Will exercise decrease your pain?

I recently looked up POTS, a medical condition that I’m unfamiliar with:

Wikipedia: Postural orthostatic tachycardia syndrome (POTS, also known as postural tachycardia syndrome) is a condition in which a change from the supine position to an upright position causes an abnormally large increase in heart rate, called tachycardia… A variety of treatments, including exercise and medications, can improve symptoms for the majority of people with POTS…

Okay, so while your heart is doing jumping jacks in your chest, it’s time to exercise? It seems like doctors suggest exercise for almost every medical condition. And it’s true, we don’t get enough exercise, but…

http://www.painnewsnetwork.org/stories/2017/1/22/even-a-little-exercise-is-better-than-none

They measured the physical activity of 1,600 adults with osteoarthritis in their hips, knees or feet; and found that just 45 minutes of moderate physical activity a week improved their function and reduced pain…

Osteoarthritis is a specific medical condition that can cause varying levels of pain and disability, but I don’t think that every chronic pain condition will respond the same to light physical activity.

In a study of 131 older adults who have osteoarthritis, participants attended 45-minute chair yoga sessions twice a week for 8 weeks.

Researchers measured their pain, pain interference (how it affects one’s life), balance, gait speed, fatigue and functional ability; before, during and after the sessions.

Compared to a control group enrolled in a health education program, the chair yoga group showed a greater reduction in pain, pain interference and fatigue during the sessions, as well as an improved gait. The reduction in pain interference lasted for about three months after the chair yoga program was completed…

When I lived in Houston, it was too hot and humid to take walks. I only started taking walks after I moved to New Mexico (and got a camera). At first, I lost some weight, which was a good thing. But the weight didn’t stay off. Part of the reason for that was my inability to find and afford quality medical cannabis. I’ve gone through periods of stability that have lasted for months — both in the legal and underground markets — but they always come to an end, interrupting any progress I might make.

Since I moved here over 3 years ago, I’ve been more physically active than I have been in the past. I’ve also taken up baking (which includes more cleaning), and that’s also increased my physical activity levels.

So, has all this increased physical activity helped to decrease my overall pain levels? It seems logical that it would. Maybe in a group of patients who suffer from osteoarthritis, you would see the majority of them achieving benefits from exercise, including a decrease in pain levels. Would the same be true of a group of patients who suffer from TMJ or Trigeminal Neuralgia?

I hate to go against logic, but as I sit here thinking about the connection between my level of physical activity and my pain levels, I can’t say that the increased physical activity has made any difference in my pain levels. Sure, sometimes a walk can increase my pain levels, but usually, my level of physical activity doesn’t appear to be related to my pain levels. I know that doesn’t make sense, but there you have it.

The Inauguration of a Dictator With a Heart of Stone

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WASHINGTON, DC (APP) — For the first time in America’s history, inauguration day brought rain — cold rain, sleet, and snow flurries, to be exact. It was like the dark, stormy sky was a giant mirror reflecting the grief of millions, if not billions, of people.

As reported by Seth Meyers, the sun was just another star that refused to perform at Trump’s inauguration. But the White House was ready, as we watched Governor Chris Christie marching next to President Trump to a song entitled “Heart of Stone,” protecting Trump’s hair from Mother Nature with a very large umbrella. An aerial shot of the umbrella uncovered Trump’s 2020 campaign slogan imprinted on it in bright red letters: “Keep America Great. Exclamation Point.”

Even though President Trump has vowed to slash government spending, that did not stop him from ordering a wall to be built around the inauguration dais to keep out the wind. Reporters were unable to discover the cost of the wind wall, but can at least report that it was paid for by taxpayers. Unfortunately for Trump (but fortunately for the internet), we discovered that even billionaires cannot control Mother Nature.

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The argument over whether President Trump sports a toupee or a comb-over is finally over, thanks to a tiny bluebird that had the courage and audacity to fly past security. Some speculate that it’s the same bird that landed on the lectern in front of Bernie Sanders during a campaign speech last year, so the internet is calling it #BerniesBird. Trending on Twitter are hashtags that include #BBSavesTheDay, #BBImpeachedTrump, and #BB4President.

