Having fibromyalgia comes with a lot of muscle pain, stiffness, and sometimes even sleeping trouble. Even though the cause is still unknown, significant research has been done to find different treatment options that may ease the pain of fibromyalgia patients. Studies have found that people suffering from fibromyalgia can benefit from eating a certain diet when used along with treatment given at Chronicillness.co Site can help to reduce symptoms and bring relief.
Omega-3:Foods like nuts and fish have anti-inflammatory effects on the body.
Magnesium:Most people, especially people who suffer from fibromyalgia, are deficient in magnesium. Magnesium deficiencies have very similar symptoms to that of fibromyalgia. Dark leafy greens, nuts like cashews and almonds, and soybeans are all good sources of magnesium.
Lean protein:Lean proteins have less saturated fat than red meats, so eating foods like fish or chicken helps fibromyalgia patients maintain a healthy weight.
Fruits and vegetables:Fruits and vegetables are full of antioxidants and vitamins promoting nervous system health. Your diet should include plenty of leafy greens like kale or spinach and fruits of all colors.
Sugar and caffeine: Even though fibromyalgia may cause fatigue, it is important to stay away from sugar and caffeine. Caffeine only gives a small boost and is usually followed by a longer period of fatigue. In addition, it interferes with getting restful sleep at night, something patients may already struggle with.
Food allergens: Get tested for allergies to find out what other foods you may be sensitive to.
Monosodium glutamate (MSG). According to an article by Everyday Health, MSG, which is an additive found in prepackaged foods, is full of salts that can cause some patients to have increased pain and swelling.
Exercise: Exercising while in pain may seem like a bad idea, but studies have shown that non-intensive exercise, such as swimming, walking, or stretching helps to loosen muscles and reduce stiffness. As an added bonus, regular exercise helps patients sleep better at night.
Weight Watching:A sedentary lifestyle due to pain and even medication can contribute to obesity among fibromyalgia patients. With regular exercise and a good diet, those suffering from fibromyalgia can have a healthy, happy lifestyle.
Be sure to consult with your doctor before adding to your diet, because some foods may interfere with how your body absorbs certain types of medications.
Taking control of painful symptoms is challenging under even the best of circumstances. Yet, taking affirmative steps in this regard can be empowering. These five tips can help you manage your pain both on your own and in connection with others.
1. Become aware of your baseline pain and create a self-care plan. Gain familiarity with your symptoms. This will allow you to recognize when further intervention or changes need to be made, or if your treatment is working. Next, develop a self-care plan. Create a schedule, routine, or checklist for your treatment so that you can comply with your physician’s directions and engage family and friends where you may require assistance.
2. Self-manage your pain alongside a comprehensive treatment plan. A comprehensive treatment plan can empower your health. There are many components that can go into a treatment plan such as proper diet and exercise. Another way to keep up with an active lifestyle is to make massage part of your daily routine. In fact, according to research, a significant reduction in pain levels can be achieved with therapeutic massage. In addition to relieving tension, massage can help decrease swelling and improve blood circulation to promote the healing of soft-tissue damage, bruising and muscle fatigue. It also helps improve flexibility and mobility faster while reducing overall stiffness.
Massage can also impact the healing process by improving relaxation, sleep, emotions and overall recovery. There are many options for massage, and often at-home tools may be the most convenient for individuals who are limited by function or time. For example the Wahl Deep Tissue Massager is a useful tool to add to a pain management regimen that’s convenient, cost-effective and respectful of your busy schedule.
3. Communicate your limitations to people close to you. By communicating clearly to your close friends and family, misunderstandings and stigma can be avoided. Clear communication can create a path toward additional support for better health outcomes. Pain is a subjective phenomenon, and until you communicate about it to your doctors, they cannot help you make a road map to reach your destination of pain relief. Communicating about your pain will help you garner support and it is the first step to alleviate the cycle of mental stress related to your painful symptoms.
