Knowing the Basics of Interventional Pain Management

Anyone, who is dealing with chronic and/or acute pain, knows the “pain” associated with the condition. In most cases, patients spend a considerable amount of time with primary care doctors, physical therapist, and specialists, hoping to find a more permanent solution. Interventional pain management is a practical alternative in such cases, where the concerned patient has tried all other treatment options.

Understanding interventional pain management

Interventional pain management is a specialized field in medicine that deals with the diagnosis and treatment of chronic and/or acute pain and other related disorders. This is more of a “multidisciplinary” approach, which is offered by a team of experienced doctors and healthcare professionals. With interventional pain management, doctors aim to reduce chronic and or acute pain, besides focusing on better living. The treatment is entirely different from other forms of pain management because there is no direct dependency on pain-relief medications. In most cases, a physician may refer the matter to a pain management doctor, who will decide on the line of treatment, depending on the facts of the case. In case of interventional pain management, pain management physician will work together with chiropractors, physical therapists, occupational therapists, psychologists, neurologist, and orthopaedic surgeon as needed to treat the condition by utilizing minimally invasive procedures such as epidural injections, facet blocks, trigger point injections, etc.

Things worth knowing

Interventional pain management is particularly beneficial for patients who are suffering from neck and back pain. Physicians may use more than one approach to the condition, depending on the diagnosis. The use of steroidal injections in the joints and epidural space is quite common, while injections are also used to treat a spinal nerve root, which is diagnosed as the source of pain. Branch blocks are also used for diagnostic purpose followed by radiofrequency ablation, while doctors may also use additional injections in the facet joints. Discography is also utilized to find the possible cause of pain, and in this procedure, a special dye is used in an injectable form into a disc to understand the pathology better.

In some cases, minimally-invasive procedures like “Radiofrequency Ablation” can be used for the medical branches, so as to restrict the movement of pain signals. Doctors may also suggest the use of heated electrodes for certain nerves that carry the pain signals, and this process is also known better as Rhizotomy. Not to forget, physical therapy and other forms of occupational therapies are also used for the treatment. Doctors also suggest lifestyle changes to patients, if they find any hope for better health.

The first appointment

You need to visit an Interventional Pain Management specialist, who will do a thorough exam to understand the possible concerns and issues related to the condition. Doctors may also suggest a few tests including x-rays and MRI for accurate diagnosis. You must also discuss the other kinds of treatments you have tried for your condition, and as required, doctors may suggest a line of therapy, after discussing the expectations, costs and other aspects.

Ethical Dilemmas Doctors Have to Confront

The ethics and professionalism in medicine are of core importance when it comes to the role of the physician in his code of conduct.

With the great prestige and nobility in this profession comes the great responsibility in doctor’s hand, as they have to go through quandary in situations when it comes to cases like euthanasia, abortion, making a decision of who even makes it onto a waiting list for organ transplant, quick and life-changing decisions, psychological pressure from the loved ones of the patient, the patients family blame the doctors if the patient is unable to make during surgery, they should understand that death is imminent and the doctors do, whatever they can to save a life.

The doctor must explain the procedure to the patient and give him full information about the benefits, risks, positive and negative effects, leaving up to the patient to make the choice about undergoing the surgical procedure. The doctor should not perform the surgical intervention, only taking into consideration his personal gains and benefits. His first priority always has to be the patients’ health and to act in the best interest to protect the patient from any kind of harm. The doctor should be impartial when it comes to the selection of deserving cases and their needs, and on the basis of their degree of sickness.

The one of the most important and foremost ethical concern is taking an informed consent. Informed Consent is taken in advance from the patient, it is an agreement or a gesture to permit the doctor to have his medical history, undergo examination procedure, diagnosis, treatment, and intervention. The patient should be competent, well aware; mentally and emotionally stable. In some cases, the patient in spite, of his serious condition, refuse to agree with the intervention or surgical procedure, where then doctors have to make a decision for the welfare of the patient.

The information of the patient can only be breached if:

  1. himself asks the physician.
  2. In the case of children, the information is conveyed to the parents; as they are very
    young to handle their condition.
  3. There is a need of the help of the healthcare team in solving the case. Whether, the disclosure is for the criminal investigation of crime or harm to others, assault case, protecting the vulnerable; such as in child abuse case.
  4. For research purposes but only as anonymous and after taking consent from the patient.
  5. When it comes to public interests it may be breached when a patient has a highly contagious disease such as tuberculosis; the doctor has to inform the patients family so that precautionary measures can be taken. If the patient has a sexually transmitted disease, let’s say HIV which is a communicable disease, the doctor may disclose his disease to his partner in order to protect from the risk of getting the disease.
  6. State registries where officials keep track of cases like diabetes, cancer, HIV/AIDS, Alzheimer disease, Amyotrophic lateral sclerosis, and many other diseases.