This enterprising bluebird first entertained the crowd by landing on the Bible during the swearing-in part of the ceremony, with undisclosed sources claiming it pooped on the book, while others reported that the bird actually pooped on President Trump’s hand.

Then, in a scene that appeared to be from the animated movie Snow White, friends of the bluebird flew into a circle around President Trump’s head, inspected his nest of hair, and proceeded to lift it completely off his head. It’s rumored that the Secret Service is still diligently looking for Trump’s expensive hairpiece.

don-il-trump

After much consideration, we have decided not to publish photos of a bald President Trump. We do not wish to cause our readers any fear or anxiety, although the photos are easily found on the internet. We also discussed the fear that causes people to cover up the fact that they’re going bald. Even though stars like Patrick Stewart celebrate the natural look, we can only imagine the level of insecurities which would cause the opposite reaction. In other words, as reporters, we’re trying to find a little bit of sympathy for President Trump (even though he’s just a bald, bullying asshole, who oozes ego out of every pore and is surrounded by sycophants and uneducated idiots).

Immediately after the inauguration, President Trump’s lawyers filed a lawsuit against Mother Nature and Hillary Clinton, calling the inauguration debacle a staged event. At one point in the lawsuit, Trump suggests the bluebirds were actually drones that were sent, of course, to make him look like a fool during the inauguration. In response to the lawsuit, Hillary Clinton tweeted, “Trump doesn’t need any help to look foolish. How long is this bald billionaire baby going to keep playing the blame game? Sad!”

As we watched President Trump’s fake blonde toupee fly away into the moody skies above, it sailed past an airplane with a sign that said, “WTF?” Further investigation discovered that a group calling itself #WomenEverywhere rented the plane and sign for the inauguration. When asked to clarify the message, a spokesperson for the group said it wanted to express, in one word, what women all over the world were feeling today.

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When asked about the inauguration debacle, President Trump said he was looking forward to the military parades scheduled for next month. “I’m thinking about having a gold throne made, so our soldiers can marvel at my awesomeness as they march by and salute my awesomeness. Think of all the jobs that will create!”

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The only good news we have to report is that the internet rumor about free weed being passed out at the inauguration appears to be true. BuzzFeed reports that a group called DCMJ passed out 4,200 free joints during Trump’s speech. The latest internet meme shows some poor pothead accidentally lighting up Trump’s toupee, resulting in a hospital visit and a near-death experience.

On board I’m the captain
so climb aboard
We’ll search for tomorrow
on every shore
And I’ll try
oh Lord I’ll try
to carry on

There’s nothing wrong or sinful about feeling good

I believe we should have access to any and all treatments for pain, including cannabis. But I don’t want pain patients to think that if they switch to cannabis, it will be the only drug or treatment they’ll need to manage their pain. (Any drug is just one part of an overall pain management program.)

I’ve been very lucky to have access to a quality strain of cannabis in the last couple of months — one of those strains that are very hard to find. I’ve wondered if daily use of a good strain would be enough to manage my high pain levels (averaging about a 7 out of 10), but I think that’s about false hope. Cannabis is great, but it’s not a wonder drug. Of course, everyone’s experience will be different, but I think I’ve had enough experience throughout the past 3+ years to reach some conclusions.

If I had a choice (which I do not), I would probably choose a combination of cannabis and a painkiller to treat my pain. The addition of a painkiller would allow me to smoke less cannabis, and the cannabis would allow me to keep my painkiller usage to a minimum. I might even add a muscle relaxer at night, because the muscles in my face deserve more rest than I’m able to provide.

If I was able to add a painkiller to my pain management program, I might be able to take a walk every other day, instead of once or twice a week. I might be able to lose some weight. With a little extra pain relief, I might not think about death so much. I might think that I have some kind of survivable future. There’s even a possibility that I’d be able to regularly clean my toilet. (Okay, maybe not.)

