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.
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:
- Painful bladder syndrome
- Irritable bowel syndrome
- Chronic low back...
Spirochetal infection symptoms include
- Muscle pain
- 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
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...
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...