Day: 07/29/2015

Thinking of you, Jaydon Chavez-Silver

http://www.huffingtonpost.com/entry/911-dispatcher-deal-with-it-yourself-quit_55b9339fe4b0074ba5a757ee?

The teenager’s killer remains on the loose. A $4,000 reward is being offered to anyone with information on Chavez-Silver’s killer, according to a Facebook remembrance page for the teen. Anyone with information is urged to call 505-242-COPS.

https://www.facebook.com/RememberingJaydon/timeline

We remember Jaydon Chavez-Silver
July 6 at 8:03am 
I wanted to share 2 stories that strangers have told me about Jaydon that made me smile.
A woman wrote a note to me that 3 weeks ago she lost her dog at Smiths and was very upset. Jaydon walked up to her (not knowing who she was) and said “ma’am are you okay, is there anything I can do”? She told him that she couldn’t find her dog. He said “don’t worry, I’ll go find her for you, stay right here”. He went and found her dog then went on with his day. She saw his picture on the news and felt compelled to come to the mortuary to tell the story. He never said a word to me about that day. Always so helpful, even with strangers.

Another woman messaged me to let me know that she had a special needs son at Manzano and that Jaydon was one of the few boys at school that made sure he did not get bullied and no one bothered him. Again, he never mentioned a word to me about that either. These stories make me so very proud of him and make me smile through the tears.

#JusticeForJaydon

(Photo taken 6/5/2015.)

New spinal cord stimulation therapy, recently approved by FDA

https://www.consumeraffairs.com/news/standing-as-well-as-sitting-could-be-hazardous-to-your-health-072915.html

In recent years researchers have made a case that sitting for prolonged periods is harmful to your health. Some have claimed it is as dangerous as smoking. But being on your feet all day might not be so healthy either. A team of international researchers conducted a small study of men and women who worked on their feet for most of each day…

An unrelated study by the American Society of Anesthesiologists might contain some good news for people who spend their day standing and then suffer from back and leg pain. The study shows that patients who received a novel high frequency form of spinal cord stimulation (SCS) therapy enjoyed significant and long-term relief from both chronic back and leg pain.

“Chronic back and leg pain have long been considered difficult to treat and current pain relief options such as opioids have limited effectiveness and commonly known side effects,” said lead author Dr. Leonardo Kapural, of Wake Forest University. “Given the prevalence of chronic pain, high frequency SCS is an exciting advance for our patients.”

SCS is a fairly common therapy that administers electric pulses to the spinal cord through a small device implanted under the skin. The new treatment, called HF10 therapy, uses proprietary high frequency pulses of 10,000 Hz, compared to traditional SCS which uses frequencies of 40 to 60 Hz.

http://www.newswise.com/articles/view/637833/?sc=dwhn

(7/28/2015) New Therapy Delivers Long-Term Relief for Chronic Back, Leg Pain, Study Find

According to a study published in the Online First edition of Anesthesiology, the official medical journal of the American Society of Anesthesiologists® (ASA®), patients who received a novel high frequency form of spinal cord stimulation (SCS) therapy experienced significantly greater, long-term relief for both chronic back and leg pain, when compared to a traditional low frequency form of SCS therapy…

Correct me if I’m wrong, but doesn’t a study require a placebo group to be considered scientific? To prove causation, not just correlation?  Do you think there’s a peer-review system over at the ASA’s “official medical journal”?  And who owns the rights to this “novel” therapy with “proprietary” technology?

http://www.bloomberg.com/research/stocks/private/snapshot.asp?privcapId=30485592

Key Executives For Nevro Corp.
Mr. Michael F. DeMane
Chairman and Chief Executive Officer
Total Annual Compensation: $550.0K
Mr. Rami Elghandour
President
Total Annual Compensation: $292.3K
Mr. Andrew H. Galligan
Chief Financial Officer and Vice President of Finance
Total Annual Compensation: $317.6K

http://patient.info/forums/discuss/spinal-cord-stimulator-226583

graham6214 to beverley82498 • 8 months ago
hi beverley im sorry to say my scs has been a disaster from start to finish and im waiting to have it removed if your hubbie goes ahead with it make sure that he get the paddle leads which are stitched in and not the leads that are injected as they have a tendency to break or twist hope this helps you with your quest even though it will not be a cure but rather than a aid to pain relief all the best graham

the_evil_edna to khi • 8 months ago
Hi hun I have had some issues & on strng pain relief, the stimlator does help but its not been anywhere near the relief I had during the trial. I’m doing better as I’m not bed bound but everyday is a struggle just to do daily thins, I have been told its a constant juggling act, drugs, reprogamming & minor ops, My consultant told me last week its a condition that i need to learn to live with its not a disease that they can fix.
I wish you the best of luck & hope you experience better long term results x