When I was taking a bucket full of prescription medications, I relied on them to manage my pain. Maybe I relied on them too much, but that’s only because, out of all the treatments I’ve tried, prescription medications worked the best. I think that’s true for most people. I think it’s true that a lot of acute and chronic pain is best controlled with painkillers. (Patients aren’t given high doses of antidepressants before surgery.) Maybe the opioid war advocates would agree with me on that, but would disagree about how long we should be allowed to use opioids to manage pain. After all, according to the other side, anyone who swallows a pain pill has a high risk of becoming a drug addict. (And what’s worse than being a drug addict? Maybe a murderer?)

I read an article recently about how cannabis affects the part of the brain that deals with your sense of time. I’ve been thinking about that…

I know that being in constant pain makes time go by very slowly. Twenty-four hours feels like a week, not one day. And then I thought about the occasions that I’ve felt “high” from a drug. You know, the shameful high that almost all pain patients deny they experience with painkillers. The high that drug addicts chase on a daily basis. The high that makes you feel good artificially because it’s from a drug. The feel-good high that is really what the drug war is all about.

Within that high — a possible side effect of some drugs — is a distortion of time. That relief allows time to float, almost fly by, as if you lost 10 pounds and your feet had wings. As if a heavy burden had been lifted just a little, allowing a tiny taste of freedom inside your prison of pain. (Everyone’s prison of pain is different, caused by mental and/or physical pain.)

Does it feel good to get high? You betchya. However, it’s not like that good feeling lasts very long. But it can last long enough to, say, take a walk (or scrub your toilet). Or the high can work as an incentive — a reward for doing the painful thing that you really don’t want to do.

I suppose it’s all about what you do with the high. Those who suffer from addiction will always be chasing the high, and because of the drug war, will always be shamed and criminalized. Looked down on for suffering from a medical condition that most people think is a choice.

Those who suffer from constant pain will always be chasing after relief, and because of the drug war, we are now treated like those who suffer from addiction.

I’d just like to point out that the high I’ve been talking about gives relief to both pain patients and drug addicts. Look down on that high if you will, but it serves a purpose. The pleasure centers in our brains are there for a reason. They’re activated not only by drugs (including caffeine and chocolate), but also by things like friendship, caring, sex, love, risk, and winning.

Good feelings are part of being human. Unfortunately, so is pain. But just like humans are not meant to feel constant pleasure, we’re also not meant to be in constant pain. We’re not meant to feel depressed every single day, and if we do, that means our brains are out of balance. We’re not meant to feel constant fear and anxiety, and if we do, that means our brains need help.

Being human means we have to suffer, but when pain reaches a level where death is preferable to life, then our brains need help. Not help for a couple of weeks or months, but constant help. The pain is constant. The help has to be constant, too.

Sometimes the help we need will include the high from drugs. Let’s stop looking down on the high. There’s nothing wrong or sinful about feeling good.

To cut costs, Medicare adopts CDC’s regulations

I think you’d be surprised at how many federal and state government agencies are a part of the opioid war. As predicted, the CDC’s opioid guidelines are being treated more like regulations than simple guidelines. With the backing of the CDC’s false theories, these agencies are deciding which treatments for pain will be available to patients — and which will label you a criminal. If you’re a pain patient with Medicare, this information will affect you.

http://www.painnewsnetwork.org/stories/2017/1/12/medicare-takes-big-brother-approach-to-opioid-abuse

A new strategy being developed by Medicare to combat the abuse of opioid pain medication will encourage pharmacists to report physicians who may be prescribing opioids inappropriately. Patients that a pharmacist believes are abusing opioids could also be referred for investigation.

The strategy, which has yet to be finalized, was outlined by the Centers for Medicare & Medicaid Services (CMS) last week in a 30-page report on the agency’s “Opioid Misuse Strategy.” It has not been widely publicized by CMS or reported in the news media…

I read a story the other day about a pain patient who was reported to his doctor by the pharmacist for buying alcohol with his prescription drugs. But I don’t think it’s news that doctors and pharmacists have also become an extension of the DEA in the opioid war, just like other government agencies.

