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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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Migraine is one of the largest chronic illnesses of childhood, one of the most disabling, and one of the most underrecognized diseases of childhood:

  • Before puberty, 6% to 7% of boys and girls have headache
  • During adolescence into young adulthood, we start seeing more females than males having...

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As clinicians and patients scramble for opioid analgesic alternatives and ways to blunt opioid withdrawal, kratom (also known as mitragynine) use among desperate patients has surged. What should practitioners know?

  • Kratom is not part of the usual standard test for urine screens
  • At low doses...

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Practitioner self-care: what to do?

  • Sleep well, eat well, socialize, exercise
  • Have strong social support
  • Connect with people at work with whom you feel safe and respected
  • Share with a coworker; ask for assistance: “This has been such a bad day for me and I’m really struggling”
  • Practice...

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Enhanced recovery after surgery (ERAS) is not a new technique or modality. It’s been around since the 1980s. It was developed by a gastrointestinal surgeon from Europe, and has started to come into emergence. Why? #1 reason: improved patient outcomes. Another? Economic impact in terms of services...

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A visceral pain example is endometriosis:

  • Often affects the intraabdominal organs
  • Can be within the wall of the uterus, affecting the uterine wall
  • Can be in the pelvic peritoneum
  • Has the capability to invade organs, causing an overlap of symptoms
  • Can be in the peritoneal layer of the...

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