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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.
Pra...
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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:
- Endometriosis
- Fibromyalgia
- Painful bladder syndrome
- Irritable bowel syndrome
- Chronic low back...
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Spirochetal infection symptoms include
- Muscle pain
- Nausea
- Vomiting
- 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
Lyme...
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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...
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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...
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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”
- Practice...
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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...
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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...
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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...
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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...