Does Eating Pot Make You Higher Than Smoking It?

http://news.discovery.com/human/health/does-eating-pot-make-you-higher-than-smoking-it-150728.htm

Eating pot results in a more intense and longer lasting high, though it doesn’t necessarily make you any higher. “I don’t know if I’d say it’s more intoxicating,” Mark A. Ware, director of clinical research at Alan Edwards Pain Management Unit, McGill University Health Centre, told The Daily Beast. “It’s just different.”

One of the main reasons for the difference? Edible marijuana passes through the liver before it enters the bloodstream — whereas smoked or vaporized marijuana goes straight to the lungs — and that process, dubbed the metabolic first-pass effect, can compound the psychoactive properties in the plant.

It also takes more time for the drug to weave its way through the liver, which means it takes longer to get high. People often ingest more of it while they sit around waiting to feel stoned…

It can also be challenging to know exactly how many psychoactive compounds are in one serving. Colorado has set 10 milligrams as the standard dose per serving, with 100 mg maximum per food item. But the potency of different strains can vary. And clinical pharmacologist Kari Franson, a professor at the University of Colorado, told Forbes that she is “still skeptical” about attempts to standardize the amount in products…

Why President Obama and Congress turned their backs on food safety

http://henrywest.net/2015/07/27/my-daily-cause-celeb/

http://www.politico.com/story/2015/07/sickness-in-the-system-120057.html?hp=b3_l1

Two decades ago, the FDA oversaw 200,000 imports; last year there were 12 million, accounting for roughly 15 percent of the nation’s food supply…

But the part of the government responsible for keeping kids’ peanut butter safe was a chronically understaffed unit of the FDA called the Office of Regulatory Affairs.

In 2009, ORA had fewer than 700 food inspectors (calculated in full-time employees) to cover hundreds of thousands of food facilities. By comparison, at the Department of Agriculture, which oversees all meat processing, the ratio is flipped: There’s more than one inspector for every one of the 6,200 facilities, and they’re on site around the clock. That level of scrutiny is a vestige of Teddy Roosevelt’s reforms: Meat companies by law aren’t allowed to operate without an inspector on hand. The FDA has had no similar mandate, so its workforce never kept pace…

U.S. food companies might get inspected every four to five years, and the overwhelming majority of foreign producers never get inspected at all. The ORA now has about 1,100 food-safety inspectors — a seemingly large increase since 2009 but still a tiny force compared with the 377,000 domestic and foreign facilities it is nominally in charge of monitoring.

The FDA’s foods program also has significantly lagged in funding over the years. In the 1970s, close to half the agency’s budget was spent on food safety and nutrition. Today, it’s closer to one-fifth. Spending on drugs and medical device programs has boomed — a trend fueled largely by industry user fees. Drug and device companies have an economic incentive to keep FDA well-staffed to speed product approvals, but there is no such incentive for food-safety inspections…

It turned out that the ice cream was contaminated with listeria that was present in two of Blue Bell’s plants — one in Texas, where the company is based, and one in Oklahoma. The Centers for Disease Control and Prevention has now linked 10 illnesses, going back to 2010, to the company’s ice cream.

The company, FDA discovered in March, had known for two years that it had an issue with listeria in its Oklahoma plant, but it wasn’t required to report its findings to the agency because of a technicality about how close to the food the bacteria was found…

They’re the kind of improvements recommended by food-safety experts who know what the public doesn’t. That, for example, the United States imports 80 percent of its seafood and roughly half of its fruits and vegetables but inspects less than 2 percent of that and tests even less…

Last month, Brad Frey was in Washington, on a trip funded by Pew, to share his story about his mother’s death. He met with the offices of Sens. Barbara Boxer and Dianne Feinstein, who is on the Appropriations Committee. The senators were receptive to his call to fund the law, he said, but they also quickly noted that Republicans are in charge…

Anatomy of a food-borne illness outbreak

A Halloween treat: Before Halloween, Shirlee Frey, 81, bought caramel apples to share with her four grandchildren. Several days later, Frey grew faint, hit her head and was airlifted to Stanford Medical Center in California for surgery to relieve brain bleeding. Doctors initially were optimistic, but days later, her condition worsened. On Thanksgiving, Frey became unresponsive. On Dec. 2, doctors determined she had listeriosis, a foodborne infection that can be dangerous for pregnant women and adults with weak immune systems…

Self-testing failure: In September, Bidart had voluntarily tested one set of samples for listeria — out of millions of apples — and the tests were negative. Testing just one sample is “worse than doing nothing because if it’s negative, it gives a false sense of security,” said Mansour Samadpour, a testing expert.