Here are some excerpts from CMS’s “Opioid Misuse Strategy” report:

http://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/Downloads/CMS-Opioid-Misuse-Strategy-2016.pdf

Increase the use of evidence-based practices for acute and chronic pain management. Evidence-based practice is an integral part of all of CMS’s priority areas, but expanding the evidence base of effective and alternative treatments for acute and chronic pain is especially vital. CMS stated this priority area specifically to emphasize the need to address the limitations of research that is currently available.

By January 1, 2019, CMS will enforce requirements that the vast majority of prescribers who write prescriptions for Medicare Part D beneficiaries must be enrolled in Medicare or be validly opted out in order for the beneficiaries’ drugs to be covered. This enrollment requirement will allow Medicare to have better oversight of prescriber behaviors and revoke enrollment of providers proven to demonstrate inappropriate behaviors.

The Medicare Part D Opioid Prescriber Summary File, which will build on this Medicare prescriber enrollment requirement, presents information on the individual opioid prescribing rates (for new prescriptions as well as refills) of prescribers of Part D drugs. This public data set will provide information on the number and percentage of prescription claims for opioid drugs, as well as each provider’s name, specialty, state, and zip code. The file can be used to explore the impact of prescribing practices of controlled substances on vulnerable populations.

Finally, through CMS’s Overutilization Monitoring System (OMS), Part D sponsors are provided quarterly reports on high risk beneficiaries and provide CMS with the outcome of their review of each case. Since 2011, the OMS helped sponsors reduce the number of potential opioid overutilizers by 47 percent among Medicare Part D beneficiaries.

Additionally, CMS is addressing the issue of drug diversion by identifying consistent thresholds across programs to flag providers as “high prescribers” and patients as “high utilizers” who may require additional scrutiny.

CMS is in the exploratory phase of identifying metrics to quantify and track progress in each priority area. For priority area 1, metrics are currently under consideration in the following areas:

For prescribers enrolled in Medicare who prescribe Part D drugs:

Percentage of opioid prescriptions:
o Exceeding CDC guideline of 90 morphine milligram equivalents (MME) per day
o Exceeding 7 days of treatment
o Written for extended release/long-acting opioids

Percentage with beneficiaries receiving an opioid prescription without other supportive therapies/treatments

Research would also increase the focus on identifying methods for migrating the significant number of chronic pain patients with long standing opioid use to other medications along with alternative modalities. Without initiating other medications at the same time as alternative therapies, these patients may vigorously resist reducing or giving up the opioids that for many years have allowed them to manage their pain at tolerable levels and lead functional lives. The benefit of tolerable pain levels and functional lives may outweigh the risk of opioid use for these patients.

Recognizing its critical role in promoting and reinforcing appropriate treatment approaches, Medicare, Medicaid, and Marketplace plans would cover therapies that are consistent with CMS’s evidentiary standards.

CMS has a number of initiatives underway to increase the use of recommended evidence-based practices for pain management. CMS provides outreach regarding best practices and technical assistance through the Transforming Clinical Practice Initiative’s Practice Transformation Networks. CMS has distributed publications on evidence-based prescribing practices to providers, often in coordination with other HHS agencies, including the Office of the Surgeon General.

CMS is also playing a part in expanding the evidence base to identify and support effective nonpharmacologic therapies and additional non-opioid pharmaceuticals. The agency’s key role is to identify services that need more evidence to support coverage by Medicare and other health plans. CMS then collaborates with research-focused HHS agencies, such as NIH, who can concentrate research on these need areas.

The focus of CMS’s immediate efforts under this priority area is twofold. First, identify non-covered treatments that already have sufficient evidence in order to quickly expand coverage of those therapies; for example, for certain common pain conditions, such as chronic lower back pain, CMS is exploring ways to streamline coverage of evidence-supported alternative therapies.

Secondly, educate providers and beneficiaries in order to improve provider utilization of evidence-based treatments and adjust patient expectations appropriately.

