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A clinical health psychologist discusses the diverse effects of chronic pain on adolescent patients, with consideration for how this phase of life differs from both childhood and adult stages. These differences have implications for the experience of pain, across biological, psychological, social...
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The inherited pain patient is really one of our greatest challenges in medicine because even if their pattern of pharmacotherapy is irrational, the vast majority only got there with the help of a physician, and I think we owe a special duty of care to patients who have iatrogenetically come to harm...
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Inherited patients usually come in with certain pharmacotherapy and you have to decide after your history and physical whether that pharmacotherapy is irrational or rational. Is it pharmacotherapy that you feel comfortable prescribing and continuing without change? Is it pharmacotherapy that you’re...
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A discussion of the challenges of effective patient/provider communications about chronic pain conditions. Drs. Cheatle and Schatman outline how new models of shared decision making and patient mindfulness can help improve the quality of the interaction while acknowledging the time constraints of...
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Clinicians involved in pain management face a practice environment that is in constant flux. In this segment, an attorney with deep experience in the medico-legal issues confronting pain practitioners outlines steps that they can take to stay current and compliant, while providing for their patients...
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There are three pathophysiological aspects to consider with mild traumatic brain injury. The first that occurs is marked accumulation of glutamate, which essentially destroys cells. It burns cells out. It kills cells. But it’s just part of a major metabolic cascade that is unhelpful to the patient...
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There are number of problems for patients who suffer from chronic pain, and one of them is frustration with the treatment outcome. We in healthcare want to be the heroes, we want to be the fireman who’s going to rush in, break down the door with the axe and pull people to safety, and I think that...
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In patients with advanced illness, pain medication regimens may be inappropriately prolonged, due to clinical inertia or misperceptions over continued benefit. This segment considers the process for evaluating the medication decision in advanced illness, and insight into compassionate patient and...
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We know more now about the risk factors and patients who may be good candidates for naloxone. These would include patients on higher doses of opioids, patients with complicated comorbidities like renal or hepatic disease, sleep apnea, and most obviously, those with active substance abuse, or a...
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Although prescription medications are of great benefit to many patients with chronic non-cancer pain, there are significant complications for patients who are either addicted or in recovery. Dr. Durham, a clinical pharmacist, professor of pharmacy, and medication prescriber, considers the...