It is the duty of the doctor to act in his best interest while dealing with a case, abide by the principles in common clinical situations, and work in the beneficence of the patient and do no harm in the treatment procedure.
The common ethical conundrums that doctors’ have to face in their course of profession:-

1- Euthanasia:

Euthanasia or physician-assisted suicide is considered as one of the supreme problems when it comes to ethics of patients treatment. The decision of euthanasia by the patient or his family is made in order to reduce the suffering of the patient in his terminal sickness. It can be voluntary or involuntary. When the patient makes a decision, it is voluntary. When the physician makes a decision it is involuntary. However, may it be voluntary or involuntary, it is unethical.

The World Medical Association issued the following declaration on euthanasia:-

“Euthanasia, that is the act of deliberately ending the life of a patient, even at his own request or at the request of his close relatives, is unethical. This does not prevent the physician from respecting the will of a patient to allow the natural process of death to follow its course in the terminal phase of sickness.”

2- Staying within their boundaries:

Doctors have to work long hours, off work, and even operate in odd hours in hospital settings and have to treat patients irrespective of their age, gender, and other attributes. They have to work in coordination with other staff members, the nurses, anesthesiologist, interns, assistants and many related members. Personal relationship or intimate relationship between the doctor and any other member like, his fellow, intern, other staff member is unethical and is prohibited. Patients often offer gifts to the doctors when their treatment intervention has been successful, or when the surgery goes well. It is quite fine, to accept those gifts as long as they are in the form of sweets or bouquet. The patient who brings gifts during the intervention may cause trouble, it may be the sign the patient needs more of the doctors’ attention. The physician should simply show reluctance to such presents and should not accept them by justifying that its’ against the ethics of their respective field.

3- Organ transplant:

Unfortunately, the availability of the transplant organs is far less, than their demand. Doctors have to make a tough decision here, that who will receive the next available organ and who will not, keeping in view the whole scenario, and what criteria is used for determining the donor. The surgeon should opt to give the transplant organ to the deserving patient on the list, on the basis of his health condition.

The physician should be approachable, equitable, able to communicate effectively and compassionately respecting the dignity of the patient regardless of his race, ethnicity, cast, choice of lifestyle. He should be dedicated to his profession, attenuate the pain of the patient by all means, preserving the health and enhancing the quality of life.

The Weakness of Contemporary Cultural Medicine

The term Cultural Medicine is used to refer to changes to a medical system provided specifically to reach out to and serve a diverse culture. The title is applied differently than Integrative Medicine. Integrative Medicine acknowledges that there are different preventive and reactive ways to address issues of preventive health, health maintenance, disease, injury and medical care (IntgMed), many of them cross-cultural. Cultural Medicine is applied to all that is not specifically IntgMed. Rather, it is that which supports underlying layers of infrastructure required to deliver ever-expanding, culture-specific positions, products and services, rather than focused, inclusive services.

An example of inclusive delivery is recognition that the national language is English. A focused, nationally oriented, fully integrative system of medicine would acknowledge the beneficial elements of all IntgMed, but it would be delivered in English (except non-translatable elements). This approach encourages all citizens to learn and excel in English and markedly limits the cost of IntgMed products/services components delivery. If for example, government-paid and/or delivered services focus on delivering a more culture-neutral, English-based IntgMed service only, costs would be markedly reduced and all citizen-consumers would be encouraged to become more English-language proficient. As an aside, pharmaceutical products, medical technologies, acupuncture needles, physical therapeutic manipulations and exercises, and other key elements of IntgMed do not recognize the human body as gender, ethnicity or culture-specific – they simply perform functions. Such subdivisions are behaviors of service providers.

One of the primary sets of questions ignored by state and U.S. governmental agencies are:

  1. Who is most qualified to determine if a proposal or intervention should be that in which we should invest given all other needs, ideas, and proposals?
  2. Who should be responsible for payment for this proposal/intervention if we proceed with it?
  3. Define success. What does it look like?
  4. When (initial and follow-up) and how shall we measure the effectiveness of the subsequent program, service, or intervention?
  5. Is it not appropriate for payers (e.g., public taxpayers) to receive easily accessible, unbiased reporting of interim services delivery progress and performance measurements?”, and
  6. What will we do if measured results are not as expected and desired (e.g., inadequate Return on Investment)?