To the marijuana industry:  Testing one bud from a large crop will not give an accurate THC/CBD count, nor will it show if parts of the batch have been contaminated with something like mold.

Stop following me

I don’t know many people who practice the Muslim religion.  Since I’m an atheist, I don’t care for any religion, but I really hope that most Muslims don’t think like this person:

https://thehiddenprestige.wordpress.com/2015/07/08/god-created-adam-and-eve-not-adam-and-steve/

Fatima Bint Sajid said:

Islam means submission…

Who knew we would live to see these mentally ill people get their rights while the blacks in America are still treated worse than retard people! …

After reading this, do you really need to read more?  How can you live in the internet age and believe that women belong at home, taking care of the kids?  What is it about religion that forces women into a subservient role?  Is that about religion or is it more about men?

You can’t change minds like this.  People who believe that being gay means you’re mentally ill. Obviously, people like this don’t understand the definition of “mental illness.”

Why would someone like this want to follow my blog?  Hey you, thehiddenprestige, why don’t you answer that question for me?  I don’t want to read about your backward beliefs, I just want to know why you’ve so rudely decided to take up my time.  Just want some more hits on your blog? Did you think that after reading one of your posts, I would, all of sudden, renounce logic and things like feminism?

I doubt you have the guts to respond.  So, why don’t you stop following me?  It’s creepy.

Doctors, Prolotherapy, and Fibromyalgia

Another pain patient told me I should try prolotherapy (after I said that I’m not interested in trying more alternative therapies), and that was a new term for me.  When I looked it up, I learned prolotherapy was just a fancy term for acupuncture and injections.  And I learned another new term, “biopuncture.”  I think you’d be surprised at what doctors are injecting these days to treat pain, all in the race away from opioids.

I found some of this information in the linked article, which I thought was interesting.  But even more interesting was the comment section, which is an inside view of what doctors think about fibromyalgia, written about a year ago.  It’s long, but it’s a good read.

And the entertaining part is from Stephen S. Rodrigues, MD, an acupuncturist I’ve run into before in the comment section.  I feel bad for Dr. Rodrigues, trying so hard to legitimize his practice. I’m sure he helps some patients or else he wouldn’t have a practice at all.

Of course, even a year ago, alternative treatments like acupuncture were barely mentioned to pain patients. But because of the drug war, now legal drug dealers (medical doctors) have to push non-drug treatments like prolotherapy.  And yet, not all these treatments are drug-free. Many injections include pain medications and steroids.  Short-term doses, which is why patients have to keep going back for more.

But hey, if they work for you, that’s great.  I can’t remember how many injections I had in total before I gave up on this avenue of treatment.  I’ve even had needles stuck in my ears (areas that are supposed to correspond to painful areas all over the body, like reflexology for the ears).

Sticking a painful sight with a needle isn’t new, but I can’t believe all the drugs they use now.  In the comment section, someone mentioned injections with blood platelets.  Um, okay, if that works for you.  Just note the possible complications.

https://www.sciencebasedmedicine.org/prolotherapy/

FIBRO

Laurenak to Windriven • a year ago
This will only be anecdotal but I just wanted to let you know that Fibromyalgia is definitely very real and debilitating and not just drug seeking behaviour. I was diagnosed during my third year of university studying an applied science degree in speech pathology, was very active at the gym and was the healthiest I’d been in years. The pain slowly crept through my body until it was hard to get out of bed in the morning due to the crippling pain and fatigue yet I still completed my degree with a distinction average and currently work full time in a private practise with a large caseload of children. Thankfully I found a decent rheumatologist (after a year of misdiagnoses, MRIs, surgery and various medications) who started me on Cymbalta (an antidepressant) and it has done wonders for the pain. I have never taken opiates and hopefully never will but I still battle every day with this condition. While I’m sure there are whiners and drug seekers out there (just with any chronic condition), there are many more of us who suffer quietly. Just wanted to share my experience.