4. Create a goal-oriented daily routine that you can achieve. Setting a reasonable framework will help you cope with your pain and stress in an effective manner. Clarifying roles and responsibilities for yourself and those within your support network can ease anxieties that could exacerbate pain. Perhaps you are taking on a function that is better delegated, oralternatively, maybe an already delegated task could be better accomplished on your own. Creating reasonable expectations for the people in your circle can help you ultimately gain traction in your health goals.
5. Learn coping mechanisms to address your mental health wellness. Coping is key to dealing with chronic pain. There are negative emotional consequences of chronic pain that require one to think positively and practice gratitude. Meditation can give you a spiritual experience and support. The regular practice of meditation creates a relaxation reflex. It calms your mind and releases tension in your body tissues. Practice positive affirmations and continue to stay focused on your goals to better health.
Additionally, music therapy can be a useful way to supplement a comprehensive pain treatment plan. Listening to the music of your choice can help your body calm and release the tension in your muscles. As suggested by a research study, music interventions may provide a practical complementary approach for the relief of acute, procedural and chronic pain management. These are only a few examples of coping mechanisms which you may choose to integrate into your treatment plan.
A lumbar medial branch block is an injection procedure that pinpoints which facet joint in the low back is causing discomfort. Facet joints are small joints located in between vertebrae that help the spine bend and twist. Each one of these unique joints is surrounded by medial branch nerves, which help carry pain signals from the joints to the brain. Although the purpose of a lumbar medial branch block is to diagnosewhich facet joint(s) are causing the most pain, this minimally invasive procedure can also provide some pain relief.
Pain in the facet joints usually develops from a spinal condition that causes inflammation. Spinal stenosis, osteoarthritis, or degenerative disc disease are just a few conditions that could lead to facet joint pain. Other causes may include trauma or injury to the low back.
The procedure begins with the patient laying face down and with the physician injecting a local anesthetic. This helps minimize the patient’s discomfort during the procedure. The physician will then use a fluoroscope and contrast dye to locate and confirm which medial branch nerves are causing pain.
Once the physician has been able to identify the affected medial branch nerves, he or she will inject an anesthetic into the targeted nerves. Two adjacent medial branch nerves in the spine are usually treated during one injection.
If the patient experiences pain relief immediately after the injection, then the physician can infer the procedure was a success. This diagnostic process will eventually determine whether or not the patient is a candidate for a procedure called radiofrequency neurotomy (ablation). This particular procedure may provide patients with longer pain relief.
As my mother always warned me that to get older is to feel some aches and pains. And I’m feeling them! My knees, my back, my.… And I’m finding lots of kinship among my middle-aged pals.
I keep hearing that CBD helps relieve chronic pain. Is it really the miracle cure it claims to be? If so, I’m tempted to run out and buy some CBD.
But I’m cautious and have a lot of questions. It seems like the claims might be too good to be true. Are they?
Yes, CBD is all the rage and, if you happen to live in a state where it’s legal, you might be seeing it sold on just about every street corner in many iterations. CBD lattes. CBD gummies. CBD-infused spa treatments. CBD for XYZ.
Here’s what we know, so far.
CBD, or cannabidiol, is a chemical compound derived from cannabis, a hemp plant that differs only from the marijuana plant because it contains less THC, or tetrahydrocannabinol, which produces marijuana’s mind-altering effects.
CBD doesn’t produce the euphoric “high” or psychoactive effects of cannabis. Instead, it’s supposed to produce a feeling of calm or relaxation. Read more about CBD for Women: What Are Women Using CBD For?
Instead of messing with your mind, CBD encourages the body to use its own endocannabinoids more efficiently by interacting with them to produce pharmacologic effects in the central nervous and immune systems. (Sounds like a mouthful, but basically CBD influences the activity of endocannabinoid receptors and in turn, activates other receptors that control things like pain perception and inflammation.) There are endocannabinoids and receptors throughout our bodies: in our brains, organs, connective tissues, glands and immune cells—just about all of the body’s organs. One researcher calls them the “bridge between body and mind.”
That’s why a lot of people are interested in using CBD and hopeful that it will help ease or manage their pain.