If you took your car in for service, paid for the services, and only fifty percent of the claimed fixes were effective, would you be satisfied? No, you would not be satisfied. If the same automotive repair company employed you, yet still provided you and your peers with the above-described poor service, would you then be satisfied and recommend to your friends that they should be satisfied in similar circumstances? You should respond, “No.” You should not be favorably biased toward the repair company simply because it employs you. However, government initiatives usually provide many millions, if not billions of dollars to the recipients of their investments, including the creation of well-paying jobs. And, unlike as would be the case in private industry, recipients of these public windfall monies and opportunities are loath to give up your tax money, and are often willing to publicly denigrate you for demanding that they be held accountable (e.g., fix the entire car as promised versus aren’t you satisfied with partial function?)

There are numerous governmental pseudo-medical/medical programs that are abysmal failures, that continue to expand. In spite of their prolonged failures at missions to curtail drug abuse, misuse, pharmaceutical products-related deaths, decrease STD/STI incidence, minimize gender-critical maladies, and social disruptions due to related issues, the programs and funding persist. With grand budgets and swollen senses of importance and entitlement, no one receives good answers to above listed six questions from these program representatives. Such are the effects and weaknesses of contemporary Cultural Medicine. Everyone in the culture, position-empowered or not, rich and poor, citizens or not, payers or not, aware of and sensitive to current budget constraints or not, believes that they should receive timely, broad-based, sometimes very expensive, individualized care and financing of their programs. And, numerous cultural subgroups (geographic, ethnic, gender-specific, age-specific, financial, religious, secular, other) with sufficient financing and/or sophisticated representation, lobby for special consideration. To suggest that they do not have the right to do so would be politically incorrect and insensitive, right?

Contact your local, regional, state and national government representatives to determine how they are addressing the weakness of contemporary Cultural Medicine in your neighborhood.

Kidney Transplant – Patient Assessment Factors

When kidneys stop working effectively, you either have an option of a dialysis or a kidney transplant. Dialysis ensures that you get rid of the waste products from your body but it does not replace all the functions of the kidneys. When you are diagnosed with failing kidneys, treatment can sometimes prevent or at least delay their complete failure.

However, with a transplant, your body can continuously remove the waste products of metabolism, and excess fluid. Kidneys also help in the production of a natural hormone called erythropoietin that prevents anemia. It also helps convert the vitamin D in food into an active compound that helps keep bones healthy. Moreover, it helps excretion of some toxic drugs. Finally, it plays an important role in helping control blood pressure.

Kidneys normally undertake all these functions. It is a known fact that kidney transplant provides patients with a better quality of life than dialysis.

Assessment for kidney transplant

There are a few very important factors to be checked before you undergo kidney transplant surgery. To begin with, you will be referred to transplant only when you are nearing or have started dialysis.

  • There is no dependency on age factor or ethnic background when it comes to assessment for a transplant. It all depends on whether you are fit enough to have the operation and deal with all the after effects of the surgery.
  • Some of the factors checked are evidence of heart disease, chest conditions and other problems. Special investigations are conducted to assess whether these risk factors are too great for transplant.
  • Next there will be a thorough discussion between the specialists such as the surgeons, nephrologist, cardiologist and the physician before the decision is finalized.
  • Once you are considered fit enough for a transplant, the specialists will explain all the risks and benefits to you.
  • Many times there is a waiting list for a transplant.
  • There will be a number of tests conducted to check whether you have had certain virus infections.
  • Well, the specialists will also ask you whether you have any close friends or family who are willing to be live donors.
  • Live donor transplants are known to give the kidneys a better chance of long term survival as compared to diseased donor transplants.

Whether you receive a particular donor kidney or not is determined initially by the blood group. It is pretty difficult to get two people to be perfectly alike, because the genes are different. It is however possible to achieve a good enough match for a successful transplant. The surgery takes around three hours and appropriate care needs to be taken post operation too. 

Three Important Things to Know About Radicava

The ALS Association is the largest charity for people with Lou Gehrig’s disease in the United States. Not only do they provide excellent patient provision through care takers and support groups, they are also the leading fundraiser for new research when it comes to ALS treatment and a possible cure. During the summer of 2014, the ALS Association’s Ice Bucket Challenge went viral online and raised over 100 million dollars. This was the largest amount of donations the fundraisers at ALS had ever seen. They were ecstatic! This boost in funding led to the research and development of three new treatments for Lou Gehrig’s disease, one being Radicava, which will likely be available August of this year. Here’s what you need to know:

