Tuesday, September 27, 2011

Today on Dr. Oz- Chronic Pain

There is a growing epidemic your doctor may be ignoring. Your Pain: When To Worry
Learn to think about pain like a doctor. These four rules can help to uncover the root of your problem and find effective treatment. Today’s audience is filled with people afflicted with chronic pain as Dr. Oz helps to shed some light on the groundbreaking research proving its existence.
Audience members Hilary (Chalfont, PA), Jacqueline (Montclair, NJ) and Shelia (Hillsborough, NJ), who all suffer from severe chronic pain, share their emotional stories, and how their primary practitioners told them there is nothing wrong with them, and try and make them believe this pain is all in their head. Chronic pain sufferer and woman’s health advocate Dr. Donnica Moore teams up with Dr. Oz, Dr. Sean Mackey member of The Institute of Medicine Committee that released the ground breaking findings on chronic pain. Dr. Julie Silver Physiatrist, who specializes in pain management to disclose the best multi-dimensional treatment for chronic pain.
Dr. Oz today talked about chronic pain, your doctor thinks it’s in your head: your doctor isn’t telling you something and Dr. oz said a lot of doctor’s are going to be really angry after todays show. Plus Dr. Oz shares the worst and best treatments for your pain. Plus Dr. Oz’s 4 critical questions you need to ask your doctor about pain.
Dr. Oz started off this segment of the show saying a lot of doctor’s are going to be really angry about what he’s talking about today. Millions of people have been suffering from chronic pain and doctor’s haven’t been taking us seriously. There is ground breaking new science proving that chronic pain is real, it’s a disease and it’s not something you’re making up.
Dr. Oz spoke with one woman in the audience who has complained of back pain and leg pain and her doctor told her to go home and have more sex with her husband and that it would help with her pain and then proceeded to show her positions that might work.
Dr. Oz said he was Peed off and said it frustrates him that it’s hard for one to get proper treatment for pain and in his opinion doctor’s do think you are crazy, they think the pain is all in your head. There are 4 reasons why doctors won’t be able to help you with chronic pain like they should.

Why You Doctor Thinks You’re Crazy

1. Doctor’s Can’t See Your Pain – If they can’t see your pain it doesn’t exist
2. Doctor’s Don’t Have Pain Management Training
3. Doctor’s Think You’re Out To Score Some Drugs
4. You’re A Woman – Dr. Moore said male doctor’s treat female patients differently.
We can now call chronic pain a disease according to the new study released, the pain itself is a disease just like diabetes, heart disease and the like says Oz. Dr. Mackay said this study is now validating what chronic pain sufferers in the audience have been saying.

Dr. Oz 4 Questions To Find The Right Pain Specialist

Next we moved on the the 4 questions you need to ask to find a doctor to treat your chronic pain:
  • How Much Pain Management Training Do You Have?
  • What Is Your Approach?
  • How Long Before I Begin To See Results?
  • How Much Will It Cost

4 Rules

Dr. Silver is the author of You Can Heal Yourself and an award-winning book from the American Cancer Society titled What Helped Get Me Through: Cancer Survivors Share Wisdom and Hope, here is what she says about When to Worry About Your Pain.
Learning to treat pain effectively takes years. As a medical doctor who specializes in Physical Medicine and Rehabilitation (PM&R), I have extensive training in treating pain. Doctors who specialize in PM&R are formally called physiatrists and are sometimes informally referred to as pain doctors.
One of the first things we learn is when to worry about pain. Since we are taught to treat so many different kinds of pain, we need to know when to sound an alarm about a patient’s condition and how to act to treat them most effectively. If you’ve been experiencing pain, it’s important that you learn to think like a pain doctor. While these “rules” about when to worry certainly do not cover every person and every situation, they are important to know to get to the source of your problem.
How to Think Like a Pain Doctor
1. Two-Week Rule 
Any pain that lasts for more than two weeks should be checked out. A lot of people think that new pain means that they have cancer. In fact, most new pain is due to bones, joints, nerves and other musculoskeletal structures. Many doctors use the two-week rule because a lot of musculoskeletal pain will resolve within a two-week period. Also, a two-week delay in diagnosis is very unlikely to change someone’s prognosis if the pain is due to cancer. Though the two-week rule applies to most pain, there are times when doctors ignore this rule and become immediately concerned (See Rules 2, 3 and 4).
2. Acute-Trauma Rule 
Doctors should immediately check all pain associated with acute trauma, such as a car accident or fall off a ladder. Usually, people aren’t overly worried that cancer is causing their pain if they have trauma that results in immediate or even slightly delayed pain. However, all pain associated with trauma necessitates an evaluation; this includes a physical examination and possible imaging tests such as x-rays or MRIs.
3. Worst Pain of My Life Rule
Doctors should be alarmed at any new and severe pain that a patient reports. It’s not unusual for a patient to actually say, “This is the worst pain I’ve ever experienced!” Often, the “worst pain of my life” is not cancer, but may be the result of something serious, such as a heart attack, appendicitis or ruptured blood vessel (aneurysm). If the pain is severe but chronic and has been worked up previously, then the “alarm bells” ring less vigorously.