Still, the jury is still out. Although CBD is widely used, the only strong research and evidence of its effectiveness has been done with a specific and rare form of childhood seizure disorders called Dravet syndrome and Lennox-Gastaut syndrome (LGS), which do not respond to antiseizure medications.
Experts say that more studies are needed in humans to determine the scope of what CBD can and cannot do. Some (that have been done on animals) have found CBD to be effective for nerve pain and the pain and inflammation of arthritis.
The studies that do point to CBD’s possible effectiveness say that it may limit inflammation in the brain and nervous system; that it stops the body from absorbing a compound associated with regulating pain and therefore may reduce the amount of pain a person feels; that it may help with insomnia and chronic pain and help people with multiple sclerosis (MS) by reducing spasms, one of the most common symptoms of MS.
The Arthritis Foundation has published advice from Daniel Chow, MD, a chronic pain expert. Here’s what it shares:
Use low doses, which seem to work best for pain relief.
Start with a CBD-only product, 5 to 10 mg twice daily, and then slowly increase, going up to dose of 50 to 100 mg per day. If that doesn’t help, try a CBD product with a low dose of THC. (But remember that THC remains illegal in many states and is only approved with a prescription for medical use in some others.)
Use only at night at first; slowly increase dose if needed.
Edibles’ effects last longer than vaping, so don’t try them until you know what CBD strain and dose work for you.
Use caution if you are 25 years old or younger and using CBD products that contain THC. This age group is at highest risk of addiction, dependency or even psychosis.
If you do choose to treat your pain with CBD, it’s best to be aware of a few facts.
CBD doesn’t come without its side effects, which include nausea, fatigue and irritability. And like grapefruit juice, CBD can raise the level of certain medications in your bloodstream (if you take the blood thinner warfarin, beware). Always check with your health care professional before taking CBD or other over-the-counter supplements or medications.
Many products do not contain the amount of CBD they claim.
The amount of CBD in products varies widely. Some contain very small concentrations of CBD, while others contain very large amounts. For instance, manufacturer Bluebird Botanical’s CBD lotions contain 700-plus mg of cannabinoids per 100 mL, while other currently available topical products contain just 50 mg of cannabinoids per 100 mL.
Because it’s not sold as a supplement, rather than a medication, CBD’s safety and purity are not regulated by the U.S. Food and Drug Administration.
If you take sedatives or other sleep-inducing medications, use CBD with caution, because it may enhance their effects.
Taking a high daily dose (20 mg per kg of body weight or hundreds of milligrams) may result in decreased appetite, diarrhea, vomiting, fever or extreme fatigue.
Products should be labeled with information on exact dosing and the type of CBD they contain. Terms for real CBD include full-spectrum, broad-spectrum, isolate or nano.
Because there are not enough studies on humans, it’s tough to know what an effective dose of CBD would be.
Brandon Beatty, CEO of Bluebird Botanicals, a leading manufacturer and distributor of hemp extracts and CBD oils, offers this advice: “Look for the concentration of cannabinoids per milligram. Check the ingredients to make sure they indicate the use of a full-plant extract as opposed to hemp seed oil, because only a full-plant extract will actually contain any amount of CBD. Hemp seed oil does not contain CBD, but it is often used as an emulsifier in many beauty products.
“Also be sure to look on the company’s website for third-party lab testing to make sure there are no harmful contaminants in your product, such as pesticides, heavy metals, mycotoxins, and residual solvents. We also recommend looking for products with ‘clean,’ natural ingredients, which is what we like to call ‘wellness the way Mother Earth intended.’”
Also, check the laws where you live. Even in areas where medical or recreational marijuana is legal, some federal agencies and state laws still restrict CBD. It’s all very confusing.
The bottom line? If you do choose to try CBD, proceed with caution and remember that there has been little medical research done on CBD. Check with your health care professional, if for no other reason than to make sure it won’t interact with any medications you currently are taking.
