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HEALTH/EDUCATION ARCHIVES -- JUNE 2010
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JUNE 14, 2010 -- JUNE 27, 2010 PRESCRIPTION DRUG ABUSE SPIKES
As an ER doctor, I am very familiar with this problem. It is also why myself and other physicians have had to advocate to hospitals and health care systems to institute 'chronic pain/opiate' policies. That is, no one who has chronic pain (with exception to cancer patients) should get opiates from the ER without an objectively verifiable new injury (such as a kidney stone). Patients put extreme pressure on us to make them happy. Often they will bring their families as 'props' to put added pressure – ie, don't let mommie continue to suffer! how can you be so cruel?! And hospitals keep track of complaints about each and every physician. There is pressure on us to make them happy. Some people do require narcotic medicines on an ongoing basis, but that should come only from their primary care doctors or, better yet, a pain clinic. And for those of you who are upset about waits at your local ER, remember that as many as a third of the patients next to you taking up time and making you wait longer are there for chronic pain. Read the article CNN/Opiate-caused ER visits skyrocket <> I think that opioids if properly used, and properly prescribed, are a valuable PART of the treatment of pain. Pain can not and should not be treated by solely pills. These patients need psychological counseling/support, physical/occupational therapies, interventional pain injections/procedures/surgeries when appropriate. There are practitioners out there who do have experience, and some with formal medical education and training in the field of Pain Medicine (which very few patients, and even clinicians even are aware). For hard to treat pain, just ramping up the dose of Percocets, Vicodins, or now the "en vogue" Methadone, is not appropriate. I have found that many non-pain trained clinicians, mostly with good intentions, are "dabbling" in these medications and this is dangerous. I would not, as a board-certified and fellowship trained pain physician prescribe chemotherapies or more complex antibiotics. The same should hold for pain medicines. Refer to a specialist who has more experience and credentials to treat many of these tough cases with their multi-faceted approaches, as well as in experiences of monitoring these medication. Read the article CNN/Opiate-caused ER visits skyrocket <> In the ER where I work, doctors give narcotics like candy. Since in our state doctors can be and have been sued for not dealing with patients pain "appropriately", and 10% of their salary depends on patient satisfaction scores, all of our drug seekers continue to come–day after day, week after week, and make up stories–"I fell", "my stomach hurts", "I have a headache".....and they know that they will be given whatever opioid they desire. Let's deal with this issue first. Read the article CNN/Opiate-caused ER visits skyrocket <> I have watched reports like this come out periodically over the years. Not one reporter seems to take this to the next step and ask the question: Why aren't the drug companies taking any effective action to curb and prevent addictions to their products. The obvious answer is that it would cut into revenues and profits. It would be interesting to see their responses. Remember, legal drug addictions are fed with drugs sold on legal channels. This means BigPharma is getting paid for them. Read the article TIME MAGAZINE/From 2004-2008, ER prescription drug abuse jumped by 111 % CUTTING QUESTION: SURGERY FOR BACK PAIN?
I perform MRIs as a career. . . Many, many of my patients land on my table because of previous back surgeries. Surgery is an option for some people, and does help some people--but not everyone. Think about it--the doctors are messing around with your spinal cord! Sometimes, no matter how good the surgeon is, it makes things worse. I'm not saying don't have surgery, but it is an option that needs thought and research, and should be a last option. Read the article YAHOO NEWS/Overtreated: Surgery too often fails for back pain <> I really get tired of reading stories that seem to minimize the truly destructive road you are on when you have real back pain. I had surgery 12 years ago and consider myself a success. Your life stands still when you are in real back pain. I had sciatica and small children to care for. There were times when I wanted to call an ambulance but the mere thought of someone touching me left me to just cry for hours till I fell asleep. I seriously thought sometimes that the only relief would be when I was dead. Articles like this make people who haven't truly suffered think that "back pain" is just the wimpy complaining or trying to get pills. Until you've walked (or crawled) a a mile in their shoes, reserve your opinions. Read the article YAHOO NEWS/Overtreated: Surgery too often fails for back pain
The study findings shouldn't surprise - there is no substitute for experience, regardless of the field. For example, studies have shown that the more heart operations performed in a hospital the higher the success rate; experienced truck drivers tend to have fewer accidents than new truck drivers; etc. Rather than argue the merits of the study, a skilled and experienced hospital administrator would be wise to have discussions with staff on actions that can be taken internally to overcome the risks associated with "green" personnel. I've frequently been impressed with how a review of basic procedures can result in simple changes that have major impact on reducing risk, again, regardless of field. Read the article U.S. NEWS & WORLD REPORT/July:When not to go to hospital <> If patients can avoid hospital treatment in July, how sick are they, really? If only the essential admissions are in July, won't they be sicker patients, with more complex needs -- and with higher risk of medical errors, and less ability to recover from the errors? In July, the whole chain of command changes in a teaching hospital. You have new residents who have never supervised interns before, and they are learning for the first time, how to catch their new intern's mistakes. And you have new attendings who, only a month before, were residents. They are learning how to supervise residents as well as interns. There is a learning curve for everyone. Plus, new faces and new schedules. Maybe the departure, the previous June, of wise mentors who you could ask for advice when you needed it. Read the article U.S. NEWS & WORLD REPORT/July:When not to go to hospital <> I am an RN who works in a teaching hospital. Nice that (if you can say that) some data supports what we have always thought. Read the article U.S. NEWS & WORLD REPORT/July:When not to go to hospital
JUNE 7, 2010 -- JUNE 13, 2010 IS COFFEE BUZZ FOR REAL OR NOT?