4. I Can’t Sleep Rule

Doctors should be concerned about any pain that awakens a patient at night. Sometimes, night pain is more serious than pain that occurs during the day with normal activities. This is because, usually, when you rest, pain improves. Pain that doesn’t improve with rest is sometimes worrisome. However, resting too much with chronic pain leads to weakness and more pain. If you have chronic pain, try and alternate rest with activity to stay strong and keep your overall pain levels down. Cancer pain is one type of pain that often doesn’t improve with rest and will awaken people at night. However, it’s important to know that a lot of musculoskeletal pain problems will bother patients at night. Hip bursitis or shoulder tendinitis can often keep a patient awake if they lie on the affected side and put pressure on the injured part of the body. It’s important not to make assumptions about what is causing night pain, and to identify the cause and treat it appropriately.
There is no doubt that pain is undertreated and that physicians and patients need to work together to find solutions. When someone tells me, “I’ve tried everything,” I often ask if he or she has had a consultation with a physiatrist. Often the answer is no. To find out more about doctors in your area who specialize in treating pain and helping people to function at the highest possible level, visit the American Academy of Physical Medicine and Rehabilitation.
Source: doctoroz.com


Thursday, September 22, 2011

It’s Time to Become Disability-Aware

A Different Normal

Living with a Chronic Condition

Richard C. Senelick, MD is a physician specializing in both neurology and the subspecialty of neurorehabilitation. He is the Medical Director ofHealthSouth RIOSA, The Rehabilitation Institute of San Antonio, and an associate clinical professor in the Department of Neurology at the University of Texas Health Science Center in San Antonio. He has authored several books on stroke, spinal cord injuries, and brain injuries. Dr. Senelick is an expert in the WebMD Stroke Community.
Did you go see the movie Tropic Thunder?  Have you rented the movie, There’s Something About Mary? Both movies have scenes that generate laughs at the expense of the disabled. It may seem like “nit picking,” but had a different minority been similarly stereotyped, the outcry would have been much louder.  The disabled are a minority who still have a significant barrier to overcome. People rarely understand the simple fact that the disabled have the same desires, dreams and aspirations of able-bodied people.
I work every day with people who have disabilities.  I am the medical director of a rehabilitation hospital where I am surrounded by patients with brain injuries, missing limbs, severe deformities and impairments. This is my “normal” environment— one in which I am totally at ease and comfortable.  In fact, I have been doing this for so many years that I frequently don’t notice the alarm or discomfort of first time visitors.
By virtue of this familiarity, the assumption is that I have either learned or intuitively know how to interact appropriately with someone with a disability. In my world, it is the rare occasion where someone actually receives criticism or a comment related to something they said or did while interacting with a disabled individual.  But, the wars in Iraq and Afghanistan have produced large numbers of “wounded warriors” who have no qualms telling us what they want and how they want to be treated.  While caring for these young men and women, it has become apparent that it is time to “test” our own disability awareness and examine whether we act in an appropriate manner.
The difficulty here is that many people are simply not aware that even though their intentions are good, their words can come across as patronizing or insensitive. Below are a couple of common missteps in our interactions with the disabled.  See if these ring true and whether you need to reassess your approach.
Greetings: It is second nature to offer your arm and shake the hand of someone you have just met.  However, I have seen many people hesitate to shake the hand of a disabled person out of fear that the person is paralyzed or missing a limb.   Greetings come in a wide variety these days, from a fist bump to a high five.  Extend an arm in greeting and an individual will respond.  However, do not invade their personal space by assuming you can rub a shoulder or pat a knee without permission. Even in our increasingly casual society, it is not acceptable to call someone honey, sweetie, baby, sugar or – my least favorite current greeting — “dude.” A few years ago, I was a patient in the hospital and an aide asked me, “How you doin’, dude?”  If not for my wife’s restraining “not now” stare, I would have come unglued.
“You are so courageous”: I recently spoke with a young woman who told me, “I always make sure to tell people with disabilities whom I meet how courageous they are.”  The definition of courage is, “the mental or moral strength to withstand danger, fear or difficulty.” Yes, a soldier’s courageous act may have resulted in their injury, but now, they may feel afraid, anxious and depressed, and need someone to acknowledge and empathize with these emotions. It is not helpful for us to tell them they are courageous, for that sets an expectation that they must check their emotions at the door and show an “expected” strength at a time when they are barely coping.
“It could have been worse”: Don’t tell a disabled person how “lucky” they are or that it could have been worse.  It diminishes the importance of the event or illness.  Statements like this come off as judgmental about the impact of the injury on that individual.  If you had a stroke that left you with the ability to walk but you still had a paralyzed arm, would you feel lucky?
“I know how you feel”: You should avoid the use of phrases such as, “I know how you feel” or, “I can imagine what it must feel like.”  Unless you have the same or similar disability, you do not know how they feel.  It is better to say, “I have never had to sit in your chair nor walk in your shoes.  I hope that I never have to, but I will be here to help you get through this difficult time.” Empathy without sympathy.  Assistance without patronization.
We recently watched moving memorials for those who died on September 11, 2001.  Ten years later we have tens of thousands of soldiers who have unfortunately joined the 5.6 million Americans who have to live in wheelchairs.   Will we honor their “new normal” with appropriate social interactions and greetings? You may say, “Of course, I will.”  But I challenge you to go a step further and become a disability etiquette educator.  Spread awareness among your co-workers, your associates and your family. And, from time to time, it never hurts to look in the mirror.