The spoon theory is relatively simple: living with chronic pain is very different from living a pain-free lifestyle. That living pain-free theoretically has an unlimited number of spoons—whereas those living with a chronic illness have a very limited number of spoons available for each day. Each action may cost one or more of them, depending on what the action requires. If a person living with chronic pain must endure a pretty demanding task, he or she will figuratively need to give up more spoons.
This concept may help those not living with chronic pain understand how trying and tiring the condition can be. After explaining this concept to a loved one or friend, an individual with chronic pain could mention they are “running low on spoons” to signify their need for rest.
Even for those living with a chronic pain condition, the spoon theory could be a great way of communicating how you’re feeling at that moment—something your fellow “spoonies” can relate to! We mentioned this in our past blog, “Supporting a Partner With Chronic Pain,” but one of the best things you can do to help someone with a chronic health condition is to provide support. Being there for one another can make a huge impact on the lives of those who must suffer from the “invisiblesymptoms” chronic pain carries.
Pain in your neck. Pain in your back. Pain during that time of the month. We’ve all had pain, some of us more than others. But how much do you really know about how to manage all your aches and pains?
We spoke with an expert on pain management to get you the answers you need. Yvonne D’Arcy, MS, CRNP, CNS, is a pain management and palliative care nurse practitioner with more than 20 years of pain management experience. She has held positions as pain and palliative care nurse practitioner for Johns Hopkins Medicine Suburban Hospital in Bethesda, Maryland, and Mayo Clinic in Jacksonville, Florida. She is the author of 10 books on pain management and presents frequently on a variety of pain topics.
Here is what she had to say about pain management and her current work.
Question: What is the latest book you’re working on?
Answer: For many years, I thought primary care practitioners needed a book for pain management. The majority of people with chronic pain are showing up in primary care practices. Arthritis, osteoarthritis, migraines, other types of chronic pain, low back pain. They show up in a primary care office. Practitioners need some direction for patient management and support. I thought this is a book that was needed for a long time. It will be published in the first quarter of the year by Springer. It’s for health care providers—physicians, nurse practitioners, physician assistants; those folks that are seeing and prescribing medications.
Question: Why did you see a need for this book for health care providers?
Answer: Primary care physicians are being inundated with all these patients with chronic pain. They do see ones with acute pain like slips, trips and falls. The vast majority of low back pain and migraine and arthritis cases are seen in the primary care setting on a long-term basis. Many of the pain clinics send people back to primary care. This book is a long time coming. I’m enjoying writing it. It contains a lot of new and interesting materials that I think clinicians will be able to use efficiently.
Question: Is pain management different for men and women?
Answer: That’s an interesting question because it depends on which side of the gender gap you’re on. I wrote a book on women’s pain and can tell you that there are definite differences. Men use morphine efficiently. Women get a huge number of side effects. Women are seen as catastrophizing more. Women try to tough it out and self-treat it. It’s hard on women because they have to take care of kids, cook, clean and have a lot on their plate. When they have pain, it is more of an issue.
Question: Is it true women have a higher tolerance for pain?
Answer: Tolerance is defined as how much pain someone is willing to experience. Women do have a higher tolerance and are willing to experience a higher level of pain. Pain is produced along the same pathways in men and women. Men tend to want things taken care of. A woman by far and large probably would just keep going with her pain with a migraine. They keep pushing ahead, looking for something to take care of it.
Women’s pain is treated a lot differently. It’s minimalized and marginalized. Male doctors try to make it seem we’re complaining of something that isn’t quite as severe as it is. If you’re a minority woman, they have found that Hispanic and African American patients don’t get pain medications as readily in emergency rooms as patients who aren’t. It’s just part of that medical disparity because doctors just don’t seem to take their pain as seriously as other patients. It’s perceived that they’re just looking for medications, even when they’re not.
Question: What should women consider when seeking pain management?
Answer: Women looking for pain management physicians need to interview them. They want to work with someone who is empathetic to their condition and who is willing to commit to long-term follow up and support. They shouldn’t be focused only on medications. They should give a more holistic response. Women are more interested in essential oils and massage and acupuncture. Look for someone who includes that in your plan of care.