The experiments were done with caffeine pills not coffee. Coffee is not just a caffeine pill (just like wine is not just alcohol). The aroma of the coffee the awakens our senses(which is why coffee lovers love to ground coffee), and the fine flavors (or just plain bitterness) alerts our taste buds. And the heat of the beverage flowing down our empty digestives warm our inner body. Then, if you drink latte with sugar, it's the glucose and carbohydrates that gives us an extra boost of energy and gush of blood into our brains in the critical morning hours. Coffee, is so much more than caffeine, and this experiment, like all experiments which are dumb-down everything, does not answer why we drink coffee and why it helps us. Read the article GUARDIAN/Drinking coffee doesn't make you more alert, caffeine study reveals <> I've been trying to convince my coffee-drinking colleagues of this for some time. I stopped drinking caffeinated drinks a few years ago after I started to get heart palpitations (not caused by caffeine, but also not helped by it) and I've never felt more alert. All drinking coffee does is creates a series of peaks and troughs in your energy levels throughout the day. I agree that the aroma, taste and warmth also wakes you up, which is why my morning cup of decaf is just as good (if not better) than the caffeinated stuff. Read the article GUARDIAN/Drinking coffee doesn't make you more alert, caffeine study reveals
MAY 31, 2010 -- JUNE 6, 2010
I grew up in a boarding school in the hills in India and we'd get bed bugs every now and then. A strong dose of sunshine seemed to be the most effective thing. At the first sign of bedbugs, we'd haul our mattresses, sheets & quilts onto the basket ball court and let them sun all day. It always worked!....Of course that might not be so easy to do if you're living in a high rise in NYC! Read the article TIMES U.K./A bed bug epidemic bites New York City <> Anyone thinking of coming to NYC can Google for the public blogs of hotels with bedbug infestations so you can be sure to steer clear (there are LOTS of them), they are everywhere in NYC now. In residential areas it is now common to see mattresses tossed out with "BUGS!" spray-painted on the side to make sure passersby and street scavengers stay clear. Read the article TIMES U.K./A bed bug epidemic bites New York City
PINPOINTING HOW ACUPUNCTURE WORKS
Acupuncture dates back to the Stone Age when they tried a sharpened stone, then bone piece. The bone needles were finally replaced with metallic needles 2,000 years ago. Read the article WALL STREET JOURNAL/How acupuncture may work <> Richard Hooker put it best in one of his M*A*S*H books (paraphrasing) - Acupuncture is based on the long proven medical fact that if you stick a needle in a guy every time he complains about something, pretty soon he will stop complaining! Read the article WALL STREET JOURNAL/How acupuncture may work <> Pain is an interesting problem. It is physical and psychological; that is, it's a neuropsychiatric reaction to physical stimulus. It diminishes immune responses, stresses the body and produces negative feedback loops. In many ways all pain treatments are designed to invoke natural pain-inhibiting pathways, including narcotics. It hardly matters whether the result is due to a "placebo" effect, indirect triggering of physiological responses, or direct manipulation of neurological chemicals; the goal is relief. In fact, in the case of neuro-physiological problems, indirect pathways may lead to longer-lasting relief than simple suppression of pain signals, which can result in pain spikes as the relief wears off. Read the article ARS TECHINCA/Acupuncture works by inducing boy's own painkiller ARE COLLEGE GRADS BLIND TO REALITY OF THE WORKPLACE?
What's really so hard to understand about this generation's attitudes about the workplace? Today's new workers have seen their parents work hard, dedicate their lives to their companies, internalize the company's line of BS, sacrifice for their companies, and then be suddenly and inhumanely discarded (walked to the door like they committed a crime and can't be trusted after many years). And for the parents generation, they are unlikely to be ever be so motivated again. I don't think it is a generational thing for people to want more time to live their lives since corporate america has made it crystal clear that dedication, loyalty, sacrifice, and hard work today, mean absolutely nothing tomorrow, and may even get you laughed at for being so foolish as to think otherwise. Read the article NPR/College grads unprepared for workplace <> No doubt many recent college grads need to be given the "scared straight" talk by no-nonsense consultants. But I would not be that hard on them. As a person now in my fifties, I have become more and more appalled at the general lack of couth rampant among all age cohorts in our society. I regularly see middle-aged persons talking on their phone or texting while standing at the cash register. I routinely hear people using "the F word" during normal conversations in public. As to a sense of entitlement, perhaps recent college grads are picking up on the Medicare and Social Security recipients who populate the Tea Party: "I got mine, pal, but no government entitlements for you!" Read the article NPR/College grads unprepared for workplace <> This is hardly a new phenomenon. When I went back to school in the 80s many of my fellow students (almost all working adults) had the attitude that their employers were paying for the class, so skip the information and just give them a grade so they could get reimbursed. Schools (with the encouragement of business interests) have de-emphasized those subjects not bearing on the specific skill set required for the positions these kids are being aimed toward. And yes, parents bear much of the responsibility as well.
Over the course of my career I worked with an ever-growing percentage of younger employees who didn't know how to dress professionally, how to eat in a restaurant (and yes, that's a job skill if you are in a client contact position), or that an evening out with clients is different from a frat party. Universities aren't supposed to teach these things to our kids - that is our responsibility as parents. We should also insist that the colleges and universities that our kids attend be more than vocational training centers. We all bear responsibility for the state of our schools and the students they turn out. Maybe it's time we started taking it seriously. Read the article NPR/College grads unprepared for workplace
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