CMS’s long term priorities focus on broadening coverage and increasing utilization of therapies that are [might be] proven to be effective. This approach will accelerate identification and implementation of effective alternative treatments for pain.

What happens when access to the only adequate treatments for pain are reduced and removed before other “effective” therapies are found? Like, what happens when Republicans repeal Obamacare before having something comparable to replace it with? I think the term “chaos” fits.

http://www.blog.cms.gov/2017/01/05/addressing-the-opioid-epidemic/

“The opioid epidemic is one of the most pressing public health issues in the United States today.” – Health and Human Services (HHS) Secretary Sylvia Mathews Burwell

Really? If more people suffer from untreated chronic pain than suffer from addiction, which is the epidemic? If more people die from suicide than from drug overdoses, which is the epidemic?

Many Medicare and Medicaid beneficiaries and their families have been affected by the consequences of opioid misuse and opioid use disorder, commonly referred to as addiction. Given the growing body of evidence on the risks of misuse, highlighted by the Centers for Disease Control’s (CDC) new guidelines for prescribing opioids that was released earlier this year, and the Administration’s commitment to combatting the opioid epidemic, CMS is outlining our agency’s strategy and the array of actions underway to address the national opioid misuse epidemic. The actions outlined here do not include CMS’s vision for the treatment of cancer and hospice patients.

See, those who suffer from cancer, or are under hospice care, deserve to have their pain treated, while everyone else can just suffer. Thanks, CDC.

Comments are closed.

Of course comments are closed. They don’t want anyone to invade their bubble. But Medicare is on Facebook, along with the agency that oversees it, HHS:

http://www.facebook.com/HHS/

http://www.facebook.com/medicare/

My comment posted today on Medicare’s Facebook page:

The CDC’s opioid regulations, and Medicare’s adoption of them, are forcing tens of millions of Americans to find alternative treatments for pain, like marijuana and kratom. How much savings does that amount to for Medicare?

What happens when you reduce and remove access to the only successfully proven treatment for pain before equally successful alternative treatments are available? How smart is it to repeal before you replace?

Many pain patients are unable to find safe and adequate replacements for opioids. Some will be forced into the underground drug market. Some will choose suicide. Most will survive, but their lives won’t be worth living. Many will just hunker down, suffer quietly, and wait to die — shamed by the opioid war into believing they deserve to suffer.

Has Medicare/CMS identified metrics to quantify and track the destruction being caused by it and the CDC? Like the increase in addiction rates, poisonings, and suicides. The increase in the use of alcohol, cigarettes, acetaminophen and NSAIDs, sugar, and other legal, over-the-counter drugs and supplements. The increase in domestic violence, family break-ups, obesity, kidney and liver disease, disability claims, and homelessness. The increase in anxiety, depression, and PTSD.

Once the government cures addiction (with money and good intentions), what is it going to do about the epidemic of intractable pain? The epidemic of suicides and gun violence? The epidemic of Americans being unable to trust even one government agency in this country?

“Good people don’t smoke marijuana.” Jeff Sessions

The Attorney General nominee Jeff Sessions has labeled me as a bad person. And yet, during his confirmation hearing, Senator Lindsey Graham asked him how he felt about being “labeled”:

Graham:  “Being accused of being a conservative… People have tried to label you as a racist or a bigot… How does that make you feel?”

Sessions:  “Well, it does not feel good.”

No, Mr. Sessions, it does not feel good. You’ve judged me without even meeting me, which means I can do the same to you.

And you, Mr. Sessions, are a dickhead.