Anyone can prescribe medications. You need to make sure that the provider is someone you can rely on and trust. I feel sorry for women when get sent to a pain management specialist. I think they get categorized even before they get treated. You need to look for someone who is open-minded and listening to you and to what you’re saying about your pain. If not, you need to find someone else.
I encourage women to go on websites with patient testimonials about providers. I think women should spend more time looking at that, so they have a good idea of what other folks have experienced. They don’t need to feel bad if a provider they see doesn’t work for them. You can use the patient advocacy system that you’re working with and have them find a different provider. You don’t have to stick with someone you don’t like.
Question: What should women know about addictive pain management options?
Answer: There are a variety of things. Some patients with chronic pain do better with low doses of opioids. They have jobs and families and they do very well. They should know that there is the potential that they can develop a reliance on them. Women need to know that medications won’t take away all their pain.
The negative thing is that there is the potential for developing substance abuse: Those who take more pills than are prescribed; get early refills; get pills from a multitude of providers. You should be going to one doctor, not shopping around town. But there is always the potential that can happen. Medications do cause addiction for some. But they are a good fit and can provide a higher quality of life, for others. It just depends. Use the lowest dose for a shorter period of time. Health care providers can offer a trial to see if it’s effective. They’re looking at in healthier ways.
Question: Anything else you want to tell women about pain management?
Answer: Women need to be self-advocates. They can’t let the system take over. They can’t be afraid to disagree. They need to say, “That just doesn’t work for me,” and tell people what they need. If we can get more women to do that, we will be in good shape.
A disc extrusion, also known as a disc herniation, usually occurs from degeneration due to a disease like osteoarthritis or the natural aging process. Other causes may include injury, trauma, overexertion, illness, or obesity. Given the circumstances, disc extrusions are largely unpreventable and may heal on their own without surgery.
In most cases, an extruded disc will cause referred pain. Meaning, pain that is felt in an area other than where the disc extrusion was caused. Symptoms of disc extrusion generally include:
For minor cases of disc extrusion, surgery may not be necessary. Many extruded discs heal on their own. Nevertheless, treatment for pain that often accompanies disc extrusion may be necessary for some patients. Treatments usually include pain medication, steroid injections, nerve blocks, and more. If the extruded disc progresses into a severely damaged or herniated disc, patients may want to consider minimally invasive spine surgery.
Talk to your pain management physician at Chronicillness.co Site of United States about treatment for disc extrusion.
Whether you live in a bustling metropolis or a quiet rural area, chances are you’ve been touched by the opioid epidemic in some way—or you will be.
While many people can safely use prescription opioids, others end up addicted to them. In fact, most people who end up using heroin (an illegal opioid) started by using prescription opioids.
Women are more apt than men to suffer from chronic pain, which sometimes means using prescription opioids. Even if you never misuse opioids yourself, your spouse, child or other loved one might be struggling. As the likely gatekeeper for your family’s health, it makes sense that you’d want to find the best resources available—or perhaps even join forces with others in your community to develop new ones. While traditional drug rehabilitation programs (both inpatient and outpatient) play an important role, novel ideas are transforming how communities across the country are tackling this problem from all angles.
Here’s a look at a few unique approaches that are making a difference for women and families.
Many parents worry about keeping their teens drug-free, and school-based early intervention programs seem to be an effective way of making that happen. Research funded by the National Institute on Drug Use found that seventh graders who participated in a LifeSkills Training (LST) prevention intervention program were substantially less likely to misuse opioids compared to children in control communities.
The LST program has been implemented in schools in many states. The LST Prescription Drug Abuse Prevention materials can be ordered online, so it’s easy to get them for your local schools (with the support of your educators and administrators).
Substance abuse often runs in families due to both genetic and environmental factors. Camp Mariposa is a free program for children, ages 9 to 12, who have been impacted by a family member’s substance abuse issues. Campers attend several weekend retreats a year, during which they spend time with mentors, learn mindfulness skills to cope with trauma and gain confidence while participating in fun activities.
