, the culture I come from, I bring all that into the room with me. The patient I’m working with, they have their cultural background, their beliefs, their expectations, and their past experiences.


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A cluster of conditions that frequently co-occur, can be local or widespread, and either solely or predominantly affect women are referred to as chronic overlapping pain conditions. They include:

  • Endometriosis
  • Fibromyalgia
  • Painful bladder syndrome
  • Irritable bowel syndrome
  • Chronic low back...

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Spirochetal infection symptoms include

  • Muscle pain
  • Nausea
  • Vomiting
  • Abdominal pain

Common types of infections

  • The two most common: Lyme disease and syphilis
  • Both are great masqueraders in terms of symptoms
  • They can cause and they can mimic other conditions and throw people off


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