  1. Radicava slows the progress of ALS by reducing oxidative stress in the body. ALS is essentially a slow reduction in the body’s ability to function overall. This eventually leads to the shutdown of vital organs within the body. One of the first signs of ALS is the presence of oxidative stress, which is an imbalance between the presence of toxins in the body and the immune system’s ability to detoxify. These effects will first manifest themselves as a general slowing of autoimmune abilities followed by the more sinister effects of ALS, such as major organ failure. Radicava offers a time out to these unfortunate realities. The new medication has been shown to slow oxidative stress, and most patients see a 33% reduction in the decline of their physical abilities. Additionally, all Radicava test patients had higher scores on the ALS Functional Rating Scale
  2. First new medicine in 22 years. Because the origins of ALS are still largely misunderstood, it is incredibly difficult to approve and test new medications. Since the mid nineteenth century, our knowledge of what causes ALS has not kept up with other medical advancements. Because of this, it is incredibly difficult to find funding for new treatments when legislatures do not understand the medicinal premise. The first and last drug to be approved for treatment of ALS was Riluzole, which slowed lung failure. Unfortunately, the relatively small benefit offered to ALS patients compared to its astronomical costs essentially relegated Riluzole to pipe dream status. The mystery surrounding its origins combined with a lack of funding lead to a two decade ASL treatment dry spell. However, after the 2014 Ice Bucket Challenge, three new medications were presented to the FDA for approval. The first to reach the pharmaceutical market will be Radicava in August!
  3. Administered by infusion. At this point you’re probably wondering how Radicava will be administered to patients. Is it overly intrusive or painful? Will it even be worth it? For those who participated in the testing of the drug, Radicava absolutely is. The treatment is administered intravenously over a fourteen day period, followed by a fourteen day rest. After the initial treatment, patients will receive injections for ten out of every fourteen days. While this is a time-consuming treatment, this is the first ASL medication with legitimate promise for, not only extending the lives of those with Lou Gehrig’s disease, but also improving their quality of life!

After so many years of failed treatments and questions surrounding the origins of ALS, Radicava’s approval is a beacon of hope for patients and their loved ones.

Types Of Genetic Disorders

Genetic disorders occur as a result of abnormalities or variations in the information encoded by the genes and chromosomes. As per the available information on genetic disorders, these disorders can be broadly classified into four different categories, which are as follows:

1. Single-gene Disorders: Also known as Mendellian or monogenic disorders, these occur when the changes or mutations occur in only a single gene. Some well-known examples of single-gene disorders include cystic fibrosis, sickle cell anemia, Marfan syndrome, Huntington’s disease and hereditary hemochromatosis. Single gene disorders can be further classified into autosomal dominant, autosomal recessive, X-linked dominant, X-linked recessive and Y-linked disorders.

2. Multifactorial Genetic Disorders: Also known as polygenic, these disorders occur as a result of mutations in multiple genes. These disorders are really complex, difficult to analyze and hard to treat. Some examples of multifactorial disorders include autism, coronary heart diseases, cleft palate, mental retardation, cancer and diabetes.

3. Chromosomal Disorders: These diseases occur as a result of abnormalities in the chromosomal structure such as missing or presence of extra copies of chromosomes. The most well-known chromosomal disorder is the Down syndrome or Trisomy 21 where a person has three copies of chromosome 21. Other examples include Klinefelter syndrome, Cri-du-Chat syndrome, Turner Syndrome and Williams’ syndrome.

4. Mitochondrial Disorders: These disorders occur when there are mutations in the mitochondrial DNA or the non-chromosomal DNA of the cell. These disorders are maternal in origin as only egg cells contribute mitochondria in a developing embryo. One very good example of a mitochondrial disorder is the Leber’s Hereditary Optic neuropathy.

Dental Health Activities

Dental health activities are designed to encourage good dental health practices and to help avoid dental cavities, gum diseases and oral cancer. State dental health programs are the primary entities responsible for conducting the core activities with regard to oral health conditions within different states. Local health departments in association with the dental community and public/private schools also arrange various dental health activities. The promotion of dental sealants and monitoring of the fluoride content in drinking water are examples of disease prevention activities. The American Dental Association provides a great deal of resources for dental health activities.

Classroom dental health activities are an integral component in the development of a child. Dental health activities to provide valuable oral care education and to promote the importance of proper dental hygiene among children are conducted with the help of posters, interactive dental health games and contests, health fairs and classroom presentations. Health educators present programs on topics such as brushing and flossing, bad breath, good nutrition and how to overcome the fear of visiting the dentist. The organization and administration of school-based fluoride mouth rinse programs and the promotion of school dental screening are examples of additional dental health activities focused on children.