There are currently 13 Camp Mariposa locations throughout the U.S., and the organization is open to expanding by partnering with additional mental health and youth support groups.
The first national self-help addiction program created specifically for women, Women for Sobriety, can be used independently or in conjunction with other recovery programs. Weekly support groups are held across the U.S. and Canada. The organization also hosts an annual weekend retreat in June that features presentations on beginning sobriety, relapse prevention and overall health and wellness.
Having a baby isn’t easy; add an opioid use disorder to the mix and things get exponentially more complicated. The Moms in Recovery program at Dartmouth-Hitchcock aims to streamline care so that pregnant women and new moms with opioid use disorder can get prenatal and postpartum care as well as psychiatric counseling and medication-assisted treatment for opioid addiction under one roof. The outpatient program also features an on-site food pantry and diaper bank and access to a pediatrician who handles monthly child wellness checkups and gives babies and moms key immunizations.
Opioid abuse disorder and problems with illegal drugs often go hand-in-hand, as heroin use among women doubled between 2003 and 2012. In Oregon, women who have been involved with the criminal justice system can get inpatient help at the Volunteers of America Oregon’s Women’s Residential Center in Multnomah County. Women live in transitional housing while participating in a program designed to prevent relapse and re-arrest. The program boasts a high success rate: Everyone who completes it moves to stable, sober housing, and most obtain solid employment or attend school afterward. Women who have children age 6 and younger can bring the kids with them to the facility.
Opioid use disorder doesn’t happen in a vacuum, and those who have become addicted to opioids aren’t the only ones who suffer. While family support groups abound—you can search for one near you at www.supportgroupproject.org—some Rhode Island residents have been working to heal and shatter the stigma by participating in a “therapeutic theatre production” through COAAST (Creating Outreach About Addiction Support Together). Participants rehearse and perform a short play, “Four Legs to Stand On,” about the impact of opioid abuse on a family, then engage in a “talkback” session designed to get audience members to share how they have been touched by this epidemic.
Hospitalization and surgery are demanding life events that lead to considerable stress and anxiety in patients. The fear of the “unknown” is a powerful force for the patient especially during the perioperative surgical time period. Unfortunately, medical errors and medications errors are often linked to miscommunication, anxiety and poor patient satisfaction which are common occurrences. Moreover, patients perceive the day of surgery as one of the most intimidating days in their lives and there is a real absence of information on predictors of anxiety in the current literature. Additionally, there is mounting evidence that patient education is one critical way to combat stress and anxiety during this time period. Studies have shown that preoperative surgical education can significantly reduce stress and anxiety preoperatively, therefore increasing patient satisfaction.
Preoperative patient education, particularly in regards to medications, is also an essential component of patient safety and satisfaction in today’s healthcare arena. It’s been suggested that changes in preoperative patient education, particularly in a pre-admission assessment testing unit (PATs), is an excellent starting point for an improvement in patient safety and for the increase in satisfaction ratings.
The hospital where this project was implemented was at a for-profit, minimally resourced university teaching hospital in Philadelphia, PA. Moreover, high risk populations, such as substance use disorders, combined with hospitals that are have low access to adequate resources in busy overpopulated urban centers, such as in Philadelphia, pose further burdens on the providers taking care of these patients during surgery. Adding to this is the mounting pressures of productivity, checklists, and efficiency, create minimal time for adequate shared-decision making for communication during the surgical process.
At the time, when I joined the anesthesiology department, there was no organizational health system infrastructure for a pain service or handling a mounting opioid crisis or a broad systemic, pre-operative consultation service to address patient questions immediately prior to surgery. Many patients would only be requested to visit a routine testing center with minimal guidance on how much pain they would have and the risks involved during the course of surgery. Moreover, the high-risk patients that had opioid pain medications or a history of substance use disorders (which was highly prevalent in this population) prior to surgery were less likely to be appropriately screened prior to surgery and less likely to have follow up afterwards since no high-risk clinic existed within the health system. In order to streamline the process, I was charged to organize these processes before, during and after surgery to ensure these high-risk patients had improved pain and communication and ultimately overall better patient satisfaction.