What do you have against cannabis, Mr. Sessions? Do you feel the same about alcohol and cigarettes? Like, good people don’t drink alcohol? Is there some reason for your illogical position on marijuana?

http://www.bloomberg.com/news/articles/2017-01-10/trump-deportation-plan-to-hand-windfall-to-a-dying-u-s-industry

In the hardscrabble desert hamlet of Milan, New Mexico, incarceration is the biggest game in town. Not far from Interstate 40, among fragrant sage and creosote bushes, stands a sprawling outpost of CoreCivic Inc., one of America’s biggest for-profit prison companies. The 1,200-bed facility, formerly a lockup for car thieves and drug dealers, is being transformed into a detention center for immigrants fleeing Mexico and Central America. It will be opening just as Donald Trump becomes president…

Since the Republican was elected, CoreCivic stock has jumped 78 percent. Rival private-prison company Geo Group Inc., is up 53 percent…

Stricter laws, tougher enforcement, more incarceration, longer sentences: for private prisons, that’s a path to profit. In Trump and his choice for attorney general, Senator Jeff Sessions, the prison industry now has important boosters in Washington…

With marijuana legalization and Congress’s easing of drug sentencing causing the first prison-population decline in three decades, it looked as if the government’s experiment of outsourcing the incarceration business was drawing to an end…

As the drug war fades, private-prison companies have shifted to the immigrant-detention business…

As part of his “100-Day Plan To Make America Great Again,” Trump said he would work with Congress to build a southern border wall and establish two- and five-year mandatory minimum prison sentences for illegal re-entry into the U.S.

A five-year minimum for the offense would expand the federal prison population by 65,000 prisoners, which would require the government to build more than 20 prisons, according to a 2015 American Bar Association letter to Congress…

For most of us, it’s about survival

http://www.bloomberg.com/news/articles/2017-01-06/the-highest-paid-u-s-executives-supervise-doctors-not-bankers

Among the 200 top-paid U.S. executives at public companies, those in health care and pharmaceutical businesses were awarded average pay packages of $37 million in their most recent fiscal year, the most of any sector, according to the Bloomberg Pay Index, which ranks executives based on awarded compensation. Information-technology managers were No. 2 at $35.3 million…

http://www.painnewsnetwork.org/stories/2017/1/7/will-an-asteroid-hit-the-us-healthcare-system

Without federal guidelines, states will push poor people out of programs, eliminate important benefits, and cut already-low payment rates to providers to save money. I remember a time in Arizona when poor men and women qualified for state assistance for health and food. Now, you must have children to qualify for many of our assistance programs…

My comment:

I was totally unprepared for the asteroid that hit me when my pain doctor dumped me. That was about 5 years ago. One of the things I’m most thankful for is that I’m no longer addicted to doctors. They no longer have any control over me. I no longer have to depend on a doctor for my pain management, and in that, there is quite a bit of freedom. Being chained to pain for so long, it’s nice to feel just a little bit of freedom.

Of course, there may be consequences for someone who is disabled by pain to remove themselves from medical treatment. It appears that one must be paying a doctor to manage a chronic illness or one isn’t considered disabled. I’ve written to Social Security Disability explaining my situation almost 2 years ago, but I’ve received no response. One day, an overworked employee will get to my file, and I don’t know what the result of that scrutiny will be. If I lose my benefits, like these poor people, I will be homeless.

http://www.yahoo.com/news/tangled-fraud-probe-100s-face-145617092.html

I don’t consider myself stronger than anyone else, so I know that others can recover from their addiction to doctors. I chose cannabis, while other pain patients are choosing kratom. But even with those treatments, there are still an enormous amount of obstacles. Tragically, some pain patients will give up and choose suicide. I don’t blame them.

I suppose it all comes down to how much risk we are willing to take. Money is the primary concern, because a person’s financial condition determines which treatment options are available. For me, the next most important concern is my pain. It’s my pain that determines how much risk I’m willing to take. It’s even my pain that decides how much money I’m willing to spend for treatment. My checkbook is the boss; however, my pain can overrule the boss, but only to a certain point — zero money.

So, here I am, wondering when my disability checks will be cut off. Wondering how Trump is going to affect my disability benefits and access to cannabis. Wondering when I’ll have to start living in my car. I don’t suppose I’ll be prepared for that asteroid, either. But at least I don’t have to wonder if my doctor will support me through all this mess.

In the meantime, all I can do is survive the best way I know how. Because, when you come right down to it, this is about survival. Good luck to us all.