FIBRO AND NARCAN

CHotel to Windriven • a year ago
Not necessarily. It would almost definitely decrease your pain tolerance while in your system, but it wouldn’t necessarily induce any pain. It doesn’t affect all opioid receptors, mainly has mu-receptor activity while having low affinity for kappa and delta receptors (though it is active there), so you’d still have active endogenous opioids floating around to some degree. Something would still have to cause the pain, which is one reason why there is likely a muscle/connective tissue component to the syndrome as well. Go for a hike until you get a little sore all over, then take a shot of narcan, that would probably be a more accurate representation of the syndrome from what I understand of it.

I believe that it is likely a real condition, but I also hold very little hope that we’ll fully understand the pathophysiology of it due to its being co-opted by drug seekers. It may even be a multitude of conditions with similar presentation, since it is likely a diagnosis of exclusion, which would explain why there are so many proposed causes and treatments with little consensus.

Andrey Pavlov CHotel • a year ago
I am not an expert on this, but to my knowledge CHotel is correct. It does affect kappa and delta opioid receptors but has a much lower affinity. It does not affect endogenous opioids at all. So it would not induce pain but it would prevent the ability to endogenously reduce induced pain. Meaning that if I punch you in the arm after I give you nalaxone it will hurt hurt more than it normally would. However, the main effect would be that it would hurt longer than it normally would.

There is also some indirect evidence of this in some trials with septic patients. Administration of nalaxone increases their blood pressure. I am not super familiar with that literature and it is pretty small, but it seems that this is thought to be because the pain response is heightening and pain causes the increase in BP. Which renders it horribly unethical to use as a pressor.

…I cannot think of an ethically valid way to argue that sensitizing a patient to pain (even if that is not ultimately the direct causal mechanism of increasing BP, it is still a known and expected effect) is justifiable short of imminent death and a last ditch effort. Even if they were well sedated, we could expect it to increase their post-recovery pain and perhaps even trigger lasting hyperalgesia.

In other news, I just got done making another batch of no-bake chocolate and peanut butter cookies, and they didn’t turn out very well.  Sometimes, life just sucks. 🙂

Pain doctors require Significant Functional Improvement

There are different views on the war against pain patients, and I think the medical industry’s view is interesting, especially from a doctor’s perspective.  Do doctors even believe there is a war against pain patients?

The article we’re talking about today is entitled “The Complex Pain Patient.”  (Complex, meaning your patient wants drug treatment.)  First, let’s look at the publication in which the article was published:

http://www.painweek.org/about/

PAINWeek is the largest US pain conference for frontline practitioners with an interest in pain management. Convening at The Cosmopolitan of Las Vegas for its 9th year on September 8-12, we expect to welcome 2100+ physicians, nurses, pharmacists, and other healthcare professionals for a comprehensive program of course offerings…

Participating Organizations
* In the last several years, the following organizations have presented full-day tracks

AMERICAN ACADEMY OF PAIN MEDICINE*
AMERICAN CHRONIC PAIN ASSOCIATION
AMERICAN HEADACHE SOCIETY
AMERICAN OSTEOPATHIC ACADEMY OF ADDICTION MEDICINE
AMERICAN PAIN SOCIETY*
AMERICAN SOCIETY FOR PAIN MANAGEMENT NURSING*
AMERICAN SOCIETY OF PAIN EDUCATORS*
EASTERN PAIN ASSOCIATION
FOUNDATION FOR ETHICS IN PAIN CARE
INTERNATIONAL MEDICAL & DENTAL HYPNOTHERAPY ASSOCIATION
INTERSTITIAL CYSTITIS ASSOCIATION
NATIONAL ASSOCIATION OF DRUG DIVERSION INVESTIGATORS*
NATIONAL FIBROMYALGIA & CHRONIC PAIN ASSOCIATION
NATIONAL STROKE ASSOCIATION
NATIONAL VULVODYNIA ASSOCIATION
NEUROMODULATION SOCIETY
NEVADA PSYCHIATRIC ASSOCIATION
PAIN SOCIETY OF OREGON
POWER OF PAIN FOUNDATION
RHEUMATOLOGY NURSES SOCIETY
TNA THE FACIAL PAIN ASSOCIATION
US PAIN FOUNDATION
VETERANS HEALTH ADMINISTRATION*
WESTERN PAIN SOCIETY

Next, let’s look at who wrote this article:  Darren McCoy, Nurse Practitioner, Certified Pain Educator at Pain Consultants of East Tennessee.