In order to streamline the process, I wanted to first improve communication with patients with an established tool that was standardized. I was already engaged with the World Health Organization (WHO) on prior work regarding pain and was familiar with tools they used for pain and surgery. One such tool was the WHO’s 2014 tool which has a primary focus on patients in the perioperative surgical journey. This specific tool was one of the newest evidence-based WHO instruments called “Patient’s Communication Tool for Surgical Safety” (PCTSS) and composed of a structured, nine-item “Before Surgery” questionnaire. The communication tool consists of a nine-item questionnaire used to improve communication between the practitioner and the surgical patient. These nine questions ask specifics regarding patient’s previous surgical procedures, fluid and food restrictions, pertinent health history, personal hygiene, medication history including supplements, whether a patient is pregnant or breastfeeding, medications to avoid preoperatively, the surgical location, their projected length of recovery and the pain expectations post-operatively.
Given that research and implementation tools developed by the WHO are well-known and respected in health care, I developed a project to use this tool throughout surgical units to improve communication during the surgical process. The goal was to decrease costs, surgical delays, cancellations, and postoperative complications. The educational questionnaire would help increase communication for preoperative patients about surgery, stress and anxiety levels, perceived postoperative goals, and aspects of a patient’s perioperative experience. This questionnaire would also help patients to better relay their preoperative history so that their health care practitioners can fulfill the necessary requirements of their care before any surgical intervention is performed. The structure of the tool would also provide an open dialogue for a more highly effective communication between the doctors and patients, and any family members present.
Improving patient safety is the primary reason to implement this project into the urban-city hospital’s perioperative decision-making process. One of the long-term goals in utilizing this project was to position this hospital’s pain division and anesthesiology department to be aligned with national leaders on the opioid crisis and patient satisfaction. The WHO questionnaire can save healthcare costs despite being a simple, low-cost tool. By reducing surgical delays and cancellations related to errors in obtaining a patient’s past medical information, the goal of decreased surgical and anesthetic risks can be achieved by better communication. The project in turn could be a cost-saving method of reducing perioperative complications and medical mishaps associated with lost and misused healthcare allocations from communication errors while also enriching the communication between health care practitioners and their preoperative patient population.
Several barriers exist to establish a new process in a hospital environment. First and most challenging is to get approval from leadership or get & lsquobuy-in’ that the process is legitimate and necessary. Second, once approval is obtained, training staff and individuals involved in implementation of the process is critical. However, given this particular hospital was under-resourced and staffing was a constant issue, many individuals were unwilling to take on another task to their already burdened daily duties. Third, assigning core leaders throughout the hospital who would implement the tool was another constant challenge. Communication with patients regarding surgery was key performance metric for leadership given hospital reimbursement was directly linked to patient satisfaction. Therefore, leadership understood that patient safety and satisfaction are paramount during patient care. Additionally, information collected during a preoperative assessment is generally used by the hospital’s surgical and anesthesiology team to determine perioperative risks and usually does not get disseminated or coordinated with teams efficiently thereafter. Therefore, collection of data to improve processes long-term would be critical to sustain the program later which would be cumbersome given antiquated computer systems that existed at the time.
The importance of addressing this issue of opioid use, pain and patient satisfaction was critically important to leadership of the hospital given that reimbursement of payment of services was tied critically to the patient surveys. However, most team members felt more compelled to work with the project to address healthcare disparities in the hospital’s most medically and socially vulnerable population in Philadelphia and the growing need to address the opioid epidemic particularly in this area was more of a secondary endpoint. Moreover, if outcome measures show improvement, a revamp of this Philadelphia hospital’s preoperative education will be warranted and funding may be warranted. This eventually would bring long-term sustainability to the program and build the framework for a larger program in the future with staffing.
When we used the tool in a pilot study population in Philadelphia to assess patient satisfaction, we found that providing this tool to engage the patient in the preoperative communication process may have an impact on overall outcomes especially in improving the awareness of complications which was statically significant (p=0.044). Many recent initiatives have stressed the importance of patient communication, both within healthcare teams and within the physician-patient relationship to improve the patient experience. This tool has the potential to engage patients further in ensuring their safety in the patient awareness of complications.
