Sunday, December 7, 2014

NEGATIVE EFFECTS OF NARCOTICS FOR PAIN

The narcotic medications, especially the morphine family are commonly used for pain management. They are very useful tools if used appropriately. However they can harm you if not used carefully. Morphine like medications called opioids have some common side effects. Constipation, nausea, itchiness, drowsiness and cognitive decline, are among the common side effects of all opioids in short term use. Respiratory depression or slowing down, or even in high doses stopping the breathing is the most dangerous side effect. Each year there are numerous patients that lose their lives because of this side effect. We all may think this is overdose and it will never happen to us because we never take too much of our medications. However the problem is the possibility of drug drug interaction or use of alcohol with opioids which can cause the breathing to stop.
In long term use opioids can become less effective. we build tolerance to it. It is because of different mechanisms. One of them is that the hook or receptor on the cells that opioids link with can move into the inside of cells and make the connection less effective, it is called receptor internalization. As a result we may end up using more of opioids to get the same or less effects with more side effects. The irony is that in some cases using this family of pain medications can actually make our pain worse. We may get into this circle of having pain, needing to use more, on and on. In many cases if we stop increasing and slowly bring the dose of opioids down the pain control improves.
The message is: MORPHINE LIKE NARCOTICS CAN BE ONLY HELPFUL IN PAIN MANAGEMENT IF USED PROPERLY AND IF NOT, THEY CAN HARM YOU.

Sunday, November 30, 2014

WHAT DO YOU WANT ME TO DO?

I am a pain patient, What do you want me to do? I am tired of the expectations of others. I am tired of not being understood and be expected to understand. I am sick of not being believed by anyone and be expected to believe all that I am told. Family, friends and society expectations and their disappointments on me mount up to mountains, but what do you want me to do? More importantly, how do you want me to do it? I have tried everything I could but nothing has panned out. I am just too tired to explain myself anymore.
why don't you for once try to understand me?
The story of every single one of us!

Sunday, November 16, 2014

THE VALUATION OF PRESENT

The present moment has been in works for more than fourteen billion years. Explosions as big as the big bang fourteen billion years ago had to commence the sequence of stars and planets to form and die until the earth be born more than four billion years ago and we come to exist more than a million years ago. The life on earth had to start as old as four billion years ago, almost as old as the birth of planet earth and evolution had to pass through oceans and sky until we gain the level of consciousness and knowledge to understand the concepts of past present and future, with the present being the only real time and the past and future be the conceptual times. Now when we bring our awareness to the present time in it's entirety, considering all that had to happen for this moment of present awareness to come to existence, what is the value of that? A moment that a universe had to be created and stars had to form and die for it to be present. This is a true present to any conscious mind. What is the valuation of this present?

Sunday, November 9, 2014

Medical Marijuana

Medical Marijuana

Another tool in Our Tool in our Tool Box to Face Neuropathic Pain By: Dr. Kevin Rod

Neuropathic pain is not a rare condition. Approximately two to three percent of people living in the developed world suffer from this condition. This means that around one million Canadians are dealing with this problem right now. When it comes to problems, the only good thing about the word MILLION is that it grabs our attention.
I have the privilege of being a pain physician and a neuropathic pain patient at the same time. This gives me a better perspective of the view from both sides of physician’s desk. Above all, I have felt and understood the frustrations of a neuropathic pain patient.
For many other medical conditions there are tests that can exactly show a structural problem that is causing the condition. Once the test results come back, there is usually a surgeon who can fix it with a knife or a doctor that can help it with a pill. When it comes to neuropathic pain, it becomes a completely different story. To begin with, Neuropathic pain is an umbrella term for a wide selection of different diseases that it can cause. Each of these hormonal, traumatic, viral, ischemic or other causes have a different natural history, course of behavior and as such respond differently to treatments. Their level of progression or severity can affect the presentation of neuropathic pain in different shapes and forms. 
Neuropathic pain once established is a very uncomfortable condition. When we have a condition like that, we like to have a test to get to the bottom of the problem and a quick solution for it so that we can get on with our lives. Unfortunately this is not possible with neuropathic pain most of the time. That is when frustration builds up for both patients and pain practitioners. As patients we are looking for answers and can’t care less for the evidence and guidelines that doctors are looking for. As doctors, we have the goal of making patients better without ever harming them. 
In order to help them and not harm them, we have to look for evidences and follow the guidelines. Dr. Angela Mailis, Dr. DE Moulin and other colleague have published a descriptive consensus statement and guidelines from Canadian Pain Society on Pharmacological management of chronic neuropathic pain in 2007. This guideline put Cannabinoids as the Fourth line of treatment. It means that there other classic and accepted groups of medications should be tried first before resorting to cannabis or products from this family. 
Currently the courts have allowed patients to have access to dried marijuana if a doctor would recommend it through a medical document. It is something like a prescription but because Health Canada does not recognize Cannabis as medication yet, we don’t call it prescription. However, the College of Physicians and Surgeons of Ontario has decided to consider it as prescription to make it simple for everyone involved. This document should have the patient name and address, the amount of marijuana allowed per day and the duration of validity for medical document in order to be accepted by one of Health Canada approved licensed producers. The patient will send it to the producer and they would sell it to patient by sending it patient’s home address. 
So what is the problem?
The problem is that patients can get all the lung hazard of smoking with smoking marijuana. Young patients of less than 25 years of age may have long lasting cognitive impairments with regular use of marijuana. Patients may have a higher risk of car accidents if drive after smoking. Mixing marijuana and alcohol can majorly increase the cognitive impairment. Mixing it with tobacco would increase the risk to patient’s long and there are some reports of increased risk of lung cancer with smoking marijuana. 