https://painkills2.wordpress.com/2015/06/12/this-is-whats-being-called-a-successful-pain-clinic/

https://painkills2.wordpress.com/2015/06/13/pain-consultants-of-east-tennessee/

And here’s part of the article:

http://www.painweek.org/journal/the-complex-pain-patient/

Some states place limits on the total daily dose of opioids prescribed. Other states place limits on how many days’ supply may be prescribed or dispensed. Still others have placed limits on how long certain medications may be prescribed. Additionally, some pharmacy corporations have instituted company-specific limits on how many patients each store may have under a medication agreement at any one time, thereby preventing a “new” chronic pain patient from being able to easily access what may otherwise be a very reasonable medical management regimen…

Some providers seem to go out on a limb to try to “help” a patient who has not shown a willingness to put forth much effort.  It is not fair for a patient to ask a provider for a sleep aid when that patient consumes a lot of caffeine or smokes routinely. It is not fair for a patient to ask for a stimulant to help with weight loss when the provider knows all it would take is a little consistent diet and activity modification for the patient to lose a pound a week. Finally, it is not fair for a patient to ask a provider to prescribe an opioid analgesic when the medical record does not indicate significant functional improvement…

This is the new catch phrase for doctors treating pain:  “significant functional improvement.” In fact, I’ve seen this kind of language within New Mexico’s Medical Cannabis Program — for a doctor to re-certify, the patient must show “improvement” while using cannabis.

One has to wonder what that looks like for a pain patient.  When you’re in constant pain, just the fact that you’re still breathing could be considered an “improvement” (to the alternative). Keeping your pain levels stable should be considered an improvement, but that’s not technically an “improvement.”  Would doctors only consider a decrease in pain levels to be an improvement? How do they take into consideration an increase in pain levels due to a worsening of the condition and the possibility that the treatment isn’t strong enough?

Patients want to reduce their pain, while the number one goal for doctors is to increase a patient’s functionality.  While these goals are not dissimilar, their priority is.

In the writer’s comparison, he goes from treating lack of sleep and weight loss to pain. Obviously, these conditions can overlap, but they are three separate medical conditions. Treating insomnia and weight loss is a lot different than treating pain, especially chronic pain.

So, when treating insomnia, improvement would be the patient getting more sleep. For being overweight, the patient would be losing weight.  Both of these improvements would include the patient becoming more functionally active.

But what kind of improvements are expected from a chronic pain patient taking opioids? Functional improvements are one thing — better pain management, sleep, activity level.  But what does “significant” functional improvement look like?

I don’t know what doctors expect opioids to do. They’re not a cure.  The only goals for the drugs are to reduce and manage pain.  Nothing else.  What kind of “significant” improvements should be experienced by someone taking drugs to manage pain?

So here I am, the perfect pain patient, dutifully reporting every month to my doctor how much I’m improving:

I slept for three hours straight the other day, doc!  It was a miracle!  I was able to walk for 30 minutes on Tuesday (but then paid for it on Wednesday).  Of course, there was nothing I could do about the different stressors throughout the month, which caused an increase in my pain levels for 7 days out of the 30.  And there were a few sneezing attacks that made my head pound more.  But don’t worry, doc, even though my pain levels increased, I didn’t adjust my medications to compensate.  That would be illegal.

However, I did have about 3 good days out of the 30 (shout out to chocolate and peanut butter no-bake cookies). And because you and the DEA are so obsessed with my pill counts, I admit that during those three days, I was able to cut back on one or two doses. Where did those pills go?  Well, I used those doses during the 7 days of increased pain I mentioned earlier… isn’t that what I said?  No?  Well, I admit, it’s hard to keep all these different numbers in my puny little female brain.  That’s why you make me write it all down on these charts, right?  

What I meant to say is that I’m improving, I’m not selling my medications, the dosages are fine, everything’s fine.

Then the doctor says, well, you’ve improved so much, these drugs have helped you so much, that now it’s time to stop taking them.

But, doc, there’s no cure for chronic pain.  Without the drugs, what will happen to all my improvements?  Where will they go?  You’re the pain management doctor, how am I supposed to manage my pain?

The doc (looking a little lost) says:  Have you tried reiki?  Magnets?  Different kinds of tea? Epsom salt?

The medical industry is trying to make you better.  Perhaps they haven’t figured out yet that chronic pain doesn’t get better.  The functionality you gain during “good” days is so easily lost during the more-frequent bad days.  Why does a doctor — that sees you for 15 minutes every month — think he is capable of rating your functionality?