There is a definite need for new strategies to counter adverse effects that hinder the quality of a person’s overall surgical experience and outcome. Preoperative anxiety, especially during surgery, is associated with difficulties in establishing intravenous access, delayed relaxation of muscles, coughing and exacerbation of respiratory issues during induction of anesthesia, heart rate and blood pressure instability, and an increase in anesthetic requirements. Patient anxiety also correlates with elevated pain levels, increased nausea and vomiting risks in the postoperative period, a lengthened recovery period and an increased risk for advanced disease processes. These symptoms all increase healthcare spending through delayed patient recovery times. The implementation of the WHO’s 2014 patient communication assessment through an efficient and well-coordinated project has the potential to enable patients to communicate more effectively with their healthcare providers, improving their awareness of the surgical process and hospital routine leading to improved postoperative outcomes and decrease the aforementioned complications. The financial impact of even small improvements in operating room efficiency is significant to a hospital with a busy OR schedule. A reduction in canceled cases increases volume and improves revenue in today’s competitive healthcare environment. When surgical procedures are delayed, valuable OR time may be wasted, and staff time is under-utilized. This project is an excellent example of the benefits that prevention of complications affords and, “if at least five major complications are prevented within the first year of using the checklist, a hospital will realize a return on its investment within that same year”. The opportunity for not only cost reduction, better surgical outcomes for patients with decreased stress and surgical fears, along with decreased numbers of surgical delays and cancellations should not be dismissed by administrators. Solving key public health problems often requires that healthcare practitioners use research-based knowledge, advocate for public policy changes and engage government agencies to implement change. In today’s healthcare field, scientific researchers, clinicians, and policy analysts have become increasingly conscious of the crucial role that implementation science has in reducing the chasm between what has been shown to be effective in research and what is feasible in healthcare practices. Here is a helpful graphic that shows the questions to ask before and after surgery
There’s a new spinal cord stimulation “sheriff” in town, and its name is Senza HF10. According to the Academy of Pain Management, this new spinal cord stimulation (SCS) therapy uses a higher frequency (10 kHz [HF10]) that surpasses the older, more traditional model. Moreover, the new SCS therapy provides significant pain relief without paresthesia, which is a side effect/therapy component of traditional SCS.
The pain management specialists at Chronicillness.co Site of United States is constantly staying up-to-date on the latest advancements in pain management and modern medicine. Because of this, the team is able to analyze what technologies should be pursued once they become available to practicing physicians.
The new, higher-frequency SCS is still in testing mode, so it may not be available for some time. Nevertheless, the pain management physicians at Chronicillness.co Site of United States is keeping track of any changes or updates the company developing this new model may make.
The current SCS model uses low-frequency stimulation (~50 HZ) to deliver a tingling or buzzing sensation to the area causing pain in an effort to mask the patient’s discomfort. This sensation is known as paresthesia, and although paresthesia is meant to limit pain, it sometimes inadvertently causes more discomfort. Furthermore, the success rate of SCS therapy is not very high, so many pain management physicians recommend other forms of treatment before using traditional SCS therapy.
This therapy is usually only considered by TPC physicians if patients have not responded to other treatments for at least six months. Chronicillness.co Site of United States wrote a blog about the success of spinal cord stimulators and how they’re implanted, which is available in the “News” section of the website.
During a clinical trial for the higher frequency device, 90 people were randomly assigned implantation with the new SCS therapy, and 81 were assigned implantation of the conventional system. The study found a significant reduction in back pain relief for both groups, but those with the high-frequency device showed a greater reduction in pain on a consistent basis. The new SCS therapy showed superiority in back and leg pain at 3, 6, and 12 months.
The Senza HF10 has not been approved by the FDA and it is still being tested for its safety and efficacy. The team at Chronicillness.co Site of United States will provide updates on this new technology as they become available.