Marijuana is not a cure for all as some may believe. Patients with history of mental disorders may do poorly on marijuana and it may aggravate schizophrenia presentations. Despite the common belief of many users, there are some people who do get addicted to marijuana; increasing urge to use more in daily use, spending a lot of time and money on acquiring marijuana, decline in social and professional performance and continuation of us how to use it                                 Dr. Kevin Rod

This article was published in the Action Ontario Fall Newsletter OUCH 

Sunday, October 26, 2014

SECOND LIFE

In our lives we get bombarded with problems and issues on a daily basis. There is not a moment that we do not have to deal with a problem or worry about it. This is the experience of everybody's life.
The ongoing struggle of dealing with never ending problems in our minds moves us away from the ability of being peaceful and happy inside. We work very hard to reach happiness through different means, but the more we seek it less we find. The problems of life surround us in a way that sometimes we feel suffocating under their pressure. Life becomes hard to take under this pressure and many fall into deep anxiety and depression, many may think of suicide under this immense pressure.
SECOND LIFE: How would it feel if when we are under this immense pressure, we could suddenly enter into the same life without any problems and worries? How light would we feel when the weight of all those problems are lifted from our shoulders? Obviously we would feel much lighter. We would be able to move away from sadness and worry for the first time.
The fact is that we are designed to be happy by nature. It is all the things we learn since birth time that may lead us seeking happiness in many things that would in turn become problems we worry about. In almost all cases it is not the actual problem that is stealing our happiness away, it's the thinking about it that brings on the cascade of negative emotions and unpleasant body sensations.
Our mind is trained by habit to have this ongoing thinking about problems as a background noise. This becomes an automatic process over time and the worry goes on and on. This process has harmful biological effects due to outflow of stress hormones into our system in long term. Now if by practice we could stop the process of negative thinking and imagine our life without these problems, all of a sudden the harmful process stops and our natural default state of inner happiness can be restarted. This is a very powerful mental exercise that takes a lot of practice to master. Each time we do this exercise, it feels like we switch into a SECOND LIFE while still being ourselves, but without the problems. Lighter and much happier. It may be hard to believe, but we actually start to feel lighter and happier for longer duration over time. Because of the flexibility in our biological  system, after a regular series of exercises, our system gets used to the SECOND LIFE biological state. A more resting, calmer and happier self emerges. We get A SECOND CHANCE TO A BETTER LIFE, the life we were supposed to live.
Ultimately with practice the second life and the first life become one and we get the chance to live like the way our nature was designed to live. Everything changes, but yet nothing has changed, we would be able to live the same life, love the same people and fight the same battles, but this time with a higher level of inner peace and happiness.
The reality is that this is not going to be easy, but it is certainly worth the effort. After all, inner peace is the most precious product in this universe.

Sunday, October 5, 2014

IT TAKES A SOCIETY TO HEAL A PATIENT

You have heard the old saying that it takes a village to raise a child. why? Because in order to protect a child and provide the best opportunities for safe development and growth of a child, we need the coordination of all elements of the child's society. The same analogy would apply to the healing of a patients.
A patient's healing depends of many elements. From personal general health, to family support and societies readiness to provide supports and services, many elements have to come together to achieve healing. A person's healing cannot happen in isolation. Society needs to have a better understanding of patient's challenges and needs in the path to recovery. A patient may need a lot of supports from society to improve health and a doctor can't do magic alone. All elements of society should coordinate in a harmonious design for better health of all. It takes a lot of planning to achieve this, but everything starts from a proper understanding. We should all come to the same page and understand that: IT TAKES A SOCIETY TO HEAL A PATIENT