Persistent Postsurgical Pain – Practical Pain Management
Surgery is often counterproductive for chronic pain, so beware!
More than 45 million surgical procedures are performed in the United States each year. It has been estimated that acute postoperative pain will develop into persistent postoperative pain (PPP) in 10% to 50% of individuals after common operations.
Since chronic pain can be severe in up to 10% of these patients, PPP represents a major clinical problem—affecting at least 450,000 people each year. Continue reading
The antibiotic course has had its day | The BMJ – July 2017
With little evidence that failing to complete a prescribed antibiotic course contributes to antibiotic resistance, it’s time for policy makers, educators, and doctors to drop this message, argue Martin Llewelyn and colleagues.
Antibiotics are vital to modern medicine and antibiotic resistance is a global, urgent threat to human health. The relation between antibiotic exposure and antibiotic resistance is unambiguous both at the population level and in individual patients.
However, the idea that stopping antibiotic treatment early encourages antibiotic resistance is not supported by evidence, while taking antibiotics for longer than necessary increases the risk of resistance. Continue reading
Common heartburn drugs tied to higher risk of death – July 2017 – By Catharine Paddock PhD
A team of researchers from Washington University have found that a person’s risk of premature death rises with long-term use of PPIs.
Interfering with our body’s biologic functions, like proton pump inhibitors do, always seems risky to me.
Because we cannot isolate the changes we make in one part of the system from the rest of it, there will always be unintended consequences; only time will tell if they are harmful or beneficial, but they will rarely be inconsequential.
FDA updates warnings for oral and injectable fluoroquinolone antibiotics due to disabling side effects
This information is an update to the FDA Drug Safety Communication: FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections; warns about disabling side effects that can occur together issued on May 12, 2016
Some signs and symptoms of serious side effects include:
- unusual joint or tendon pain,
- muscle weakness,
- a “pins and needles” tingling or pricking sensation,
- numbness in the arms or legs,
- confusion, and
Recall of Zimmer Biomet’s Spinal Fusion Stimulators – May 31, 2017
Just when I thought electric stimulation could not possibly be damaging:
Zimmer Biomet has recalled the SpF PLUS-Mini and SpF XL IIb Implantable Spinal Fusion Stimulators due to higher than allowed levels of potential harmful chemicals,
“which may be toxic to tissues and organs, and that were found during the company’s routine monitoring procedure,” according to a release from the US Food and Drug Administration.
How are “harmful chemicals” released by an electric stimulator? Nowhere in the article are the specific “harmful chemicals” listed. Continue reading
Op-ed: Demonizing opioids endangers lives, too | The Salt Lake Tribune – By Julieann Selden – Apr 2017
Another example of the dangers of NOT using opioids to control pain.
Potential opioid benefits are glaringly absent from the campaign billboards and websites.
Extreme pathos warns Utahns to “steer clear of opioids,” suggesting Tylenol and exercise as alternatives.
The rhetoric is guilt-inducing, unrealistic to many situations, and diminishes the credibility of the campaign. Continue reading
Yes, people can die from opiate withdrawal – Wiley Online Library -Shane Darke, Sarah Larney, Michael Farrell – Aug 2016
It is generally thought that opiate withdrawal is unpleasant but not life-threatening, but death can, and does, occur. The complications of withdrawal are often underestimated and monitored inadequately.
Death is an uncommon, but catastrophic, outcome of opioid withdrawal.
So, why do so many doctors believe that simply discharging a pain patient, whether out of fear of the DEA or even for lack of compliance, causes no harm? Continue reading
And yet another article on the overuse of epidurals, showing how they are being used to generate more profit for “interventional” pain specialists.
Experts Say Epidural Steroid Injections Overused — Pain News Network – August 19, 2015/ Pat Anson
Epidural steroid injections are being used too often to treat back pain, in part because of an insurance compensation system that encourages doctors to generate more income by using the procedure, several leading experts in pain management have told Pain News Network.
Critics say epidural injections are overused and patients risk permanent damage to their spinal cords if they get the shots too often. Continue reading
Below is another article on the dangers of epidural injections. This procedure isn’t so popular because it bestows benefits on the recipient as much as because insurance companies compensate them so well.
Beware of worthless procedures and epidural steroids for your back pain – KevinMD – Cathryn Jakobson Ramin | Conditions | April 29, 2017
in a 2015 review of the medical literature, the Agency for Healthcare Research and Quality had found no evidence that epidural steroid injections were effective in treating symptoms of spinal stenosis or typical lower-back pain. Continue reading
Potential Risks of Pharmacy Compounding – Drugs R D. – 2013 Mar – free full-text PMC article
Published reports of independent testing by the FDA, state agencies, and others consistently show that compounded drugs fail to meet specifications at a considerably higher rate than FDA-approved drugs.
Pharmacy compounding involves the preparation of customized medications that are not commercially available for individual patients with specialized medical needs. Traditional pharmacy compounding is appropriate when done on a small scale by pharmacists who prepare the medication based on an individual prescription.
the regulatory oversight of pharmacy compounding is significantly less rigorous than that required for Food and Drug Administration (FDA)-approved drugs; as such, compounded drugs may pose additional risks to patients. Continue reading