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...
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”
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...
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...
Expert Witness Testimony
- Expert witness testimony in the US has contributed to courtroom confusion regarding the practitioner’s duties & responsibilities; it’s led to an attempt to put some uniform recipe into all prescribing and it’s neglected the patients.
- Many experts are hired because they...
What to know:
- The brain and spinal cord are surrounded by dura, a membrane, and in typical adults there’s 150 mL of cerebrospinal fluid (CSF) in that region, which gets turned over 3 times a day
- But if a patient produces too much CSF and they can’t get rid of it in a timely fashion, there will...
Healing—possibly up to 80%—comes from factors outside of what practitioners usually do in the clinic or hospital. Patients, through diet, can combat some chronic pain and fight some genetic factors. Most people don’t realize that what they eat influences their pain. What else should patients be...
Pain conditions—such as vulvodynia, temporomandibular disorders, irritable bowel syndrome, interstitial cystitis/painful bladder syndrome, fibromyalgia, endometriosis, and chronic tension-type and migraine headache—often occur together and either solely or predominantly affect women. Would...
Michael C. Barnes, JD, MIEP, a Washington, DC, attorney on the future of pain management and drug policy. Does medical marijuana have a role?
It’s an interesting time in United States for drug policies:
- As we see efforts to loosen restrictions on what are currently federally illicit substances...
Neuromodulation has become an important alternative treatment option in refractory chronic neuropathic pain syndromes. The field of neuromodulation has advanced over the years. Now you can give patients:
- Multiple frequencies up to 10,000 hertz
- Different kinds of patterns of stimulations, like...