Organizations such as Oral Health America develop, implement, and facilitate educational and service programs designed to raise awareness of the importance of oral health. Nationwide activities and campaigns coordinate schools, governments, care providers, and corporate and community partners in the fight against tooth decay and oral disease prevention. Many state dental health programs are involved in epidemiological surveys, applied research projects and community needs assessments. This information is important in developing an appropriate and responsive community programming. Many public health systems operate independent public health dental activities. These activities vary in scope and size across each state depending on population requirements. State grants are allotted to develop innovative dental activities and programs specific to individual states? needs, and improve access to oral health services.

Misuse of Medical Equipment

When doctors order tests like x-rays and CAT scans they usually only need a simple reason for doing so. Unfortunately, in many cases these types of health care equipment is misused or ordered when it is not really necessary. When this happens a patient ends up paying for a service they should not have had to. The costs alone from misuse of health care equipment is staggering. Not only is it putting a dent in the pockets of patients, but it is also part of the reason for rising health care costs.

Besides the financial side of misuse of health care equipment, there is the health concerns to consider. X-rays, for example, are known to be dangerous. A person is being subjected to radiation which can be profoundly damaging to the body. There is a limit on the recommended number of X-rays a person should receive, but many times when a doctor orders a x-ray, they are unaware of the person s history with getting x-rays. Additionally, x-rays are harmful for pregnant women and for reproductive organs, in general. Too many x-rays can lead to many health problems.

The misuse of health care equipment is something that is likely to go unnoticed. More and more insurance companies, though, are requiring further validation for such uses which may help to end misuse. However, most of the time as long as a doctor deems it necessary, the procedure will continue.

When it comes to medical equipment, x-rays are probably the most used type of health care equipment. In emergency rooms around the country, doctors usually are quick to order an x-ray if the diagnosis is not immediately recognizable. The misuse of health care equipment can lead to many problems for the patient.

The Health Care System is Broken – Should Big Parma Buy Hospitals?

We all know that the health-care system in the United States of America is broken and it doesn’t take a rocket scientist to figure that out. As podium pushers and politicians tell us that they will give us universal health care we all know that that is impossible. We also know that the Social Security system is running dry and we can barely afford that.

We know that there are all kinds of lobbyists from the health-care industry in Washington, DC trying to keep it going and keep the government paying for all these health services in our hospitals. The truth this is the Medicare system in the United States was originally ill-conceived and it is only gotten worse throughout the years. Today it represents a huge cost that we can no longer afford.

Indeed the health-care system is broken, but who is coming to the rescue and how come these politicians keep promising us universal health care – a scheme that would clearly bankrupt our nation? So who is going to bail out all the hospitals if the government stops footing the bill?

Maybe big Pharma and the pharmaceutical companies might buy up all the hospitals in order to make sure that those hospitals only sell their drugs? America is on drugs there is no doubt about that and the average Grandma now is probably taking 13 different medications all counter-acting each other, wow, now that is certainly quality of life.

It is incredible this crisis – maybe we should combine these two crisis – the health-care industry and big Pharma and put them together so we can manage them better as we cut off some of this excessive corporate welfare? Too hard hitting for you? So, what’s your solution then?

Tips On Reducing Health Care

When it comes to lowering your health insurance premiums it takes no rocket scientist to figure out how it’s done. If you’re trying to reduce your insurance premiums then you need to become less of a risk for the insurance companies. You can become less of a risk for insurance companies through exercise, eating healthy and preventative care.

If you’re not exercising at least three times per week then you have got to get on a program. A good program consists of you doing cardiovascular training three times per week for 45 minutes. You should be weight training at least twice per week for 30 minutes. For some, getting to the gym might be out of the question. If it’s difficult for you to get to the gym, then take up some other form of exercise including walking, running, hiking and sports.

If you’re not currently eating 5-6 meals per day then you have got to get on the band wagon. All nutritional experts agree on the principle of grazing throughout the day, taking in smaller portions for meals. When you are doing this you are allowing your body to digest food much easier thus creating a faster metabolism. When your metabolism speeds up then you are able to lose weight and get in shape. Along with eating five to six meals per day also remember to eat healthy. The best part about eating healthy is that there are many options for healthy food. The best tip for eating healthy is to keep it as natural as possible. Try to avoid processed food at all costs.

Preventative care is you being proactive with your body, and going in for a check-up if something feels out of place. Preventive care is you avoiding unnecessary risks that could jeopardize your health. This mindset is you acting, and not being acted upon. If you are truly exercising a preventative attitude then you won’t allow yourself to get obese or unhealthy, because you are in control of your future. If you exercise, eat healthy, and implement preventative health care, you will be able to not only live longer and healthier, but you will also have reduced your health care substantially.