- If systemic Lyme, a blood test
- If a neuro Lyme, determine via a spinal tap
- Spinal taps can be done under fluoroscopic guidance with sedation; a Gertie needle with a blunt tip doesn’t shear the meninges; postlumbar puncture symptoms are fewer
- Offer a spinal tap, if needed...
Neurophysiology research has shown some biochemical and structural changes that occur when a person has been traumatized or has PTSD are similar in terms of neurobiology to those with substance abuse disorders as well as chronic pain.
- Some patients don’t understand that they have had traumatic...
Why/how? These patients…
- May become hypersensitive to pain as well as other sensory stimuli
- Tend to be more sensitive to light and sound as well as painful stimuli
- Suffer from fatigue and poor sleep
- Are more likely to suffer from mood disorders, like anxiety and depression, and have...
Are baby boomers self-medicating with marijuana, whether medical or recreational? Pain is common in the aging population. Elderly patients, trying to avoid prescription medications, may try marijuana.
What to consider:
- Many of these patients have never used cannabis
- Clinical evidence of pain...
- Individuals with chronic pain may lack the awareness that they are feeling grief.
- They may experience losses in comfort, sexual function, career, income, self-efficacy, cognitive function, intimacy, pride, joy, self-esteem, self-control, independence, mental health, hope, dignity, and certainty. ...
HOPE is a type of patient visit that differs from the old SOAP framework. Most patients don’t realize that as soon as they enter a doctor’s office they are stuck in a SOAP framework. SOAP is:
- Subjective: What you tell me when you walk into my office
- Objective: What I observe or the tests that I...
We’ve learned a lot about treatments for menopausal symptoms, meaning vaginal symptoms as well as nonvaginal or nongenital symptoms. In general, when someone thinks about therapies for menopausal symptoms most think of hormonal replacement therapy and that’s still true. However, there are also...
Pain neuroscience education applies the biopsychosocial model of pain, integrating treatment of peripheral and central nociceptive components with other contributors of pain. Part of the goal is to have patients actively engaged in behaviors that increase activity, turn down the volume of the...
Multimodal, nonpharmacologic approaches are recommended as firstline treatments for pain but are often unavailable in resource-limited settings. In 2016, a multimodal pain management program was created and evaluated at Tom Waddell Urban Health primary care clinic in the Tenderloin neighborhood of...
Researchers performed MRI's on groups who’ve not been exposed to trauma and compared them to a group who’ve experienced trauma and been diagnosed with PTSD. Calculations determined the volumes of different brain areas. Noted: decreased volumes in the hippocampus and amygdala, which are both part of...
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